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An Elegant Defense: The Extraordinary New Science of the Immune System: A Tale in Four Lives
An Elegant Defense: The Extraordinary New Science of the Immune System: A Tale in Four Lives
An Elegant Defense: The Extraordinary New Science of the Immune System: A Tale in Four Lives
Audiobook12 hours

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

Written by Matt Richtel

Narrated by Fred Sanders

Rating: 4 out of 5 stars

4/5

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About this audiobook

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.

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, #1 bestselling author of The Lost City of the Monkey God

Editor's Note

Scientific detective story…

Take a tour of how our immune system works with a Pulitzer Prize–winning journalist. This scientific detective story sets out to illuminate the mysteries of our body’s powerful defense system through the intimate experiences of four patients.

LanguageEnglish
PublisherHarperAudio
Release dateMar 12, 2019
ISBN9780062698513
Author

Matt Richtel

Matt Richtel is a reporter at the New York Times. He received the Pulitzer Prize for national reporting for a series of articles about distracted driving that he expanded into his first nonfiction book, A Deadly Wandering, a New York Times bestseller. His second nonfiction book, An Elegant Defense, on the human immune system, was a national bestseller and chosen by Bill Gates for his annual Summer Reading List. Richtel has appeared on NPR’s Fresh Air, CBS This Morning, PBS NewsHour, and other major media outlets. He lives in San Francisco, California.

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Reviews for An Elegant Defense

Rating: 4.2347418028169015 out of 5 stars
4/5

213 ratings29 reviews

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  • Rating: 5 out of 5 stars
    5/5
    The wonderful world of immunology explained in such a lucid manner. The author is a great storyteller.

    1 person found this helpful

  • Rating: 5 out of 5 stars
    5/5
    At times i was struggling to keep up with the science talk but I kept with it and I’m so glad. This book is a great listen. The people mentioned in this book are absolutely extraordinary. I loved it.

    1 person found this helpful

  • Rating: 2 out of 5 stars
    2/5
    Exceedingly long winded account of the recent breakthrough in immunology research.

    1 person found this helpful

  • Rating: 4 out of 5 stars
    4/5
    I bought this book on one of my first trips back to the bookstore during the pandemic (for obvious reasons), but I didn't read it right away. As it turns out, I am glad that I didn't, as I talked my dad into choosing this for our ongoing buddy read project, and it was definitely better that way. Both on the chapter-a-week pace and having someone to dissect this with.I did get a lot out of this book, though I often thought I would like it better if it had a better editor and/or it had been written by a scientist rather than a journalist. Still, this book is definitely framed around personal stories, and as a reporter he was well suited to telling those (though some of his little offhand societal observations provoked big eyerolls from me.)I probably would have been more annoyed reading this alone, but this was good enough.
  • Rating: 5 out of 5 stars
    5/5
    This is a must read in the day of COVID-19. It gives you a really excellent outline of Immune system and how amazing it is and how it affects your to day-to-day life.
    The story is told through 4 people that suffer from different types of autoimmune disorders. How human cooperation and standing on the shoulders of giants of science and Medicine has gotten us to the point where hopefully in the near future we will have a cure for COVID-19 or a vaccine.
  • Rating: 5 out of 5 stars
    5/5
    The story is about courage and hope of three people and their fight against their own immune systems causing havoc. Sometimes successful, sometimes not but always about hope. It gets into the weeds a bit about how our immune system defends us and occasionally hurts us but without that background it would impossible to understand how important these discoveries are and what are the possibilities.
  • Rating: 5 out of 5 stars
    5/5
    A must read for everyone. I thank the author Matt Richtell for writing this very enlightening and informative book. Thank you Matt.
  • Rating: 5 out of 5 stars
    5/5
    Fascinating read about power and complexity of the immune system mixed with fantastic storytelling by the author. Beautifully done.
  • Rating: 5 out of 5 stars
    5/5
    Amazing and unmissable, popular science at its best! Great insights and knowledge for everyone.
  • Rating: 5 out of 5 stars
    5/5
    Muy interesante, son temas muy complejos, narrados de una manera muy sencilla. El narrador estupendo.
  • Rating: 5 out of 5 stars
    5/5
    Page turner! Extremely interesting, warmly presented. Lots of scientific research simply explained.
  • Rating: 5 out of 5 stars
    5/5
    I enjoyed reading this book. There was a lot of science and explanations, but he broke things down in ways that the non-science major reader could understand. He added humor to the book and I appreciated that as well. I loved the focus on the four different people and how they were impacted in different ways by their immune systems. It added a more realistic and personal view on how the various diseases impact the body. I highly recommend this book.
  • Rating: 5 out of 5 stars
    5/5
    Has changed my view of how far to take cleanliness and the importance of the immune system and healthy lifestyle
  • Rating: 2 out of 5 stars
    2/5
    Could have been a great book if the author kept his cultural Marxist ideas to himself. "Nationalism is an autoimmune disease" is a little too much.

