“Prologue to Chapter 7.” The Immortal Life of Henrietta Lacks, by Rebecca Skloot, Broadway Paperbacks, an Imprint of the Crown Publishing Group, a Division of Random House, Inc., 2011.
This is a work of nonfiction. No names have been changed, no characters invented, no events fabricated. While writing this book, I conducted more than a thousand hours of interviews with family and friends of Henrietta Lacks, as well as with lawyers, ethicists, scientists, and journalists who’ve written about the Lacks family. I also relied on extensive archival photos and documents, scientific and historical research, and the personal journals of Henrietta’s daughter, Deborah Lacks.
I’ve done my best to capture the language with which each person spoke and wrote: dialogue appears in native dialects; passages from diaries and other personal writings are quoted exactly as written. As one of Henrietta’s relatives said to me, “If you pretty up how people spoke and change the things they said, that’s dishonest. It’s taking away their lives, their experiences, and their selves.” In many places I’ve adopted the words interviewees used to describe their worlds and experiences. In doing so, I’ve used the language of their times and backgrounds, including words such as colored. Members of the Lacks family often referred to Johns Hopkins as “John Hopkin,” and I’ve kept their usage when they’re speaking. Anything written in the first person in Deborah Lacks’s voice is a quote of her speaking, edited for length and occasionally clarity.
Since Henrietta Lacks died decades before I began writing this book, I relied on interviews, legal documents, and her medical records to re-create scenes from her life. In those scenes, dialogue is either deduced from the written record or quoted verbatim as it was recounted to me in an interview. Whenever possible I conducted multiple interviews with multiple sources to ensure accuracy. The extract from Henrietta’s medical record in chapter 1 is a summary of many disparate notations.
The word HeLa, used to refer to the cells grown from Henrietta Lacks’s cervix, occurs throughout the book. It is pronounced hee-lah.
About chronology: Dates for scientific research refer to when the research was conducted, not when it was published. In some cases those dates are approximate because there is no record of exact start dates. Also, because I move back and forth between multiple stories, and scientific discoveries occur over many years, there are places in the book where, for the sake of clarity, I describe scientific discoveries sequentially, even though they took place during the same general period of time.
The history of Henrietta Lacks and the HeLa cells raises important issues regarding science, ethics, race, and class; I’ve done my best to present them clearly within the narrative of the Lacks story, and I’ve included an afterword addressing the current legal and ethical debate surrounding tissue ownership and research. There is much more to say on all the issues, but that is beyond the scope of this book, so I will leave it for scholars and experts in the field to address. I hope readers will forgive any omissions
We must not see any person as an abstraction.
—ELIE WIESEL
Instead, we must see in every person a universe with its own secrets,
with its own treasures, with its own sources of anguish,
and with some measure of triumph.
FROM THE NAZI DOCTORS AND THE NUREMBERG CODE
There’s a photo on my wall of a woman I’ve never met, its left corner torn and patched together with tape. She looks straight into the camera and smiles, hands on hips, dress suit neatly pressed, lips painted deep red. It’s the late 1940s and she hasn’t yet reached the age of thirty. Her light brown skin is smooth, her eyes still young and playful, oblivious to the tumor growing inside her—a tumor that would leave her five children motherless and change the future of medicine. Beneath the photo, a caption says her name is “Henrietta Lacks, Helen Lane or Helen Larson.”
No one knows who took that picture, but it’s appeared hundreds of times in magazines and science textbooks, on blogs and laboratory walls. She’s usually identified as Helen Lane, but often she has no name at all. She’s simply called HeLa, the code name given to the world’s first immortal human cells—her cells, cut from her cervix just months before she died.
Her real name is Henrietta Lacks.
I’ve spent years staring at that photo, wondering what kind of life she led, what happened to her children, and what she’d think about cells from her cervix living on forever—bought, sold, packaged, and shipped by the trillions to laboratories around the world. I’ve tried to imagine how she’d feel knowing that her cells went up in the first space missions to see what would happen to human cells in zero gravity, or that they helped with some of the most important advances in medicine: the polio vaccine, chemotherapy, cloning, gene mapping, in vitro fertilization. I’m pretty sure that she—like most of us—would be shocked to hear that there are trillions more of her cells growing in laboratories now than there ever were in her body.
There’s no way of knowing exactly how many of Henrietta’s cells are alive today. One scientist estimates that if you could pile all HeLa cells ever grown onto a scale, they’d weigh more than 50 million metric tons—an inconceivable number, given that an individual cell weighs almost nothing. Another scientist calculated that if you could lay all HeLa cells ever grown end-to-end, they’d wrap around the Earth at least three times, spanning more than 350 million feet. In her prime, Henrietta herself stood only a bit over five feet tall.
I first learned about HeLa cells and the woman behind them in 1988, thirty-seven years after her death, when I was sixteen and sitting in a community college biology class. My instructor, Donald Defler, a gnomish balding man, paced at the front of the lecture hall and flipped on an overhead projector. He pointed to two diagrams that appeared on the wall behind him. They were schematics of the cell reproduction cycle, but to me they just looked like a neon-colored mess of arrows, squares, and circles with words I didn’t understand, like “MPF Triggering a Chain Reaction of Protein Activations.”
I was a kid who’d failed freshman year at the regular public high school because she never showed up. I’d transferred to an alternative school that offered dream studies instead of biology, so I was taking Defler’s class for high-school credit, which meant that I was sitting in a college lecture hall at sixteen with words like mitosis and kinase inhibitors flying around. I was completely lost.
“Do we have to memorize everything on those diagrams?” one student yelled.
Yes, Defler said, we had to memorize the diagrams, and yes, they’d be on the test, but that didn’t matter right then. What he wanted us to understand was that cells are amazing things: There are about one hundred trillion of them in our bodies, each so small that several thousand could fit on the period at the end of this sentence. They make up all our tissues—muscle, bone, blood—which in turn make up our organs.
Under the microscope, a cell looks a lot like a fried egg: It has a white (the cytoplasm) that’s full of water and proteins to keep it fed, and a yolk (the nucleus) that holds all the genetic information that makes you you. The cytoplasm buzzes like a New York City street. It’s crammed full of molecules and vessels endlessly shuttling enzymes and sugars from one part of the cell to another, pumping water, nutrients, and oxygen in and out of the cell. All the while, little cytoplasmic factories work 24/7, cranking out sugars, fats, proteins, and energy to keep the whole thing running and feed the nucleus. The nucleus is the brains of the operation; inside every nucleus within each cell in your body, there’s an identical copy of your entire genome. That genome tells cells when to grow and divide and makes sure they do their jobs, whether that’s controlling your heartbeat or helping your brain understand the words on this page.
