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An Elegant Defense: The Extraordinary New Science of the Immune System: A Tale in Four Lives
A magnificently reported and soulfully crafted exploration of the human immune system–the key to health and wellness, life and death. An epic, first-of-its-kind book, entwining leading-edge scientific discovery with the intimate stories of four individual lives, by the Pulitzer Prize–winning New York Times journalist.
A terminal cancer patient rises from the grave. A medical marvel defies HIV. Two women with autoimmunity discover their own bodies have turned against them. Matt Richtel's An Elegant Defense uniquely entwines these intimate stories with science’s centuries-long quest to unlock the mysteries of sickness and health, and illuminates the immune system as never before.
The immune system is our body’s essential defense network, a guardian vigilantly fighting illness, healing wounds, maintaining order and balance, and keeping us alive. Its legion of microscopic foot soldiers—from T cells to “natural killers”—patrols our body, linked by a nearly instantaneous communications grid. It has been honed by evolution over millennia to face an almost infinite array of threats.
For all its astonishing complexity, however, the immune system can be easily compromised by fatigue, stress, toxins, advanced age, and poor nutrition—hallmarks of modern life—and even by excessive hygiene. Paradoxically, it is a fragile wonder weapon that can turn on our own bodies with startling results, leading today to epidemic levels of autoimmune disorders.
Richtel effortlessly guides readers on a scientific detective tale winding from the Black Plague to twentieth-century breakthroughs in vaccination and antibiotics, to the cutting-edge laboratories that are revolutionizing immunology—perhaps the most extraordinary and consequential medical story of our time. The foundation that Richtel builds makes accessible revelations about cancer immunotherapy, the microbiome, and autoimmune treatments that are changing millions of lives. An Elegant Defense also captures in vivid detail how these powerful therapies, along with our behavior and environment, interact with the immune system, often for the good but always on a razor’s edge that can throw this remarkable system out of balance.
Drawing on his groundbreaking reporting for the New York Times and based on extensive new interviews with dozens of world-renowned scientists, Matt Richtel has produced a landmark book, equally an investigation into the deepest riddles of survival and a profoundly human tale that is movingly brought to life through the eyes of his four main characters, each of whom illuminates an essential facet of our “elegant defense.”
A terminal cancer patient rises from the grave. A medical marvel defies HIV. Two women with autoimmunity discover their own bodies have turned against them. Matt Richtel's An Elegant Defense uniquely entwines these intimate stories with science’s centuries-long quest to unlock the mysteries of sickness and health, and illuminates the immune system as never before.
The immune system is our body’s essential defense network, a guardian vigilantly fighting illness, healing wounds, maintaining order and balance, and keeping us alive. Its legion of microscopic foot soldiers—from T cells to “natural killers”—patrols our body, linked by a nearly instantaneous communications grid. It has been honed by evolution over millennia to face an almost infinite array of threats.
For all its astonishing complexity, however, the immune system can be easily compromised by fatigue, stress, toxins, advanced age, and poor nutrition—hallmarks of modern life—and even by excessive hygiene. Paradoxically, it is a fragile wonder weapon that can turn on our own bodies with startling results, leading today to epidemic levels of autoimmune disorders.
Richtel effortlessly guides readers on a scientific detective tale winding from the Black Plague to twentieth-century breakthroughs in vaccination and antibiotics, to the cutting-edge laboratories that are revolutionizing immunology—perhaps the most extraordinary and consequential medical story of our time. The foundation that Richtel builds makes accessible revelations about cancer immunotherapy, the microbiome, and autoimmune treatments that are changing millions of lives. An Elegant Defense also captures in vivid detail how these powerful therapies, along with our behavior and environment, interact with the immune system, often for the good but always on a razor’s edge that can throw this remarkable system out of balance.
Drawing on his groundbreaking reporting for the New York Times and based on extensive new interviews with dozens of world-renowned scientists, Matt Richtel has produced a landmark book, equally an investigation into the deepest riddles of survival and a profoundly human tale that is movingly brought to life through the eyes of his four main characters, each of whom illuminates an essential facet of our “elegant defense.”
448 pages, Kindle Edition
First published March 12, 2019
About the author
Matt Richtel
15 books161 followersMatt Richtel is a best-selling author and Pulitzer Prize-winning reporter for The New York Times based in San Francisco.
He co-created and formerly wrote the syndicated comic Rudy Park under the pen name Theron Heir. Since 2012, the strip is now written by its longtime illustrator Darrin Bell.
He co-created and formerly wrote the syndicated comic Rudy Park under the pen name Theron Heir. Since 2012, the strip is now written by its longtime illustrator Darrin Bell.
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Displaying 1 - 30 of 784 reviews
June 22, 2019
When I was a youngster in school, the story I heard on the immune system was really pretty simple. It was the way your body fought infections, and it did that with white blood cells, that would attack and kill off anything that wasn't you. A lot has been learned since then, and this book is an attempt to update that picture, as well as tell the real human impact of what happens to four people who in one way or another have a problem with their immune system functioning. A major scientific story, plus four human stories, is a lot to pack into one book, but Richtel does a good job of it.
The first thing wrong with the story of the immune system that I learned, is that it leaves out a lot. It turns out that there is an entire other purpose of the immune system, besides fighting infection, and that is to identify when cells that used to be human cells in good standing, have gone rogue, and turned into something else. We call that cancer. It turns out we all have cancer, all the time, and our immune system is constantly finding those cells who have stopped playing on the good guys' team, and using one of several mechanisms to kill them off. Except, of course, when for one reason or another it fails to do so, and then we get "cancer", the kind where you know you have it, and you might die of it.
The second thing that is wrong with that old and simple story of the immune system, is that it doesn't mention the hardest part, which is not the killing of bacteria or viruses or cancerous tumors, but identifying which of them need to be killed. Richtel likens the immune system, not to a military, but more to a bouncer in a giant party, who has to deal with the troublemakers without disrupting the party too much. Of course, the thing that makes this most difficult is it is ALSO rather like the military, because it has to kill the enemy, in large numbers sometimes. Imagine a military operation that needs to take out the enemy without disrupting the party that they're at.
