Drawing on her PhD in cellular immunology and her impressive resume as an “amateur sociologist,” Ehrenreich plots out the classist heritage of the now $3.7 trillion wellness industry. She uncovers a set of unsound assumptions and power dynamics beneath the medicalized moralism of being one’s “best self.” Wellness, for Ehrenreich, proffers an “illusion of control” when in fact all that is certain is that “we all gotta die of something,” as my father used to say when I would nag him about his tobacco dipping habit (he hasn’t quit).
His sentiment aligns with Ehrenreich’s in this book, which draws its strength and weaknesses from her firsthand experience. She grew up in a working-class milieu. She “became a feminist in the fullest sense” when a scandalized obstetrician asked where such “a nice girl” like her, pregnant at around 28, learned words like “cervix” and “dilate.” She has patronized fitness clubs for 30 years. She survived breast cancer. Now 76, she can write from experience that “no matter how much effort we expend, not everything is potentially within our control, not even our own bodies and minds.”
Yet, “scientific medicine” and “holistic wellness” — the two components of 21st-century wellness she delineates and then deconstructs — presuppose the opposite: that poor health and death are, at least in part, failures of the mind to control the body. “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,” this reasoning goes. “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.”
Such thinking has classist implications, whether judgments about my family’s recipes or stereotype-ridden discourse around the opioid crisis. However, things did not have to be this way. As Ehrenreich discovers, not only is the science of wellness dubious, but its systems of self-control (like dieting and preventative medicine) also reify class and gender hierarchies. What’s more, the “self” we’re supposedly controlling may not even exist. In this sprawling book, Ehrenreich puts forth an explanation for how these ideas evolved into what she considers “our” epidemic of wellness, as well as suggestions for how “we” might escape.