Book of the week
An Elegant Defense: The Extraordinary New Science of the Immune System
If you don’t understand the human immune system, don’t feel too bad, said Dan Friedman in the Los Angeles Review of Books. “After all, you’re no different from most scientists until the very recent past.” But that’s why Matt Richtel’s new book is so useful. Immunology has been transformed in the past decade by discoveries that may soon enable medical professionals to outsmart cancer, AIDS, and other deadly diseases. Richtel, a Pulitzer Prize–winning New York Times reporter, “has exactly the right set of tools” to demystify the science. And because Richtel focuses on four people who were gravely afflicted or miraculously saved by their immune systems, the learning arrives alongside “deeply affecting” drama.
Richtel begins by introducing Jason, a friend of his since childhood, said Matt McCarthy in USA Today. Jason was in his mid 40s when he was diagnosed with Hodgkin’s lymphoma, and by the time we meet him he is ready to take a chance on an experimental drug that promises to disrupt cancer’s power to trick the immune system into helping it grow. We also meet Merredith Branscombe and Linda Segre, both debilitated by immune systems that are attacking their healthy cells. Together with Bob Hoff, whose immune system has somehow kept HIV in check, these four provide what Richtel calls “a kind of immunological Goldilocks story”—a chance to see the effects of individual immune systems that are too weak, too strong, and just right. He offers some more curious analogies as well, likening autoimmune disorders to xenophobia and even Nazism. “Yet it’s this outside-of-the-box thinking that makes Richtel’s book so rich and engaging.”
It would be better without its occasional lapses into hyperbole, said Jerome Groopman in The New York Review of Books. James Allison and Tasuku Honjo jointly won a Nobel Prize last year for having identified proteins that act, often unfortunately, as brakes on the immune system; their discovery doesn’t need to be hyped as “on par with the greatest human achievements.” Still, Richtel is careful to remind us that immunology remains a field full of mysteries. Though immunotherapy did temporarily shrink Jason’s tumors, they eventually grew again, ending his life. But we in the medical field are learning, and as we do, the progress we make should help others like Jason survive. Richtel has taken upon himself to give lay readers a means of understanding what’s known so far about the intricate biology of our immune systems, and “he succeeds in this formidable task.” ■