Because, one of the big things we have learned about ourselves in the last several decades, biologically speaking, is that the question of who we are and who we aren't is a lot more complicated than we thought. The bacteria that thrive, normally, in a healthy person's digestive system, are not the enemy. On the other hand, the cancerous cells which started from our own human DNA, are the enemy. So it's not as simple as "find the Other and destroy it". Even people who don't know anything about how this works, know one of the major molecules involved: histamines. Except they really know about antihistamines, which are drugs intended to block our own immune system's histamines, because they are making the mistake of (for example) deciding that juniper pollen is a horrible enemy which must be attacked at all cost, and that is why we get allergies. "Allergy" is a word for "your immune system attacking something that would not otherwise be a problem". If your immune system understood not to attack juniper pollen, you wouldn't have a problem during That Time Of Year (which is why people without the allergy can breathe in plenty of it with no ill effects; it's your own immune system that is responsible for the ill effects).
Some of the people Richtel follows are dealing with autoimmune disorders, where the immune system has gotten even further out of alignment, and now is attacking parts of the self. How could this ever happen? Well the details are still being worked out, but surely part of the answer is that sometimes, it NEEDS to attack parts of the self. The need to fight cancer, is a big part of the reason that our immune system sometimes has a hard time learning to relax.
There's a lot of science to cover here, and Richtel does a lot of switching back and forth between the science involved (and the history of that science), and the people he has chosen to tell us about who are impacted by it. Me personally, I could do with more of the science and less of the personal history, but there are plenty of others for whom it would be the opposite, and he does a good job of balancing the two.
Towards the end, we learn about techniques such as monoclonal antibodies, which are attempting to harness the immune system in new ways, to help it do a better job of knowing what (and when) to attack. The promise is great, but the potential complications are as well. For every headline about a potential new breakthrough, there is usually a quiet acknowledgement a year or two later that it wasn't as simple as at first thought. My guess is, that we will find it to be harder than expected to improve on the immune system, and there are a lot more ways to do the job more poorly than there are ways to improve on it.
What we can do, however, is stop messing with it. Excessive use of antibiotics, excessively sterile food and homes, and carcinogens in our environment, are three of the ways that we make this job harder. At the very least, the more we know about how the immune system does it's job, the better we can understand how to not get in its way.
The first thing wrong with the story of the immune system that I learned, is that it leaves out a lot. It turns out that there is an entire other purpose of the immune system, besides fighting infection, and that is to identify when cells that used to be human cells in good standing, have gone rogue, and turned into something else. We call that cancer. It turns out we all have cancer, all the time, and our immune system is constantly finding those cells who have stopped playing on the good guys' team, and using one of several mechanisms to kill them off. Except, of course, when for one reason or another it fails to do so, and then we get "cancer", the kind where you know you have it, and you might die of it.
The second thing that is wrong with that old and simple story of the immune system, is that it doesn't mention the hardest part, which is not the killing of bacteria or viruses or cancerous tumors, but identifying which of them need to be killed. Richtel likens the immune system, not to a military, but more to a bouncer in a giant party, who has to deal with the troublemakers without disrupting the party too much. Of course, the thing that makes this most difficult is it is ALSO rather like the military, because it has to kill the enemy, in large numbers sometimes. Imagine a military operation that needs to take out the enemy without disrupting the party that they're at.
Because, one of the big things we have learned about ourselves in the last several decades, biologically speaking, is that the question of who we are and who we aren't is a lot more complicated than we thought. The bacteria that thrive, normally, in a healthy person's digestive system, are not the enemy. On the other hand, the cancerous cells which started from our own human DNA, are the enemy. So it's not as simple as "find the Other and destroy it". Even people who don't know anything about how this works, know one of the major molecules involved: histamines. Except they really know about antihistamines, which are drugs intended to block our own immune system's histamines, because they are making the mistake of (for example) deciding that juniper pollen is a horrible enemy which must be attacked at all cost, and that is why we get allergies. "Allergy" is a word for "your immune system attacking something that would not otherwise be a problem". If your immune system understood not to attack juniper pollen, you wouldn't have a problem during That Time Of Year (which is why people without the allergy can breathe in plenty of it with no ill effects; it's your own immune system that is responsible for the ill effects).
Some of the people Richtel follows are dealing with autoimmune disorders, where the immune system has gotten even further out of alignment, and now is attacking parts of the self. How could this ever happen? Well the details are still being worked out, but surely part of the answer is that sometimes, it NEEDS to attack parts of the self. The need to fight cancer, is a big part of the reason that our immune system sometimes has a hard time learning to relax.
There's a lot of science to cover here, and Richtel does a lot of switching back and forth between the science involved (and the history of that science), and the people he has chosen to tell us about who are impacted by it. Me personally, I could do with more of the science and less of the personal history, but there are plenty of others for whom it would be the opposite, and he does a good job of balancing the two.
Towards the end, we learn about techniques such as monoclonal antibodies, which are attempting to harness the immune system in new ways, to help it do a better job of knowing what (and when) to attack. The promise is great, but the potential complications are as well. For every headline about a potential new breakthrough, there is usually a quiet acknowledgement a year or two later that it wasn't as simple as at first thought. My guess is, that we will find it to be harder than expected to improve on the immune system, and there are a lot more ways to do the job more poorly than there are ways to improve on it.
What we can do, however, is stop messing with it. Excessive use of antibiotics, excessively sterile food and homes, and carcinogens in our environment, are three of the ways that we make this job harder. At the very least, the more we know about how the immune system does it's job, the better we can understand how to not get in its way.
April 6, 2019
I can only hope this got a better editor and a good once over before the final version was published. I was excited I was selected to receive an ARC through the LibraryThing Early Reviewers program and found the content interesting but in dire need of editing. I found so many careless mistakes and scientific mistakes (yes I am a scientist, though not an immunologist).