Defler paced the front of the classroom telling us how mitosis—the process of cell division—makes it possible for embryos to grow into babies, and for our bodies to create new cells for healing wounds or replenishing blood we’ve lost. It was beautiful, he said, like a perfectly choreographed dance.
All it takes is one small mistake anywhere in the division process for cells to start growing out of control, he told us. Just one enzyme misfiring, just one wrong protein activation, and you could have cancer. Mitosis goes haywire, which is how it spreads.
“We learned that by studying cancer cells in culture,” Defler said. He grinned and spun to face the board, where he wrote two words in enormous print: HENRIETTA LACKS.
Henrietta died in 1951 from a vicious case of cervical cancer, he told us. But before she died, a surgeon took samples of her tumor and put them in a petri dish. Scientists had been trying to keep human cells alive in culture for decades, but they all eventually died. Henrietta’s were different: they reproduced an entire generation every twenty-four hours, and they never stopped. They became the first immortal human cells ever grown in a laboratory.
“Henrietta’s cells have now been living outside her body far longer than they ever lived inside it,” Defler said. If we went to almost any cell culture lab in the world and opened its freezers, he told us, we’d probably find millions—if not billions—of Henrietta’s cells in small vials on ice.
Her cells were part of research into the genes that cause cancer and those that suppress it; they helped develop drugs for treating herpes, leukemia, influenza, hemophilia, and Parkinson's disease; and they’ve been used to study lactose digestion, sexually transmitted diseases, appendicitis, human longevity, mosquito mating, and the negative cellular effects of working in sewers. Their chromosomes and proteins have been studied with such detail and precision that scientists know their every quirk. Like guinea pigs and mice, Henrietta’s cells have become the standard laboratory workhorse.
“HeLa cells were one of the most important things that happened to medicine in the last hundred years,” Defler said.
Then, matter-of-factly, almost as an afterthought, he said, “She was a black woman.” He erased her name in one fast swipe and blew the chalk from his hands. Class was over.
As the other students filed out of the room, I sat thinking, That’s it? That’s all we get? There has to be more to the story.
I followed Defler to his office.
“Where was she from?” I asked. “Did she know how important her cells were? Did she have any children?”
“I wish I could tell you,” he said, “but no one knows anything about her.”
After class, I ran home and threw myself onto my bed with my biology textbook. I looked up “cell culture” in the index, and there she was, a small parenthetical:
In culture, cancer cells can go on dividing indefinitely, if they have a continual supply of nutrients, and thus are said to be “immortal.” A striking example is a cell line that has been reproducing in culture since 1951. (Cells of this line are called HeLa cells because their original source was a tumor removed from a woman named Henrietta Lacks.)
That was it. I looked up HeLa in my parents’ encyclopedia, then my dictionary: No Henrietta.
As I graduated from high school and worked my way through college toward a biology degree, HeLa cells were omnipresent. I heard about them in histology, neurology, pathology; I used them in experiments on how neighboring cells communicate. But after Mr. Defler, no one mentioned Henrietta.
When I got my first computer in the mid-nineties and started using the Internet, I searched for information about her, but found only confused snippets: most sites said her name was Helen Lane; some said she died in the thirties; others said the forties, fifties, or even sixties. Some said ovarian cancer killed her, others said breast or cervical cancer.
Eventually I tracked down a few magazine articles about her from the seventies. Ebony quoted Henrietta’s husband saying, “All I remember is that she had this disease, and right after she died they called me in the office wanting to get my permission to take a sample of some kind. I decided not to let them.” Jet said the family was angry—angry that Henrietta’s cells were being sold for twenty-five dollars a vial, and angry that articles had been published about the cells without their knowledge. It said, “Pounding in the back of their heads was a gnawing feeling that science and the press had taken advantage of them.”
The articles all ran photos of Henrietta’s family: her oldest son sitting at his dining room table in Baltimore, looking at a genetics textbook. Her middle son in military uniform, smiling and holding a baby. But one picture stood out more than any other: in it, Henrietta’s daughter, Deborah Lacks, is surrounded by family, everyone smiling, arms around each other, eyes bright and excited. Except Deborah. She stands in the foreground looking alone, almost as if someone pasted her into the photo after the fact. She’s twenty-six years old and beautiful, with short brown hair and catlike eyes. But those eyes glare at the camera, hard and serious. The caption said the family had found out just a few months earlier that Henrietta’s cells were still alive, yet at that point she’d been dead for twenty-five years.
All of the stories mentioned that scientists had begun doing research on Henrietta’s children, but the Lackses didn’t seem to know what that research was for. They said they were being tested to see if they had the cancer that killed Henrietta, but according to the reporters, scientists were studying the Lacks family to learn more about Henrietta’s cells. The stories quoted her son Lawrence, who wanted to know if the immortality of his mother’s cells meant that he might live forever too. But one member of the family remained voiceless: Henrietta’s daughter, Deborah.
This right here shows how no one knew what was happening and how they were lied to constantly. That is super unethical and when research and studies are being done, all participants, family members, etc should know what is being done. Dr. Gey is in the wrong.
As I worked my way through graduate school studying writing, I became fixated on the idea of someday telling Henrietta’s story. At one point I even called directory assistance in Baltimore looking for Henrietta’s husband, David Lacks, but he wasn’t listed. I had the idea that I’d write a book that was a biography of both the cells and the woman they came from—someone’s daughter, wife, and mother.
I couldn’t have imagined it then, but that phone call would mark the beginning of a decade-long adventure through scientific laboratories, hospitals, and mental institutions, with a cast of characters that would include Nobel laureates, grocery store clerks, convicted felons, and a professional con artist. While trying to make sense of the history of cell culture and the complicated ethical debate surrounding the use of human tissues in research, I’d be accused of conspiracy and slammed into a wall both physically and metaphorically, and I’d eventually find myself on the receiving end of something that looked a lot like an exorcism. I did eventually meet Deborah, who would turn out to be one of the strongest and most resilient women I’d ever known. We’d form a deep personal bond, and slowly, without realizing it, I’d become a character in her story, and she in mine.
