Current Affairs

Barbara Ehrenreich on Medicine, Macrophages, and Megafauna…

A discussion of the Wellness craze, how science adapts to new information, and the human idea of the self.

This interview originally aired on the Current Affairs podcast on September 2019, and was subsequently printed in the Nov./Dec. 2019 issue. You can listen to it here, or below:

LYTA GOLD:

I am recording this episode from the home of Barbara Ehrenreich, that’s the legendary writer and leftist organizer, who is also one of my personal heroes. This is really exciting for me. Thanks for letting me invade your home today.

BARBARA EHRENREICH:

Oh, thank you for invading my home!

LG:

In Natural Causes, you go after these myths that surround death and our wellness culture. Why do you choose to bust that particular myth of wellness?

BE:

I was at the age where you got Medicare, and the medical system wants to extract as much as it can from you, so I was always being told by doctors that I should undergo this test or that test. And I started questioning these things, one after another, driving the doctors nuts, but also thinking: do I want to spend my time doing this? Okay, suppose you find something bad, how can you fix it? Do you have something? What are you recommending?

LG:

You are very critical in the book of these unnecessary tests like mammograms or PSA [prostate cancer] tests….

BE:

I say in the book what professional organizations say, which is: don’t do the PSA test, because the hazards of getting of getting a false positive are so great. Same with mammograms. You could be forced to have a biopsy, which is surgery, where you are put under complete anesthesia and a chunk of your body is taken out — and usually for no purpose.

LG:

I wouldn’t be surprised if you got some negative pushback, and people would get upset with you.

BE:

Why is this woman trying to kill us?!

LG:

But the idea is that if something is wrong, you will know it is wrong, and you will go to the doctor.

BE:

I say: you should know that this is questioned, and the number of things like mammograms and colonoscopies is way out of line with that of comparable countries.

LG:

There’s this moral judgment that goes into it, there’s this idea that if you fail to prevent something it’s your fault.

BE:

In this country, in our culture, we have transformed the whole notion of morality from how we treat other people and so on to how healthy are we. How healthy is our behavior, I’m so sick of that, and I get it from so many friends. You know, “so-and-so is so good at her diet,” or “so-and-so doesn’t take care of herself.” This should not be where we locate our moral judgments.

LG:

There’s a real connection that you draw in the book between this theme of having control over your body, and the rich people who promulgate these ideas. When you are elucidating intellectual history you are not just—these are not just random ideas, there are people who espouse them for a reason. They’ve got names, they’ve got bank accounts, there are good reasons why they do this. They do it to make money, and they do it to enforce certain kinds of class structures too.

BE:

Are you thinking of people like Gwyneth Paltrow? Well, the model of wellness that she and others of her ilk propagate is basically a kind of consumerism. You should have these products, you should be rubbing them into your skin, you should be curating meals, and every item that you consume should be justified in some way. 

LG:

In Bright-Sided you talk a lot about this positive thinking, tracing the origins of it and what a cult it is and how much—people go to these mega-churches and they really buy into the prosperity gospel, and they think they can just wish themselves rich. And you have this great quote in Bright-Sided from T. Harv Eker, from Secrets of the Millionaire Mind, and he tells you to place your hand on your heart and say “I admire rich people, I bless rich people, I love rich people, and I am going to be one of those rich people.”

BE:

Yeah, yeah. I didn’t know about positive thinking until I had breast cancer and started looking into the anthropology of the whole pink ribbon cult, and going to all the available websites, reading all the pamphlets and books about how you will get better if you think positively, if you are sure your outcome will be good, which just infuriated me beyond belief. You are saying to people: it’s your own fault. So many people die thinking that they are to blame because they failed to think positive enough, not just with breast cancer but with other cancers. That’s just cruel.

LG:

Yeah, and you point out there is no science whatsoever to support this idea.

BE:

Oh, there is a whole brand of pseudo-science of positive psychology.

LG:

It’s fascinating how many aspects of our lives, the positive thinking, the victim blaming, how much of that touches health, wealth, all of these different parts. It is so ingrained. I have heard people say variations of “happiness is a choice.” It’s just bizarre how common it has become, and with remarkably little pushback, I would say.

BE:

I guess I would blame psychology itself, the more mainstream psychology, for its extreme individualism. If you talk to a therapist, you are going to be talking about yourself. They are not going to want to hear about class and race and gender except for how you are dealing with these little obstacles. There is no way of seeing things in a more social or collective way, which is what we have to do. You can’t just look at the individual.

LG:

In Natural Causes you talk about mindfulness… a trend that you point to that has been created by Silicon Valley and also solved by them. Because everyone is so busy, they are so distracted, but mindfulness came along, and mindfulness could be sold as a product.   