It almost felt like the author didn't really know much about what he was writing about and didn't invest in truly learning and knowing his subject. He seemed to have wanted to write a book spurred on by the passing of his good friend, and those parts are good, but he seemed to have tried to "fake it till you make it" in the science parts. That or this is the way most books start off but then a good editor comes in and finds these things before it goes to print, in that case its time for a better editor!
But as much as I was kept on my toes looking for mistakes after I found my first couple I still enjoyed the history of immunology and the stories of the case studies he included.
These are the larger mistakes I found:
Page 177 CD4+ Tcells are correctly described as the generals and CD8+ T cells as the soldiers then on page 185 the depletion of CD8 cells is described as the section of T cells that act as a general. Complete opposite and not correct!
Also in ch 30, page 219-220, Enbrel is incorrectly described in how it works. First it is called an antibody. This is not correct, it is a circulating receptor fusion protein, an inhibitor molecule. Then it is stated that “with enbrel and other drugs that act on TNF, the idea is to get the cells that are causing problems to commit suicide.” This is not correct, Enbrel blocks TNFa, thus it inhibits it’s activity, not encourages it. So yes, while TNF signaling can lead to apoptosis it is not doing so when inhibited by Enbrel.
(correct me if I am wrong on that second one, it is my understanding of the function of Enbrel and the signaling pathway involved)
Pg 303, Ch39 - "This time they infected a chick in the right wing but not the left wing. At the same time, though, they pierced the right wing." That should read they pierced the left wing.
More than once, for example in ch 54, the author referenced adrenaline as epinephrine and norepinephrine. This is not true, epinephrine is what is known as adrenaline while norepinephrine is a noradrenaline.
I was also surprised Car-T cell therapy was not mentioned at all. As it is currently a very hot and promising area of research and personalized medicine development taking place with promises to cure a variety of cancers.
I have seen other reviews that picked up on errors I missed. I will try to make it a point to pick up this book when I see it in the book store or the library and see if any of these things have been fixed. I think the book would be very good with a good review and edit by a scientist. 2.5*
It almost felt like the author didn't really know much about what he was writing about and didn't invest in truly learning and knowing his subject. He seemed to have wanted to write a book spurred on by the passing of his good friend, and those parts are good, but he seemed to have tried to "fake it till you make it" in the science parts. That or this is the way most books start off but then a good editor comes in and finds these things before it goes to print, in that case its time for a better editor!
But as much as I was kept on my toes looking for mistakes after I found my first couple I still enjoyed the history of immunology and the stories of the case studies he included.
These are the larger mistakes I found:
Page 177 CD4+ Tcells are correctly described as the generals and CD8+ T cells as the soldiers then on page 185 the depletion of CD8 cells is described as the section of T cells that act as a general. Complete opposite and not correct!
Also in ch 30, page 219-220, Enbrel is incorrectly described in how it works. First it is called an antibody. This is not correct, it is a circulating receptor fusion protein, an inhibitor molecule. Then it is stated that “with enbrel and other drugs that act on TNF, the idea is to get the cells that are causing problems to commit suicide.” This is not correct, Enbrel blocks TNFa, thus it inhibits it’s activity, not encourages it. So yes, while TNF signaling can lead to apoptosis it is not doing so when inhibited by Enbrel.
(correct me if I am wrong on that second one, it is my understanding of the function of Enbrel and the signaling pathway involved)
Pg 303, Ch39 - "This time they infected a chick in the right wing but not the left wing. At the same time, though, they pierced the right wing." That should read they pierced the left wing.
More than once, for example in ch 54, the author referenced adrenaline as epinephrine and norepinephrine. This is not true, epinephrine is what is known as adrenaline while norepinephrine is a noradrenaline.
I was also surprised Car-T cell therapy was not mentioned at all. As it is currently a very hot and promising area of research and personalized medicine development taking place with promises to cure a variety of cancers.
I have seen other reviews that picked up on errors I missed. I will try to make it a point to pick up this book when I see it in the book store or the library and see if any of these things have been fixed. I think the book would be very good with a good review and edit by a scientist. 2.5*
April 13, 2020
“Your immune system isn’t a war machine. It’s a peacekeeping force that more than anything else seeks to create harmony.”
As a child, my mother often referred to the "little soldiers" fighting off the viruses and bacteria - that's why we needed to wash our hands, as well as eat our veggies. Likely your parents said something similar! (Interesting that these cells have been painted this way culturally for so long I can't think of any other cells in our body that are anthropomorphized in this way...).
This book attempts several things - a history and introductory of immunology, a personal look at several lives (more than the four lives on the cover implies) and their own immune systems, and a biography of the author's close childhood friend. Richtel weaves these three things together, and it works to an extant. I was left wondering if the book started as a biography to his close friend (which he devotes a lot of ink to throughout the book) and morphed into this larger work.
As a journalist, Richtel interviews many doctors, patients, and medical researchers to form the base of the book. I listened to it on audiobook, but seeing other reviews of the hard copy, I learned that the book has no references. That is disappointing, since the text relies so heavily on other people's research. Another tick that bothered me - and just seemed like poor editing - was the frequent repetition of the title "elegant defense" and also "festival of life". Richtel uses these phrases approximately 100 times in the text, and it is hard not to notice. There's something to repetition for educational sake, but this was *too much*.
I learned a great deal from this book - about the history of the field, autoimmune disorders, retroviruses, and cancers, and how being too clean and sanitized actually can cause more harm. He cites a specific study about the Amish vs. the Hutterites and the rates of infection, allergies, and autoimmune disorders amongst the two genetically similar people groups, but who have different hygieve - specifically as it relates to animal husbandry. Also on hygiene, he has a conversation with the peditrician that tells parents to let their kids eat dirt and boogers to boost their immunities! Of course, there is a reason we need to wash our hands... but it is very possible that we're doing it too much.
Overall enjoyable and educational read, that would have been even more effective with edits and structural work - and clear references.
As a child, my mother often referred to the "little soldiers" fighting off the viruses and bacteria - that's why we needed to wash our hands, as well as eat our veggies. Likely your parents said something similar! (Interesting that these cells have been painted this way culturally for so long I can't think of any other cells in our body that are anthropomorphized in this way...).
