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Book Review of: What You Don't Know Can Kill You:

A Physician's Radical Guide to Conquering the Obstacles to Excellent Medical Care

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Review of What You Don't Know Can Kill You, by Dr. Laura Nathanson (Paperback, May 2007)

Reviewer: Mark Lamendola, author of over 6,000 articles.

The medical industry in America has become bureaucratized. And like any bureaucracy, it's a collection of bloated processes and mismanagement. The whole point of it--to heal the patient--has ceased being relevant. The system gets in its own way, and patients often suffer needlessly and terribly because of that. What is a person to do? This book answers that very question.

Somewhere not long ago, I read that medical care per capita in America costs something like five or six times as much as in other industrialized nations. Like it or not, the medical care industry is big business in America. But it's big business cross-bred with bureaucracy--anyone who doubts this has never had to fill out the many "file it and forget it" forms that ask for the same information over and over.

It's also a business not run the professionals who are trained in its science. It's run by people mired in bureaucratic processes. Such processes defeat both progress and competence. Small wonder bureaucrats are also simply called parasites.

The constant "cost-cutting" conducted by insurance companies consists mostly of ways to cheat the insured. The various "small print" rules that defy logic combine with the sheer maze of Kafkaesque hurdles to leave patients twisting in the proverbial breeze. There may not be $500 available for preventing years of agony, but somehow there is always enough money for the staggering pay packages bestowed upon insurance company CEOs.

A new hope

In the middle of this mess comes a paperback guide written by a doctor. She doesn't prescribe how to cure our system of what ails it, but she does provide a way to reduce the symptoms. This guide can help a patient (or his/her care manager, such as a wife or husband) detect and correct medical errors before they spiral out of control.

Just how far out of control can they spiral? Dr. Nathanson related the story of Kim Tutt, who was diagnosed with cancer at age 34. A mother of two, Ms. Tutt was at first told she had only months to live. But hope sprang anew, when a surgical option presented itself. So she endured five surgeries to remove her lower jaw and teeth and rebuild that part of her face with bone from her lower leg. Not exactly a painless process.

Only after she had gone through this hell (with its irreversible disfigurement) did the fact emerge that slides from her biopsy (taken of a cyst under her gum, which was her original problem) had been contaminated with cells from someone else. Ms. Tutt never had cancer. It was all a mistake.

But if Ms. Tutt had a copy of this book, that mistake would have been averted. She would not have had those five surgeries. She would still have her jaw and teeth today.

What's inside

So, what's in this book? First, you have to understand that Dr. Nathanson lost her husband due to the very problems this book guides you through (or under, or over, or around). It provides guidance for other problems, as well.

Dr. Nathanson is a widow because of defects in the medical system. But she is also an experienced pediatrician. As such, she has to be able to explain medical concepts to parents and their children. Her ability to do this is reflected in her clear writing style.

The book consists of four Parts. It also has a glossary plus an appendix that explains managed care. The introduction is more informative than the traditional fluff piece that often bears that title. Start this book by reading that introduction.

Part One contains nine chapters. Here, Dr. Nathanson takes us through the history of her husband's (Chuck) illness prior to his hospital stay. Threaded into the narrative are the lessons learned, plus supplemental information for people going through anything similar.

Part Two contains four chapters. We learn a little bit about Chuck's hospital stay, but the focus is on being a sentinel. That is, a guardian of the person undergoing medical treatments (especially if hospitalized). The question is one of how to do it correctly, so you are actually helping instead of being an additional burden to an already overworked hospital staff.

In Part Three, Dr. Nathanson discusses what happened after Chuck died. She also looks at the many opportunities there had been to prevent Chuck's death. She looks at how and why these were lost. And she provides solid advice on how to prevent a similar tragedy.

For many people, Part Four will be the core of the book. It contains handy worksheets and explanations of how to use them, so you can manage the medical care process from start to finish. It ties back to much of the information in Part One, thereby bringing us full circle.

Arm yourself

This guide will teach you how to read a medical chart and how to know when it contains disinformation instead of accurate information (this is actually a very common problem). You also learn exactly how to cut through the deliberate obfuscations and determine if the right questions have been answered, the right tests have been done, and if the right methodology is behind the diagnosis.

Misinformation, fuzzy logic, unclear statements, unsupported conclusions, and incomprehensible commentary on a medical chart are nearly always passed along without being identified. This is true for several reasons, which Dr. Nathanson discusses. This problem is not going to go away, so you have to step in and handle it.  This book shows you how to do that, and it shows you many other things as well.