Deborah and I came from very different cultures: I grew up white and agnostic in the Pacific Northwest, my roots half New York Jew and half Midwestern Protestant; Deborah was a deeply religious black Christian from the South. I tended to leave the room when religion came up in conversation because it made me uncomfortable; Deborah’s family tended toward preaching, faith healings, and sometimes voodoo. She grew up in a black neighborhood that was one of the poorest and most dangerous in the country; I grew up in a safe, quiet middle-class neighborhood in a predominantly white city and went to high school with a total of two black students. I was a science journalist who referred to all things supernatural as “woo-woo stuff;” Deborah believed Henrietta’s spirit lived on in her cells, controlling the life of anyone who crossed its path. Including me.
“How else do you explain why your science teacher knew her real name when everyone else called her Helen Lane?” Deborah would say. “She was trying to get your attention.” This thinking would apply to everything in my life: when I married while writing this book, it was because Henrietta wanted someone to take care of me while I worked. When I divorced, it was because she’d decided he was getting in the way of the book. When an editor who insisted I take the Lacks family out of the book was injured in a mysterious accident, Deborah said that’s what happens when you piss Henrietta off.
The Lackses challenged everything I thought I knew about faith, science, journalism, and race. Ultimately, this book is the result. It’s not only the story of HeLa cells and Henrietta Lacks, but of Henrietta’s family—particularly Deborah—and their lifelong struggle to make peace with the existence of those cells, and the science that made them possible.
When people ask—and seems like people always be askin to where I can’t never get away from it—I say, Yeah, that’s right, my mother name was Henrietta Lacks, she died in 1951, John Hopkins took her cells and them cells are still livin today, still multiplyin, still growin and spreadin if you don’t keep em frozen. Science calls her HeLa and she’s all over the world inmedical facilities, in all the computers and the Internet everywhere.
When I go to the doctor for my checkups I always say my mother was HeLa. They get all excited, tell me stuff like how her cells helped make my blood pressure medicines and anti-depression pills and how all this important stuff in science happen cause of her. But they don’t never explain more than just sayin, Yeah, your mother was on the moon, she been in nuclear bombs and made that polio vaccine. I really don’t know how she did all that, but I guess I’m glad she did, cause that mean she helpin lots of people. I think she would like that.
But I always have thought it was strange, if our mother cells done so much for medicine, how come her family can’t afford to see no doctors? Don’t make no sense. People got rich off my mother without us even knowin about them takin her cells, now we don’t get a dime. I used to get so mad about that to where it made me sick and I had to take pills. But I don’t got it in me no more to fight. I just want to know who my mother was.
Not only does it allow the reader to live the experience, as close as we can get to Henrietta’s perspective, but it sets it up for what happens in the future, to further impact the reader.
On January 29, 1951, David Lacks sat behind the wheel of his old Buick, watching the rain fall. He was parked under a towering oak tree outside Johns Hopkins Hospital with three of his children—two still in diapers—waiting for their mother, Henrietta. A few minutes earlier she’d jumped out of the car, pulled her jacket over her head, and scurried into the hospital, past the “colored” bathroom, the only one she was allowed to use. In the next building, under an elegant domed copper roof, a ten-and-a-half-foot marble statue of Jesus stood, arms spread wide, holding court over what was once the main entrance of Hopkins. No one in Henrietta’s family ever saw a Hopkins doctor without visiting the Jesus statue, laying flowers at his feet, saying a prayer, and rubbing his big toe for good luck. But that day Henrietta didn’t stop.
She went straight to the waiting room of the gynecology clinic, a wide-open space, empty but for rows of long straight-backed benches that looked like church pews.
“I got a knot on my womb,” she told the receptionist. “The doctor need to have a look.”
For more than a year Henrietta had been telling her closest girlfriends something didn’t feel right. One night after dinner, she sat on her bed with her cousins Margaret and Sadie and told them, “I got a knot inside me.”
“A what?” Sadie asked.
“A knot,” she said. “It hurt somethin awful—when that man want to get with me, Sweet Je-sus aren’t them but some pains.”
When sex first started hurting, she thought it had something to do with baby Deborah, who she’d just given birth to a few weeks earlier, or the bad blood David sometimes brought home after nights with other women—the kind doctors treated with shots of penicillin and heavy metals.
Henrietta grabbed her cousins’ hands one at a time and guided them to her belly, just as she’d done when Deborah started kicking.
“You feel anything?”
The cousins pressed their fingers into her stomach again and again.
“I don’t know,” Sadie said. “Maybe you’re pregnant outside your womb—you know that can happen.”
“I’m no kind of pregnant,” Henrietta said. “It’s a knot.” “Hennie, you gotta check that out. What if it’s somethin bad?”
But Henrietta didn’t go to the doctor, and the cousins didn’t tell anyone what she’d said in the bedroom. In those days, people didn’t talk about things like cancer, but Sadie always figured Henrietta kept it secret because she was afraid a doctor would take her womb and make her stop having children.
About a week after telling her cousins she thought something was wrong, at the age of twenty-nine, Henrietta turned up pregnant with Joe, her fifth child. Sadie and Margaret told Henrietta that the pain probably had something to do with a baby after all. But Henrietta still said no.
“It was there before the baby,” she told them. “It’s somethin else.”
They all stopped talking about the knot, and no one told Henrietta’s husband David any-thing about it. Then, four and a half months after baby Joseph was born, Henrietta went to the bathroom and found blood spotting her underwear when it wasn’t her time of the month.
She filled her bathtub, lowered herself into the warm water, and slowly spread her legs. With the door closed to her children, husband, and cousins, Henrietta slid a finger inside her-self and rubbed it across her cervix until she found what she somehow knew she’d find: a hard lump, deep inside, as though someone had lodged a marble just to the left of the open-ing to her womb.
Henrietta climbed out of the bathtub, dried herself off, and dressed. Then she told her husband, “You better take me to the doctor. I’m bleedin and it ain’t my time.”
Her local doctor took one look inside her, saw the lump, and figured it was a sore from syphilis. But the lump tested negative for syphilis, so he told Henrietta she’d better go to the Johns Hopkins gynecology clinic.