This book attempts several things - a history and introductory of immunology, a personal look at several lives (more than the four lives on the cover implies) and their own immune systems, and a biography of the author's close childhood friend. Richtel weaves these three things together, and it works to an extant. I was left wondering if the book started as a biography to his close friend (which he devotes a lot of ink to throughout the book) and morphed into this larger work.
As a journalist, Richtel interviews many doctors, patients, and medical researchers to form the base of the book. I listened to it on audiobook, but seeing other reviews of the hard copy, I learned that the book has no references. That is disappointing, since the text relies so heavily on other people's research. Another tick that bothered me - and just seemed like poor editing - was the frequent repetition of the title "elegant defense" and also "festival of life". Richtel uses these phrases approximately 100 times in the text, and it is hard not to notice. There's something to repetition for educational sake, but this was *too much*.
I learned a great deal from this book - about the history of the field, autoimmune disorders, retroviruses, and cancers, and how being too clean and sanitized actually can cause more harm. He cites a specific study about the Amish vs. the Hutterites and the rates of infection, allergies, and autoimmune disorders amongst the two genetically similar people groups, but who have different hygieve - specifically as it relates to animal husbandry. Also on hygiene, he has a conversation with the peditrician that tells parents to let their kids eat dirt and boogers to boost their immunities! Of course, there is a reason we need to wash our hands... but it is very possible that we're doing it too much.
Overall enjoyable and educational read, that would have been even more effective with edits and structural work - and clear references.
June 27, 2022
I actually think this is a good book for anyone who might not know much about biology and wants to learn more about the immune system and the history of the science of it. I did learn a few things especially about the scientists involved in doing the research about the things I learnt about in undergrad which was cool. I'm not sure why but I had trouble staying engaged when reading this however. I think the framing of things in metaphor and simile didn't work for me in this situation (every time I saw the phrase festival of life I just wanted to role my eyes). I also did not feel invested in the narrative aspect. Whenever it switched to discussing the four people whose immunological issues are covered I just wanted to start skimming. It also felt like the book jumped around a lot but maybe its because I was mainly reading before bed. Overall a good book but it just didn't do it for me personally.
May 7, 2019
I didn't get far into this book before I decided it wasn't worth my time.. There were, in my opinion, too many problems for me to go further..
When I started this book the first thing I looked for were references.. Guess what? THERE ARE NONE!
I am really confused on how anyone can write a book with "New Science" in the title and eliminate references. There are only a few references I found in the text, but nothing specific.
Second, the author seems to give additional, unnecessary details within the text - i.e. " 'Who told you to call this nigger Mr. Brown?' the physician said." This little deal had basically NOTHING to do with the topic the author was in but he choose to add details like this to his text.
Third, everything seemed pretty broad brushed for me. Like, "He attempted to describe his seminal experiment link T cells and B cells. He tried me. I will not try you." As a reader, I say, uh, no... this is why I am reading this book. My guess is that the author really had no f-ing clue what the doctor was explaining to him so he decided to skip it.
The author really lost me when he talked about antibiotics and mentioned how valuable they are when growing the food supply. Well, this isn't in line with "new" science that has been proving that these additional antibiotics pumped into our foods is actually harming us!
Due to the gross negligence of this author, I quit this book at page 87. I would have rather the author discuss the 4 people on a case by case situation, extrapolating their stories with the information with medical advances/explanations. Oh yeah, and INCLUDE REFERENCES!
When I started this book the first thing I looked for were references.. Guess what? THERE ARE NONE!
I am really confused on how anyone can write a book with "New Science" in the title and eliminate references. There are only a few references I found in the text, but nothing specific.
Second, the author seems to give additional, unnecessary details within the text - i.e. " 'Who told you to call this nigger Mr. Brown?' the physician said." This little deal had basically NOTHING to do with the topic the author was in but he choose to add details like this to his text.
Third, everything seemed pretty broad brushed for me. Like, "He attempted to describe his seminal experiment link T cells and B cells. He tried me. I will not try you." As a reader, I say, uh, no... this is why I am reading this book. My guess is that the author really had no f-ing clue what the doctor was explaining to him so he decided to skip it.
The author really lost me when he talked about antibiotics and mentioned how valuable they are when growing the food supply. Well, this isn't in line with "new" science that has been proving that these additional antibiotics pumped into our foods is actually harming us!
Due to the gross negligence of this author, I quit this book at page 87. I would have rather the author discuss the 4 people on a case by case situation, extrapolating their stories with the information with medical advances/explanations. Oh yeah, and INCLUDE REFERENCES!
November 10, 2023
In the reading of "An Elegant Defense: The Extraordinary New Science of the Immune System: A Tale in Four Lives" an annoying buzzing was happening---like a distant train horn becoming louder upon its approach. That buzzing is like our immune system responding to a threat. Over 3.5 billion years ago our cells learned to discern what's symbiotic and what's hostile. Richtel teaches us---most intimately---about our immune system/technologically superior ways of treating immune diseases. One such individual with disease was Jason Greenstein (friend of Richtel) who learns of the seriousness of his condition by reading a note from his physician recommending "hospice care."
“Cancer played a nasty trick on his elegant defense. It overtook the immune system’s communication channels and instructed his body’s soldiers to stand down. Then it used his immune system to protect the cancer as if it were a precious, healthy new tissue, and it would have him spiraling to his grave."
—Matt Richtel
Eventually organisms evolve and immune systems did keep pace with humans and mammals. “The thymus makes T cells,” writes the Richtel. Mighty T cells---signaled by dendritic cells, morph into soldiers, shooting out cytokines; the B cells use antibodies to connect to antigens. And on another line of defense the macrophages, neutrophils, along with natural killer cells, patrol the body, exploring, tasting and killing. Pulitzer Prize winner Richtel dismisses claims of setting a goal to attain a formidable possible immune system. This text is made most fluidly palatable by following four individuals whose immune systems were responsible for their death and life.
