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In 2007 a seven-year-old boy came into Nadine Burke Harris’s new clinic in Bayview–Hunters Point, San Francisco, with the height of a four-year-old. He had stopped growing at four, the year he was sexually abused. Burke Harris, a paediatrician born in Vancouver in 1975, went looking for an explanation and found the 1998 Adverse Childhood Experiences (ACE) study by Vincent Felitti and Robert Anda, which linked childhood abuse, neglect and household dysfunction to heart disease, cancer and early death decades later. She built a screening and treatment practice on it, gave a TEDMED talk about it in 2014, and in 2019 became California’s first Surgeon General. This guide covers her one book: what it is about and where to begin.
By Lisanne Swart · 1 key book · 2018–2018 · Updated October 2026
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Quick answer
Nadine Burke Harris has written one book: The Deepest Well: Healing the Long-Term Effects of Childhood Adversity (2018), about how adverse childhood experiences (ACEs) change the body and raise the risk of disease in adulthood. In the UK it was reissued in 2020 as Toxic Childhood Stress. Start there; her 2014 TEDMED talk is a 16-minute introduction to the same argument.
Where to Start with Nadine Burke Harris
If you are new to the research on childhood adversity
→ The Deepest Well (2018) — the ACE study and the stress response, explained through her patients.
If you are a parent or caregiver
→ The Deepest Well (2018) — read Part 3, “Prescription”, on sleep, exercise, nutrition, mindfulness, mental health care and healthy relationships.
If you work in medicine, education or social work
→ The Deepest Well (2018) — the Bayview clinic’s screening model and its limits.
Nadine Burke Harris’s Book
The Deepest Well
Burke Harris tells how her patients at the Bayview Child Health Center in San Francisco, starting with Diego, a seven-year-old who had stopped growing after being abused at four, led her to the 1998 ACE study and to the biology of toxic stress: a stress response that is switched on so often, like “living with a bear”, that it damages the body. The book is in four parts, Discovery, Diagnosis, Prescription and Revolution, and includes her own family history and the founding of the Center for Youth Wellness in 2012. Houghton Mifflin Harcourt published it in January 2018; in the UK, Bluebird reissued it in 2020 as Toxic Childhood Stress.
How to Read The Deepest Well
There is only one book, and it builds in sequence: the first two parts set out the science through Diego and other patients, the third gives the practical “prescription” and the fourth argues for changes in medicine and public policy. Readers who want the practical side can go to Part 3, but the earlier chapters explain why it works.
If you would like to test the argument before committing to a whole book, watch her 2014 TEDMED talk first. Afterwards, read her alongside the critics of ACE screening, such as Bruce Perry, who share her view of childhood adversity but not her case for a questionnaire.
A reading path
1. Her TEDMED talk (2014)
2. The Deepest Well (2018)
3. Part 3, “Prescription”, again as a reference
The years · 1975–2023
Quick facts about Nadine Burke Harris
- Known for
- Making the link between adverse childhood experiences and adult disease part of routine paediatric care, first at her Bayview clinic and then as California’s first Surgeon General.
- 1975
- Born in Vancouver, Canada
- 2007
- Founds the Bayview Child Health Center
- 2018
- The Deepest Well
- 2023
- David G. Nichols Health Equity Award
- Born
- 5 October 1975, Vancouver, British Columbia; of Jamaican heritage, raised in California from the age of four
- Education
- BA, UC Berkeley (1996); MD, UC Davis (2001); MPH, Harvard
- Clinic
- Founding physician of the Bayview Child Health Center, San Francisco (2007)
- Founded
- Center for Youth Wellness, San Francisco (2012)
- Office
- First Surgeon General of California, February 2019 to February 2022
- Honours
- Heinz Award (2016); David G. Nichols Health Equity Award, American Pediatric Society (2023)
The red mark is 2018: The Deepest Well, her only book.
How Nadine Burke Harris Writes: The Clinic First
Burke Harris writes like a doctor presenting cases. Each idea arrives through a patient: Diego, who stopped growing at four, and other children at the Bayview clinic whose asthma, weight or behaviour did not respond to standard treatment. Only then does she turn to the research, mainly the 1998 ACE study by Vincent Felitti and Robert Anda among more than 17,000 Kaiser Permanente patients.