Hopkins was one of the top hospitals in the country. It was built in 1889 as a charity hos-pital for the sick and poor, and it covered more than a dozen acres where a cemetery and in-sane asylum once sat in East Baltimore. The public wards at Hopkins were filled with patients, most of them black and unable to pay their medical bills. David drove Henrietta nearly twenty miles to get there, not because they preferred it, but because it was the only major hospital for miles that treated black patients. This was the era of Jim Crow—when black people showed up at white-only hospitals, the staff was likely to send them away, even if it meant they might die in the parking lot. Even Hopkins, which did treat black patients, segregated them in colored wards, and had colored-only fountains.
So when the nurse called Henrietta from the waiting room, she led her through a single door to a colored-only exam room—one in a long row of rooms divided by clear glass walls that let nurses see from one to the next. Henrietta undressed, wrapped herself in a starched white hospital gown, and lay down on a wooden exam table, waiting for Howard Jones, the gynecologist on duty. Jones was thin and graying, his deep voice softened by a faint Southern accent. When he walked into the room, Henrietta told him about the lump. Before examining her, he flipped through her chart—a quick sketch of her life, and a litany of untreated conditions:
This really shows that there were so many things that the family was struggling with. She had so many untreated conditions because she was unable to get the proper treatments. Even after her death, her family was unable to afford proper health care, even though her cells were being bought and sold to make those options for healthcare.
Sixth or seventh grade education; housewife and mother of five. Breathing difficult since childhood due to recurrent throat infections and deviated septum in patient’s nose. Physician recommended surgical repair. Patient declined. Patient had one toothache for nearly five years; tooth eventually extracted with several others. Only anxiety is oldest daughter who is epileptic and can’t talk. Happy household. Very occasional drinker. Has not traveled. Well nourished, cooperative. Patient was one of ten siblings. One died of car accident, one from rheumatic heart, one was poisoned. Unexplained vaginal bleeding and blood in urine during last two pregnancies; physician recommended sickle cell test. Patient declined. Been withhusband since age 15 and has no liking for sexual intercourse. Patient has asymptomatic neuro syphilis but cancelled syphilis treatments, said she felt fine. Two months prior to current visit, after delivery of fifth child, patient had significant blood in urine. Tests showed areas of increased cellular activity in the cervix. Physician recommended diagnostics and referred to specialist for ruling out in fection or cancer. Patient canceled appointment. One month prior to current visit, patient tested positive for gonorrhea. Patient recalled to clinic for treatment. No response.
I think that it Is hard to say whether or not the situation was fair in terms of her reading consent forms and agreeing to them. For one, according to paragraph 74, sentence 1, she had a sixth or seventh grade education. In this sense, she could’ve had issues understanding certain things within the forms she was signing. Another issue was that she was enduring great pain and stress through this time. She wanted the tumor gone and most likely didn’t have a clear head about what she was signing.
It was no surprise that she hadn’t come back all those times for follow-up. For Henrietta, walking into Hopkins was like entering a foreign country where she didn’t speak the language. She knew about harvesting tobacco and butchering a pig, but she’d never heard the words cervix or biopsy. She didn’t read or write much, and she hadn’t studied science in school. She, like most black patients, only went to Hopkins when she thought she had no choice.
Jones listened as Henrietta told him about the pain, the blood. “She says that she knew there was something wrong with the neck of her womb,” he wrote later. “When asked why she knew it, she said that she felt as if there were a lump there. I do not quite know what she means by this, unless she actually palpated this area.”
Henrietta lay back on the table, feet pressed hard in stirrups as she stared at the ceiling. And sure enough, Jones found a lump exactly where she’d said he would. He described it as an eroded, hard mass about the size of a nickel. If her cervix was a clock’s face, the lump was at four o’clock. He’d seen easily a thousand cervical cancer lesions, but never anything like this: shiny and purple (like “grape Jello,” he wrote later), and so delicate it bled at the slightest touch. Jones cut a small sample and sent it to the pathology lab down the hall for a diagnosis. Then he told Henrietta to go home.
Soon after, Howard Jones sat down and dictated notes about Henrietta and her diagnosis: “Her history is interesting in that she had a term delivery here at this hospital, September 19, 1950,” he said. “No note is made in the history at that time, or at the six weeks’ return visit that there is any abnormality of the cervix.”
Yet here she was, three months later, with a full-fledged tumor. Either her doctors had missed it during her last exams—which seemed impossible—or it had grown at a terrifying rate.
Henrietta Lacks was born Loretta Pleasant in Roanoke, Virginia, on August 1, 1920. No one knows how she became Henrietta. A midwife named Fannie delivered her into a small shack on a dead-end road overlooking a train depot, where hundreds of freight cars came and went each day. Henrietta shared that house with her parents and eight older siblings until 1924, when her mother, Eliza Lacks Pleasant, died giving birth to her tenth child.
Henrietta’s father, Johnny Pleasant, was a squat man who hobbled around on a cane he often hit people with. Family lore has it that he killed his own brother for trying to get fresh with Eliza. Johnny didn’t have the patience for raising children, so when Eliza died, he took them all back to Clover, Virginia, where his family still farmed the tobacco fields their ancestors had worked as slaves. No one in Clover could take all ten children, so relatives divided them up—one with this cousin, one with that aunt. Henrietta ended up with her grandfather, Tommy Lacks.
Tommy lived in what everyone called the home-house—a four-room log cabin that once served as slave quarters, with plank floors, gas lanterns, and water Henrietta hauled up a long hill from the creek. The home-house stood on a hillside where wind whipped through cracks in the walls. The air inside stayed so cool that when relatives died, the family kept their corpses in the front hallway for days so people could visit and pay respects. Then they buried them in the cemetery out back.
Henrietta’s grandfather was already raising another grandchild that one of his daughters had left behind after delivering him on the home-house floor. That child’s name was David Lacks, but everyone called him Day, because in the Lacks country drawl, house sounds like hyse, and David sounds like Day.
Young Day was what the Lacks family called a sneak baby: a man named Johnny Cole-man had passed through town; nine months later Day arrived. A twelve-year-old cousin and midwife named Munchie delivered him, blue as a stormy sky and not breathing. A white doctor came to the home-house with his derby and walking stick, wrote “stillborn” on Day’s birth certificate, then drove his horse-drawn buggy back to town, leaving a cloud of red dust behind.