“Cancer played a nasty trick on his elegant defense. It overtook the immune system’s communication channels and instructed his body’s soldiers to stand down. Then it used his immune system to protect the cancer as if it were a precious, healthy new tissue, and it would have him spiraling to his grave."
—Matt Richtel
Eventually organisms evolve and immune systems did keep pace with humans and mammals. “The thymus makes T cells,” writes the Richtel. Mighty T cells---signaled by dendritic cells, morph into soldiers, shooting out cytokines; the B cells use antibodies to connect to antigens. And on another line of defense the macrophages, neutrophils, along with natural killer cells, patrol the body, exploring, tasting and killing. Pulitzer Prize winner Richtel dismisses claims of setting a goal to attain a formidable possible immune system. This text is made most fluidly palatable by following four individuals whose immune systems were responsible for their death and life.
This entire review has been hidden because of spoilers.
January 5, 2021
Um passeio bastante marcate por como funciona nosso sistema imune, que saiu aqui no Brasil como Imune: A extraordinária história de como o organismo se defende das doenças.
Richtel elege algumas pessoas para contar a história delas e de condições que desenvolveram relacionadas a imunidade (câncer, HIV e autoimunidade) para falar sobre como nosso sistema imune funciona, o que acontece quando ele não funciona e o que acontece quando ele funciona demais e reage contra o próprio corpo.
É um livro bastante didático que consegue transformar em legível a área de biológicas onde encontrei mais termos, cifras e vias complexas. O que é um trabalho hercúleo. Em uma época onde todo mundo quer saber como vacinas funcionam, que tipo de imunidade desenvolvemos e o que é importante, é uma leitura recomendadíssima.
Richtel elege algumas pessoas para contar a história delas e de condições que desenvolveram relacionadas a imunidade (câncer, HIV e autoimunidade) para falar sobre como nosso sistema imune funciona, o que acontece quando ele não funciona e o que acontece quando ele funciona demais e reage contra o próprio corpo.
É um livro bastante didático que consegue transformar em legível a área de biológicas onde encontrei mais termos, cifras e vias complexas. O que é um trabalho hercúleo. Em uma época onde todo mundo quer saber como vacinas funcionam, que tipo de imunidade desenvolvemos e o que é importante, é uma leitura recomendadíssima.
May 31, 2019
I really liked this book, although it wasn't until perhaps halfway through that I realized it's not just factual nonfiction about the human immune system, but also the story of the author's friend Jason's struggle with cancer -- and the stories of several other figures stricken by various maladies of the immune system.
I did find Richtel's voice a bit too much; he sometimes gets a little too chatty/cute/precious when describing the details of how the immune system works. He also defers a lot of the explanation to quotes from the scientists he interviews, who generally are using broad analogies.
In several places, Richtel works on a metaphor between a healthy immune system and a healthy society. For example, to work well, your immune system needs a wide variety of cells -- T cells, B cells, dendritic cells, neutrophils, etc -- all working together, and Richtel compares this to the diverse international group of scientists who collaborate on immunology research. (He also compares excessive nationalism to an autoimmune disorder, which I think is apt.)
However, I think the author should have decided what book he was writing. An exposition about how the immune system works, and the history of the relevant discoveries? The story of his friend's fight with cancer? An essay on how our society and culture should interact with itself and other societies and cultures, using the immune system as a metaphor? Any one of those could be a good book.
I found that The Gene: An Intimate History does a better job balancing a description of the science while also linking in personal/family history.
If you are interested in the immune system, be sure to also look at I Contain Multitudes: The Microbes Within Us and a Grander View of Life.
I did find Richtel's voice a bit too much; he sometimes gets a little too chatty/cute/precious when describing the details of how the immune system works. He also defers a lot of the explanation to quotes from the scientists he interviews, who generally are using broad analogies.
In several places, Richtel works on a metaphor between a healthy immune system and a healthy society. For example, to work well, your immune system needs a wide variety of cells -- T cells, B cells, dendritic cells, neutrophils, etc -- all working together, and Richtel compares this to the diverse international group of scientists who collaborate on immunology research. (He also compares excessive nationalism to an autoimmune disorder, which I think is apt.)
However, I think the author should have decided what book he was writing. An exposition about how the immune system works, and the history of the relevant discoveries? The story of his friend's fight with cancer? An essay on how our society and culture should interact with itself and other societies and cultures, using the immune system as a metaphor? Any one of those could be a good book.
I found that The Gene: An Intimate History does a better job balancing a description of the science while also linking in personal/family history.
If you are interested in the immune system, be sure to also look at I Contain Multitudes: The Microbes Within Us and a Grander View of Life.
December 28, 2021
I might have rated An Elegant Defense higher, if there had been fewer goofy similes and a lot less mansplaining. Authors, take note, talking down to the reader is not cute or endearing.
Chapter 12: The Infinity Machine
There are no references or citations, which did result in a lower rating. I also noticed a few small errors in the text; they didn't affect my rating.
Chapter 11: Vaccines
Chapter 22: GRID
The name pneumocystis carinii, used in the book, is incorrect. It was changed to pneumocystis jirovecii in 1999 and is deemed retroactively correct dating back to 1976.
You might also enjoy:
✱ I Contain Multitudes (highly recommended)
✱ The Emperor of All Maladies: A Biography of Cancer
✱ The Gene: An Intimate History
✱ The Family Gene
✱ Gut: The Inside Story of Our Body’s Most Underrated Organ
✱ Into the Gray Zone
✱ Microcosm: E. coli and the New Science of Life
✱ Parasite Rex
Chapter 12: The Infinity Machine
This is complex stuff. But a pep talk: This section is as deep and important as any in describing the wonder of the human body. Dear reader, please soldier on!Ugh, please stop.
There are no references or citations, which did result in a lower rating. I also noticed a few small errors in the text; they didn't affect my rating.
Chapter 11: Vaccines
From a cowpox lesion of a milkmaid, he poisoned an eight-year-old boy.Jenner didn't poison James Phipps, he inoculated him.
