health

Podcast • April 17, 2018

Barbara Ehrenreich on the Cult of Wellness

This is an unlocked, bonus segment of Open Source. You can hear weekly conversations and extended interviews like this one by subscribing and supporting our work on Patreon. In her new book, Natural Causes: An ...

This is an unlocked, bonus segment of Open Source. You can hear weekly conversations and extended interviews like this one by subscribing and supporting our work on Patreon.

In her new book, Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer, the veteran reporter Barbara Ehrenreich takes aim at a host of maladies in the world of modern medicine: bloated hospital and insurance industries, Silicon Valley charlatans preaching everlasting life, and especially wellness and self-help gurus. Against the fitness entrepreneurs and “positive thinkers,” Ehrenreich (who has a PhD in cellular immunology) is putting forward a “dystopian view of the body.” She writes: “The body is not a smooth-running machine in which each part obediently performs its tasks for the benefit of the common good. It is at best a confederation of parts—cells, tissues, even thought patterns—that may seek to advance their own agendas, whether or not they are destructive of the whole.”

Ehrenreich argues that a delusion of Control pervades the culture, and good or bad health is increasingly pinned on “individual responsbility.” Dying is not a crime, she says, neither a sign of weakness. In conversation here, she’s expanding on these themes, as well as the ironies of “successful aging,” and what exactly is wrong with the Ray Kurzweil view of the human body.

Produced by Homa Sarabi-Daunais and Conor Gillies. Photo by Reed Young for The Guardian, 2014.

Podcast • February 9, 2015

Depression, Inside-Out

Depression—characterized by persistent feelings of sadness, hopelessness, or alienation—afflicts one of every 10 US adults. Our guest George Scialabba, a writer and public intellectual based in Cambridge, is speaking about his decades-long bout with the illness on ...

Depression—characterized by persistent feelings of sadness, hopelessness, or alienation—afflicts one of every 10 US adults. Our guest George Scialabba, a writer and public intellectual based in Cambridge, is speaking about his decades-long bout with the illness on the occasion of an article he wrote for The Baffler magazine, called “The Endlessly Examined Life.”

One of the things that hurts most about depression is that you don’t really believe that it’s ever going to go away, get better. It just doesn’t seem like something with a plausible cause. So you can’t imagine what the remedy is. So people should tell you: “Look, eventually, everybody gets a little better. Some people are still mildly depressed, but virtually no one is acutely depressed for decades and decades — their whole life. It’ll get a little better, and probably a lot better. So hang on.”

unnamedGeorge found and published the various clinical notes that his doctors wrote about him and his condition over nearly 40 years. It’s the first publication of its kind—part personal journey, part modern medical history of depression therapy, drugs, and electro-shock treatments. We’re talking, now, about what the doctors tend not to write down: namely, what depression has to do with the deep philosophical and religious search about life.

One of the things George found in his own search was the humanism of D.H. Lawrence. As George reads from his essay collection, The Modern Predicament:

Lawrence believed that the universe and the individual soul were pulsing with mysteries, from which men and women were perennially distracted by want or greed or dogma. He thought that beauty, graceful physical movement, unselfconscious emotional directness, and a sense, even an inarticulate sense, of connection to the cosmos, however defined – to the sun, to the wilderness, to the rhythms of a craft or the rites of a tribe – were organic necessities of a sane human life. “Man has little needs and deeper needs,” he wrote. “We have fallen into the mistake of living from our little needs till we have almost lost our deeper needs in a sort of madness.”

Podcast • January 27, 2015

Steve Brill’s Bitter Pill

Steve Brill is our guest. He’s an old-fashioned reporter at book length – out of the David Halberstam school. He’s taken apart the passage of Obamacare in an investigation he titled America’s Bitter Pill: Money, ...

Steve Brill is our guest. He’s an old-fashioned reporter at book length – out of the David Halberstam school. He’s taken apart the passage of Obamacare in an investigation he titled America’s Bitter Pill: Money, Politics, Back-Room Deals, and the Fight to Fix Our Broken Healthcare System.