BE:

Yes, you have to pay attention, it’s true—but pay attention to what? I mean, if you are a working parent, as I always was and am, what do you do? Do you finish writing the email to the boss, or do you pick up the toddler screaming on the floor? Mindfulness does not answer that question for you. It doesn’t even answer the question, the bigger question: why are you being put in that position? Why isn’t there childcare? Why are your hours so long? I can’t stand it. I do get emotional about these things because they are—there is so much entitlement and there is so much class privilege built into it. I first encountered this in the Bay Area, from a rich lady who happened to be my landlord for a few months, and I had never heard the word before, but she told me to be very “mindful” over the precious objet she had in the apartment. It was just Martha Stewart kind of crap, but I had never heard that. I saw and began to identify that it was kind of a rich people’s thing.

LG:

One thing you really bring up is it sort of came from Buddhism, but it has been really shorn of all meaning and value. 

BE:

My son actually pointed out—he had gone through a little Buddhist phase in college—and he said, it’s Buddhism but without the idea of transcendence. The idea of transcendence and transcending the self into a different relationship with the world and the universe, you won’t find that with mindfulness.

LG:

The tech tycoons of Silicon Valley, these are the men who are regarded as having great scientific minds, and being these brilliant scientists, and that they dabble in this weird pseudo-mysticism…no one seems to notice that there is anything weird about that.

BE:

Yeah, it’s odd because Silicon Valley has a heavy population of engineers, and people are fed some smattering of science in their background, but they don’t even seem to have noticed studies that show that a few minutes of intermittent meditation from your app do nothing. Or even longer periods of meditation, let’s say like 10 minutes. You’d do just as well in terms of having a glass of wine with a friend, or taking a long walk, something like that. They created the problem in so many ways, with all these devices, but they haven’t found the solution.

LG:

It’s interesting that there is a real lack of interest in actual science, and the process of science.

BE:

Yeah they seem to be extremely vulnerable to hucksterism. I mean some of the characters that got the mindfulness movement off the ground; one of them actually was a former clown in the U.K. I can’t remember his name, but he’s in there. Makes me think I could walk in there and sell them something.

LG:

It does make you temped to try and get in on this grift.

BE:

Yeah right.

LG:

It’s working for them.

BE:

What are we doing?

LG:

And I read a lot about this idea of mind uploading, biohacking, and I have these very earnest young men telling me this is a thing that is going to happen, that all of our minds are going to be uploaded to a cloud. And as I was reading Natural Causes, you mentioned how doctors are taught to think of the body as inert, because they are taught on cadavers, and on cells that are dissected and put on a slide. It feels as though there is a connection there, as though the body is something that can be conquered and hacked, and even the mind is something that can be conquered and hacked, and the idea of the body being dead.

BE:

I think so. I mean, it’s a very deep philosophical issue that I tried to raise in Natural Causes. It comes from this fundamental notion of western science for hundreds of years now, that the natural world is dead, and the only agency in the natural world is ourselves, and then that monotheistic God, who is so far away. So yeah, the body just becomes dead matter to be manipulated or poisoned with various kinds of things. And I am calling for a whole different approach, the growing science that individual cells in the body have agency.

LG:

That absolutely blew my mind. Macrophages specifically, they don’t have consciousness exactly, but they do have volition of a sort.

BE:

This was a total surprise to me. When I was a graduate student in cell biology, nobody for one moment would have uttered the phrase “cellular decision making.” Now it’s a subject of international conferences. There’s a recognition that in some sense—maybe decide is not the right word, I don’t know—but it’s not that different from the analogy I gave of me walking down a crowded sidewalk: I’m getting a lot of information all the time, is someone going to bump into me, am I going to get run over by a car, whatever. Just as a macrophage is constantly getting signals from other cells in the body, and then these signals have to be integrated in some way, for me that might be the decision to walk a little faster or get out of the way of somebody or something. For a macrophage, it might be “get out of here” or “come to where we are, there is something good to eat over here.” 

LG:

They are big cells, they are immune system cells?  

BE:

Yeah. “Macrophage” means “big eater.”

LG:

Pretty descriptive. So, one of the things you talk [about], which is completely horrifying, is macrophages gather outside of a cancer. And initially, the idea was that they must be trying to help, they must be trying to eat the cancer cells, but they are very much helping the cancer spread and that’s part of how a metastasis happens.

BE:

I had done my graduate work on macrophages with the firm idea they were the good guys. It is their job to rush over and eat a bacterium or a virus. They are our defense. So scientists near the beginning of the 20th century began to observe macrophages crowding around tumors. Surprise: we now know that they actually conduct individual cancer cells into the bloodstream, where they can go onto colonize other areas of the body, and we know this because of these remarkable developments in microscopy, the ability to observe individual cells in the body. I’m so amazed, but that is what is fun. 

LG:

Well that is one of the remarkable things—you have a Ph.D in cellular biology, you’ve studied quite a lot. You are a scientifically minded person; things change all the time. You get new information, we learn new things. 

