After Jason died, I stood at the base of his bed and thanked him for always being kind to the little guy. Depending on the setting, each of us can find ourselves as the little guy or the top dog, as needing or being able to give, as supplicant, friend, bully, or antagonist. Each of us, like microscopic bit players in a larger organism, also has an outsized power to signal cooperation, find harmony, to hasten hostilities or dampen them.
The deep friendship I wound up forming with Jason captures a searing truth instructed by the immune system. We are in this together.
Acknowledgments
One day I was talking about the immune system for this book with Dr. Mike McCune, an accomplished researcher and clinician at the University of California, San Francisco. We’d spent hours talking at various points. I thanked him for the generosity of his time.
He said, “I’m trying to build the world’s most conversational immunologist.”
I asked what he meant, and he explained that immunology needs a translator, someone to bring these concepts to life and explain them to the public.
Dr. McCune, I hope you feel that your time was invested wisely. This is a wish I have too for the dozens upon dozens of scientists and doctors to whom I owe an incredible debt. This group includes the men and women I wrote about and quoted in the book and many others whose names are not included here but whose time and wisdom proved invaluable to me. Please accept my deepest gratitude for your patience, your good humor, and above all, your scientific work. You have saved, strengthened, and lengthened many lives.
Thanks to Dorsey Griffith for your patient research assistance. Vicki Yates, you’ve been a godsend on this and other projects.
I am lucky to have found a family at William Morrow. Peter Hubbard, editor and friend, thank you for your humor, bedside manner, and great wisdom. Thanks to Nick Amphlett, ever present, ever able. Huge thanks, as always, to Liate Stehlik, a publisher, friend, and unflappable ship’s captain in the rocky book-world seas.
Laurie Liss, my agent and sister slightly removed, much love. Our tree isn’t dead yet.
I owe tremendous debt to Douglas Preston, world-class writer and teacher, who took on the role of sounding board and periodic editor for this book. I couldn’t have asked for better counsel.
Thank you and love to my wife, Meredith Jewel Barad, the foundation of the whole damn thing, and to Milo and Mirabel, our angels, and Uncle Mort and Pickles, our pets. Thanks, Mom and Dad.
To Dr. Mark Brunvand: You spent hours sharing, explaining, opening your heart, becoming teacher and friend. Thank you for all of that and for a lifetime spent doing the same for so many of your patients, steering the narrows.
To Bob Hoff: I will forever carry your story because it taught me so much about courage. You weathered a brutal period in this country, and of course, in your own health and in the deaths of so many friends. Your dignity blows me away. Thank you for being so open. I find it pitiful that the pockets of discrimination remain, and I hope like hell that this sickness, this autoimmunity of bigotry, will subside before it leads to the catastrophic.
To Linda Segre, I offer three words: grace under pressure. I realize it can’t be as easy as you make it sometimes look. I’m sure the reader shares my gratitude for your sharing of the challenges of making your own way while struggling with the demons of autoimmunity.
To Merredith Branscombe, please accept a double shot of thanks: you told me your story and you acted as an eagle-eyed aide-de-camp in my journalistic thinking. Your experience as a writer and creator added a layer of insight that elevated this effort. Thank you.
To Jason’s family, and to Beth, words are insufficient. You treated me like a brother. I am sorry for the loss of Jason and for Cathy. She was a blast of a human being, funny and warm and most certainly the font of Jason’s fire.
Jason.
Every so often, I talk to Jason. It’s usually a whisper after Milo, my son, has done something special on the baseball field. “Greenie,” I’ll say, “I’d have called you about that one.” Or “Did you see that, Greenie?”
You remain in my heart. I count among my blessings that we came to call each other friend. Your light shines on.
Index
The pagination of this digital edition does not match the print edition from which the Index was created. To locate a specific entry, please use your e-book reader’s search tools.
Note: Page references in italics indicate photographs.