Chapter 22: GRID
The name pneumocystis carinii, used in the book, is incorrect. It was changed to pneumocystis jirovecii in 1999 and is deemed retroactively correct dating back to 1976.
You might also enjoy:
✱ I Contain Multitudes (highly recommended)
✱ The Emperor of All Maladies: A Biography of Cancer
✱ The Gene: An Intimate History
✱ The Family Gene
✱ Gut: The Inside Story of Our Body’s Most Underrated Organ
✱ Into the Gray Zone
✱ Microcosm: E. coli and the New Science of Life
✱ Parasite Rex
December 17, 2019
I really learned a lot from reading this book. Richtel takes readers slowly, in easy to understand language, on the journey that scientists have taken to understand our immune systems. An Elegant Defense is not a dry or boring read.
At the beginning, Richtel introduces 4 people who are all dealing with different aspects of their immune systems. One of them is a friend from childhood who is fighting Hodgkin's Disease. The ups and down of this man's treatment are tough for the author to deal with as well as for this man who is far from a perfect patient. Initially, the goal for this man is to try to rev up his immune system to fight his cancer which is a wicked tricky disease.
There are two women who are both dealing with the negative physical problems brought on by auto-immune diseases. This family of diseases like lupus and rheumatoid arthritis are brought on when your immune system attacks you. Usually, one's joints are involved but the negative changes in one's body can range far beyond those symptoms.
Finally, there is the homosexual man who is HIV positive but doesn't suffer physically. All though he has to watch his many friends and lovers pass away. Remarkably, his immune system keeps him healthy in ways the scientists don't know how to replicate.
These are all fascinating stories that help to explain the complexity of our immune systems.
At the beginning, Richtel introduces 4 people who are all dealing with different aspects of their immune systems. One of them is a friend from childhood who is fighting Hodgkin's Disease. The ups and down of this man's treatment are tough for the author to deal with as well as for this man who is far from a perfect patient. Initially, the goal for this man is to try to rev up his immune system to fight his cancer which is a wicked tricky disease.
There are two women who are both dealing with the negative physical problems brought on by auto-immune diseases. This family of diseases like lupus and rheumatoid arthritis are brought on when your immune system attacks you. Usually, one's joints are involved but the negative changes in one's body can range far beyond those symptoms.
Finally, there is the homosexual man who is HIV positive but doesn't suffer physically. All though he has to watch his many friends and lovers pass away. Remarkably, his immune system keeps him healthy in ways the scientists don't know how to replicate.
These are all fascinating stories that help to explain the complexity of our immune systems.
Shelved as 'did-not-finish'
March 11, 2019Sadly I did not get along with this one. Richtel's writing is amazing when he's focusing on a person, but the science sections are in need of some cleaning up. I read an ARC so it may be edited before release, but as-is I'm tempted to break out my red pen every few pages. DNF at 15%.
Thanks to William Morrow and Edelweiss for providing a review copy.
Thanks to William Morrow and Edelweiss for providing a review copy.
February 9, 2022
Wish doctor had handed me a copy of this book when he told me I had cancer. Would have been useful to have this information BEFORE seeing oncologist and surgeon.
Covers the whole history of immunology. Plague to AIDS. Presumes some rudimentary cell biology.
There is no free lunch. Immortality is a myth. Victories are temporary. Bacteria and Viruses will survive and adapt faster than humans. Best outcome is homeostasis, collaborative harmony.
Good job Matt Richtel.
Covers the whole history of immunology. Plague to AIDS. Presumes some rudimentary cell biology.
There is no free lunch. Immortality is a myth. Victories are temporary. Bacteria and Viruses will survive and adapt faster than humans. Best outcome is homeostasis, collaborative harmony.
Good job Matt Richtel.
March 23, 2019
Wow!
I’m almost at a loss for words to describe AN ELEGANT DEFENSE and emphasize not only how important but also how interesting this book is. So I begin my comments with an exclamation (wow).
This is a science book. But (whoa, don’t go away) it is probably unlike any science book you’ve had experience with. It is casual and easy to understand. And even though it does contain scientific words, Matt Richtel occasionally reminds the reader what they mean and how they are applicable to what he then describes.
I am not a scientific or medical person. I only decided to read this because Richtel is a Pulitzer Prize winner for his A DEADLY WANDERING. And was I surprised that someone could make the science of the immune system so darned interesting. Honestly, it was as if I was reading an exciting thriller last night when I stayed up reading this book until I fell asleep sometime past midnight. Maybe that’s because he gives real-life examples of what he is talking about.
Richtel divides AN ELEGANT DEFENSE into five parts, each perfectly named (as are the chapters). First he introduces us to four people, examples of “the extraordinary new science of the immune system.” Next comes the science, which Richtel still manages to keep casual, even humorous at times. And he sometimes adds to this part other real-life examples. The remainder of the book concentrates more on the people he began with.
Much, maybe most, of AN ELEGANT DEFENSE is personal. Yes, I learned a lot. But I think, even with these readable explanations and examples showing how our immune systems are so important to everything about our bodies, this book absorbed me because Richtel makes it personal, especially Jason. Jason is the reason I stayed awake past midnight last night.
I won the ARC of AN ELEGANT DEFENSE through librarything.com.
I’m almost at a loss for words to describe AN ELEGANT DEFENSE and emphasize not only how important but also how interesting this book is. So I begin my comments with an exclamation (wow).
This is a science book. But (whoa, don’t go away) it is probably unlike any science book you’ve had experience with. It is casual and easy to understand. And even though it does contain scientific words, Matt Richtel occasionally reminds the reader what they mean and how they are applicable to what he then describes.
I am not a scientific or medical person. I only decided to read this because Richtel is a Pulitzer Prize winner for his A DEADLY WANDERING. And was I surprised that someone could make the science of the immune system so darned interesting. Honestly, it was as if I was reading an exciting thriller last night when I stayed up reading this book until I fell asleep sometime past midnight. Maybe that’s because he gives real-life examples of what he is talking about.