Munchie prayed as he rode away, Lord, I know you didn’t mean to take this baby. She washed Day in a tub of warm water, then put him on a white sheet where she rubbed and patted his chest until he gasped for breath and his blue skin warmed to soft brown.
By the time Johnny Pleasant shipped Henrietta off to live with Grandpa Tommy, she was four and Day was almost nine. No one could have guessed she’d spend the rest of her life with Day—first as a cousin growing up in their grandfather’s home, then as his wife.
As children, Henrietta and Day awoke each morning at four o’clock to milk the cows and feed the chickens, hogs, and horses. They tended a garden filled with corn, peanuts, and greens, then headed to the tobacco fields with their cousins Cliff, Fred, Sadie, Margaret, and a horde of others. They spent much of their young lives stooped in those fields, planting tobacco behind mule-drawn plows. Each spring they pulled the wide green leaves from their stalks and tied them into small bundles—their fingers raw and sticky with nicotine resin—then climbed the rafters of their grandfather’s tobacco barn to hang bundle after bundle for curing. Each summer day they prayed for a storm to cool their skin from the burning sun. When they got one, they’d scream and run through fields, snatching armfuls of ripe fruit and walnuts that the winds blew from the trees.
Like most young Lackses, Day didn’t finish school: he stopped in the fourth grade because the family needed him to work the fields. But Henrietta stayed until the sixth grade. During the school year, after taking care of the garden and livestock each morning, she’d walk two miles—past the white school where children threw rocks and taunted her—to the colored school, a three-room wooden farmhouse hidden under tall shade trees, with a yard out front where Mrs. Coleman made the boys and girls play on separate sides. When school let out each day, and any time it wasn’t in session, Henrietta was in the fields with Day and the cousins.
If the weather was nice, when they finished working, the cousins ran straight to the swimming hole they made each year by damming the creek behind the house with rocks, sticks, bags of sand, and anything else they could sink. They threw rocks to scare away the poisonous cottonmouth snakes, then dropped into the water from tree branches or dove from muddy banks.
At nightfall they built fires with pieces of old shoes to keep the mosquitoes away, and watched the stars from beneath the big oak tree where they’d hung a rope to swing from. They played tag, ring-around-the-rosy, and hopscotch, and danced around the field singing until Grandpa Tommy yelled for everyone to go to bed.
Each night, piles of cousins packed into the crawl space above a little wooden kitchen house just a few feet from the home-house. They lay one next to the other—telling stories about the headless tobacco farmer who roamed the streets at night, or the man with no eyes who lived by the creek—then slept until their grandmother Chloe fired up the woodstove be-low and woke them to the smell of fresh biscuits.
One evening each month during harvest season, Grandpa Tommy hitched the horses after supper and readied them to ride into the town of South Boston—home of the nation’s second-largest tobacco market, with tobacco parades, a Miss Tobacco pageant, and a port where boats collected the dried leaves for people around the world to smoke.
Before leaving home, Tommy would call for the young cousins, who’d nestle into the flat wagon on a bed of tobacco leaves, then fight sleep as long as they could before giving in to the rhythm of the horses. Like farmers from all over Virginia, Tommy Lacks and the grandchildren rode through the night to bring their crops to South Boston, where they’d line up at dawn—one wagon behind the next-waiting for the enormous green wooden gates of the auction warehouse to open.
When they arrived, Henrietta and the cousins would help unhitch the horses and fill their troughs with grain, then unload the family’s tobacco onto the wood-plank floor of the warehouse. The auctioneer rattled off numbers that echoed through the huge open room, its ceil-ing nearly thirty feet high and covered with skylights blackened by years of dirt. As Tommy Lacks stood by his crop praying for a good price, Henrietta and the cousins ran around the tobacco piles, talking in a fast gibberish to sound like the auctioneer. At night they’d help Tommy haul any unsold tobacco down to the basement, where he’d turn the leaves into a bed for the children. White farmers slept upstairs in lofts and private rooms; black farmers slept in the dark underbelly of the warehouse with the horses, mules, and dogs, on a dusty dirt floor lined with rows of wooden stalls for livestock, and mountains of empty liquor bottles piled al-most to the ceiling.
Night at the warehouse was a time of booze, gambling, prostitution, and occasional murders as farmers burned through their season’s earnings. From their bed of leaves, the Lacks children would stare at ceiling beams the size of trees as they drifted off to the sound of laughter and clanking bottles, and the smell of dried tobacco.
In the morning they’d pile into the wagon with their unsold harvest and set out on the long journey home. Any cousins who’d stayed behind in Clover knew a wagon ride into South Boston meant treats for everyone—a hunk of cheese, maybe, or a slab of bologna—so they waited for hours on Main Street to follow the wagon to the home-house.
Clover’s wide, dusty Main Street was full of Model As, and wagons pulled by mules and horses. Old Man Snow had the first tractor in town, and he drove it to the store like it was a car—newspaper tucked under his arm, his hounds Cadillac and Dan baying beside him. Main Street had a movie theater, bank, jewelry store, doctor’s office, hardware store, and several churches. When the weather was good, white men with suspenders, top hats, and long cigars—everyone from mayor to doctor to undertaker—stood along Main Street sipping whiskey from juice bottles, talking, or playing checkers on the wooden barrel in front of the pharmacy. Their wives gossiped at the general store as their babies slept in a row on the counter, heads resting on long bolts of fabric.
Henrietta and her cousins would hire themselves out to those white folks, picking their tobacco for ten cents so they’d have money to see their favorite Buck Jones cowboy movies. The theater owner showed silent black-and-white films, and his wife played along on the piano. She knew only one song, so she played happy carnival-style music for every scene, even when characters were getting shot and dying. The Lacks children sat up in the colored section next to the projector, which clicked like a metronome through the whole movie.
As Henrietta and Day grew older, they traded ring-around-the-rosy for horse races along the dirt road that ran the length of what used to be the Lacks tobacco plantation, but was now simply called Lacks Town. The boys always fought over who got to ride Charlie Horse, Grandpa Tommy’s tall bay, which could outrun any other horse in Clover. Henrietta and the other girls watched from the hillside or the backs of straw-filled wagons, hopping up and down, clapping and screaming as the boys streaked by on horseback.