ABVD chemotherapy, 277–78
Acquired immunological tolerance, 98–99
Acute stress, 266–67
Acyclovir, 369
Adaptation, 238–39
Adaptive immune system, 77, 146, 149–54
antigen presentation, 151–54
genetic recombination, 88–91
HIV and, 348, 349
Adderall, 231
Adrenal glands, 206, 216, 267, 278
Adrenaline, 206, 265, 267, 287, 288, 402–3
AIDS. See HIV/AIDS
Alien (movie), 264
Alkan, Sefik, 140
Allergic sensitization, 243–44
Allergies, 236–37, 241–42
Amish study, 242–45
Allison, James, 295, 296–99, 305, 308–9, 330
Alzheimer’s disease, 356–59, 360
Ambien, 217, 353
American College of Rheumatology, 214, 228, 355
Amish, 242–45
“Among School Children” (Yeats), 233
Amyl nitrate, 176
Anfinsen, Christian, 125, 131
Antibacterial soaps, 235, 236, 246–47, 257–58
Antibiotic resistance, 247–49, 259
Antibiotics, 11, 82–85, 400
Antibodies, 42–43, 66–67, 311
Antibody diversity, 254–55
Antibody-encoding genes, 88–91
Antibody-forming precursor cells, 71–72
Antibody-mediated immunity, 67
Antigen presentation, 151–54
Antigens, 42, 77, 100–101, 115, 135, 149–54
Antikörper, 42
Antimicrobial resistance, 247–49, 259
Antinuclear antibodies (ANA) test, 208, 212
Anti-Semitism, 224–25
Apoptosis, 219–20
Argonauts, 56, 93–94, 409
Armstrong, Neil, 379
Aselli, Gaspare, 38, 73
Ashwell, Jonathan, 266
Asthma, 241–42, 243, 244
Astrocytes, 360–62
Atkins diet, 197–98
Atomic bombings of Hiroshima and Nagasaki, 60
Attenuated, 80
Autoimmune disorder, 8–9, 91, 109, 133, 198
of Hobbs, 228–30
of Linda, 29–30, 199–201, 212, 216–18, 249, 351–53
of Merredith, 30, 31–32, 226–27, 232–34, 399–400
treatments, 29, 99–100, 143–44, 206–7, 216–18, 234–35
Autoimmune response, 118–19
Autoimmunity, 8–9, 91, 136, 202, 398
diagnosis, 202, 212–14
diagnosis of Linda, 29–30, 201, 212, 216
diagnosis of Merredith, 31–32, 227, 229–30
environmental factors, 215–16, 241
genetics and, 226
history, 203–10
sex and, 9, 214–15
sleeplessness and, 272
Automobiles, 259
Avian influenza, 169–70
Axilla, 334–35
Azathioprine, 228
Azidothymidine (AZT), 183–84, 193
B7-1, 295, 296–97, 313–14
B7-2, 295, 296–97
Bacteria, 49–50, 51, 258–59
antibiotic resistance, 247–49
microbiome, 250–55, 257
Baker, Brian, 189, 343–44, 349
Barad, Meredith, 280, 290–91, 393
Barker, Clyde F., 95
Barres, Ben, 360, 362–64, 408
Barré-Sinoussi, Françoise, 179
Basel Institute for Immuno
logy, 88, 140
Basic science, 122–23
Basophils, 43, 117
B cells (B lymphocytes), 46, 55, 71–74, 76, 76–77
antibody-encoding genes, 88–91
BEAM chemotherapy, 319–20, 321–22
Beethe, Poppy, 335, 373–74, 378
Beginner’s Guide to Winning the Nobel Prize, The (Doherty), 102
Bingo Experiment, 185
Bird flu, 169–70
Black Plague, 49–50, 169
Blood-brain barrier (BBB), 359–60
Bluestone, Jeffrey, 295
Bob Hoff. See Hoff, Robert T. “Bob”
Body temperature, 109–10
Boehm, Thomas, 106
Bone marrow, 70–72, 207
Bone marrow transplant, 92–93, 100–101, 319–20, 321–22
Boston Consulting Group, 28, 199–200, 201
Boulder High School, 15–17
Bowman, Carol, 198
Bowman, Linda. See Segre, Linda
Brain, 7, 356–65
cells and immune function, 360–62
Branscombe, Bea, 222, 223–26
Branscombe, Merredith, 11, 30–32, 221–35, 223
