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 ... To lend further color 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 ... Like a kid spinning a superhero tale, Richtel employs delightfully effusive prose ... 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...frustrating, often agonizing medical conundrums ... He draws frequently on the analogy of the immune system’s quest to identify the 'self' and the 'alien' within, in doing so highlighting society’s parallel struggle and the lessons we still need to learn.
Richtel succeeds in this formidable task using colloquial prose with touches of humor ... The patient stories are vividly told ... While successfully communicating the science of Allison and Honjo and related clinical advances to a lay reader, Richtel occasionally lapses into hyperbole.
An Elegant Defense gives a thorough, richly entertaining and just-wonky-enough beginner’s class in immunology through the case studies of four patients ... These four tales help readers without prior scientific training tackle the alphabet soup of immunology ... Mr. Richtel also objects to the militaristic rhetoric surrounding the immune system ... Yet even Mr. Richtel can get caught up in a breathlessly martial style that runs the risk of both inaccuracy and bombast-fatigue ... It’s hard to disagree with Mr. Richtel’s sentiment, but cherry-picking teachable moments from biology is a dicey endeavor ... Mr. Richtel takes wide liberties with the stress-disease model ... Until we know more about how the immune system responds to...cues, past and present, dispensing warnings such as Mr. Richtel’s can be at best anxiety-provoking and at worst victim-blaming.