An Elegant Defense: The Extraordinary New Science of the Immune System: A Tale in Four Lives

4.5 4.5 out of 5 stars | 1,384 ratings

Price: 6.99

Last update: 09-04-2024


About this item

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 audiobook, entwining leading-edge scientific discovery with the intimate stories of four individual lives, by the Pulitzer Prize-winning New York Times journalist.

“An Elegant Defense by Matt Richtel is one of those rare nonfiction books that transcends the genre. On one level it is a fascinating and engrossing account of the latest, and quite astonishing, discoveries involving the human immune system and how it works. But it is also a story about people facing mortality, about the passion of scientists searching for truth, and a meditation on death and how all of us struggle with the ultimate mystery. Heartfelt and moving, full of compassion, love, and the human drama, this is the work of a writer of high ethical character who is grappling with big issues and deep humanistic problems. What an inspiring and wonderful read. I highly recommend this extraordinary book.” (Douglas Preston, number-one best-selling author of The Lost City of the Monkey God)


Top reviews from the United States

Don
5.0 out of 5 stars Well Researched and Readable
Reviewed in the United States on July 31, 2024
An engaging and detailed description of the recent developments in understanding the Immune System.
Donald
5.0 out of 5 stars Science and Stories
Reviewed in the United States on May 7, 2019
I read “An Elegant Defense” because of its subject. This book reminded me of “The Microbe Hunters,” a classic about discoveries of the medical science greats. I assumed there wasn’t much to learn about the immune system. I was wrong. This book surprised on several levels.

First was the author’s background. I didn’t expect a medical expository from a New York Times journalist. But within the book, author Richtel also describes his personal journey into journalism, and his own medical issues.

Second were Richtel’s creative efforts to lend realism to a technical subject. He uses commonplace analogies to describe what is happening within the immune system; for instance, he likens a wayward immune system molecule to a janitor: “then the janitor goes nuts and starts eating everything in sight… not only cleaning up, but taking cups and plates out of the hands of partygoers.” Richtel also inserts examples – some personal – of individuals with immune system problems. These powerful stories personalize immune system illnesses and reinforce an explanation of the science.

But most surprising is the book’s medical content, detailed yet explained in an everyday and understandable way. I couldn’t have imagined this field as having advanced so far, so fast. A development turning point was the HIV/AIDS epidemic, which attracted significant funding.

The book describes the short and eventful history of immunology by introducing the reader to one of the most complicated organic systems: the immune system. The author points out that cancer and autoimmunity are both manifestations of this same immune system. Researchers discovered that autoimmune conditions such as rheumatoid arthritis are caused by the immune system’s attacking “self,” while cancer tricks the immune system into inactivity in the face of invasion. The author describes emerging drugs against these imbalances. One type of immunotherapy medication puts the brakes on the immune system to curb autoimmune destruction. Another immunotherapy drug type strips away cancer’s masking mechanism, so the immune system can recognize its true enemy.

In course of this historical journey, the reader encounters many interesting side trips such as: fever, the hygiene hypothesis, antibiotic-resistant strains, the microbiome, and wound healing. The book concludes with the author’s reflections on broader themes, such as how the immune system exhibits cooperation, the wisdom of biodiversity, death and evolution, and the need for a healthy and balanced lifestyle.

“An Elegant Defense” combines a well-chosen subject, a lucid explanation of technical content, and an appealing approach to personalization. Be prepared to learn a new vocabulary, and to receive a treasure of medical knowledge.
William
4.0 out of 5 stars Good reading with good information
Reviewed in the United States on April 3, 2019
I was looking forward to learning about the immune system and I did learn quite a bit. The author presented key concepts and introduced us to numerous scientists who broke new ground getting to these understandings. The book certainly follows the structural path of other biological books I've read lately. That is, he follows the scientists in a roughly chronological path as he presents their discoveries and then relates the progress to treatment of some specific patients.

The reading flowed nicely, I never felt like giving it up or bogged down anywhere. Yet all in all it was somewhat disappointing for me in several aspects. Written by a non-scientist, the actual layout and function of the immune system did not come across in a clear, uncluttered, memorable framework. Come to think of it there was not even any description in even minimal depth of the lymphatic system, which certainly is involved. And the scientists were so numerous and their personal stories minimal enough that it was almost a waste of time trying to humanize them and their work.

His primary exploration of a patient was with his friend Jason, and he did a good job of that. Yet I didn't find myself nearly as enamored of Jason as the author was.

So I'd say it's a good book to read but I won't recommend it highly to my friends.
Dr Ali Binazir
5.0 out of 5 stars A thriller: the history & science of immunology interwoven into compellingly poignant human tales
Reviewed in the United States on March 26, 2019
Fantastic read! Richtel compellingly interweaves the science and history of immunology into the lives of four patients, each dealing with different aspects of immune function & dysfunction: overreaction, underreaction, recognizing self as enemy, recognizing enemy as self, and much more.

It's an ambitious premise, and he pulls it off magnificently. I had to read the whole thing in one sitting. What makes the book supremely compelling is the vivid story of his childhood friend Jason's cancer treatment. Jason not only granted Richtel access to all of his medical records and doctor visits, but also had the kind of revelatory long talks and walks that only best friends can have. The result is an unusually well-rounded psychological portrait of a patient, along with the tortuous course of his treatment that reads like a detective story, except real. The tales are poignant, and I found myself crying (and laughing) multiple times.

As someone who's studied immunology twice, as both biologist and medical student, I found the book a useful refresher of immune function, with some updates into the 21st century. If you do not have a background in immunology, however, this is a must-read. Every day, billions of malign agents are trying to kill you, and fail only because your immune system is on guard. How does it recognize and ward off the infinitude of pathogens that could invade and lay you low? How can it tell outsiders from insiders? And how does it put the brakes on itself when it's in full defense mode?
The inner workings the immune system should make you gasp with wonder at the beauty of how nature could come up with something so insanely intricate and effective. It's literally keeping you alive every moment of every day, so do yourself a favor and read up on your T cells, B cells, dendritic cells, interferons, and cytokines so you can better appreciate this miracle.
-- Ali Binazir, M.D., M.Phil., Happiness Engineer and author of  The Tao of Dating: The Smart Woman's Guide to Being Absolutely Irresistible , the highest-rated dating book on Amazon, and  Should I Go to Medical School?: An Irreverent Guide to the Pros and Cons of a Career in Medicine

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