

Barbara Ehrenreich cuts an unusual figure in American culture. A prominent radical who never became a liberal, a celebrity, or a reactionary, who built a successful career around socialist-feminist writing and activism, she embodies an opportunity that was lost when the New Left went down to defeat. Since the mid-1970s she has devoted her work to an unsparing examination of what she viewed as the self-involvement of her professional, middle-class peers: from their narcissism and superiority in Fear of Falling and Nickel and Dimed to their misplaced faith in positive thinking in Bright-Sided. Again and again, she has offered a critique of the world they were making and leaving behind them. She is, in other words, both a boomer and the opposite.



At first glance, her new book, Natural Causes, is a polemic against wellness culture and the institutions that sustain it. What makes the argument unusual is its embrace of that great humbler, the end of life. “You can think of death bitterly or with resignation ... and take every possible measure to postpone it,” she offers at the beginning of the book. “Or, more realistically, you can think of life as an interruption of an eternity of personal nonexistence, and seize it as a brief opportunity to observe and interact with the living, ever-surprising world around us.” With a winning shrug, she declares herself “old enough to die” and have her obituary simply list “natural causes.”

Ehrenreich contemplates with some satisfaction not just the approach of her own death but also the passing of her generation. As the boomers have aged, denial of death, she argues, has moved to the center of American culture, and a vast industrial ecosystem has bloomed to capitalize on it. Across twelve chapters, Ehrenreich surveys the health care system, the culture of old age, the world of “mindfulness,” and the interior workings of the body itself, and finds a fixation on controlling the body, encouraged by cynical and self-interested professionals in the name of “wellness.” Without opposing reasonable, routine maintenance, Ehrenreich observes that the care of the self has become a coercive and exploitative obligation: a string of endless medical tests, drugs, wellness practices, and exercise fads that threaten to become the point of life rather than its sustenance. Someone, obviously, is profiting from all this.

While innumerable think pieces have impugned millennials’ culture of “self-care”—and argued that the generation born in the 1980s and ’90s is fragile, consumerist, and distracted—Ehrenreich redirects such criticisms toward an older crowd. Her book sets out to refute the idea that it’s possible to control the course and shape of one’s own biological or emotional life, and dissects the desire to do so. “Agency is not concentrated in humans or their gods or favorite animals,” she writes. “It is dispersed throughout the universe, right down to the smallest imaginable scale.” We are not, that is, in charge of ourselves.

Ehrenreich has long been willing to question professional givers of advice. Born in 1941, she had her formative political and intellectual experiences in the Women’s Health Movement of the 1970s, in which women sought to create their own knowledge about and control over their bodies. In these efforts, they encountered endless patronizing hostility from male professionals. Doctors discouraged the Lamaze method of childbirth, which focuses on breathing and relaxation techniques, and instead favored anesthesia during labor and delivery. They were outraged at the movement for cervical self-examinations and they warned of the dangers of unsterilized speculums. (Ehrenreich cites feminist writer Ellen Frankfort’s cutting retort: “Yes, of course, anything that enters the vagina should first be boiled for at least ten minutes.”)