Friday, May 17, 2013

Book Review: ALL NATURAL by Nathanael Johnson

I reserved our public library's copy of this book because the author is a friend of a friend, who told me I might like it.  Here's the verdict: I do!  I like it immensely!  I am thinking of buying a copy for my mother, since she would also enjoy it!

(Nobody paid me anything to write this.  I sent the author a message once, but we are largely unacquainted.)

The book starts out with a very amusing recounting of the author's childhood, being raised by wolves radical back-to-nature types.  (They make my mother's Vegetarian Nut Loaf look positively mainstream.)  He meets his future wife, the daughter of a surgeon, and they marry and are soon expecting a child, at which point we segue into a chapter on birth in America.

I could have written this chapter.  My favorite line: "I was looking for something more like No Nonsense Evidence-Based Midwifery." Ah, Bug's midwives, of "a zero-transfer C-section rate is unrealistic and dangerous" fame!  He goes into the statistics of C-sections, maternal morbidity and mortality, and ensuing complications carefully, in detail, and in a very understandable manner - and also talks about the bad outcomes that can happen in the absence of medical care, and the fine line between lifesaving interventions and overcautious practices that harm patients (like routine continuous fetal monitoring).

The next chapters are about raw milk, nutrition, vegetables, sugar (really, doesn't affect immunity; nicely dissected and taken down, with a fine understanding of the phrase "There is no evidence."), pork farming, immunity, vaccines, the environment.  These subjects are all handled delicately and in a very neutral manner with no proselytizing.  

The last chapter is about medicine, and how to balance lifesaving treatments with unnecessary testing and intervention.  The author shares an anecdote from his mother, who intelligently researches a possible hepatitis infection, and insists on a second test because the first one has a high false-positive rate.  He also relates his own bout of appendicitis.  He talks about primary care, emergency medicine, and end-of-life care, our problems with dealing with the root causes of... well, everything - and one of medicine's great failures, that of treating the symptoms. The last chapter is a nice bookend to the first- C-sections and suicides, birth and death.

There are 19 pages of closely-spaced endnotes.  A lot of research went into this book.  I would like to add I've found no inaccuracies in this book, which is high praise from this pedantic, proofreading-maniac of a scientist.  In some cases, I would perhaps have liked to see a stronger opinion come through (if you want to read about vaccines go look up Andrew Wakefield's financial interest in scaring people, and the reasons for his medical license being revoked in Great Britain).  Some subjects could perhaps use a bit more depth; for example, the author talks about  the 'immunity hypothesis', that more dirt and germs prevent autoimmune disease, and cites the rise of things like asthma in developed countries-  but he doesn't mention the role of pollution, or of cheap and accurate sequencing in diagnosis. On the other hand, there's only so many pages in a book, and the author clearly doesn't want to be prescriptive or evangelical.  He is leading you through his journey of exploration.  

If you have a friend who thinks that ridiculous, stupid, inaccurate, dangerous Sears book is the gospel, this will not convince him or her.  If you know someone who has an actual inquring mind - especially people who are not trained as scientists- this is perfect.  As for you, dear readers, you should all go read it immediately.


* Did you know this strain has a stable plasmid with a horizontally-transferred Shigella toxin, which binds to ribosomes, and that's why it's so toxic?  I wrote a paper about it in college.

7 comments:

  1. I want to read it RIGHT NOW. Also, I wish to lend a copy to my lovely, intelligent, yet misguided about certain things friend. I believe she is open to changing her mind on some issues.

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    1. One can only hope! It really is a very gentle, thoughtful exploration of science and 'all natural' options. She might even enjoy it.

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  2. I wish this had been out (and I had found it) when I was pregnant with my first. I also wish I could give it to my local ICAN chapter.

    With my second I was hoping for a VBAC and joined my local ICAN (International Cesarean Awareness Network) chapter to get some leads on practices that were VBAC friendly.

    They were all like- have a home birth. Here's the name of a traveling midwife who will live with you for the last month of your pregnancy and deliver your baby. Or have a home birth- I had a HBAC after 3 c-sections! My acupuncturist who was treating my infertility knew I was pregnant before I even tested positive and then turned my breech baby with I was 40 weeks pregnant.

    All manner of craziness. I had to leave there was so much ridiculous, dangerous pseudoscience. I really was never able to convey to them that I was fine with a repeat c-section, I just wanted to be sure it was a necessary surgery.

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    1. I know people who have had home breech births. This is well beyond my tolerance- as would be a home birth after C-section - because, as you know, when things go wrong in these situations, which they do at a higher rate than in other, low-risk situations - they really need an OR. Now. Five minutes ago.

      A friend of mine was trying for a VBAC and joined some local thing but they were more like... here are the risks! Here are good times to call it quits! Here is support! Here are doctors who will be willing to try this with you and will, in fact, not recommend a C-section until it is medically indicated. (She ended up having a C-section; the baby was over a week late and starting to show signs of distress during labor.)

      I... just can't even start with the idea that "I did it and it was fine" is a sufficient reason. It's like when people say "Oh, the doctors found it just in time/ I had a funny feeling and went to the ER/ I got a headache and it was an aneurysm, so lucky I was near a hospital." Yes. Because the unlucky people are now DEAD. Sample bias much?

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    2. Yes. They were trying to convince me to try for a home birth. I didn't want to say, I think you all are reckless to try. So, I went with, "You know how important it is to feel safe and supported during labor- I just don't think I'd be able to relax and feel safe at home. I'd worry too much."

      When I wound up with a repeat C-section after 7.5 hours of active layer only got me to 1cm dilated, I'm sure they were all thinking, "Told you so. Should have birthed at home."

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  3. I found your blog from a comment you left on The Egg Timer, and I'm excited to read along!

    I'm a PhD organic chemist (specifically a 'natural products chemist', which leads people to make all kinds of incorrect assumptions about what I do!)

    Thank you for this book recommendation! It looks to be right up my alley. I am often trying (usually unsuccessfully) to find well-reasoned and researched arguments regarding various back-to-nature arguments. In their absence, I typically follow whomever strikes me as less annoying (usually, but not always, the mainstream Western medicine types).

    Another book that struck me as granola, but with well-reasoned and scientifically-sound arguments was Animal Vegetable Miracle by Barbara Kingsolver. I also really liked Michael Pollan's books...

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    1. Hello! I used to do total synthesis of natural products so I know EXACTLY what you mean... and yeah, I can only imagine. SIGH.

      My uncle knows Barbara Kingsolver in person - they are neighbor-ish- and his description of her as a person, especially her self-righteous hobby farming, have rather put me off. If I ever manage to put it from my mind, however, I will take your doubtless excellent recommendation!

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