autoimmune disorder of, 30–32, 31–32, 226–27, 398, 399–400
autoimmunity diagnosis, 31–32, 227, 229–30
autoimmunity symptoms, 227, 232–34
autoimmunity treatment, 227–29, 231–32, 234, 400
early life of, 30–31, 222–23
family background of, 222–26
genetic predisposition to autoimmunity, 225–26
lifestyle changes of, 234–35
Brentuximab vedotin, 322–23, 328, 331–32, 334, 336, 368, 369, 370
Bristol-Myers Squibb, 295, 312, 329, 332
British Journal of Homeopathy, 236
British Society for Immunology, 64
Brodie, Maurice, 80–81
Brunvand, Mark, 383–84
connection with patients, 325–27
early life of, 325, 327
Fauci and, 320, 325
HIV/AIDS and, 161–62, 166
Jason’s treatment, 277, 319–20, 322–23, 328, 334, 335–36, 367–76, 378–79, 385–86, 388–89, 391
Mount McKinley climb, 324–25
Bruton, Ogden, 66–67
Bubonic plague, 49–50, 168, 169
“Buffalo hump,” 189
Bursa of Fabricius, 37, 67–68, 70
B vitamins, 400
California Institute of Technology (Caltech), 131, 250–51, 257
Cancer, 6, 59, 275–79, 356, 397
monoclonal antibody therapeutics, 310–18
sleep loss and, 270
wound healing and, 303–4, 306–7
Carter, Jimmy, 386
CD8, 177, 191, 345–47
CD19, 330
CD28, 295, 297, 313–14, 315
CD30, 322, 336
Celebrex, 228, 231
Celiac disease, 29, 242
Cell division, 15, 54–55, 304, 306–7
Cell phones, 259
Celsus, Aulus Cornelius, 110–11
Centers for Disease Control and Prevention (CDC), 74, 78, 79, 166, 168
Charity Hospital (New Orleans), 68–69
Chemotherapy, 130
immunotherapy compared with, 144
Jason’s treatments, 277–79, 280–81, 291–92, 319–20, 321, 369–71
Chester Beatty Research Institute, 60
Chevron, 197
Chrysler Concorde, 19
Circumstantial evidence, 214, 216
Citalopram (Celexa), 328
Classical conditioning, 150
Cleaning products, 239, 240, 246–47, 257–58
Clinical Chemistry, 205
Coenzyme Q10 (CoQ10), 234
Colds, 7, 112, 395, 399
Colon cancer, 15
Colonic cleansing, 190
Colorado Blood Cancer Institute, 319–20, 334, 371
Columbia School of Journalism, 284–85, 286, 288–89, 290
Complement component 1q (C1q), 363
Compound E, 206–7
Concerned Fellows League (CFL), 16, 285, 336
Conflict, 397
Connors, Mark, 184–85, 187–88, 346–47
Cooper, Max, 68–70, 92–93, 100, 107
Cooperation, 396–98
Coors Events Center, 11–12
Cortisol, 206–7, 267
Cosmas, Saint, 94, 95
“Covering up,” 210
Crohn’s disease, 9, 198
Crying, 365
CTLA-4, 295–99, 305, 308, 313–14, 332
Cutter Laboratories, 82
Cyclobenzaprine, 231
Cyclosporine, 100
Cytokines, 133–37, 315–16, 403–4
interleukin-1 discovery, 125–28
Cytokine storm, 170, 315–16, 330, 391
Cytotoxic (killer) T cells, 103–5, 117–19
Damian, Saint, 94, 95
Dampening the immune system, 99, 256–57, 258, 270, 271
Delwart, Eric, 51
Denali, 324–25
Dendritic cells, 114–15, 115, 134–35, 313
Dendron, 114
Denver Broncos, 335, 372, 376
Denver General Hospital, 161–62, 278
Denver Post, 222–23
Depression, 268, 270, 289, 328
Dermatomyositis, 229
Diabetes, 6, 9, 189, 242, 398
Diamond Foods, 249, 352
Diet, 197–98, 365, 398, 403
Dinarello, Charles, 119–28, 187, 401, 402
early life of, 121–22
fever and inflammation research, 109, 110, 119–21, 123–24, 136–37
interleukin-1 discovery, 125–28
