In the thirty years since the Chernobyl disaster we have learned a great deal about the causes of the accident, the human side of the story of those who worked at the station, the operators and their families in the now-abandoned nearby town of Pripyat, the hundreds of thousands of “liquidators,” and the millions of individuals affected by fallout, including some 300,000 who were evacuated from various exclusion zones and heavily affected rural areas, mostly to the north and east in (Soviet) Belarus, Ukraine, and small parts of Russia. What are the long term consequences of radioactive fallout to land and living things? How many people have and will die from exposure to radioactivity? In Manual for Survival, Kate Brown documents the efforts of scientists and doctors in Belarus and Ukraine to understand the short- and long-term impact of radiation exposure on Soviet and post-Soviet citizens, and the challenges even to simple data collection. Her conclusions stand in stark contrast to those of the International Atomic Energy Agency (IAEA), the World Health Organization (WHO), and the United Nations (UN) Scientific Committee on the Effects of Atomic Radiation that estimated perhaps 5,000 total deaths. The numbers will be much higher, perhaps on the order of 10,000 or 50,000 excess cancers and premature deaths. But we shall never know with certainty owing to a variety of factors—including the challenges of conducting research in the former Soviet Union, the obfuscation of data in some quarters who appear to seek to minimize the impact, and scientific uncertainty itself.