Much has been written about the strengths and flaws of Chernobyl—the HBO miniseries nominated for 19 Emmys that chronicles the catastrophe at the eponymous Russian nuclear power plant in 1986. In the mind of this reviewer, it’s a riveting if sobering television gem, and highly recommended. And to this newly enlivened debate over nuclear power we can now add Kate Brown’s book, Manual for Survival: A Chernobyl Guide to the Future, a tour de force about the radiological aftermath of the Chernobyl disaster. A science historian at the Massachusetts Institute of Technology, Brown peels away the layers of long-held mythologies—that in the end, the accident only killed 54 people, and that “radiation phobia” among the people who sustained heavy radioactive fallout was a bigger problem than any of the other health outcomes.

Brown, who is conversant in Russian, devoted years to extensive archival research (much of which was scattered and hidden from official attempts at confiscation). She conducted interviews with villagers, military officials, factory workers, medical doctors, Soviet nuclear experts, emergency responders, KGB operatives (who assumed control over much of the data from the accident), and international nuclear safety and radiation health experts. The result is a rich and deeply disturbing picture of the environmental perils of extensive and lasting nuclear contamination.

She digs prodigiously, much to the disfavor of defenders of nuclear power, into the widespread practice of secrecy and deception regarding the radiological harm from elevated, long-term, chronic exposures. All told, the accident required some 600,000 emergency responders and remediation workers, 75 percent of whom worked in highly contaminated areas. About 336,000 people were permanently evacuated, whereas about five million people still live in areas of elevated long-term contamination. Other than a major war, there are few, if any, technological mishaps that can hold a candle to the consequences of a major power-reactor accident. Former Soviet leader Mikhail Gorbachev admitted as much in 2005, when he declared that the Chernobyl accident was the crowning blow to the collapse of the Soviet Union.

If official public denial of extensive land contamination hazards didn’t work, Brown points out, there was always demotion, firing, funding cuts, and even imprisonment for those who didn’t go along with the official line of minimal harm. Experts in the World Health Organization, the International Atomic Energy Agency, the Red Cross, and the U.S. National Cancer Institute aided and abetted this cover-up in favor of gross and generalized assumptions designed to provide public reassurance that the worst was over.

Brown points out that Chernobyl was among the worst in a long continuum of several Soviet nuclear disasters and mishaps—the most recent being an explosion of a suspected nuclear-powered cruise missile under development, this past August, which killed seven people. Ironically, as a result of these numerous and severe nuclear accidents, the Soviet Union had developed a more sophisticated medical expertise in the treatment of victims of exposure to radiation than the United States.

The cadre of Soviet doctors who worked for the secret nuclear weapons program were saving lives and were kept out of sight. Instead, the Soviet leadership was happy to trot out Dr. Robert Gale, an American expert on bone-marrow transplants from UCLA. With the aid of American oil baron Armand Hammer, who had close ties to the Soviet Union, Gale was able to perform risky medical procedures not permitted in the United States, which were later found to do more harm than good. “They used him in their public relations management of the disaster,” says Brown, who argues that Gale fed misinformation to a starved media and diverted attention away from the failure of the Soviets to deal with the overwhelming problem of radioactive fallout. “Gale stood as a symbol of the superiority, ingenuity, and initiative of Western, capitalist medicine over the supposed inherent shortcomings of socialist medicine,” says Brown. “That false impression persisted and deepened in the coming years.”

The condescending myth of American medical superiority was used effectively to dismiss alarming data emerging from the contaminated areas as poor science. Much of the effort by the WHO, the IAEA, and the Red Cross was spent discouraging local-based health studies. Their presumptive arrogance went so far as to note that radiation phobia engendered by “bad science” was a bigger health problem than widespread and often intensive land contamination. “Scientists who were attributing various biological and health effects to radiation,” the international organizations concluded, “might themselves be causing significant psychological harm to the very people they were attempting to help.”

With a few exceptions, while officially sanitized radiation dose data was accepted as gospel without any challenge to its credibility, the U.N. – and American-sponsored experts turned a blind eye to several very serious areas of contamination. Fallout from the accident created several large “hot spots” whose dangers were enhanced by local environmental conditions. For instance, Brown visited a wool-gathering station in Belarus, where women employees were so severely exposed, they were officially designated as “liquidators” (emergency responders and cleanup workers) after the accident. Tens of tons of the wool, hand-sorted by the women, were so radioactive that they caused radiation burns and were buried as radioactive waste. Many of the women died within a few years.