rabbit research, 120–21, 124–25, 131
Direct evidence, 213–14
Dirt eating, 235, 246
Disinfectants, 239, 240, 246–47, 257–58
Diversity, 348–50, 396. See also Immune diversity
DNA, 50, 145, 178, 264, 304–5
Doherty, Peter, 102–5, 145, 192, 318
Dulbecco, Renato, 87–88
Dunne, Jack, 176
Dust mites, 241
Dvorak, Harold, 303
Ehrlich, Paul, 41, 41–43, 204–5
Eichler, Joseph, 197
Eisenhower, Dwight D., 122
Enbrel, 219–20, 228, 231, 353–55
Engleman, Ephraim, 404
Environment
autoimmunity and, 215–16, 241
immune system and, 69, 239–41
microbiota and, 254
Eosinophils, 117, 244, 245
Epidemiology, 175–76
Epinephrine, 267, 287, 403
Erythrocyte sedimentation rate, 21–22
Escherichia coli (E. coli), 50, 154, 238
Eukaryotic parasites, 51
European Journal of Immunology, 117
Evolution, 43–44, 49, 106–7, 214, 238–39, 252–53, 266–67, 276–77, 364, 406
Exercise, 402–4
Fabricius ab Aquapendente, 37
Fauci, Anthony, 65, 138–39, 143, 397, 398
Brunvand and, 320, 325
on cytokines, 134, 137
HIV/AIDS research, 164–65, 173, 175, 176, 179, 180–81
on natural killer cells, 119
on neutrophils, 116–17, 126
Fentanyl, 369
Festival of Life, 45–47, 66, 134, 405–6
Fever, 109–11, 120–21, 123, 125–26, 397–98
Fibroblast, 301–2
Fight-or-flight response, 266–67, 269–70, 271–72, 286–87, 288
Flash Gordon (comic), 129
Fleming, Alexander, 83–84
Flexeril, 217
Flu, 59, 74–75
Flu pandemic of 1918, 167–69
Food allergies, 241–42
Food and Drug Administration (FDA), 183, 219, 228, 248, 317
fast-track designation, 332–33
Ford Windstar, 3–4, 281, 382, 408
Formaldehyde, 81
Formalin, 81
“Frankenmouse,” 311–12
Fukuda, Keiji, 169–70
Gallagher, Danny, 12
Gallo, Robert, 177–80
Gamma globulins, 66–67
Garrod, Alfred, 204
Gender differences, 214–15
General Services Administration (GSA), 24
Genes (genetics), 53, 88–91, 178, 242, 250
antibody-encoding genes, 88–91
Genetic recombination, 88–91
Genetics Society of America, 99
Genetic structure, 88
Germ killing, 234–35, 236, 239, 240, 245–47, 257–58
Amish study, 242–45
Giardia, 51, 86
Glaser, Ronald, 261–63, 262
Alzheimer’s disease of, 357–59, 364–65
death of, 408
stress and immune response research, 262–63, 265–66, 286
Glaucoma, 363
Glial cells, 360–61
Glucocorticoid, 267
Glucocorticoid receptor, 266
“Gold shots,” 209
Gout, 204
Grady, Denise, 329–30
Granulocytes, 117
Green Man Group, 18–19
Greenstein, Catherine, 4, 15, 20, 21, 280, 376, 382–89, 407
Greenstein, Guy, 15, 384, 407
Greenstein, Jason
arrest of, 338
back issues of, 385–91
BEAM and transplant, 319–20, 321–22
bone marrow transplant, 101, 319–20, 321–22
brentuximab treatment, 328, 331–32, 334
business ventures of, 3–4, 18–19, 291, 331–32
cancer diagnosis of, 4–6, 9–10, 10, 11–12, 19–22, 275–77
chemotherapy treatments, 4–6, 11–12, 277–79, 280–81, 291–92, 319–20, 321, 369–71
counsel of friends, 335–39
death of, 393–94
early life of, 13–18, 14
father Joel and, 13–16, 17–18
girlfriend Beth and, 4–6, 20, 281–84, 323, 337, 377–78, 391
hospice care discussion, 373–75
nicknames of, 5, 13
psychological counseling, 320–21
relapses, 381–83, 385–86, 390
remission, 381, 383–85
storytelling of, 280–81