Scott Carney's Reviews > Immune: a Journey into the Mysterious System that Keeps You Alive

FIRST THE GOOD: This is the simplest explanation of the immune system that I've ever come across that doesn't gloss over the startling complexity of the innate and adaptive immune responses. Dettmer uses simple metaphors to visually explain impenetrable terminology so that even a lay person can understand what is happening. MHC Class II receptors are hotdog buns, antigens are hotdogs, MHC Class I molecules are portholes into the cellular machinery. These simple visualizations really help, as do the illustrations that pull from the brilliance of the Kurgzesagt channel. I also loved the footnotes that delve into fascinating asides and yet keep the overall story (can you call it a story?) on track.

THE LESS THAN GOOD: Once Dettmer was done explaining the immune pathways--about three quarters of the way through--some of his takeaways start to lose focus. This is because his intensely reductionist lens that focuses primarily on pathways, has trouble taking in the big picture. It's not exactly Dettmer's fault--this is the way that every immunology textbook and class I've come across also treats the topic. But it leads to a really strange cyclical logic.

For instance: throughout the book he writes that the immune system is absolutely not conscious--and that immune cells are basically mindless robots whose amazing adaptive properties emerge out of mechanical complexity. And yet he (and every immunologist I've met) can't resist anthropomorphizing cellular action--by calling macrophages angry, having one cell tell another to do something, communication across the system, recognizing self and other, and a hundred other examples. Somehow cells "make decisions" and also are "mindless robots". In this framing, the adaptive and innate immune system is just an assemblage of parts, which I think misses the point that it's all connected to an unarguably conscious human. Just because we (sort of) understand how those parts fit together doesn't mean that absolute reductionism is the only way to understand it--indeed, as he demonstrates, we don't even have the language to discuss how an unconscious immune system functions.

This becomes problematic when he begins to scale up to takeaways. For instance, the book takes casual aim at the wellness industry by suggesting the very idea of "boosting" the immune system is on its face nonsensical and even dangerous. Then, on the very next page (p281 para 3) he writes "working out also directly boosts your immune system", contradicting the thesis of the chapter. Then he says diet doesn't really matter as long as you eat sensibly. But what sensible eating means is lost in a casual wave of the hand. His point does stand that there are a lot of people who take advantage of scientific sounding language to sell products, but that really requires a medical anthropological lens more than the tight focus on receptor chains.

In the section on "Stress and the Immune System" he makes another major error. He correctly notes that stress suppresses the immune system, and how we got here evolutionarily, but then makes a totally crazy statement that the best way to counteract that effect is to further reduce external stress. So instead of building resilience by exposing yourself to physical stress so that your immune system doesn't react to it so strongly, the suggestion is to further retreat from the world so that when some external force does act on the body you're not ready for it.

IN A NUTSHELL: Overall this book is excellent. I'd recommend it to absolutely anyone who wants to try to understand all the moving parts of the universe inside your body that keeps you alive. The takeaways should be taken with a pinch of salt.

WHY ONE STAR?: Simply because you, dear review reader, probably sort by one star reviews to see the worst criticism and that's a little unfair. Five star reviews are often too enthusiastic to be taken seriously, and one star reviews are usually too angry to be useful. He already had more than enough 5 star reviews to have a nice rating overall and I wanted this review to be useful. In truth, this is a very good book.