With Melissa Block
Author Barbara Ehrenreich is out with a new book, "Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer." We'll look at her bold new arguments. Guest host Melissa Block talked with Ehrenreich, and Dr. Ronan Factora, a doctor at the Cleveland Clinic who works at the Center for Geriatric Medicine. The highlights below have been lightly edited for clarity.
On Ehrenreich's aim in writing the book
Ehrenreich: "One thing I tried to do was alert people to all the medical dissent about some of these tests, the controversy going on in the medical profession. This is not just coming from me, I am gathering the studies and showing how a lot of these tests are not — as the doctors say — evidence-based.
One of the big themes in my book is that we don't really have control over everything that goes on in our bodies. We can't. And the great example of that is, well, some of the diseases like cancer. Cancer can have lifestyle risk factors and so on, I'm not denying that. But basically, it is a rebellion by certain cells who decide to go rogue, and take over the whole body. Now, that's pretty foolish of them, because they'll die when the body dies, but they don't know that. Autoimmune diseases: cells in the immune system deciding not to attack microbes, but just go after every organ in the body they feel like."
"We don't really have control over everything that goes on in our bodies. We can't."Barbara Ehrenreich
Block: "The broader point you're making here though, is that the body can sometimes be at war with itself, it's sort of a dystopian view of the body."
Ehrenreich: "In fact, after breast cancer, they told me: 'You should never lift a weight heavier than five pounds.' Ha. I paid no attention to any of those things, and threw myself back into exercise. I love exercise. I'm not doing it so I'll live longer. I'm doing it because it makes me feel good. And after a scary episode, like breast cancer, we think very carefully about how we want to spend our time. And that's good."
On how patients and doctors should talk about wellness:
Factora: "Everyone is dying at some point. So when we have these decisions about medical treatments and intervention surgeries and whatnot, age is just one factor to keep in mind. When I talk to patients and find out whether or not to proceed, one of the things that I ask about is what are the goals — what are we going to do with the information that we're going to get, what do you expect to achieve with proceeding with this medication, this surgery.
People will have various sets of goals. Some people do want to live longer. Some people would like to maintain independence, maintain function. And others are really focused on quality of life. When you're younger, many of these sorts of goals overlap with one another. But as you get older, there's only so many years we can squeeze out as you go to your 70s, 80s, 90s. So that goal of extending your life longer may not be as reasonable. It may be more reasonable for us to be able to preserve your function, your independence. ... really, we're talking about reducing pain, maintaining quality of life. So it varies from person to person, but it does require an individualized conversation."
On people who can't afford healthcare
Block: "I wonder if the conversation that we're having here though isn't really a conversation at 10,000 feet when you consider the luxury of opting out of screening and out of care when there are so many people who don't have that choice. They get that care because they have no insurance and they don't have access to medicine. To be able to choose to say 'no' is a real privilege."
Ehrenreich: "Yes. I wholeheartedly agree. To me, it's really disturbing that in our country we devote so much public spending and resources to the people over 65 when Medicare kicks in. Meanwhile, we know, there is maternal mortality is increasing right now in the U.S."
On the motives behind medicine:
Factora: "I cannot deny the fact there is an industry behind medicine. We've got big pharma that is producing medications and have all these devices available for health purposes. But around all of this, is data and information that is published by folks who have nothing to do with the industry to really demonstrate the viability, the usefulness, the utility of these devices not just in prolonging life, but preserving the quality of life. When you talk to your doctor, you don't want to look at them and say, 'this is the face of pharma talking to me and just pushing medication' — there is validity and science behind what they're recommending...
These decisions that are made with a doctor have to be a collaboration. You both have to be on the same page. And if you feel pushed, one way or another, then, it may be due to lack of information on your part about what this intervention is meant to achieve. Or, lack of information from the doctor's part, in terms of what your concerns are and what is it that they're trying to achieve with this intervention that may not be in line with your own values or goals."
Barbara Ehrenreich, author, journalist and political activist, author of "Natural Causes." (@B_Ehrenreich)
Dr. Ronan Factora, a doctor at Cleveland Clinic who works at the Center for Geriatric Medicine.
From The Reading List:
Excerpt of Barbara Ehrenreich's new book, "Natural Causes":
The Atlantic: Your Body is a Teeming Battleground -- "Ehrenreich is not, however, an apostle of unwellness, and Natural Causes is not a how-to book. Instead, she focuses on the conceptual and 'deep moral reverberations' of the discovery that our immune system can aid and abet a 'cellular rebellion against the entire organism.' What if our convenient 'holistic, utopian' view of the 'mindbody' as a 'well-ordered mechanism'—kept in harmony by positive thinking and solicitous tending—is wrong?"
At age 76, author Barbara Ehrenreich has decided she is “old enough to die.” And that means opting out of medical screenings and annual exams. “I refuse to accept a medicalized life,” she writes in her new book, Natural Causes. The best-selling author with a PhD in cellular immunology comes down hard on the national obsession with wellness.
This hour, On Point: rethinking aging. And we’ll remember the life of the plain-spoken former First Lady Barbara Bush-- who died yesterday at age 92.
-- Melissa Block
This program aired on April 18, 2018.