By contrast, the U.N. Scientific Committee on the Effects of Atomic Radiation reported in 1992 that radiation doses were so low in the path of the fallout that it would be impossible to see any harmful effect (above the normal rates). This conclusion was based on dubious dose estimates and theoretical extrapolations from the experience of Japanese atomic bomb survivors, who were still alive five years after the bombings, in October 1950. Unlike people exposed to years of chronic, fractionated doses from Chernobyl fallout, the Japanese survivors received a single, short-term burst of tissue-damaging high-dose radiation from the atomic bomb explosions.

Brown ably confronted one of the study’s main authors, who “forgot” to include powerful evidence of a big jump in childhood thyroid cancers, which he found to be credible when he received it personally from Belarusian scientists, well before completing the 1992 study.

Now, after more than 30 years, U.N.-sponsored researchers have backed away from the 1992 UNSCEAR study by concluding that “studies of clean-up workers/liquidators suggest dose-related increases of thyroid cancer and hematological malignancies in adults,” as well as “increases in cardiovascular and cerebrovascular disease. If confirmed, these would have significant public health and radiation protection implications.”

Then there were the deliberately created large-scale hot spots. Belarus was especially impacted after the Soviets deployed cloud-seeding aircraft to prevent deadly Chernobyl fallout from reaching Moscow and other cities in Europe during the May Day parades. As much as 90 percent of the radioactivity from fallout could be deposited by a thunderstorm. The aircraft were so heavily contaminated that ground crews fled after their radiation instruments went off-scale. Several of the air crew suffered early deaths. In 2006, a former Soviet colonel, in charge of dealing with heavily contaminated areas near the exploded reactor, told me that “acts of barbarism were necessary” because the Kremlin considered Chernobyl to be a “war on Mother Russia.”

“No one told the Belarusians that the southern half of the republic had been sacrificed to protect Russian and Ukrainian cities,” Brown observes. “In the path of the artificially induced rain there lived several hundred thousand Belarusians.” In 1998, after he and his wife published findings showing a correlation between heart disease in children in Belarus and their exposure to radioactive cesium from Chernobyl, Dr. Yuri Bandazhevsky was arrested and imprisoned, initially for treason. Bandazhevsky had been the director of the Gomel medical school, located in southeastern Belarus, in an area that bore the brunt of the radioactive fallout from the cloud seeding. He spent eight years in jail and was released after several European charities waged a campaign for his freedom. None of the experts working for the WHO, the IAEA or the Red Cross objected to the heavy-handed violation of Bandazhevsky’s basic rights as a physician and scientist.

In the United States, the Chernobyl disaster underscored the hazards of our own nuclear programs. Unlike the commercial nuclear power industry, the U.S. nuclear weapons complex includes a host of one-of-a-kind facilities, many built 50 to 70-plus years ago. Over the decades, like its Soviet counterparts, each Energy Department site in the complex created its own unique culture, shaped by secrecy, isolation, and the demands of the Cold War nuclear arms race.

And in the context of U.S. nuclear power production, the design flaw that led to the Chernobyl reactor explosion was well known, dating back to the Manhattan Project in 1942. Described as a “positive void coefficient,” the weakness was associated with graphite-moderated, water-cooled reactors, in which excessive steam buildup, combined with a corresponding loss of water, could lead to catastrophic surges in power. At the first production reactors at Hanford, Washington—which shared the same basic design as the Chernobyl plant—the issue was considered a serious potential safety flaw even before they were built. “There was not much we could do about this,” said Alvin Weinberg, the administrator at Oak Ridge National Laboratory during and after the Manhattan Project, “except to try to ensure that water cooling never failed.” He later noted, “No one dared to think of the consequences of a complete failure of the cooling.”

By February 1954, members of the Atomic Energy Commission’s Advisory Committee on Reactor Safeguards reported that “the potential disaster [from reactors] at Hanford has been increasing.” Serious consideration was given in 1954 to breaching the massive Grand Coulee Dam “in the event of a foreseeable loss of cooling water.” These inherently dangerous plutonium-production reactors at the Energy Department’s Hanford site operated for 20 years before they were shut down in the 1960s. Unfortunately, the Soviet Union was unaware or did not appreciate the severe nature of this problem until it was too late.

As Brown reports, despite official efforts to stall and otherwise suppress a timely study of childhood thyroid cancers correlated to Chernobyl and the spread of airborne fallout, Keith Baverstock, a WHO scientist, found the data collected by Belarusian doctors to be compelling. Of particular concern was iodine-131 (I-131). With a half-life of eight and a half days, I-131 is among the more abundant fallout constituents and is rapidly absorbed and concentrated in milk. It was definitively linked to nodules and cancer among the people on the Rongelap and Uterik Atolls of the Marshall Islands who had been exposed to heavy fallout from U.S. H-bomb tests. The Belarusian scientists carefully documented a 50-fold increase in thyroid cancers among children, with the most coming from the highly contaminated zone of Gomel.

