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

by Matt Richtel


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“A deeply reported and entertainingly written exploration of the human immune system and how it works.” —USA Today

National Bestseller * Essential reading during the novel coronavirus (COVID-19) pandemic

The Pulitzer Prize–winning New York Times journalist "explicates for the lay reader the intricate biology of our immune system" (Jerome Groopman, MD, New York Review of Books)

New York Times science reporter Matt Richtel's An Elegant Defense illuminates the human immune system as never before, uniquely entwining intimate patient stories with science’s centuries-long quest to unlock the mysteries of sickness and health.

The immune system is our body’s essential defense network, a guardian vigilantly fighting viruses and illness, healing wounds, maintaining order and balance, and keeping us alive. Its legion of microscopic foot soldiers—from T cells to “natural killers”—patrols our body, linked by a nearly instantaneous communications grid. It has been honed by evolution over millennia to face an almost infinite array of threats.

For all its astonishing complexity, however, the immune system can be easily compromised by fatigue, stress, toxins, advanced age, and poor nutrition—hallmarks of modern life—and even by excessive hygiene. Paradoxically, it is a fragile wonder weapon that can turn on our own bodies with startling results, leading today to epidemic levels of autoimmune disorders.

Richtel effortlessly guides readers on a scientific detective tale winding from the Black Plague to twentieth-century breakthroughs in vaccination and antibiotics, to the cutting-edge laboratories that are revolutionizing immunology—perhaps the most extraordinary and consequential medical story of our time. The foundation that Richtel builds makes accessible revelations about cancer immunotherapy, the microbiome, and autoimmune treatments that are changing millions of lives. An Elegant Defense also captures in vivid detail how these powerful therapies, along with our behavior and environment, interact with the immune system, often for the good but always on a razor’s edge that can throw this remarkable system out of balance.

Drawing on his groundbreaking reporting for the New York Times and based on extensive new interviews with dozens of world-renowned scientists (including Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases), Matt Richtel has produced a landmark book, equally an investigation into the deepest riddles of survival and a profoundly human tale that is movingly brought to life through the eyes of his four main characters, each of whom illuminates an essential facet of our “elegant defense.”

Product Details

ISBN-13: 9780062698537
Publisher: HarperCollins Publishers
Publication date: 03/12/2019
Pages: 448
Sales rank: 169,457
Product dimensions: 6.10(w) x 9.10(h) x 1.60(d)

About the Author

Matt Richtel is a Pulitzer Prize–winning New York Times reporter and bestselling nonfiction and mystery author. He lives in San Francisco with his wife, Meredith, a neurologist, and their two children. In his spare time, he plays tennis and piano and writes (not very good) songs. Visit him online at

Table of Contents

Author's Note xvii

Part I Lives in the Balance

1 The Ties That Bind 3

2 Jason 13

3 Bob 23

4 Linda and Merredith 26

Part II The Immune System and the Festival of Life

5 The Bird, Dog, Starfish, and Magic Bullet 37

6 The Festival 45

7 Festival Crashers 48

8 The Mystery Organ 57

9 The B-Word 66

10 T Cells and B Cells 73

11 Vaccines 78

12 The Infinity Machine 86

13 Transplant 92

14 The Immune System's Fingerprint 102

15 Inflammation 109

16 Fever 120

17 Flash Gordon 129

18 The Harmonious Way 138

19 Three Wise Men and the Monoclonal Antibody 140

20 A Second Immune System 146

Part III Bob

21 Sex Machine 159

22 GRID 161

23 The Phone Call 171

24 CD4 and CD8 175

25 Magic 182

26 The Prime 187

Part IV Linda and Merredith

27 Linda 197

28 The Wolf 202

29 Invisible Evidence 212

30 Best of Both Worlds (Sort Of) 219

31 Merredith 222

32 Should You Pick Your Nose? 236

33 Microbiome 250

34 Stress 261

35 Sleep 268

Part V Jason

36 A Word About Cancer 275

37 Laughter and Tears 280

38 The Lazarus Mouse 293

39 Wound Healing 300

40 Programmed Death 308

41 The Breakthrough 317

42 Jason Races Time 319

43 Shepherd of Death 324

44 Trials, Personal and Clinical 328

45 The Other Shoe 334

Part VI Homecoming

46 Bob 343

47 Linda 351

48 Jan and Ron 356

49 Jason Down the White Tunnel 366

50 Jason Rises 377

52 Apollo 11 380

52 Home 381

53 Jason's Way 393

54 The Meanings of Life 395

55 The Meaning of Jason 405

Acknowledgments 411

Index 415

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