Barbara Ehrenreich is probably best known for her book Nickel and Dimed: On (Not) Getting By in
America. She actually has authored a
long list of books, all with intriguing titles, that appear sociological in
focus. It is somewhat surprising then to
realize that her formal education resulted in a doctorate in cellular
immunology from Rockefeller University.
Apparently, her range of interests were too broad to be constrained by a
career in such a narrow discipline. It
would be awareness of a growing revolution in knowledge of how the human immune
system actually worked that would drive her back to her original field for the
production of her most recent effort: Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer. She was
motivated by an article she encountered.
“The article….reported that the
immune system actually abets the growth and spread of tumors, which is like
saying that the fire department is indeed staffed by arsonists. We all know that the function of the immune
system is to protect us, most commonly from bacteria and viruses, so its
expected response to cancer should be a concerted and militant defense.”
We tend to think of our bodies as well-tuned, highly-efficient
machines with all sorts of mechanisms in place to ensure continued
functionality. But we all know that once
the body reaches adulthood (or maximum efficiency), it begins a long downhill
journey to dysfunction and ultimate death.
Given this initial view of ourselves we tend to believe people who tell
us that this gradual decay is something that we can overcome by exercise, diet,
or medication. Ehrenreich’s devotes a great
deal of her book to the attempt to disabuse us of these foolish notions.
“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. What, after all, is cancer, other
than a cellular rebellion against the entire organism.”
“I know that in an era where
both conventional medicine and the wooliest ‘alternatives’ hold out the goal of
self-mastery, or at least the promise that we can prolong our lives and improve
our health by carefully monitoring our lifestyles, many people will find this
perspective disappointing, even defeatist.
What is the point of minutely calibrating one’s diet and time spent on
the treadmill when you could be vanquished entirely by a few rogue cells within
your own body?”
Ehrenreich reached an age at which death was no longer
improbable. Rather than try to stave off
further physical and mental decline by taking heroic measures, she decided that
the time she had left was best used by pursuing a lifestyle that provided her pleasure
and satisfaction. Let others forgo
pleasure and satisfaction in the vain attempt to prolong a life that is thus
rendered much less worth living.
Ehrenreich elaborates on these thoughts throughout the
book. What is of interest here are the
details she provides about the surprising roles of the immune system.
To perform its function of protecting us from things like
microbes and parasites that are foreign to our bodies, the immune system
consists of an impressive array of structures and processes designed to disable
or destroy these things. However, the
power to destroy can be dangerous if malfunctions can occur. And they do.
There are at least 80 types of autoimmune diseases where the immune system, for whatever reason, turns on specific
body parts. Examples include rheumatoid
arthritis, lupus, celiac disease and Graves disease.
Ehrenreich likes the analogy to powerful military forces
that are necessary for defense but, historically, have been difficult to
control.
“Any human society within a
spear’s throw of potential enemies needs some kind of defensive
force—minimally, an armed group who can defend against invaders. But there are risks to maintaining a
garrison, or, beyond that, a standing army: The warriors may get greedy and
turn against their own people, demanding ever more food and resources. Similarly, in the case of the body, without
immune cells we would be helpless in the face of invading microbes. With them, we face the possibility of
treasonous attacks on our ‘selves’—the autoimmune diseases….likened to ‘a
mutiny in the security forces of a country’.”
Given that there is no explanation for why autoimmune diseases
exist, Ehrenreich tends to think of immune system processes as being
unreliable, in much the same way that humans are unreliable. This is the basis for her earlier reference
to immune system cells “that may seek to advance their own agendas.” It is the readers’ choice if they wish to buy
into this line of thinking. One should
at least keep an open mind while considering her description of the role a particular
type of cell plays in “protecting” us.
Ehrenreich spent her graduate student days studying the cells
known as macrophages (translates to “big eaters”). Her studies convinced her that these were
powerful actors working to protect us.
“With the exception of stem
cells, there is probably no cell in the body more versatile than the
macrophage, which originates, like so many other leucocytes, in the bone
marrow. Immature macrophages, called
monocytes, are released into the bloodstream, where they may become attracted
to a stationary object, like a dead or injured cell, and settle down to devour
it. As the macrophage eats, it grows and
becomes ‘activated’—filled with vacuoles containing digestive enzymes that
allow it to eat still more.”
Besides this clean-up function, macrophages are the designated
killers of microbes deemed dangerous.
“Antibodies are the ingeniously
bespoke protein molecules designed to bind to particular antigens—or patches of
a microbe’s surface—either disabling the microbe or marking it for destruction
by macrophages.”
As if they had a mind of their own, macrophages also
participate in activities that are far from benign.
“Macrophages had been known
since the nineteenth century to gather at tumor sites….optimistically, one
might imagine that the macrophages were massing for an assault on the
tumor. Instead, it turned out that they
spent their time in the neighborhood of tumors encouraging the cancer cells to
continue on their reproductive rampage.
They are cheerleaders on the side of death. Francis Balkwill, one of the cell biologists
who contributed to the recognition of treasonous macrophage behavior, described
her colleagues in the field as being ‘horrified’.”
“The evidence for macrophage collusion
with cancer keeps piling up. Macrophages
provide cancer cells with chemical growth factors and help build the new blood vessels
required by a growing tumor. So
intimately are they involved with the deadly progress of cancer that they can
account for as much as 50 percent of a tumor’s mass. Macrophages also appear to be necessary if
the cancer is to progress to its deadliest phase, metastasis, and if a
cancerous mouse is treated to eliminate all its macrophages, the tumor stops
metastasizing.”
This type of behavior was first recognized in the case of
breast cancer, but it has since been observed in other cancers.
“Breast cancer is not the only
form of cancer that depends on macrophages for access to blood vessels and
hence metastasis to new sites in the body.
So far, there is evidence that macrophages assist in the metastasis of
lung, bone, gastric, and other cancers.”
Where there is inflammation, macrophages will congregate
for the or the bad. Macrophages are now recognized as the cells most involved
in the production of plaque which contributes to atherosclerosis.
“Many pathological or at least
annoying conditions, from acne to arthritis, arise from inflammation. And inflammation,
which involves a variety of leucocytes, is spearheaded by macrophages….At a
later stage in the human life cycle, we find macrophages involved in
arthritis and diabetes, as well as
chewing away at living bones to produce osteoporosis.”
Ehrenreich does not pretend to provide a complete
description of all the immune system features, nor even just the roles played
by macrophages. She does provide enough
information to make one wonder about the wisdom of the common advice to do
whatever is possible to strengthen one’s immune system as a counter to disease.
Her goal was to convince the reader that his or her body
is not a well-tuned machine that only needs to be maintained in order to
continue to run healthily. Health can be
something we have no control over. And
as we age the effort to maintain health can be so intrusive in our lives that
it detracts from our ability to enjoy the time we have left. She provides this advice.
“I hope this book will encourage
you to rethink the project of personal control over your body and mind. We would all like to live longer and
healthier lives; the question is how much of our lives should be devoted to
this project, when we all, or at least most of us, have other, often more
consequential things to do.”
“You can think of death bitterly
or with resignation, as a tragic interruption of your life, and take every
possible measure to postpone it. 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.”
The interested reader might find the following articles
informative:
No comments:
Post a Comment