    2 people found this helpful

  • Rating: 3 out of 5 stars
    3/5
    An Elegant Defense: The Extraordinary New Science of the Immune System:An exploration of the human immune system illustrated with four immunotherapy cases to explain how our defense systems protect and sometimes injure the body.The topic is interesting, the writing style mixes anecdotal with scientific details.
  • Rating: 3 out of 5 stars
    3/5
    I learned a few things, but this was a bit over my head. It would have helped if it focused more on the people in the case studies.
  • Rating: 2 out of 5 stars
    2/5
    Matt Richtel, as far as I can tell, is not a scientist, researcher, or doctor, but has written this book about the science of our immune system. An interesting topic, and one I want to learn about, and oh how I wish the book had been written by someone like Siddhartha Mukherjhee or Atul Gawande. First, and not least, I was annoyed by his writing style. There are constant authorial interjections like, "but wait, there's more," and "You would think so, but you'd be wrong."The book attempts to entwine the history of the science of our immune systems and the current status of our knowledge of immunology with the stories of four patients with immune system issues: Jason with cancer, Linda and Meredith with auto-immune diseases, and Bob with HIV. I think he went way overboard trying to filter the science through these personal stories, and did a fairly inept job of explaining the immune system, autoimmune diseases, and immunotherapy. Some facts filter through here and there, and I did learn something. I just wish for a more organized and well-written book on the topic.
  • Rating: 5 out of 5 stars
    5/5
    I was lucky enough to receive a copy of this book from the Early Reviewers program...thank you, librarything! I requested it because someone I care for has an autoimmune condition and I wanted to understand more about it. Richtel provides an in depth, and accessible study of the immune system, using actual stories, both of people suffering from immune issues, as well as the doctors and scientists who studied the immune system. HIs book brought home to me how recent many of the discoveries are, and how vast and complex the human body is. He shares his wonder and appreciation for the studies and discoveries of others.
  • Rating: 4 out of 5 stars
    4/5
    If you read this book, you'll never again think about the healing of a cut, an infection or an illness in quite the same way. If you love reading about science and health and are fascinated with the delicate balance that keeps us alive and healthy (or not), you'll enjoy this book. The author keeps it interesting and readable by presenting some of the science using 4 case studies. There were still some parts that were impossible to digest in a casual reading. I found it to be about as clear an explanation as possible of a complicated subject especially considering that the author gave a detailed history of immunology up to the present day.
  • Rating: 4 out of 5 stars
    4/5
    I just finished An Elegant Defense by Matt Richtel, about our immune system. I wish I could be more enthusiastic. He wore me out! It's a fascinating subject, and he's good at making it understandable, but I wish he had simplified it even more. The interaction of all the acronyms that are hard to remember, along with the complexity of the immune system, make this a tough go for the neophyte. Those with some knowledge may have a much easier time of it. What doctors and researchers are finding out, particularly (for me) about autoimmune diseases, is amazing.
  • Rating: 4 out of 5 stars
    4/5
    Fantastic. I'm talking about the immune system, not the book. The immune system is amazingly complex and fascinating. The author does a creditable job explaining how it works. But one definitely gets the sense that he doesn't think most readers can fathom the hard science involved in understanding it. He attempts to make it accessible to the average reader by making it as much about the people, the researchers, doctors and patients as he does about the nitty-gritty of the immune system itself. This does make the book an easier read, but it left me with the feeling I had missed out on a more thorough understanding. For that, I will have to turn elsewhere. But for those who want a lighter touch and to see how the immune system influences the lives of real people in very human ways then I would highly recommend this work.
  • Rating: 3 out of 5 stars
    3/5
    When Jason, a close friend of journalist Matt Richtel, was afflicted with lymphoma and received an experimental new immunotherapy drug that, for a while, resulted in dramatic improvement, Richtel was inspired to learn all he could about the immune system and the new medical techniques involving it, and to share his friend's story. This book is the result, although it also features the stories of three other people as well as Jason's: two women with autoimmune disorders, and a man who possesses a natural immunity to AIDS.Unfortunately, though, the result really isn't quite the book about the immune system I wanted to read. I feel kind of bad saying that. I certainly did learn some things, and some of the moments involving Jason that Richtel shares with us are quite poignant. (Although he does give in to the entirely understandable impulse to share more details about his friend than the book really needed.) The truth is, Richtel is trying to do a really, really hard thing here. The immune system is fantastically complicated and still not entirely understood, and the field is full of dry, hard-to-remember terminology. Trying to convey all of that to the lay reader in a way that makes sense is difficult, maybe impossible. But, for me, at least, the book errs on the side of trying a little too hard to be accessible. There was one notable moment in here where I finally started getting really into the nitty-gritty science details he was talking about, really finally feeling interested and able to follow the complexities of the thing... and that's the point where Richtel stops his explanation cold with a "Whew!" and an apology for how hard that was to follow. Which I found really frustrating. There are also several moments in the more science-y sections when he deliberately leaves things out, saying he'll deal with that when he gets back to talking about the patients' stories, and moments during the patients' stories when he leaves things out and says he'll get back to that in the science-y parts. I know all of this is meant to help readers stay engaged, by breaking up the technical stuff and focusing on human-interest stuff, but for me it kind of backfired and just made it all harder to follow. I will say that I do like the parallels he draws between the immune system and human society, including the importance of diversity and the danger of being so focused on protecting "self" against "other" that the "self" ends up being damaged. It's not scientific, by any means, but I think it's actually a very apt analogy. Also not scientific, but less appealing, is Richtel's willingness to flirt a bit with the pseudoscientific ideas of so-called "alternative medicine." He doesn't do it much, fortunately, but the moments when he does had me rolling my eyes a little.Anyway. I will say that while this isn't the book about the immune system I wanted, I can see how some -- especially, perhaps, readers with less of a science-y background -- might find it to be much closer to what they want.