She explains the biology in plain images rather than jargon. The best known is the bear in the forest: the stress response that saves your life if you meet a bear once, and harms you if the bear comes home every night. She also writes about herself, including her mother’s untreated mental illness, her brother’s stroke and a pregnancy loss, which keeps the book from reading like a report about other people.
The book is also an argument for policy, which is what she went on to do as Surgeon General: routine screening, trauma-informed care and treatment in the doctor’s office. For writers who work on the same ground, from Bessel van der Kolk to Gabor Maté, see Authors like Nadine Burke Harris.
Watch
How childhood trauma affects health across a lifetime
Burke Harris’s TEDMED talk of September 2014, published on TED’s channel, sets out the argument of The Deepest Well four years before the book.
Frequently asked questions about Nadine Burke Harris’s books
How many books has Nadine Burke Harris written?
One: The Deepest Well: Healing the Long-Term Effects of Childhood Adversity (2018). The UK reissue Toxic Childhood Stress (2020) is the same book under another title.
How many books has Nadine Burke Harris written?
There is only one so far: The Deepest Well, published in January 2018 by Houghton Mifflin Harcourt.
Where should I start with Nadine Burke Harris?
With The Deepest Well. If you want a shorter introduction first, watch her TEDMED talk from 2014, “How childhood trauma affects health across a lifetime”.
What is Nadine Burke Harris’s most famous book?
The Deepest Well (2018), her only book. Her 2014 TEDMED talk is at least as widely known; Wikipedia counted more than 7.2 million views by June 2020.
What is The Deepest Well about?
How adverse childhood experiences, such as abuse, neglect or growing up with a parent who has a mental illness or addiction, keep the body’s stress response switched on, and why that raises the risk of heart disease, cancer and other illness in adulthood. It also covers screening and what helps: sleep, exercise, nutrition, mindfulness, mental health care and healthy relationships.
Are The Deepest Well and Toxic Childhood Stress the same book?
Yes. Bluebird, an imprint of Pan Macmillan, reissued The Deepest Well in the UK on 25 June 2020 as Toxic Childhood Stress, noting that it was “previously published as The Deepest Well”.
Was Nadine Burke Harris the first Surgeon General of California?
Yes. Governor Gavin Newsom appointed her in January 2019 and she was sworn in on 11 February 2019. She stepped down in February 2022, saying she wanted to focus on her family.
Did Nadine Burke Harris discover adverse childhood experiences?
No. The ACE study was published in 1998 by Vincent Felitti and Robert Anda, based on Kaiser Permanente patients. Burke Harris read it after 2007 and applied it to children, through screening at her Bayview clinic and the Center for Youth Wellness she founded in 2012.
Is ACE screening controversial?
Partly. Under Burke Harris, California launched ACEs Aware in January 2020, paying Medi-Cal providers to screen patients. Robert Anda, a co-author of the original ACE study, wrote that the questionnaire was designed for research and that an individual score is not a reliable diagnostic tool; Bruce Perry and others called it too simple for individual care. Burke Harris replied that the tools were tested and that not screening means waiting until children are badly harmed.
Is Nadine Burke Harris still alive?
Yes. She was born on 5 October 1975 in Vancouver, Canada.
Footnotes
- Nadine Burke Harris — Wikipedia
- Toxic Childhood Stress — Pan Macmillan
- Nadine Burke Harris: The Deepest Well — Paul & Daisy Soros Fellowships, 2018
- California’s first surgeon general resigns — EdSource, 2022
- Painful questions: critics question California’s universal ACEs screening — The Imprint, 2020
- TED Talk: How childhood trauma affects health across a lifetime — Office of the California Surgeon General
Bibliography last verified 9 October 2026. Where sources give different first-publication years, this page uses the year in library catalogues or the publisher’s own record.
This list was not put together by a machine.
The notes are all mine,
and the books are all his.
Lisanne x
Written by Lisanne Swart, who has curated reading lists and author guides at lisanneswart.com since 2021.
See more on her personal bookshelf.
“Childhood trauma isn’t something you just get over as you grow up.”
— Nadine Burke Harris, “How childhood trauma affects health across a lifetime”, TEDMED (2014)
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