When do you know you’re old enough to die? Barbara Ehrenreich has some answers

With her latest book, Natural Causes, Barbara Ehrenreich notes that theres an age at which death no longer requires much explanation

Four years ago, Barbara Ehrenreich, 76, reached the realisation that she was old enough to die. Not that the author, journalist and political activist was sick; she just didnt want to spoil the time she had left undergoing myriad preventive medical tests or restricting her diet in pursuit of a longer life.

While she would seek help for an urgent health issue, she wouldnt look for problems.

Now Ehrenreich felt free to enjoy herself. I tend to worry that a lot of my friends who are my age dont get to that point, she tells the Guardian. Theyre frantically scrambling for new things that might prolong their lives.

It is not a suicidal decision, she stresses. Ehrenreich has what she calls a very keen bullshit detector and she has done her research.

The results of this are detailed in her latest book, Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer, published on 10 April.

Part polemic, part autobiographical, Ehrenreich who holds a PhD in cellular immunology casts a skeptical, sometimes witty, and scientifically rigorous eye over the beliefs we hold that we think will give us longevity.

She targets the medical examinations, screenings and tests were subjected to in older age as well as the multibillion-dollar wellness industry, the cult of mindfulness and food fads.

These all give us the illusion that we are in control of our bodies. But in the latter part of the book, Ehrenreich argues this is not so. For example, she details how our immune systems can turn on us, promoting rather than preventing the spread of cancer cells.

When Ehrenreich talks of being old enough to die, she does not mean that each of us has an expiration date. Its more that theres an age at which death no longer requires much explanation.

That thought had been forming in my mind for some time, she says. I really have no hard evidence about when exactly one gets old enough to die, but I notice in obituaries if the person is over 70 theres not a big mystery, theres no investigation called for. Its usually not called tragic because we do die at some age. I found that rather refreshing.

In 2000, Ehrenreich was diagnosed with breast cancer (she wrote the critical, award-winning essay Welcome to Cancerland about the pink ribbon culture).

The experience of cancer treatment helped shape her thoughts on ageing, she says.

Within this last decade, I realised I was not going to go through chemotherapy again. Thats like a year out of your life when you consider the recovery time and everything. I dont have a year to spare.

In Natural Causes, Ehrenreich writes about how you receive more calls to screenings and tests in the US including mammograms, colonoscopies and bone density scans as you get older. She claims most fail the evidence-based test and are at best unnecessary and worst harmful.

Ehrenreich would rather relax with family and friends or take a long walk than sit in a doctors waiting room. She lives near her daughter in Alexandria, Virginia, and likes to pick up her 13-year-old granddaughter from school and hang out with her a while.

Work is still a passion too. She fizzes with ideas for articles and books on subjects that call for her non-conformist take.

Once a prominent figure in the Democratic Socialists of America, she is also busy with the Economic Hardship Reporting Project she founded, which promotes journalism about inequality and poverty in the US, and gives opportunity to journalists who are struggling financially. (The Guardian often partners with the organisation.)

Ehrenreich, who is divorced, has talked to her children Rosa, a law professor, and Ben, a journalist and novelist about her realisation she is old enough to die, but not in a grim way. That wouldnt be her style. While a sombre subject, she chats about it with a matter-of-fact humour.

I just said: This is bullshit. Im not going to go through this and that and the other. Im not going to spend my time, which is very precious, being screened and probed and subjected to various kinds of machine surveillance. I think theyre with me. I raised them right, she laughs.

The last time I had to get a new primary care doctor I told her straight out: I will come to you if I have a problem, but do not go looking for problems.

She pauses: I think I beat her into submission.

Natural Causes is Ehrenreichs 23rd book in 50 years. Much of her work is myth-busting, such as Bright-sided, which looks at the false promises of positive thinking; other work highlights her keen sense of social justice. For her best-selling 2001 book Nickel and Dimed, she went undercover for three months, working in cleaning, waitressing and retail jobs to experience the difficulties of life on a minimum wage.

A recent exchange with a friend summed up what Ehrenreich hoped to achieve with Natural Causes.

