An Elegant Defense: The Extraordinary New Science of the Immune System: A Tale in Four Lives
“This book is at once enlightening, frightening, and heartwarming. Though filled with scientific descriptions of medical discoveries and experimental and proven treatments in a complex field, it is surprisingly easy to read.”
An Elegant Defense is more than a book about the science of immunology. It’s also the very human stories of four individuals who suffer from immune and auto-immune diseases and disorders and of those throughout the ages who have made it their mission to try to heal these conditions. Readers who suffer from challenged immune systems will welcome validation for the physical and emotional trials they endure, gain deeper understanding of their ailments, and find hope for the future. Readers who are interested in the human body’s capacity to both harm or heal itself will be fascinated.
This book is at once enlightening, frightening, and heartwarming. Though filled with scientific descriptions of medical discoveries and experimental and proven treatments in a complex field, it is surprisingly easy to read. Richtel, a Pulitzer Prize-winning journalist and author, does his best to help readers grasp difficult concepts. He explains complicated ideas by using simple metaphors and similes from sports, war—and whatever works—and repeats information just often enough for it to gradually sink in.
To increase readability and remind us that this book is not a medical tome but ultimately about the people who are afflicted with immune and auto-immune diseases, Richtel intersperses discourse with the journeys of four sufferers: Jason, Linda, Meredith and Bob. Moreover, he is liberal with his use of humor and upfront about his deep, personal interest in this field. Who can resist reading on when Richtel beings a chapter with: “A case can be made that the field of immunology originated with a chicken.”?
Richtel takes us step by step through the breakthroughs in the field of immunology, which of course was not called by that name when the early discoveries were made. He starts his history in the 16th century and wends his way through plagues and pandemics, diseases and disorders: Bird Flu, Black Plague, Bubonic Plague, polio, lupus, HIV/AIDS, smallpox, rheumatoid arthritis, and cancer.
He describes how one scientific discovery builds on and links with others, stressing the amazing diversity of contributors from myriad disciplines and countries. Rather than describe what its luminaries have done, whenever possible, he offers excerpts of interviews with them so that we learn firsthand about their ideas, work, and connection to the field.
Along with time-traveling the reader through the long history of some of today’s greatest immunological advances, the book also answers basic questions: what causes allergies; what’s the difference between parasites, viruses, and bacteria; is there a purpose for inflammation or fever when we’re sick or injured; what are antibodies; how does auto-immunity come about; what is a microbiome and what part does it play in keeping us healthy; and should we believe the promises about the barrage of products that claim to boost our immune system?
He provides answers to some of our more personal pressing questions as well: why our individual immune systems fail or succeed, how to manage and live with debilitating auto-immune conditions, and what we need more and less of to stay healthy. His recommendations include reducing stress, decreasing consumption of processed foods, not smoking, avoiding overuse of antibiotics, and increasing sleep. One surprising piece of advice is that we need not obsess as much as we do about germs in particular and cleanliness in general. In fact, Richtel explains why we actually may need more dirt and germs in our lives to keep us healthy.
On cleanliness and sleep, Richtel lets Dr. Meg Lemon, a Denver physician who treated one of the four individuals he tracks in this book, make her case: “Your job isn’t to keep your house spotlessly clean. You should sleep until you’re not tired any more. Sleep is the easiest medicine to regulate. A single night alters your immune system. It blows things out of whack in one night.” On our obsession with longevity, he agrees with Ruslan Medzhitov, a pioneering Yale scholar in immunology: “We have to distinguish between life-span and health-span. You don’t want to live forever, but you do want to be healthy when you’re old.”
At the end of the book, Richtel makes the physiological and personal political by pointing out that our bodies and society share much in common. He maintains that physiological and cultural diversity “both play essential roles in survival.” He compares our current “xenophobia, blind nationalism and racism” to an auto-immune disorder, when the immune system mistakes “self” for alien or other and begins a relentless assault on the body, warning that, “A culture, tone-deaf in its own defense, attacks itself so aggressively that it puts itself at serious risk.” Pointing us in the opposite direction from today’s restrictive and homogenizing trends, he encourages us to broaden our genetic pool and enjoy a wide range of viewpoints.