Deadly Biocultures offers a timely and provocative contribution to the rich literature on biopolitics from which it draws. Ehlers and Krupar provide unique examples and deep engagement with a wide array of American biocultures, or the "cultural spheres where biomedicine extends beyond the formal institutions of the clinic, the hospital, the lab, and so forth and is incorporated into broader social practices and rationalities" (1). Their writing expertly balances theoretical engagement with grounded explanations, making it both accessible and insightful and an obvious addition to any course syllabus delving into the relationships between life, death, discourse, and power.

At its core, Deadly Biocultures is about challenging binaries using the inherent contradictions found within the myriad manifestations of those binaries in US biocultures. Ehlers & Krupar first and foremost challenge the binary of life and death, beautifully illustrating countless examples of how projects of life-making produce, hasten, individualize, and obscure death. They thoughtfully push the reader to consider novel examples of how efforts to make life for some, kill (in the Foucauldian sense) others. In the process, they also upend binaries of self/body, just/unjust, control/chaos, good/bad, healthy/unhealthy, normal/abnormal, natural/unnatural, and productive/unproductive.

In the book's first chapter, Ehlers and Krupar trouble what they term the affect of hope, illustrating how narratives of hope related to breast cancer transcend the scale from an individual's hope for remission to a communal hope for a cure. Given the attention that the search for a cure is made to demand, considerably less energy is put into researching environmental exposure to carcinogens and social justice action that holds those corporations producing carcinogenic toxins responsible for environmental cleanup (particularly in already marginalized communities). Ehlers and Krupar thus argue that the affect of hope circumscribes both research and action. What is more, they present a clear case for how such narratives of hope responsibilize individuals to maintain a hopeful affect throughout treatment and invisibilize those diagnosed with 'terminal' cases.

In the second chapter, Ehlers and Krupar turn their attention to the racialization of medicine in the United States, using the examples of race-targeted pharmaceuticals and 'medical hot-spotting,' or the targeting of individuals and communities with high healthcare usage/costs. Ehlers and Krupar present a well-argued case for how such race-targeted practices reaffirm the racial Othering of non-white individuals, extract the healthcare needs of minorities from the conditions of structural racism that contribute to those needs, and ultimately financialize race. While such pharmaceuticals and interventions make life for some Black individuals, they fail "to cultivate nonwhite futures," instead securing "minority status as nonfuturity" (64).

Ehlers and Krupar then turn their attention toward the medicalization, pathologization, and commodification of fat and fatness, highlighting how "the affirmation to thrive can curtail life and be deadly" (89). In response to the moral panic over obesity, biocultural and biomedical weight loss 'solutions' framed as assisting fat individuals to thrive, or 'live more,' can detract from users' quality of life and, in extreme cases, kill. At the same time, Ehlers and Krupar highlight the ambiguity of such framings of fat as excess waste by pointing to the discovery that stem cells can be extracted from fat tissue, thus reframing fat as a potential source of biovalue. As such, Ehlers and Krupar argue that "fat has no ontological status" (72), but rather that its meaning shifts with its location (both where on the body it is and whether it is on the body).

In their fourth chapter, Ehlers and Krupar direct readers toward the normative project that is 'securing against' aging. As US culture has increasingly tied aging to the economic cost of supporting the elderly population, Ehlers and Krupar point to the contradictions between the cultural emphasis on 'longevity at any cost' and guarding against those costs (both financial and social) by staying physically active, mentally sharp, and 'aging well.' Once again, we see Ehlers and Krupar's careful attention to scale as they highlight the tensions that arise as we shift between the individual and the national scales, and their astute attention to the multiplicity of death (social death, physical death, mental death, economic death).

Finally, Ehlers and Krupar explore the growing trend toward greening the "disposal and commemoration of human remains" (135). The decision of what happens to our bodies after we die becomes a site through which privileged people can affirm their lives as afterlife. Ehlers and Krupar ask us to consider how practices such as the breaking down and recycling of body parts so as to leave 'no remains' or the bioremediation of dead bodies privatizes and obscures "the labor of handling and disposing of the dead" (150), ignores a long history of biopiracy and exploitation of bodies of people of color "to support white life" (152), legitimizes austerity measures that have cut funding to support burial services for the poor, recodes the body as natural in ways that discount the "noncompostable and even hazardous body parts" (154) that make up our sociotechnical modern bodies, and overlooks the inequalities and social status of the living that are reflected in burial practices.

In a clear effort to move beyond critique, Ehlers & Krupar conclude each chapter by highlighting possible futures, cultural phenomena, and social trends that resist the dominant narratives that are the subject of their critique. They consider how breast cancer patients might hope for other things (help paying medical bills, acceptance of death, etc.), the work that Black Lives Matter die-ins do, how acknowledging pleasure as an expression of health disrupts the pathologization of fatness, the cohousing movement as a site of resistance, and how to "accept the living and dead as cobelonging" (159). Not only do they direct the reader to these thought-provoking examples, but they expertly model this refusal of binaries in their bringing into conversation diverse sites of comparison that transcend and disrupt the life/death dualism. What is more, Ehlers & Krupar offer up a suggested response. They direct the reader to sit with death, to match mourning with critique, and to build care practices that enable them to attend to their own needs and those of others. In so doing, they leave the reader with a sense of possibility and purpose.

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Copyright (c) 2021 Skye Naslund

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