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257 pages, Kindle Edition
First published April 10, 2018
So, this one goes into understanding what exactly is behind a "natural cause" death and just about everything between life and the great beyond.
Once I realized I was old enough to die, I decided that I was also old enough not to incur any more suffering, annoyance, or boredom in the pursuit of a longer life.
For most people, throughout most of the twentieth century, medical care necessarily involved an encounter with a social superior—a white male from a relatively privileged background.In addition, she goes into how medial procedures can be invasive and demeaning, as well as how no matter your amount of preventative care - chances are that something will get you in the end.
We can, or think we can, understand the causes of disease in cellular and chemical terms, so we should be able to avoid it by following the rules laid down by medical science: avoiding tobacco, exercising, undergoing routine medical screening, and eating only foods currently considered healthy. Anyone who fails to do so is inviting an early death. Or to put it another way, every death can now be understood as suicide.
Rejecting the traditional – and continuing – themes of harmony and wholeness, (Elie Metchnikoff) posited a biology of conflict within the body and carried on by the body's own cells as they compete for space and food and oxygen. We may influence the outcome of these conflicts – through our personal habits and perhaps eventually through medical technologies that will persuade immune cells to act more in more responsible ways – but we cannot control it. And we certainly cannot forestall its inevitable outcome, which is death.
Just as programmed cell death, apoptosis, cleanly eliminated damaged cells from the body, so do the diseases of aging clear up the clutter of biologically useless older people – only not quite so cleanly. And this perspective may be particularly attractive at a time, like now, when the dominant discourse on aging focuses on the deleterious economic effects of largely aging populations. If we didn't have inflammatory diseases to get the job done, we might have to turn to euthanasia.
The reductionist science that condemns the natural world to death is not “science” per se but a singular, historically contingent version of it – a version that depends on the notion that nature is a passive mechanism, the operations of which are observable, predictable, and subject to the law-like rules that govern inert matter.
It is one thing to die into a dead world and, metaphorically speaking, leave one's bones to bleach on a desert lit only by a dying star. It is another thing to die into the actual world, which seethes with life, with agency other than our own, and at the very least, with endless possibility. For those of us, which is probably most of us, who – with or without drugs or religion – have caught glimpses of this animate universe, death is not a terrifying leap into the abyss, but more like an embrace of ongoing life.
“The only cure for bad science is more science, which has to include both statistical analysis and some recognition that the patient is not ‘just a statistic,’ but a conscious, intelligent agent, just as the doctor is.”
“The objection raised over and over to any proposed expansion of health insurance was, in so many words: Why should I contribute to the care of those degenerates who choose to smoke and eat cheeseburgers? … we persist in subjecting anyone who dies at a seemingly untimely age to a kind of bio-moral autopsy: Did she smoke? Drink excessively? Eat too much fat and not enough fiber? Can she, in other words, be blamed for her own death?”
“It turns out that many cells within the body are capable of what biologists have come to call ‘cellular decision making.’ Certain cells can ‘decide’ where to go and what to do next without any instructions from a central authority, almost as if they possessed ‘free will.’”
“Things I had been taught to believe are inert, passive or merely insignificant—like individual cells—are in fact capable of making choices, including very bad ones.”
“Inevitably, a parallel was drawn between the healing rituals of supposedly primitive peoples and the procedures of modern Western medicine. The latter also take place in specifically designated spaced and are usually performed by costumed personnel, wearing white coast and sometimes masks, who also manipulate objects generally unavailable to the public at large.”
“Commenting on the occasional deployment of clowns to cheer up pediatric hospital patients, one canny observer noted the parallels between these newcomers to the medical scene, ‘primitive’ shamans, and the usual physicians, right down to the ‘unusual costumes,’ and even masks, worn by all of them. The patient undresses, the ‘healer’ (or clown or shaman) utters incantations and performs carious actions on the patient’s body. Then, in the medical case, comes the ‘confession,’ in which the patient is grilled as to his or her personal transgressions.”
“They are no more scientifically justified than the actions of a ‘primitive’ healer. They do not serve any physiological purpose, only what she calls ‘ritual purposes.’ The enema and shaving underscore the notion that the woman is an unclean and even unwelcome presence in the childbirth process. Anesthesia and the lithotomy position send ‘the message that her body is a machine,’ or as Davis-Floyd quotes philosopher Carolyn Merchant, “a system of dead, inert particles,’ in which the patient has no role to play. These are, in other words, rituals of domination, through which a woman at the very peak of biological power and fecundity is made to feel powerless, demeaned, and dirty.”
“In one sense, childbirth rituals ‘worked.’ The women giving birth were often traumatized, reporting to Davis-Floyd that they ‘felt defeated’ or ‘thrown into depression’: ‘You know, treating you like you’re not very bright, like you don’t know what’s going on with your own body.’ Yet, having submitted to so much discomfort and disrespect, they were expected to feel grateful to the doctor for a healthy baby. It was a perfect recipe for inducing women’s compliance with their accepted social role: rituals of humiliation followed by the fabulous ‘gift’ of a child.”
“The interaction requires the patient to exhibit submissive behavior—to undress, for example, and be open to penetration of his or her bodily cavities. These are the same sorts of procedures that are normally undertaken by the criminal justice system, with its compulsive strip searches, and they are not intended to bolster the recipient’s self-esteem. Whether consciously or not, the physician and patient are enacting a ritual of domination and submission, much like the kowtowing required in the presence of a Chinese emperor.”