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form of weaponry, resembling one of the ramshackle armies in the movie The Chronicles of Narnia. Some of these warrior cells toss a bucket of toxins at the invader and then move on; others are there to nourish their comrades with chemical spritzers. The body’s lead warriors, the macrophages, close in on their prey, envelop it in their own “flesh,” and digest it. As it happens, macrophages were the topic of my Ph.D. thesis; they are large, mobile, amoebalike creatures capable of living for months or years. When the battle is over, they pass on information about the intruder to other cells, which will produce antibodies to speed up the body’s defenses in the next encounter. They will also eat not only the vanquished intruders but their own dead comrades-in-arms.

    For all its dizzying complexity—which has kept other graduate students toiling away “at the bench” for decades—the immune system is hardly foolproof. Some invaders, like the tuberculosis bacillus, outwit it by penetrating the body’s tissue cells and setting up shop inside them, where the bacilli cannot be detected by immune cells. Most diabolically, the HIV virus selectively attacks certain immune cells, rendering the body almost defenseless. And sometimes the immune system perversely turns against the body’s own tissues, causing such “autoimmune” diseases as lupus and rheumatoid arthritis and possibly some forms of heart disease. It may not be perfect, this seemingly anarchic system of cellular defense, but it is what has evolved so far out of a multimillion-year arms race with our microbial enemies.

    The link between the immune system, cancer, and the emotions was cobbled together somewhat imaginatively in the 1970s. It had been known for some time that extreme stress could debilitate certain aspects of the immune system. Torture a lab animal long enough, as the famous stress investigator Hans Selye did in the 1930s, and it becomes less healthy and resistant to disease. It was apparently a short leap, for many, to the conclusion that positive feelings might be the opposite of stress—capable of boosting the immune system and providing the key to health, whether the threat is a microbe or a tumor.

    One of the early best-selling assertions of this notion was Getting Well Again , by O. Carl Simonton, an oncologist; Stephanie Matthews-Simonton, identified in the book as a “motivational counselor”; and psychologist James L. Creighton. So confident were they of the immune system’s ability to defeat cancer that they believed “a cancer does not require just the presence of abnormal cells, it also requires a suppression of the body’s normal defenses .” 11 What could suppress them? Stress. While the Simontons urged cancer patients to obediently comply with the prescribed treatments, theysuggested that a kind of attitude adjustment was equally important. Stress had to be overcome, positive beliefs and mental imagery acquired.

    The Simontons’ book was followed in 1986 by surgeon Bernie Siegel’s even more exuberant Love, Medicine, and Miracles , offering the view that “a vigorous immune system can overcome cancer if it is not interfered with, and emotional growth toward greater self-acceptance and fulfillment helps keep the immune system strong.” 12 Hence cancer was indeed a blessing, since it could force the victim into adopting a more positive and loving view of the world.

    But where were the studies showing the healing effect of a positive attitude? Could they be duplicated? One of the skeptics, Stanford psychiatrist David Spiegel, told me he set out in 1989 to refute the popular dogma that attitude could overcome cancer. “I was so sick of hearing Bernie Siegel saying that you got cancer because you needed it,” he told me in an interview. But to his surprise, Spiegel’s study showed that breast cancer patients in support groups—who presumably were in a better frame of mind than those facing the disease on their