Unless you know for sure you and everyone you love will never need medical care, consider this book a "must have."


Reviewer's background note: How we got here

It helps to understand why we are in our present mess. The way to unburden our overloaded medical system is for each individual to lead a healthy lifestyle, but that is an unrealistic expectation in America. Most people obsessively engage in the very behaviors that make them sick.

Examples include overeating, skipping real food in favor of highly processed grains, failing to exercise rigorously and often, keeping an inconsistent sleeping schedule, not allowing sufficient sleeping time, ingesting soft drinks, and frequently eating foods contaminated with hydrogenated oil.

Just look at how your local supermarkets are stocked, if you doubt that poor nutritional choices are normal. Why is the produce section so small relative to the rest of the food area of the store? The proportions should reversed. Almost every item in the typical shopping cart is a nutritional mistake. The percentage of shopping cart contents consisting of fresh fruits and vegetables usually ranges from abysmally low to zero. See how many people are buying beans (other than sugar-drenched "baked beans" or kidney beans in the can)--it's just as bad. People choose to be sick. It's abnormal to choose to be well.

It's also abnormal to take simple protective measures against injury. Try this experiment. Read the manual for a lawn mower. You will notice that it says to always wear safety glasses. It probably also says to wear hearing protection. Any time you must raise your voice to carry on a normal conversation, the noise level is high enough to cause permanent hearing loss. Yet, how many people do you see operating a mower with no safety glasses and no hearing protection?

Sadly, such behavior is the rule and not the exception. This mass obsession with becoming a patient in our medical system has hugely contributed to the high level of dysfunction that system now has, simply by overloading it on a massive scale. Since we can't cure the problem ("we have found the enemy, and it is us"), we have to figure out how to manage it. That's where this book comes in.

To reduce your personal dependence on our medical care system, read the free articles at



About these reviews

You may be wondering why the reviews here are any different from the hundreds of "reviews" posted online. Notice the quotation marks?

I've been reviewing books for sites like Amazon for many years now, and it dismays me that Amazon found it necessary to post a minimum word count for reviews. It further dismays me that it's only 20 words. If that's all you have to say about a book, why bother?

And why waste everyone else's time with such drivel? As a reader of such reviews, I feel like I am being told that I do not matter. The flippancy of people who write these terse "reviews" is insulting to the authors also, I would suspect.

This sound bite blathering taking the place of any actual communication is increasingly a problem in our mindless, blog-posting Webosphere. Sadly, Google rewards such pointlessness as "content" so we just get more if this inanity.

My reviews, contrary to current (non) standards, actually tell you about the book. I always got an "A" on a book review I did as a kid (that's how I remember it anyhow, and it's my story so I'm sticking to it). A book review contains certain elements and has a logical structure. It informs the reader about the book.

A book review may also tell the reader whether the reviewer liked it, but revealing a reviewer's personal taste is not necessary for an informative book review.

About your reviewer

  • Books are a passion of mine. I read dozens of them each year, plus I listen to audio books.
  • Most of my "reading diet" consists of nonfiction. I think life is too short to use your limited reading time on material that has little or no substance. That leads into my next point...
  • In 1990, I stopped watching television. I have not missed it. At all.
  • I was first published as a preteen. I wrote an essay, and my teacher submitted it to the local paper.
  • For six years, I worked as an editor for a trade publication. I left that job in 2002, and still do freelance editing and authoring for that publication (and for other publications).
  • No book has emerged from my mind onto the best-seller list. So maybe I'm presumptuous in judging the work of others. Then again, I do more describing than judging in my reviews. And I have so many articles now published that I stopped counting them at 6,000. When did I stop? Probably 20,000 articles ago! (It's been a while).
  • I have an engineering degree and an MBA, among other "quant" degrees. That helps explain my methodical approach toward reviews.
  • You probably don't know anybody who has made a perfect or near perfect score on a test of Standard Written English. I have. So, a credential for whatever it's worth.

About reading style

No, I do not "speed read" through these. That said, I do read at a fast rate. But, in contrast to speed reading, I read everything when I read a book for review.

Speed reading is a specialized type of reading that requires skipping text as you go. Using this technique, I've been able to consistently "max out" a speed reading machine at 2080 words per minute with 80% comprehension. This method is great if you are out to show how fast you can read. But I didn't use it in graduate school and I don't use it now. I think it takes the joy out of reading, and that pleasure is a big part of why I read.

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