Henrietta often yelled for Day, but sometimes she cheered for another cousin, Crazy Joe Grinnan. Crazy Joe was what their cousin Cliff called “an over average man”—tall, husky, and strong, with dark skin, a sharp nose, and so much thick black hair covering his head, arms, back, and neck that he had to shave his whole body in the summer to keep from burning up. They called him Crazy Joe because he was so in love with Henrietta, he’d do anything to get her attention. She was the prettiest girl in Lacks Town, with her beautiful smile and walnut eyes.
The first time Crazy Joe tried to kill himself over Henrietta, he ran circles around her in the middle of winter while she was on her way home from school. He begged her for a date, saying, “Hennie, come on … just give me a chance.” When she laughed and said no, Crazy Joe ran and jumped straight through the ice of a frozen pond and refused to come out until she agreed to go out with him.
All the cousins teased Joe, saying, “Maybe he thought that ice water might’a cool him off, but he so hot for her, that water nearly started boiling!” Henrietta’s cousin Sadie, who was Crazy Joe’s sister, yelled at him, “Man you so much in love with a girl, you gonna die for her? That ain’t right.”
No one knew what happened between Henrietta and Crazy Joe, except that there were some dates and some kisses. But Henrietta and Day had been sharing a bedroom since she was four, so what happened next didn’t surprise anyone: they started having children together. Their son Lawrence was born just months after Henrietta’s fourteenth birthday; his sister Lucile Elsie Pleasant came along four years later. They were both born on the floor of the home-house like their father, grandmother, and grandfather before them.
People wouldn’t use words like epilepsy, mental retardation, or neurosyphilis to describe Elsie’s condition until years later. To the folks in Lacks Town, she was just simple. Touched. She came into the world so fast, Day hadn’t even gotten back with the midwife when Elsie shot right out and hit her head on the floor. Everyone would say maybe that was what left her mind like an infant’s.
The old dusty record books from Henrietta’s church are filled with the names of women cast from the congregation for bearing children out of wedlock, but for some reason Henrietta never was, even as rumors floated around Lacks Town that maybe Crazy Joe had fathered one of her children.
When Crazy Joe found out Henrietta was going to marry Day, he stabbed himself in the chest with an old dull pocketknife. His father found him lying drunk in their yard, shirt soaked with blood. He tried to stop the bleeding, but Joe fought him—thrashing and punching—which just made him bleed more. Eventually Joe’s father wrestled him into the car, tied him tight to the door, and drove to the doctor. When Joe got home all bandaged up, Sadie just kept saying, “All that to stop Hennie from marrying Day?” But Crazy Joe wasn’t the only one trying to stop the marriage.
Henrietta’s sister Gladys was always saying Henrietta could do better. When most Lackses talked about Henrietta and Day and their early life in Clover, it sounded as idyllic as a fairy tale. But not Gladys. No one knew why she was so against the marriage. Some folks said Gladys was just jealous because Henrietta was prettier. But Gladys always insisted Day would be a no-good husband.
Henrietta and Day married alone at their preacher’s house on April 10, 1941. She was twenty; he was twenty-five. They didn’t go on a honeymoon because there was too much work to do, and no money for travel. By winter, the United States was at war and tobacco companies were supplying free cigarettes to soldiers, so the market was booming. But as large farms flourished, the small ones struggled. Henrietta and Day were lucky if they sold enough tobacco each season to feed the family and plant the next crop.
So after their wedding, Day went back to gripping the splintered ends of his old wooden plow as Henrietta followed close behind, pushing a homemade wheelbarrow and dropping tobacco seedlings into holes in the freshly turned red dirt.
Then one afternoon at the end of 1941, their cousin Fred Garret came barreling down the dirt road beside their field. He was just back from Baltimore for a visit in his slick ‘36 Chevy and fancy clothes. Only a year earlier, Fred and his brother Cliff had been tobacco farmers in Clover too. For extra money, they’d opened a “colored” convenience store where most customers paid in IOUs; they also ran an old cinderblock juke joint where Henrietta often danced on the red-dirt floor. Everybody put coins in the jukebox and drank RC Cola, but the profits never amounted to much. So eventually Fred took his last three dollars and twenty-five cents and bought a bus ticket north for a new life. He, like several other cousins, went to work at Bethlehem Steel’s Sparrows Point steel mill and live in Turner Station, a small community of black workers on a peninsula in the Patapsco River, about twenty miles from downtown Baltimore.
In the late 1800s, when Sparrows Point first opened, Turner Station was mostly swamps, farmland, and a few shanties connected with wooden boards for walkways. When demand for steel increased during World War I, streams of white workers moved into the nearby town of Dundalk, and Bethlehem Steel’s housing barracks for black workers quickly overflowed, push-ing them into Turner Station. By the early years of World War II, Turner Station had a few paved roads, a doctor, a general store, and an ice man. But its residents were still fighting for water, sewage lines, and schools.
Then, in December 1941, Japan bombed Pearl Harbor, and it was like Turner Station had won the lottery: the demand for steel skyrocketed, as did the need for workers. The government poured money into Turner Station, which began filling with one-and two-story housing projects, many of them pressed side by side and back-to-back, some with four to five hundred units. Most were brick, others covered with asbestos shingles. Some had yards, some didn’t. From most of them you could see the flames dancing above Sparrows Point’s furnaces and the eerie red smoke pouring from its smokestacks.
Sparrows Point was rapidly becoming the largest steel plant in the world. It produced concrete-reinforcing bars, barbed wire, nails, and steel for cars, refrigerators, and military ships. It would burn more than six million tons of coal each year to make up to eight million tons of steel and employ more than 30,000 workers. Bethlehem Steel was a gold mine in a time flush with poverty, especially for black families from the South. Word spread from Maryland to the farms of Virginia and the Carolinas, and as part of what would become known as the Great Migration, black families flocked from the South to Turner Station—the Promised Land.
The work was tough, especially for black men, who got the jobs white men wouldn’t touch. Like Fred, black workers usually started in the bowels of partially built tankers in the shipyard, collecting bolts, rivets, and nuts as they fell from the hands of men drilling and welding thirty or forty feet up. Eventually black workers moved up to the boiler room, where they shoveled coal into a blazing furnace. They spent their days breathing in toxic coal dust and asbestos, which they brought home to their wives and daughters, who inhaled it while shaking the men’s clothes out for the wash. The black workers at Sparrows Point made about eighty cents an hour at most, usually less. White workers got higher wages, but Fred didn’t complain: eighty cents an hour was more than most Lackses had ever seen.