Short form: It’s the story of a messy democracy awash in special-interest money trying to reform a messy health care system itself awash in money and private powers. The moral is every bit of the discontent; everything that’s wrong with Obamacare comes directly out of the way the bill was cooked. There were many steps in good directions, Steve Brill would tell you, but still our politics and our doctoring both need emergency care.

Among the Washington compromises and insurance-industry negotiations, we’re discussing a story that hits close to home here in Boston, too: that of the medical device industry. As Steve Brill says:

The medical device industry is one of the most profitable industries. Their profit margins are through the roof; the leading medical device company, Medtronic, has much higher profit margins even than Apple.

So part of the Obamacare law that made some sense was: they put an excise tax of 3% on all medical devices—all durable medical equipment, as they call it. Now the rationale was we’re about to give people who make pacemakers, and artificial hips, and artificial knees, and neurostimulators for your back that nobody really needs but everybody gets—we’re about to give them tens of millions of new customers. Let’s get a little bit of a tax on them. It’s an excise tax, which means it’s not just on domestic companies, it’s on foreign companies.

And the industry howled. They said: This is a jobs killer; this is a profit killer; it’s terrible. And it wasn’t just the Republicans. In Washington, when it comes to healthcare lobbying it is bipartisan.

The sainted Elizabeth Warren is trying to get that tax repealed. Al Franken is trying to get that tax repealed, as well as the Republicans. It’s the one bipartisan thing going on capitol hill—is let’s repeal the medical device tax—because their tentacles are so deep on capitol hill.

Now is it a jobs killer? Is it a profits killer? Let’s look at Medtronic. Since Obamacare was signed, Medtronic’s profit is up 67% and it’s added more than 5,000 people to the payroll. Doesn’t sound like a jobs killer; doesn’t sound like a profit killer. … Obamacare is a gravy train for these companies. The idea that a 3% tax has hurt them is hilarious, there’s just no evidence of it.

Podcast • July 16, 2013

Gerald Shea’s Song Without Words

I wondered whether music might not be the unique example of what might have been — if the invention of language, the formation of words, the analysis of ideas had not intervened — the means ...

I wondered whether music might not be the unique example of what might have been — if the invention of language, the formation of words, the analysis of ideas had not intervened — the means of communication between souls.

Marcel, enthralled by the chamber music, appalled at the intermission chatter, in Proust’s Remembrance of Things Past: The Captive, the Moncrieff-Kilmartin translation, page 260 in Volume III of the Vintage edition, 1982.

Gerald Shea’s exquisite and affecting memoir of his deafness could be read as an extended riff on Proust’s fantasy. About halfway through his 70 years, Gerry Shea realized that he was severely deaf — that he’d been coping somehow, at a price, with an affliction he refused to notice. What he learned in stages was to observe how his brain works — how poetry and music, sign and spoken language and the “commerce of souls” actually work, perhaps for all of us. Shea is a word-master in his own right who comes almost to prefer the pure song — in the tradition of Mendelsohn, too, who wrote the little piano gems Songs Without Words and refused lyrics for them. But Gerry Shea got there the hard way — as a lawyer, not a musician.

Through the first half of his 70-years, Gerry Shea misheard almost everything. Example: the opening line of the Frank Loesser song, “I Believe in You,” came through as “You are the tear two ties of a keeper of incoming loot” — not “You have the cool clear eyes of a seeker of wisdom and truth,” as writ. At Yale young Shea was a singing star but he didn’t belong in class. He took the star history lecturer Charles Garside to be saying that the emperor Charles V “indebited the minstrel stills of this automatic million,” when the professor was saying: “Charles inherited the administrative skills of his grandfather Maximilian…”

On such Jabberwocky in ears he didn’t know had been damaged by scarlet fever at age 5, Shea went from Yale to Columbia Law and then to a big job with the international firm of Debevoise Plimpton. He had mastered lip-reading and his own mode of translating the garbled nonsense in his ears — his “lyricals,” as he called them. But how in the world, you ask, did he avoid having his ears tested for all those years? The deeper riddle in our conversation is: why? And why, when severe deafness finally showed up unmistakably on a job test, he waited a year even to consider hearing aids or any other help. This is the point where the story became, for me, a heart-seizing meditation on afflictions imagined and denied, on identities chosen and clung to — stubbornly and with some cruel effects; and then the joy of letting go.