  • Rating: 3 out of 5 stars
    3/5
    I received a free copy of this book from the publisher in exchange for an honest review.A very accessible book on the immune system and immunology for the reader who isn't a medical expert. The author keeps the book in the light reading/popular science category by talking about four real people with unusual medical problems and/or unusual immune systems who ended up on the bleeding edge of immunology treatment. I came away with a new respect for the immune system and was intrigued by a lot of the technology (no wonder these drugs cost so much! and who knew they could do entire immune system transplants!) and I was intrigued by some of the doctors' hypotheses, but in my case, abrupt changes in subject matter and dwelling on personal stories for two or three pages at a time made me impatient to get back onto the main topic. In general, the book reads as if it needs some serious edits; there are sloppy and weird personal asides and errors all over the place. I read an ARC, so it's possible that some of this was edited in the final version.Some of the advice in the book about more mindful living to avoid inflammation and stress was excellent. Many of us need to try to stop living in a constant adrenaline rush so that our immune systems will go off high alert.I am eager to learn more on this subject and to study related topics such as inflammation, autoimmune diseases, and the microbiome.
  • Rating: 3 out of 5 stars
    3/5
    This is a casual and readable narrative that is partly an exploration of immunology (its history and the current science), partly a biography of several patients whose diseases/treatments involve the immune system, and partly the author’s own memoir.The science is fascinating and Richtel is able to communicate his borderline (not excellent) grasp of it to the reader. (Note that there are numerous errors in my advance copy; I hope they are corrected before publication.) The case histories disappointed me; they are socially oriented and very thin on medical aspects. And although Richtel is a good-natured narrator, he incorporates too many fiction techniques -- too much suspense-building and teasing about things that will be revealed later (but never are?) and too many segues into fun facts that are irrelevant and distracting and should have been deleted.Overall, it accumulates to a partial introduction/update on the immune system and an homage to people (one of his friends, in particular) who are affected by issues with their immune systems.
  • Rating: 3 out of 5 stars
    3/5
    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 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.
  • Rating: 4 out of 5 stars
    4/5
    This was an interesting book about a fascinating subject, the human immune system. Although I am not a medical professional, I am a person with probably far too much education and am deeply interested in human biology/science, so was very excited to read this. Although I thought it was well written for laypersons such as myself, it tried to be too much. Maybe due to timing, I also think there was a lot left out, especially in certain ways we are seeing that auto-immunity is not necessarily "the body attacking itself," but working very hard to rid the body of certain viral loads, toxicities and pathogens that many of us carry since birth or young adulthood (or acquire environmentally or via medications). That said, I did learn a lot about the emergence of immunology and some smaller details about our immune system I did not know. I did not have a deep interest in the four individuals he chose as the elements for the story, so that might have been part of the problem. Overall though, I think it was an ambitious, interesting attempt, just I might not have been the target audience.
  • Rating: 4 out of 5 stars
    4/5
    The immune system may be the most complex thing in the human body and one of the things that is still least understood by us. Richtel finds a way to present the material that is both casual and easy to understand while also covering it accurately and showing how important the subject is to him. The book largely covers auto-immune disorders, HIV and cancer and tells the story of these illnesses through the story of some patients who have experienced them. I recommend this book and would like to add that you absolutely do not have to enjoy science or have a medical background to enjoy this book. Richtel makes the subject shockingly accessible.I didn't give it the 5th star for a few reasons. I felt it was a little too casual. It left out a LOT of info. In fact, if it didn't relate to the 4 patients showcased, it really wasn't covered at all. As a nurse, I'm aware of some of the up and coming interesting things being done with immunotherapy and immunology and there were several things that I had hoped he'd have in the book that weren't there.However, I'm probably being too picky. The immune system is a massive topic that still isn't well understood by anyone and Richtel did an amazing job making it understandable. If you are curious about blood cancers, autoimmune diseases, or a quick history of HIV, and have very little to no science background, you'll love this book. If you want an all encompassing explanation of the immune system somewhat along the line of Mukherjees "An Emperor of Maladies" was about cancer, this isn't that.
  • Rating: 5 out of 5 stars
    5/5
    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 for “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.
  • Rating: 5 out of 5 stars
    5/5
    I'm really surprised with how much I learned from this book. Richtel does a good job of describing the history of immune system research and how it all works. It is organized in short, easy to digest chapters and is interspersed with real people and cases. I also was surprised with how it ended...which rarely happens with a science based, non-fiction, book. I highly recommend this to anyone, regardless of medical science background. I received this through the Early Reviewers program.