Fred had made it. Now he’d come back to Clover to convince Henrietta and Day that they should do the same. The morning after he came barreling into town, Fred bought Day a bus ticket to Baltimore. They agreed Henrietta would stay behind to care for the children and the tobacco until Day made enough for a house of their own in Baltimore, and three tickets north. A few months later, Fred got a draft notice shipping him overseas. Before he left, Fred gave Day all the money he’d saved, saying it was time to get Henrietta and the children to Turner Station.
Soon, with a child on each side, Henrietta boarded a coal-fueled train from the small wooden depot at the end of Clover’s Main Street. She left the tobacco fields of her youth and the hundred-year-old oak tree that shaded her from the sun on so many hot afternoons. At the age of twenty-one, Henrietta stared through the train window at rolling hills and wide-open bodies of water for the first time, heading toward a new life.
After her visit to Hopkins, Henrietta went about life as usual, cleaning and cooking for Day, their children, and the many cousins who stopped by. Then, a few days later, Jones got her biopsy results from the pathology lab: “Epidermoid carcinoma of the cervix, Stage I.”
All cancers originate from a single cell gone wrong and are categorized based on the type of cell they start from. Most cervical cancers are carcinomas, which grow from the epithelial cells that cover the cervix and protect its surface. By chance, when Henrietta showed up at Hopkins complaining of abnormal bleeding, Jones and his boss, Richard Wesley TeLinde, were involved in a heated nationwide debate over what qualified as cervical cancer, and how best to treat it.
TeLinde, one of the top cervical cancer experts in the country, was a dapper and serious fifty-six-year-old surgeon who walked with an extreme limp from an ice-skating accident more than a decade earlier. Everyone at Hopkins called him Uncle Dick. He’d pioneered the use of estrogen for treating symptoms of menopause and made important early discoveries about endometriosis. He’d also written one of the most famous clinical gynecology textbooks, which is still widely used sixty years and ten editions after he first wrote it. His reputation was international: when the king of Morocco’s wife fell ill, he insisted only TeLinde could operate on her. By 1951, when Henrietta arrived at Hopkins, TeLinde had developed a theory about cervical cancer that, if correct, could save the lives of millions of women. But few in the field believed him.
Cervical carcinomas are divided into two types: invasive carcinomas, which have penetrated the surface of the cervix, and noninvasive carcinomas, which haven’t. The noninvasive type is sometimes called “sugar-icing carcinoma,” because it grows in a smooth layered sheet across the surface of the cervix, but its official name is carcinoma in situ, which derives from the Latin for “cancer in its original place.”
In 1951, most doctors in the field believed that invasive carcinoma was deadly, and carcinoma in situ wasn’t. So they treated the invasive type aggressively but generally didn’t worry about carcinoma in situ because they thought it couldn’t spread. TeLinde disagreed—he believed carcinoma in situ was simply an early stage of invasive carcinoma that, if left untreated, eventually became deadly. So he treated it aggressively, often removing the cervix, uterus, and most of the vagina. He argued that this would drastically reduce cervical cancer deaths, but his critics called it extreme and unnecessary.
Diagnosing carcinoma in situ had only been possible since 1941, when George Papanicolaou, a Greek researcher, published a paper describing a test he’d developed, now called the Pap smear. It involved scraping cells from the cervix with a curved glass pipette and examining them under a microscope for precancerous changes that TeLinde and a few others had identified years earlier. This was a tremendous advance, because those precancerous cells weren’t detectable otherwise: they caused no physical symptoms and weren’t palpable or visible to the naked eye. By the time a woman began showing symptoms, there was little hope of a cure. But with the Pap smear, doctors could detect precancerous cells and perform a hysterectomy, and cervical cancer would be almost entirely preventable.
At that point, more than 15,000 women were dying each year from cervical cancer. The Pap smear had the potential to decrease that death rate by 70 percent or more, but there were two things standing in its way: first, many women—like Henrietta—simply didn’t get the test; and, second, even when they did, few doctors knew how to interpret the results accurately, because they didn’t know what the various stages of cervical cancer looked like under a microscope. Some mistook cervical infections for cancer and removed a woman’s entire reproductive tract when all she needed was antibiotics. Others mistook malignant changes for infection, sending women home with antibiotics only to have them return later, dying from metastasized cancer. And even when doctors correctly diagnosed precancerous changes, they often didn’t know how those changes should be treated.
TeLinde set out to minimize what he called “unjustifiable hysterectomies” by documenting what wasn’t cervical cancer and by urging surgeons to verify smear results with biopsies be-fore operating. He also hoped to prove that women with carcinoma in situ needed aggressive treatment, so their cancer didn’t become invasive.
Not long before Henrietta’s first exam, TeLinde presented his argument about carcinoma in situ to a major meeting of pathologists in Washington, D.C., and the audience heckled him off the stage. So he went back to Hopkins and planned a study that would prove them wrong: he and his staff would review all medical records and biopsies from patients who’d been diagnosed with invasive cervical cancer at Hopkins in the past decade, to see how many initially had carcinoma in situ.
Like many doctors of his era, TeLinde often used patients from the public wards for research, usually without their knowledge. Many scientists believed that since patients were treated for free in the public wards, it was fair to use them as research subjects as a form of payment. And as Howard Jones once wrote, “Hopkins, with its large indigent black population, had no dearth of clinical material.”
The doctors justified the use of using patients in public wards as medical research subjects because they were treated for free. Them being used as a research subject was their “payment.” I disagree with this reasoning- I think it’s unethical to do this kind of experiment with no consent. Whether the treatment is free or not doesn’t determine how “human” someone is, and a patient should be asked about this regardless of the situation.
This doesn’t balance out in my opinion, because paying for a medical procedure and getting tested on without knowledge of it are two very different things and don’t relate in the slightest. It’s inherently unethical to use human subjects in medical tests without the subjects knowing about it, and trying to write it away with the poor excuse of free treatment doesn’t make it okay to treat other humans as if they’re lesser than others.
3. In chapter 3 Henrietta’s cells are taken to Dr. Gey, who is ultimately able to preserve and grown them. Now that you have read about Henrietta’s early life, marriage, family, and illness, do you have an opinion about whether it was ethical to take her cells without telling her what might be done with them? How could a reader’s knowledge of the facts of her life affect his or her response to this question? Should it?