For me it was always a spiritual or perhaps intellectual problem. I thought everybody else heard what I heard, but that they could translate it and I couldn’t. At Yale, I felt in many ways, academically anyway, I probably didn’t belong there… I did live in a way in my own world of poetry. Lyricals are really an unconscious poetry. It was the life probably that I did love. Even though the problem of misunderstanding was there, I loved my universe and I still do… As soon as somebody tried to approach my private world of lyricals, I really didn’t want to let them in… I think probably because of insecurity, because of fear. Because of my knowledge of myself as perhaps an incomplete human being. Perhaps as someone who was at home with his own internal poetry. It was simply a world that I wanted to keep to myself. I was different from other people, and I was going to live that way and stay that way — except in the law, because I had somehow to earn my bread.

Relief came when hearing aids were virtually forced on him at age 35. The reward was hearing the rest of his music; the flutes, violins and piccolos; the wind in his willows, so to speak, with all due credit to the author Kenneth Grahame.

When I finally got the hearing aids and I realized that the external world was making a lot more sound than I’d heard, it brought me to tears. The first time I wore my glasses with hearing aids in them… suddenly out in that field I felt as if I was not alone and I heard the sound of crickets coming from every direction. It was a beautiful, beautiful sound I hadn’t heard since I was a child, a further awakening to me as to who I was and the world I was really living in. ‘There it is again,’ as Rat says to Mole in The Wind in the Willows. ‘O, Mole, the beauty of it! The merry bubble and joy, the thin, clear happy call of the distant piping! Such music I never dreamed of, and the call in it is stronger even than the music is sweet!’ That thin clear call has really become the heart of my life. That’s what Mendelson was talking about, the definite message of music that carries you with it. The most beautiful part of my life, clearly, is music… The heart of my life. Maybe it always was.

Gerald Shea in conversation with Chris Lydon in Marblehead, Massachusetts, July 2013.

Podcast • March 13, 2008

Cuba for the Long Run (II): Adrian Lopez Denis

Adrian Lopez Denis finds it laughable that even the best of the Anglo-American media, The Economist and The New Yorker, made iconic covers of cigar smoke (and crushed cigar butts) when Fidel Castro bowed out ...

Adrian Lopez Denis finds it laughable that even the best of the Anglo-American media, The Economist and The New Yorker, made iconic covers of cigar smoke (and crushed cigar butts) when Fidel Castro bowed out of office — a man who quit smoking 40 years ago, in a country that has produced a generation of creative young survivors since the heyday of the 1959 Revolution.

Econ Castro

Adrian is a social historian at Brown (Ph.D from UCLA), and the son of a medical doctor in Cuba. He likes to say that only George W. Bush sees the transition in Cuba these days as a turning point of any kind. He sees nothing spectacular coming out of Cuba soon, “no headlines in the next five years,” much less a civil war.

NYr Castro

Adrian’s emphasis in our conversations is always on the continuity of informal realities in Cuba: the vitality of the informal economy, the power of family networks and the “transnational households” that keep Havana and Miami connected, and the pleasure-seeking “culture of informality” that overwhelmed the commissars from Eastern Europe. An authoritarian tendency is part of the long Cuban tradition. So, too, is a profound problem of racial suspicion and discrimination, a legacy of slavery that the Revolution only chipped at. So in Adrian’s account of Cuba, nothing is quite what it seems or what any of the slogans suggest. And most of the consequences Cuba deals with are the unintended ones.