Richtel divides AN ELEGANT DEFENSE into five parts, each perfectly named (as are the chapters). First he introduces us to four people, examples of “the extraordinary new science of the immune system.” Next comes the science, which Richtel still manages to keep casual, even humorous at times. And he sometimes adds to this part other real-life examples. The remainder of the book concentrates more on the people he began with.
Much, maybe most, of AN ELEGANT DEFENSE is personal. Yes, I learned a lot. But I think, even with these readable explanations and examples showing how our immune systems are so important to everything about our bodies, this book absorbed me because Richtel makes it personal, especially Jason. Jason is the reason I stayed awake past midnight last night.
I won the ARC of AN ELEGANT DEFENSE through librarything.com.
January 22, 2019
Matt Richtel is one of those rare writers able to convey complex concepts with ease. He pulls apart interwoven strands of the human immune system to reweave it for us through the stories of physicians, scientists, and patients. Several times I found myself saying, “You have to hear this,” before reading aloud a few particularly fascinating paragraphs to whatever family member was in the room.
This is an especially useful book for anyone with health issues, since a closer familiarity with one’s own immune system can help us keep up with research and advocate for ourselves. If I have any complaints, it’s that the author’s main patient story (spoiler alert) is deemed a “success” in several chapters, but the outcome is one that’s sadly familiar to too many who have endured years of torturous, expensive, body-depleting chemotherapy treatments. The author does, all too briefly, get around to the wisdom of listening to one’s own body to find solutions outside mainstream medicine.
I also appreciated the author’s wider perspective on the intersection between science and culture. As he writes near the close of the book, “…Our survival, as individuals and a species, is best served by cooperation. This may sound obvious, but civilization, even of late, has been dominated by the push and pull of our competing instincts to cooperate and alienate, to see what people share in common or prey on what divides them. The lesson of the immune system is that the better able we are to find common ground, the more allies and weapons we have to contend with a greater, common foe.”
I appreciated the opportunity to get an advance reader’s copy. An Elegant Defense is an impressively researched and ultimately optimistic book.
This is an especially useful book for anyone with health issues, since a closer familiarity with one’s own immune system can help us keep up with research and advocate for ourselves. If I have any complaints, it’s that the author’s main patient story (spoiler alert) is deemed a “success” in several chapters, but the outcome is one that’s sadly familiar to too many who have endured years of torturous, expensive, body-depleting chemotherapy treatments. The author does, all too briefly, get around to the wisdom of listening to one’s own body to find solutions outside mainstream medicine.
I also appreciated the author’s wider perspective on the intersection between science and culture. As he writes near the close of the book, “…Our survival, as individuals and a species, is best served by cooperation. This may sound obvious, but civilization, even of late, has been dominated by the push and pull of our competing instincts to cooperate and alienate, to see what people share in common or prey on what divides them. The lesson of the immune system is that the better able we are to find common ground, the more allies and weapons we have to contend with a greater, common foe.”
I appreciated the opportunity to get an advance reader’s copy. An Elegant Defense is an impressively researched and ultimately optimistic book.
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October 7, 2021DNF'd. This is extremely messy. It somehow gives you lots of information and none at all at the same time. The author cannot stay focused for anything. Instead of presenting things in a clear, linear way, he jumps around in stories and cuts back and forth. There's also too much of his voice in there. I think the intent is to make it less dry and more personal but I don't care. I'm not reading this for him, just for the science he's supposed to be telling me about--science he never seems totally comfortable with. Using four people to tell the story could have been interesting but it's done in a way that makes it so hard to care.
September 11, 2019
Pultizer Prize Winner, Matt Richtel, takes us on a journey of our immune systems, how they work and how they fail and why. Through extension research by Physicians, Scientists and Researchers who study and explore the structure and function of the immune system, there has been a great turnabout in treating patients suffering from cancer, HIV, autoimmune diseases to name a few. Even in the age of the Black Plague and other epidemics, there were often a few who made it through without any dire consequences. What were the antibodies that caused them to ward off these diseases? The author introduces us to four patients and we follow along on their paths. This is a must read for anyone seeking quality of life.
October 19, 2020
An Elegant Defense is a book about immune system in humans and the latest medical science on treating immune system related diseases, including AIDS (immune deficiency caused by HIV virus), hotchin's lymphoma (cancer in lymphatic system, a part of the immune system), rheumatoid arthritis and other autoimmune diseases. Informative, easy to understand.
However, I do not like the author's "storytelling" style. It feels forced, too many irrelevant details. The life lessons the author drew from the patients read like a lecturer's notes. I am also not keen on the author's constant allusion to social and history lessons, using the same term (immune system) as metaphor in a book about science and medicine.
However, I do not like the author's "storytelling" style. It feels forced, too many irrelevant details. The life lessons the author drew from the patients read like a lecturer's notes. I am also not keen on the author's constant allusion to social and history lessons, using the same term (immune system) as metaphor in a book about science and medicine.
Shelved as 'abandoned-dnf'
June 15, 2020DNF at 18%.
This reads like something that would appear in Reader's Digest. It's heavy on pathos and heroism, thick with hyperbole and strange metaphors, and it is very light (and not always accurate) on science. Maybe the author should have focused on writing a memoir about his friend and the others profiled within and not tried to delve into a complicated subject so obviously outside his expertise.
This reads like something that would appear in Reader's Digest. It's heavy on pathos and heroism, thick with hyperbole and strange metaphors, and it is very light (and not always accurate) on science. Maybe the author should have focused on writing a memoir about his friend and the others profiled within and not tried to delve into a complicated subject so obviously outside his expertise.
June 29, 2019
Summer bingo-Non-fiction about science
What a disappointment! The first thing that troubled me about this book is that there are no references. Everything the author writes about the immune system is anecdotal and some of what he writes is inaccurate and misleading. He doesn't demonstrate a good understanding of the immune system and, at one point, when discussing T & B cells, said he found it too trying to understand so he would not try the reader with the information.
