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

4.02  ·  Rating details ·  479 ratings  ·  112 reviews
A magnificently reported and soulfully crafted exploration of the human immune systemthe 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 medica
Hardcover, 448 pages
Published March 12th 2019 by William Morrow
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4.02  · 
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 ·  479 ratings  ·  112 reviews

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Jun 22, 2019 rated it liked it
Shelves: white
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, ...more
Mar 11, 2019 marked it as did-not-finish  ·  review of another edition
Shelves: arc
Sadly 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.
Apr 05, 2019 rated it it was ok
Shelves: books-i-own, arc
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 kn
Laura Weldon
Jan 22, 2019 rated it it was amazing  ·  review of another edition
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 o
Apr 27, 2019 rated it it was amazing  ·  review of another edition
Shelves: health-fitness
A great read to better understanding our immune system while learning about the discoveries that have lead to saving lives. If you are interested in immunology this is a great book to read.
May 07, 2019 rated it it was ok
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 t
Dan Drake
May 28, 2019 rated it it was ok
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 t
May 22, 2019 rated it really liked it  ·  review of another edition
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.
Mar 23, 2019 rated it it was amazing  ·  review of another edition
Shelves: favorites

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
Carly Friedman
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 fr ...more
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.
Apr 11, 2019 rated it really liked it  ·  review of another edition
An Elegant Defense is a layman's introduction to the science of the immune system, interwoven with the stories of four people with different kinds of immune ailments. Two of them have immune systems that are too active (autoimmune diseases). Two of them have immune systems that are not active enough (AIDS and cancer). The book is strongest and most engrossing when Richtel is telling these stories -- especially the story of his friend, the cancer patient. The other three stories are somewhat pale ...more
Apr 17, 2019 rated it really liked it
Shelves: science, own, health, giveaways
An Elegant Defense: The Extraordinary New Science of the Immune System: A Tale in Four Lives is a detailed look at the human immune system and it’s responses to threats. Matt Richtel combines explanatory text with test cases. When I began the book, I was hoping to get right to the content and was frustrated for a few chapters. I do understand his decision to include case studies, but the text didn’t always flow smoothly between chapters. That being said, I did learn a lot along the way. I especi ...more
Dennis Hogan
Apr 10, 2019 rated it it was amazing  ·  review of another edition
Just finished An Elegant Defense: The Extraordinary New Science of the Immune System: A Tale in Four Lives by Matt Richtel, a Pulitzer Prize-winning NY Times reporter. This is among the best science and health books I’ve ever encountered. It chronicles the health issues facing four people each suffering from a unique immune system-related disease, cancer, lupus, rheumatoid arthritis, and AIDS. Richtel gets into just enough science to get to the core of the medical issues while focussed on the hu ...more
Jun 08, 2019 rated it liked it
Shelves: popular-science
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 sayi
May 26, 2019 rated it really liked it
Shelves: nonfiction, medicine
This book leans more heavily into science than human interest, but is nonetheless accessible and compelling. I do wish the author hadn’t tried so hard to metaphorically connect the work of the immune system with societal ills like bigotry and xenophobia, but his underlying point is no less true.
Apr 27, 2019 rated it really liked it  ·  review of another edition
Shelves: medicine
The immune system is extremely complex and new discoveries are being made constantly. MR does a fine job of explaining what is known, or suspected, about the immune system. Give the rise of auto-immune diseases, and suspected links between other diseases and the immune system, this book should be of great interest to many readers. His explanations are clear and he uses 4 people with different immune problems as case studies to show how the immune system works or doesn't or overworks in the the b ...more
Apr 01, 2019 rated it liked it  ·  review of another edition
If you didn’t know the title of this book was An Elegant Defense, the author only mentions it like a million times so you’ll catch on, don’t worry. I debated giving this two stars because I felt like a lot of the book could’ve used more editing and less repetition but the information was good and the stories weren’t hard to get through.

I did feel Richtel left unanswered questions about the people’s lives which I guess aren’t really relevant to their health stories, but then why would he include
Apr 17, 2019 rated it really liked it  ·  review of another edition
I listened to the audiobook version, and I hope it was just a reading error (around the 60% mark) when it was stated "animals raised without antibiotics lead to a rise in antibiotic-resistant bacteria," but if not, that is a major fact-checking problem.

It's also not my only issue with this book.

It's definitely interesting - an excellent choice for readers who like authors like Deborah Blum or Atul Gawande or Sam Kean who mix relevant contemporary and historical anecdotes in with detailed scienc
May 06, 2019 rated it it was amazing  ·  review of another edition
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.

May 03, 2019 rated it it was amazing  ·  review of another edition
This review has been hidden because it contains spoilers. To view it, click here.
Mar 21, 2019 rated it it was amazing  ·  review of another edition
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 tr
Apr 10, 2019 rated it really liked it  ·  review of another edition
In "An Elegant Defense," New York Times reporter Matt Richtel discusses the intricacies of the human body's immune system, "the glue that defines the whole of human health and wellness." It is our first line of defense when we are injured or ill. This remarkable sentinel has multiple tasks. Among them are cleaning wounds, regenerating tissue, and repairing organ damage. In addition, the immune system keeps a watchful eye on potential malignancies and other threats. Unfortunately, this powerhouse ...more
May 21, 2019 rated it liked it  ·  review of another edition
Matt Richtel has written a popular history of immunology covering seemingly diverse diseases such as HIV AIDS, Cancer, and autoimmune diseases and the latest therapies involving biologics targeting them.

The book is important and necessary but suffers from awkward sentence constructions, mind numbing sports metaphors and general heterosexual male banter, all of which are extremely triggering for me and made me want to stop reading.
The book is also disjointed, something that the author credits t
Mar 24, 2019 rated it really liked it  ·  review of another edition
I received this book from the publisher in exchange for a review.

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
Brenda He
Jul 08, 2019 rated it really liked it  ·  review of another edition
This book has a unique way of approaching the topic. While the writing style has managed to captivate me, i find myself getting lost in the middle of the book as it appeared to bring us through the history of immunology. It is like multiple revised version of what is immunology and it’s related concept- I thought this is it until the next discovery. If the objective of the author is to bring us through what scientist went through, i think it’s successful. But as a layman with simple understandin ...more
Chris Allan
I learned stacks about the immune system from this book, and a little bit about the four people he takes as iconic examples of immune system problems. The issue is that reading the book was like listening to a young kid with ADHD tell a story. He would start on an interesting discovery or experience, get halfway into it, and then jump over to another tale. Sometimes he would come back to it several chapters later, by which time you’ve lost the thread of the first story, and then he’d start on a ...more
Jun 29, 2019 rated it did not like it
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 t
Ameya Warde
Excellent book, and important reading for folks with health issues, from chronic illness to cancer. Its definitely aimed at the layman with little to know background knowledge about immunology. I felt like he did a great job overall explaining things that can be complicated, though other reviewers said it was overly simplified... still a good entry point, I think.

This was definitely heavy on the biography of Jason, which I don't mind in principle but I think it could have been scaled back a bit
Jul 23, 2019 rated it liked it  ·  review of another edition
Shelves: 2019-reading
I am a scientist, and I find it fascinating to put the personal side of the story together with the science. However, I found this book lacking for a couple of reasons:
1) I am pretty knowledgeable about some of the science presented and there were some glaring inaccuracies. As one example, Richtel reported that 5 patients died in the Tegenero trial of the CD28 superagonist antibody. This is wrong. Actually all patients went home (they did suffer long term side effects). There were other inaccura
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