Adrian Lopez

Adrian Lopez Denis: a ‘continuities’ man

From below it’s a country that found its own way to get over the Cold War, Cuban style. We have already a whole generation in the post-Cold War period. Young people don’t remember the Cold War, and young people people are what drives Cuba forward, both on the island and in Miami… What’s on their mind is survival, and it’s not survival of the fittest. This is not a Darwinian environment, necessarily…

Don’t minimize the unintended consequences of the Cuban revolution. By equalizing income levels and for the most part erasing the old established divisions of class… one of the unintended consequences of that transformation was that people created networks of solidarity, facing a state that controlled public spaces in a very pervasive way. People developed alternatives to it, or a sense of networks… Building on top of a long tradition of an informal economy in Cuba, those networks are now responsible for the dynamics of daily life… They cross all divisions. These are networks of survival, so when you need to survive you can not look at the ideology or the race or the gender of the person you are interacting with. You can’t be that picky…

Race… is one of the deepest problems that Cuba has, and this is one of most obvious failures of the Cuban Revolution. In areas like gender equality, the Cuban Revolution was much more accomplished than in areas like solving the race differential… The Cuban Revolution was never feminist, but the policy was more comprehensive in transforming attitudes of men toward women than in this very weak attempt to transform the attitudes of white people toward black people… The other thing is that the leadership of the Cuban Revolution was terrified of the possibility of an alternative political mobilization of the Afro-Cuban population. Cuban elites and middle classes have been terrified of that for 200 years, since the Haitian revolution. It’s a fear that runs deep in the culture. It’s another consequence of slavery; you had that fear in every society that goes through slavery. The fear of the barbarian is a myth that runs deep. It’s the saddest part of all this story. That is where I think everything the Cuban Revolution tried to do in the soicial and economic arena failed, because the government decided they could not allow the Afro-Cuban population to organize themselves to improve their conditions. The Afro Cuban population was there to receive what the government gave them, and be grateful. They not to fight for more, not to fight for equality, basically… The consequence is that there’s more people in prison today in Cuba than anywhere else in the world. Cuba has the largest prison population in the world right now… It’s a very tragic situation, and the Afro-Cuban population is over represented in prisons, and that is the most obvious sign that something is really going deeply wrong in your country in terms of racial politics… We’re not talking about 300 political prisoners. That’s a footnote. We’re talking about the more or less 200,000 people that are in prison in Cuba today… It’s the most incarcerated society ever created in history… for “being black,” stealing a chicken, surviving.

All this informality that I was celebrating a few minutes ago is illegal… The people that pay the price are the people that are more active in the informal economy, people that are more creative. It’s the same creativity that goes into playing jazz… It’s talking to other people, getting along, being able to improvise. You get an Afro-Cuban population that has been for centuries at the bottom of society, that has been needing these connections, developing these networks since the time of slavery; and a government that doesn’t understand the vitality of these networks and tries to substitute a top-down system that really doesn’t work. So there you go.

Adrian Lopez Denis of Brown University, in conversation with Chris Lydon at the Watson Institute, March 12, 2008.

Adrian Lopez Denis gives us, finally, a moment and a place to dwell on. Late in the fall semester, next December 17, he will sweep his contingent of Brown students in Cuba into the mass pilgrimage to the church and hospital outside Havana of San Lazaro , the patron saint of the poor and the sick in Cuba. It was built in 1917 to treat lepers; today it’s famous for its AIDS sanitarium. It is one of the intricate symbols, as Adrian says, of “the island that was there before the Cold War, and that’s going to be there after.”

As many as 60,000 Cubans will celebrate this complicated feast of San Lazaro . “Its a perfect picture of the Cuban Revolution,” Adrian concluded. “It’s a hospital, a prison and a school. People are there because they want to be, and people are there that don’t want to be there. It’s like a microcosm of Cuba. And now they have one of these in every province, fourteen in all… We have the lowest HIV-posititive rate in the Atlantic — a spectacular, stunning success of the Cuban Revolution. And it’s done basically by forcing isolation on people. You get free drugs because you’re sick, but you get isolated and put in this prison because you’re sick.”