I was very disturbed to read what he wrote about vaccines. When describing the early trials of the polio vaccine, he focused on two early trials that failed and resulted in morbidity and then just glossed over the eventual success of the vaccine. He even downplayed the role of vaccines by claiming that antibiotics are of more importance to the immune system than vaccines, when in fact, with the current problem of antibiotic resistance, vaccine development is more important than ever.
Overall, I was irritated by the sloppy science and the lack of references. I was hoping this would be similar to The Gene:An Intimate History by Siddhartha Mukherjee, but it doesn't come close.
What a disappointment! The first thing that troubled me about this book is that there are no references. Everything the author writes about the immune system is anecdotal and some of what he writes is inaccurate and misleading. He doesn't demonstrate a good understanding of the immune system and, at one point, when discussing T & B cells, said he found it too trying to understand so he would not try the reader with the information.
I was very disturbed to read what he wrote about vaccines. When describing the early trials of the polio vaccine, he focused on two early trials that failed and resulted in morbidity and then just glossed over the eventual success of the vaccine. He even downplayed the role of vaccines by claiming that antibiotics are of more importance to the immune system than vaccines, when in fact, with the current problem of antibiotic resistance, vaccine development is more important than ever.
Overall, I was irritated by the sloppy science and the lack of references. I was hoping this would be similar to The Gene:An Intimate History by Siddhartha Mukherjee, but it doesn't come close.
July 22, 2019
An interesting and informative exploration of research on the human defense system. Starting the with Black Plague, the book includes very early theories and research to recon breakthroughs. For each of the major topics, which were cancer, AIDS, and autoimmune disorders, Richtel went into detail on a specific person who tell with that issue. The result was a book that never became too technical and remained fully rooted in the real world of patients, individuals, and families. Furthermore, he frequently makes connections between the immune system, which has to distinguish between our bodies and invaders, to real-world issues like xenophobia. I did get lost at times listening to the audiobook but overall a good book!
April 2, 2020
Pretty livid that I got 3/4 of the way through this book, decided to do more research on a claim that was particularly shocking, just to discover that said claim was entirely, demonstrably false. Where are the fact checkers? Who edited this? I have zero reason to believe anything else in this book is rooted in science, and I am looking forward to reading some of the many genuinely scientific recommendations other readers have made in their reviews and forgetting about this one entirely.
October 5, 2019
Currently, my immune system is trying to kill me. I've been put in the Lupus box by one rheumatologist who called and said "you have Lupus, I phoned in a prescription take two a day" I found another and he put me in the Mixed Connective Tissue Disorder box because I didn't hit all the right notes for anything else. Yet, despite on-going treatment I continue to degrade. This book helped me to understand a bit more about our "elegant defense" system through stories about people as well as easier to understand scientific research. The time I spent reading this book was worthwhile in helping me understand some of the medications I am on and why also how freaking difficult it is to dissect and figure out what the problem is because when the immune system goes whacky it sends other things whacky and the docs are playing wackamole, x fixes y but causes z, so now what? And then out of left field, something wonderful or horrible happens. Maybe it will help my patients knowing how difficult this particular field is, clearly being agitated and annoyed pisses off ones immune system, I should start doing small favors for myself.
March 19, 2020
Pseudo science written by a reporter. I don’t believe he fully grasped the topic and couldn’t explain the topic succinctly. Agree with previous reviewer that this seemed less about science and more about personal stories which I personally was less interested in vs the actual science behind the immune system advances.
April 7, 2019
I understand this is written for a general audience, but as someone with a substantial amount of background in this field (which is why I was drawn to this book), I found it a bit too simplistic and lacking in detail in the technical components.
Shelved as 'did-not-finish'
May 3, 2022Nope. Scientific errors and weird/uncomfortable commentary scattered throughout the less than 50 pages I read. Also no citations which always irritates me in science writing
November 14, 2023
This is not the type of book I usually pick up, but I'm really glad I did! A look at the immune system through the stories of four different people, the book was full of facts, anecdotes, and information. Really good!
December 12, 2020
Immunology has advanced so much since I my studies in professional school. I learned so much from this book.
June 18, 2019
3.5 stars.
The author, Matt Richtel, is a wonderful storyteller. The book is centered around 4 different patients: 1 with HIV, 2 with autoimmune diseases, and 1 with cancer. The chapters these 4 patients and their lives were very well done and were very interesting. He did a good job portraying what living with these diseases is like.
However, he didn't do a great job writing about the scientific aspects. I constantly found myself having to research a topic separately because what Richtel was saying was sparse or didn't make sense. Here's a quote from a section where he is attempting to talk about a big discovery a scientist made: "This is one of those experiments that is too technical to describe, and, in its own way, not the stuff of Hollywood". I wanted to love this book - the topic is fascinating! The 4 stories of real life patients were fascinating! I just wanted it to delve deeper.
The author, Matt Richtel, is a wonderful storyteller. The book is centered around 4 different patients: 1 with HIV, 2 with autoimmune diseases, and 1 with cancer. The chapters these 4 patients and their lives were very well done and were very interesting. He did a good job portraying what living with these diseases is like.
However, he didn't do a great job writing about the scientific aspects. I constantly found myself having to research a topic separately because what Richtel was saying was sparse or didn't make sense. Here's a quote from a section where he is attempting to talk about a big discovery a scientist made: "This is one of those experiments that is too technical to describe, and, in its own way, not the stuff of Hollywood". I wanted to love this book - the topic is fascinating! The 4 stories of real life patients were fascinating! I just wanted it to delve deeper.
May 22, 2019
The author bent over backwards to make the science understandable. I don't think I'll retain a lot of it, but I am left with wonder and admiration for the body's immune system. Explaining the science while profiling 4 people with immune system health challenges was helpful. I really loved the last chapter where the author tries to articulate some meaning from what he has learned in his life and through research for this book. Recommended.
Shelved as 'did-not-finish'
November 6, 2020This isn't working for me. There's something about the way it varies from the obvious to extremely technical that just makes me lose interest. There's not enough middle ground nor have I managed to really feel for the patients involved & I want to. I've tried going back to this several times & I just feel like I'm battered by the change in focus. It just becomes boring.
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