I gave the book to a dear friend of mine a week ago. Shes 86 and shes a very distinguished social scientist and has had a tremendous career. She said: I love this, Barbara, its making me happy. I felt wow. I want people to read it and relax. I see so many people my age and this has been going on for a while who are obsessed, for example, with their diets.

Im sorry, Im not going out of this life without butter on my bread. Ive had so much grief from people about butter. The most important thing is that food tastes good enough to eat it. I like a glass of wine or a bloody mary, too.

Barbara
Barbara Ehrenreich: Cancer is a cellular rebellion. Photograph: Stephen Voss for the Guardian

Yet despite her thoughts on the wellness industry with its expensive health clubs (fitness has become a middle-class signifier, she says) and corporate wellness programs (flabby employees are less likely to be promoted, she writes), Ehrenreich wont be giving up the gym anytime soon. She works out most days because she enjoys cardio and weight training and lots of stretching, not because it might make her live longer.

That is the one way in which I participated in the health craze that set in this country in the 70s, she says. I just discovered there was something missing in my life. I dont understand the people who say, Im so relieved my workout is over, it was torture, but I did it. Im not like that.

In Natural Causes, Ehrenreich uses the latest biomedical research to challenge our assumption that we have agency over our bodies and minds. Microscopic cells called macrophages make their own decisions, and not always to our benefit they can aid the growth of tumours and attack other cells, with life-threatening results.

This was totally shocking to me, she says. My research in graduate school was on macrophages and they were heroes [responsible for removing cell corpses and trash the garbage collector of the body]. About 10 years ago I read in Scientific American about the discovery that they enable tumour cells to metastasise. I felt like it was treason!

She continues: The really shocking thing is that they can do what they want to do. I kept coming across the phrase in the scientific literature cellular decision-making.

This changed her whole sense of her body, she says.

The old notion of the body was like communist dictatorship every cell in it was obediently performing its function and in turn was getting nourished by the bloodstream and everything. But no, there are rebels I mean, cancer is a cellular rebellion.

Ehrenreich, an atheist, finds comfort in the idea that humans do not live alone in a lifeless universe where the natural world is devoid of agency (which she describes as the ability to initiate an action).

When you think about some of these issues, like how a cell can make decisions, and a lot of other things I talk about in the book, like an electron deciding whether to go through this place in a grid or that place. When you see theres agency even in the natural world. When you think about it all being sort of alive like that, its very different from dying if you think theres nothing but your mind in the universe, or your mind and Gods mind.

Death becomes less a terrifying leap into the abyss and more like an embrace of ongoing life, she believes.

If you think of the whole thing as potentially thriving and jumping around and having agency at some level, its fine to die, she adds reassuringly.

Read more: https://www.theguardian.com/lifeandstyle/2018/apr/07/barbara-ehrenreich-natural-causes-book-old-enough-to-die

Feminism, politics and death: my mum died the night Hillary Clinton lost

They may seem like unrelated events but the end of Clintons campaign and my mothers life made me reflect differently on my own political career

My mother died the night Hillary Clinton lost. These might seem like two very unrelated events and youd be right about that. But for me, and my somewhat particular circumstances, Ive found a plethora of meaning about life and death, feminism and politics.

See, it was also the night I was due to be sworn in as a councillor for my local city council. It was my first political foray and Ive reflected on the start of my own political journey while on the other side of the world a smart and skilled female politician saw the end of hers, with our whole gender brutalised by a despicable Trump. And though Mum doesnt know it, all my political guts I got from her.

Mum was diagnosed with breast cancer 10 days before the 2016 Australian federal election. Dad called me from Canberra to say he had taken Mum to hospital and she had acute pneumonia. I was going through the processes of my Labor nomination for council elections. With days to the federal election, every spare moment I wasnt working I was door-knocking and pre-polling.

I dont remember that first conversation with Dad. I do remember the call the next day when Dad told me Mum had terminal cancer (as well as acute pneumonia) and the cancer had spread through her ribs, spine and pelvis. I was at my desk so I booked a flight home and, as I headed out the door, asked a colleague to cancel me out of every election activity I was signed up for.

Breast cancer is a disease that inflicts itself predominantly on women. Its also one of the most misdiagnosed cancers around. Mum had her last mammogram only months earlier and it hadnt appeared. I grew bitter quickly.