In early 1992, Baverstock called for a fact-finding mission by the WHO, which was soon canceled by the European Commission and the NCI. But Baverstock, with the aid of a private donor, went forward with the mission, despite the explicit threat of losing his job with the WHO. By September, Baverstock and his colleagues published a letter on their findings in the scientific journal Nature, in which they concluded, “the consequences to the human thyroid, especially in fetuses and young children, of the carcinogenic effects of radioactive fallout is much greater than previously thought.” So after more than 30 years, U.N.-sponsored researchers concluded that thyroid cancer following childhood exposures to I-131 “has now been shown to persist for decades.”

The United States’ involvement with the Chernobyl aftermath was shaped largely, and shamefully, by the desire to avoid potential legal liabilities associated with the 166 U.S. open-air nuclear weapons tests in Nevada and the Marshall Islands. At the time of the Chernobyl accident, compensation radiation claims for injuries and deaths from bomb testing were looked upon by the nuclear weapons program as a dagger aimed at the heart of U.S. national security. This reality was driven home at a meeting of the Health Physics Society, which my wife, Kitty Tucker, the public interest lawyer and environmental activist, and I attended a year after Chernobyl. The main speaker was an attorney from the Energy Department, who gave a speech entitled, “Radiation: The Offense and the Defense.” He prefaced his presentation, in a room filled with nuclear industry employees, by flatly stating “this is the party line,” and then proceeded to expatiate on how successful radiation compensation claims would seriously curtail nuclear weapons, nuclear power and nuclear medicine. He then introduced the group to a U.S. Department of Justice litigator, who was to lead workshops sponsored by the society to train health physicists to become expert witnesses against claimants.

In 1982, after congressional investigations revealed willful negligence and deception about the dangers of fallout from the Nevada tests, the U.S. Congress authorized the NCI to assess the impact of radioactive iodine throughout the United States. The NCI was given this task because of concern over the monopoly control of radiation health research by the nuclear weapons industry. However, by 1983, the study was under the supervision of Bruce Wachholz—who had left his job at the DOE weapons program as a manager of the Marshall Islands medical follow-up studies and legal adviser against radiation damage claims filed by people downwind of the Nevada Test Site. Wachholz would later be given control over a major NCI study of the impacts of radioactive iodine from Chernobyl.

While working as a senior official in the Energy Department in June 1997, I learned of the NCI fallout study and received a briefing from the NCI researchers. At the meeting, as I pored over pages of color-coded maps of the United States, I found there were widespread and alarming exposures, especially to children, as far away as upstate New York. After noticing the briefing document was dated September 1992, indicating dose reconstruction had been completed five years earlier, I asked why the NCI had been sitting on this report for such a length of time. I was told the NCI was waiting for the results from its own Chernobyl study, which was also being “slow-walked.” Later my suspicions were confirmed by a colleague who worked with Wachholz and quit in frustration over long delays, saying that “Bruce was convinced if they just sat on the fallout study, it’d never get out.”

I and several others made sure that it got out. Eventually, after a Senate investigation in September 1998, the NCI conceded that the fallout study had been withheld from the public and that tens of thousands of Americans probably contracted thyroid cancer from milk contaminated by A-bomb fallout from explosions at the Nevada Test Site. Wachholz was singled out by Senate investigators for delays and mismanagement of the U.S. fallout and Chernobyl thyroid cancer studies.

Kate Brown eventually makes it clear that the biggest radiological catastrophes contaminating the Earth were deliberately perpetrated in order to test nuclear weapons in the open air. The U.S. and Soviet Union exploded the major preponderance (85%) of a total of 520 atmospheric nuclear weapons tests, contaminating the Northern Hemisphere with long-lived and poisonous radioactive debris that far exceeds that of Chernobyl and all other nuclear accidents. For instance, at a secret meeting in November 1954 of the Atomic Energy Commission’s General Advisory Committee, experts “cautioned against the use of milk in heavily contaminated areas” in the United States, following six large, recent H-bomb explosions in the Marshall Islands. But no public warnings were given. The six tests, which dwarfed the combined releases from Chernobyl and Fukushima, raised global background radiation levels 10 to 20 times. Hot spots 5,000 miles away in the United States showed radiation levels as much as 200 times greater than normal background.

The painful lesson from Brown’s indispensable book and HBO’s engrossing miniseries is that when it comes to nuclear weapons and energy programs, governments, by accident or design, have been willing to send their people into harm’s way with impunity.

A senior scholar at the Institute for Policy Studies, Robert Alvarez served as senior policy adviser to the Energy Department’s secretary and deputy assistant secretary for national security and the environment from 1993 to 1999. During this tenure, he coordinated the Energy Department’s nuclear material strategic planning and established the department’s first asset management program.