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.