Inside your action-packed immune system, it’s ‘good guys eating bad guys!’

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

|    Karen Iris Tucker    |

IT WAS Halloween night in 1977. A young Robert T Hoff dressed as a mummy, having purchased a 30-foot roll of gauze at a fabric store and wrapped himself in it. At a party that evening, he had an encounter with a redheaded guy that changed the trajectory of his life. Hoff was diagnosed with HIV in 1984.

In that formative year of the AIDS crisis – more than a decade before the introduction of HAART treatment, the ‘cocktail’ combination of drugs that transformed treatment – such a diagnosis was unimaginably frightening and nearly always fatal. Yet Hoff never got sick. In the ensuing years, he’d inspect his body for telltale signs of the disease, including the purple lesions of Kaposi’s sarcoma, a type of skin cancer. His immune system continued to elude the virus; the disease never progressed.

“I would meet people and it was just unbelievable, they all died. I’d make new friends and all those guys died,” Hoff told Matt Richtel, a Pulitzer Prize-winning New York Times science reporter and novelist, of his harrowing early days living with HIV. He never took antiviral drugs, but Hoff’s immune cells remained numerous and healthy. Driven to understand how and why this could be, Richtel chronicles Hoff’s fascinating experience in a new book, An Elegant Defense: The Extraordinary New Science of the Immune System – A Tale in Four Lives. The book also follows the complicated health trials of two women with autoimmune diseases and one of Richtel’s childhood friends who battled cancer later in life.

In between these four personal stories, Richtel weaves in intricate, sometimes obscure details on the origins of and advances in immunology, the science of the human immune system. He also explores a relatively new mode of treatment, immunotherapy, which helps the immune system fight cancer and other debilitating diseases.

To lend further colour to the medical narrative, Richtel interviews leading scientists and physicians in the spheres of immunology and oncology, drawing out not only their scientific perspectives but also their soulful takes on mortality. In doing all this, Richtel brilliantly blurs the lines between biology primer, medical historical text and the traditional first-person patient story.


Richtel’s bedrock is his unabashed romance with the immune system, which he affectionately nicknames ‘an elegant defence’, for its complex ability to ward off any number of would-be invaders that could compromise our health. “It is an ever-vigilant, omnipresent peacekeeping force in the Festival of Life,” he said early on in the book.

Like a kid spinning a superhero tale, Richtel employs delightfully effusive prose, particularly as he relates such intricacies as the science of inflammation and the roles of the immune system’s most advanced fighters, T cells and B cells, which Richtel notes are two of the most effective biological structures in the world.

“Once a T cell or B cell finds its evil mate, its infection doppelgänger, it can set in motion a powerful defense, following hard on the innate reaction, bringing in defenders trained specifically to bounce out this particular antigen. Explosions! Implosions! Toxic gas attacks! Good guys eating bad guys!”

Knowing that some readers may be less inclined to follow the wondrous minutiae of immunology, Richtel harnesses his reporter’s eye for the human condition.

Beyond Hoff’s miraculous story, he relays the frustrating, often agonising medical conundrums that befall Linda Segre, a Type A avid golfer and partner at a consulting firm who is suddenly wracked by symptoms of rheumatoid arthritis, an autoimmune disease in which the immune cells attack the joints. – WP-BLOOM