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

Matt Richtel is a terrific writer. His book on immune system is titled: An Elegant Defense: The Extraordinary New Science of the Immune System: A Tale in Four Lives. 

In my childhood, my parents taught me the very basics of our immune system, like I have a large number of tiny soldiers inside my body that fight with many viruses, bacteria and other pathogens to protect me. They told me that when I get injured, like a small cut on finger, it is these tiny soldiers come and repair the wounded area. I passed the similar knowledge to my son when he was younger. 

That's about it. That's what I knew as I played soccer in the mushy mud, cricket under the scorching sun, kabadi in monsoon rain, while hopping from tree to rooftop back to another tree with hand made slingshot, jumping on reddish brick or slippery grass.  In subsequent years, schooling taught me a bit more, like the B and T Cells, antigens, antibody, how vaccine works, etc. Also, I learnt how having good eating habits and doing exercises regularly keep our immune system strong. 

Matt Richtel presented our amazing immune system through the lives of four people. One of them was his closest childhood friends. 

Our immune system is very complex, but Matt Richtel presented this complex and least understood subject lucidly, in simple words and within the actual life stories. 

One major point from this book is that our immune system defends us, not by only raging wars against pathogens, but also and mainly by maintaining and promoting peace. Only when everything fails, the immune system goes to all out war. 

I find the story of Robert (Bob) T. Hoff profound. He was infected with HIV virus that killed his friends and loved ones, but Bob survived, he never got sick from HIV. His powerful immune system shielded him from the menacing AIDS that killed millions of people. 

The story of Jason Greenstein was heartbreaking. His entrepreneurial heart, strong determination and resilience facing the uphill battles against a terminal cancer (Hodgkin's lymphoma) one after another, going through pain after pain, is tragic, but he is also a source of inspiration for Matt Richtel to dig deep into immune system and various immunotherapies that Jason and three other lives depicted in the book gone through.

Our elegant immune system tries to keep peace. It is not a relentless war monger that many in the wider population including me learnt from childhood, but its main purpose is to maintaining harmony, the balance between our "self" and "alien". The writer drew a meaningful parallel here: how a healthy immune system cooperates with our friendly bacteria ("alien"), helping each other, while when immune system goes awry, autoimmune disorder happens when our own immune system attacks the very cells and organs that it is programmed to protect. It has stunning similarity within human societies, where "Xenophobia, blind nationalism and racism, is an autoimmune disorder. A culture, tone deaf in its own defense, attacks so aggressively that it puts itself at serious risk. Biology's lesson, honed like water-polished stone, teach us that cooperation with our species' diversity is undeniably key to harmony and survival". 

Here is a good quotation from the book: "civilization ..... has been dominated by the push and pull of our competing instincts to cooperate and alienate, to see what people share in common or prey on what divides them. The lesson of the immune system is that the better able we are to find common ground, the more allies and weapons we have to contend with a greater, common foe." (page 396)

It is the global efforts from every nation, every culture and creed, that are needed to fight our "greater, common foe", which is the very inevitable death itself, "If we learn together and cooperate, we can tackle autoimmunity and cancer and Alzheimer’s, and who knows what other seemingly impossible foes." (page 397).

Here is another great quote: "the immune system cautions us to take the least destructive path possible to a livable balance. When we don’t cooperate, when we err too easily on the side of war—literal and proverbial, physical and verbal, armed and political—we emulate one of the most self-destructive of our traits: an overheated defense system."

Tinkering with immune system by using various medicines to treat diseases has risks, many of which are still going through scientific research. However, rather than tinkering with our immune system, there are four powerful things that we have control of: sleep, exercise, meditation and nutrition. 

Basically, sleep and exercise keep our immune system (adrenal) from firing too intensely. Lack of sleep and lack of quality exercise raise inflammation throughout our body, and also makes our immune system less functional. Exercise also slows down the natural aging process.

Embracing good nutrition is also super important. "The less toxic the things you put into your body, the less likely your body is to create, or need to create, an inflammatory response.........When it comes to food, science identifies risks associated with unnatural substances you digest, additives and chemicals and factory inventions that are not actual food. They make it likelier that your immune system has little choice but to react."

Here the writer points out that more active we can be, both our body and our brain, the more signal we pass to our internal system that we play a vital role in our own and our species' survival, this generates a continuous cycle of regeneration and increases the probability of our survival. The revere is also true where when we become still, both physically and mentally, our internal system interprets that we want to quit and it takes away our resources that we need to survive.

In the end, our death is inevitable. Matt Richtel points out that our immune system evolved to defend us as an overall species, but not as our individual self. It keeps us alive until we pass our genetic materials to next generation, then bring our offspring to adulthood so that it can protect itself and the cycle can continue. When our task is done, the inevitable demise comes. There is no way to stop it. We cannot live forever.

None of us can control this, but what we can plausibly control is how we age, how healthy we remain to our last days. The key point here is: "Less pain, anxiety, disabling disease. Less fragility." 

Here is one quotation from the book that I find to be profound: "two competing principles in exquisite balance: We must continue to strive, dream, and exercise all the passions that have gotten us this far, while also doing a much better job of accepting death. Death is not just inevitable, not just programmed into us and facilitated in ways by our immune system. It is essential for our survival." (page 407)

I loved reading this book and heartily recommend others to read it.