At the same time this was a federal election where it was one bloke versus another bloke versus another bloke, and women barely seemed to get a mention. I had volunteered the bulk of my time on campaigns to support female candidates in tough Victorian seats, none who won. I sat bedside my mother who taught me everything and watched women largely erased out of public life.

On Sunday 3 July, a day after the federal election Mum was only in the second week of a disastrous five week stint in hospital my journal shows compassion draining out of me:

I suspect I will grow rough and battle hardened and unforgiving from this. A part of me hopes I will. Perhaps I will grow ruthless and mean and brutal like life and that might make me powerful like men. I dont think Mum will like the new me. Ill have an excuse to be mean now, finally.

I thought at length about quitting the council race. We didnt know the timeline Mums cancer was working to, although wed been told up to 24 months for stage four breast cancer. I was enjoying caring for her and all her needs. But quality of life for Mum was also about quality of life for her daughters and, honestly, I just always thought shed make it a little longer.

So I ran my council campaign in between working full time and flying back home to care for Mum, alternating every second weekend with my sister. Offering a parallel world to my campaigning life, my life with Mum gave me such relief. I loved the quiet nights I shared with her. From the carers bed in her room, I would lie facing her and would listen for her breathing as her lungs drew in air from her oxygen tank.

In late October, I won the third and final spot at the council ward elections; Mum went back into hospital and I flew home again.

While nothing can prepare you for the death of a parent I did everything I could to prepare myself. I read memoir and non-fiction (by women) and I talked with women who had experience, both personal and professional.

In the final days, as Mum slept sedated, I read A Very Easy Death by Simone de Beauvoir. It was the 50th anniversary of the translation of the French feminists account of her mothers death. The months of that death also mirrored my mothers own: a few long weeks over October and November.

De Beauvoirs mothers death was frightening to me because it was everything her maman didnt want. She wasnt ready for death and her medical wishes were not respected: the doctors operated on her even though she had begged de Beauvoir that she wouldnt let them touch her body. Her final moments were full of pain and distress. De Beauvoir wasnt even there as she had slept through the panicked phone calls from her sister.

I was not watching the US election results that afternoon and evening in November. Mum was at Canberras public hospice set amongst beautiful gardens and overlooking Lake Burley Griffin. For the last few days she had been heavily sedated. Mums breathing changed late in the afternoon and we knew, not long now.

In academia, philosopher Michel Foucault called it a heterotopia, but most of us might think of it as a bit of a headfuck, a space or place in time that has more meaning or relationship to another space than it might first appear. As my mum lay dying, I was in a room full of strong women with her. My cousin brought in the bad news from the US and I slumped in my chair beside Mum, overwhelmed by yet more insurmountable grief. I thought if I was back in Melbourne, if my mum wasnt dying, Id be at my council ceremony right now and Hillary might even have been winning but here I was in this awful parallel universe that happened to be real.

Mum died that night. A little after midnight, I woke from a light doze and Mum was turned slightly in her bed, facing me and she had stopped breathing. I leaned in close and checked for a pulse on her wrist. Her skin was so perfectly warm. The family all woke and we said our goodbyes.

I stayed with Mums body till morning. I picked out clothes for her as the nurses cleaned and dressed her. Then finally watched on as they are you ready for this? put Mums body into the transport bag. I followed the nurses as they pushed her bed down the hallway to the cold room, where I thanked them and having already said my goodbyes, left for my car and for my first day without my mum in a bleak, bleak new world.

In the months after, it was through the company of women, and particularly women who have lost their mothers, that I have found my feet again. I havent turned bitter and mean as I once thought or hoped I would. My feminism is softer with new compassion but also bolder with new militancy.

Im still finding my political feet, but Ive been elected to a council with majority women membership plus we have a female mayor and CEO too. At every council meeting I reflect deeply on the values, learnt from my mother, that drive my decision-making even if at times they wont make me popular.

I dont see much of Hillary in the news these days, which Im thankful for. It reminds me of Mum each time and when I do, bystanders watch me dab at my eyes and think she must really have liked Hillary. Little do they know that was the night my mum died.

Read more: https://www.theguardian.com/lifeandstyle/2017/jun/18/feminism-politics-and-death-my-mum-died-the-night-hillary-clinton-lost