BE: 

[Doctors] get stuck in their paradigms and that’s very frustrating to me, because there are so many things in my readings of science [where] everybody should be throwing up their hands and saying we gotta start all over and integrate this. But nobody wants to leap out in front and be identified as being a nutcase, in case anything doesn’t work out. 

LG:

You talk a bit about this idea of the unitary self…that is what mindfulness is meant to do, you the individual are meant to locate yourself in yourself, and your control over yourself. It’s just that this paradigm isn’t true. It doesn’t make any sense scientifically.

BE:

I talk in Natural Causes about the rise of the idea of the self, because this is not something that our species is born with. But the idea that there is some kind of hard core of Barbara-ness in me, distinct from you in your own kernel of selfness…it arises slowly; in the book I said I was tracing it to the 17th/16th centuries. Now, I would go back further because of what I am working on now. For some reason, and it had to do with Donald Trump—partly because I needed to escape, I needed some way, and since I can’t do the self-care wellness thing that was being recommended to Democrats at that time, I got really interested in paleographic cave art. And I can’t explain exactly why, but it had to do with Trump’s narcissism. I thought: narcissism, where does it come from? Because there is the swollen self that eats everything else up, and I noticed in paleographic cave art there are very few human-type creatures…you know about this?

LG:

It’s usually deer; it’s usually prey and predators.

BE:

Yeah, right. Megafauna, the experts call them. The human-like creatures have no faces, they are stick figures, no faces. So that pushes back the invention of the self to much earlier. Now I would put it more around the Bronze Age.

LG:

There is this idea of a soul, is that similar enough or is that different?

BE:

Well the soul is a self that is defined by another entity, a deity, and our connection to that hypothetical being. The self is something that we should be able to apprehend without that idea.

LG:

That’s a good distinction, I like that a lot…I think it is a good time to segue actually into what is my favorite book of yours, which is Living with a Wild God. 

BE:

Yeah, so there are people who felt very encouraged and liberated by the book, and there are people who thought I had gone completely round the bend.

LG:

It’s a really special book, a really unusual book…you talk about how as a teenager you experienced a kind of extreme solipsism, which I think a lot of teenagers go through, but I think you are really honest about it in the book, which I think is the difference…That solipsism is so much like that excessive focus on the self, this cult of the self and the wellness cult we hear about…You talk about, and I have a quote here from Living with a Wild God, “my adolescent solipsism is incidental compared to the collective solipsism our species has embraced for the last few centuries in the name of modernity, a worldview in which there exists no consciousness or agency…but our own.”

BE:

Pretty tragic.

LG:

Yeah. That was very resonant today when I reread this, because with climate change that comes up so much, that we are causing all of this damage, and we are causing this damage because of this collective solipsism. Like we are the only living beings that matter. 

BE:

Oh God, yeah. This is the kind of thing that keeps taking me back to the Paleolithic. Because people really did not distinguish between the human and the animal, say 30,000 years ago.

LG:

What do you think made the change that made us lose that relationship with animals, being part of the world?

BE:

Well, we killed them. I mean that’s why there are so many books stacked in [my] living room about megafauna. I mean this is a big, big question. How much of the disappearance of the megafauna—how much was it climate change or something else? But it is pretty incontrovertible that wherever humans went, they wiped out species. In North America, the extinction of so many creatures seems to come about around the time of the arrival of humans from Asia. That’s one argument. That we did it and one of the reasons we did it was through overkill. Because what are you going to do if you are a little band of primates running after bison? You can use fire and noise and a flint-tipped spear, or you can drive them over a cliff—and there are such collections now of bones of herbivores at the bottom of cliffs, and they were killing far more than they needed to eat. It was the easiest way to kill them…

But that’s what made us dominant, ultimately. It’s that we could fight predators by banding together. You don’t do so well if the leopard shows up at the fireside and everybody drops their baby and climbs a tree. That group is not going to exist very long. But when you learn to form a ring around the most vulnerable members of the group, and confront the predator that way, you’ve got a chance. 

LG:

You talk about how one of the things that got you out of your solipsism was partly these experiences you had, but also, as you wrote, “I fell in love with my comrades, my children, my species.” 

BE:

Yeah, the experience of the “movement” as we called it. Having to go out on the streets and talk to people as I handed them leaflets or whatever, organizing meetings and things like that.

LG:

Do you think that there’s a way in which it can also bring about this sense of the world of being alive, that we can connect those ideas?

BE:

It should be part of our morality—a respect for the natural world and for non-human animals and so on, as well as our love for each other and our species. And it’s not there. I’m really distressed about what’s happening right now.

LG: 

Do you have any recommended actions, any organizing tips, things people should be doing?

BE:

Whatever is handy, do it. Whatever you can get your neighbors and friends to join in with, do it.

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