In my opinion, she should have given more warning/knowledge about what they were doing. Her life was hard, and she was a stay-at-home mother who was sweet to everyone in her town. Although scientists have been able to make some remarkable discoveries with her cells, I believe that she should have had more knowledge of what she was signing onto. She sort of signed the consent forms blindly without knowing what they were, where the doctors should have told her what those forms meant and asked if they could use her cells for future research. I think a reader’s knowledge of her circumstances can and should shape their opinion on whether her cells should have been used basically without her consent or not. The more you realize about her life and how much mistrust in the medical system their community already had, the more you understand why her family is hesitant to talk to anyone and feels in some ways that they’ve been cheated out of these important discoveries.
In this particular study—the largest ever done on the relationship between the two cervical cancers—Jones and TeLinde found that 62 percent of women with invasive cancer who’d had earlier biopsies first had carcinoma in situ. In addition to that study, TeLinde thought, if he could find a way to grow living samples from normal cervical tissue and both types of cancerous tissue—something never done before—he could compare all three. If he could prove that carcinoma in situ and invasive carcinoma looked and behaved similarly in the laboratory, he could end the debate, showing that he’d been right all along, and doctors who ignored him were killing their patients. So he called George Gey (pronounced Guy), head of tissue culture research at Hopkins.
Gey and his wife, Margaret, had spent the last three decades working to grow malignant cells outside the body, hoping to use them to find cancer’s cause and cure. But most cells died quickly, and the few that survived hardly grew at all. The Geys were determined to grow the first immortal human cells: a continuously dividing line of cells all descended from one original sample, cells that would constantly replenish themselves and never die. Eight years earlier—in 1943—a group of researchers at the National Institutes of Health had proven such a thing was possible using mouse cells. The Geys wanted to grow the human equivalent—they didn’t care what kind of tissue they used, as long as it came from a person. Gey took any cells he could get his hands on—he called himself “the world’s most famous vulture, feeding on human specimens almost constantly.” So when TeLinde offered him a supply of cervical cancer tissue in exchange for trying to grow some cells, Gey didn’t hesitate. And TeLinde began collecting samples from any woman who happened to walk into Hopkins with cervical cancer. Including Henrietta.
On February 5, 1951, after Jones got Henrietta’s biopsy report back from the lab, he called and told her it was malignant. Henrietta didn’t tell anyone what Jones said, and no one asked. She simply went on with her day as if nothing had happened, which was just like her—no sense upsetting anyone over something she could deal with herself.
That night Henrietta told her husband, “Day, I need to go back to the doctor tomorrow. He wants to do some tests, give me some medicine.” The next morning she climbed from the Buick outside Hopkins again, telling Day and the children not to worry.
“Ain’t nothin serious wrong,” she said. “Doctor’s gonna fix me right up.”
Henrietta went straight to the admissions desk and told the receptionist she was there for her treatment. Then she signed a form with the words OPERATION PERMIT at the top of the page. It said:
I hereby give consent to the staff of The Johns Hopkins Hospital to perform any operative procedures and under any anaesthetic either local or general that they may deem necessary in the proper surgical care and treatment of: ______________________________
I think that harvesting the cells was not a necessary procedure, and they should’ve been more transparent about how they were going to do that. The message says that she was signing off to the procedures needed to save her life, this didn’t include the harvest.
Based on this statement, they had the ability to observe the sample from her cervix if it was necessary in proper cervical care. So in my opinion, they did not have the right to use it in their research and to send it to other doctors and scientists. They did, though, have the right to obtain the sample if it was to help Henrietta. Using it in their own research was not necessary towards helping Henrietta’s case which makes it unjust to use her cells in further studies.
However, because of the lack of clarity of the title and consent form, as well as the history of taking samples from people for free without consent, it seems more realistic that they didn’t have the right consent.
Because of the nature of the disclosure she signed, TeLinde and Gey didn’t have any legal right to test her cells that were removed, and she had no idea about what they were doing with them after her surgery. They should have been more up front and transparent about their intentions for further research and should have at least given Henrietta a warning beforehand.
Learning more about her personal life definitely put another shade on this, knowing about how little education she’d had and the circumstances, but still I do think if she signed them away then that’s the way it is (at least based on the limited amount of details we get about this exchange)
Henrietta printed her name in the blank space. A witness with illegible handwriting signed a line at the bottom of the form, and Henrietta signed another.
Then she followed a nurse down a long hallway into the ward for colored women, where Howard Jones and several other white physicians ran more tests than she’d had in her entire life. They checked her urine, her blood, her lungs. They stuck tubes in her bladder and nose.
On her second night at the hospital, the nurse on duty fed Henrietta an early dinner so her stomach would be empty the next morning, when a doctor put her under anesthetic for her first cancer treatment. Henrietta’s tumor was the invasive type, and like hospitals nationwide, Hopkins treated all invasive cervical carcinomas with radium, a white radioactive metal that glows an eerie blue.
When radium was first discovered in the late 1800s, headlines nationwide hailed it as “a substitute for gas, electricity, and a positive cure for every disease.” Watchmakers added it to paint to make watch dials glow, and doctors administered it in powdered form to treat everything from seasickness to ear infections. But radium destroys any cells it encounters, and patients who’d taken it for trivial problems began dying. Radium causes mutations that can turn into cancer, and at high doses it can burn the skin off a person’s body. But it also kills cancer cells.
Hopkins had been using radium to treat cervical cancer since the early 1900s, when a surgeon named Howard Kelly visited Marie and Pierre Curie, the couple in France who’d dis-covered radium and its ability to destroy cancer cells. Without realizing the danger of contact with radium, Kelly brought some back to the United States in his pockets and regularly traveled the world collecting more. By the 1940s, several studies—one of them conducted by Howard Jones, Henrietta’s physician—showed that radium was safer and more effective than surgery for treating invasive cervical cancer.
The morning of Henrietta’s first treatment, a taxi driver picked up a doctor’s bag filled with thin glass tubes of radium from a clinic across town. The tubes were tucked into individual slots inside small canvas pouches hand-sewn by a local Baltimore woman. The pouches were called Brack plaques, after the Hopkins doctor who invented them and oversaw Henrietta’s radium treatment. He would later die of cancer, most likely caused by his regular exposure to radium, as would a resident who traveled with Kelly and also transported radium in his pockets.One nurse placed the Brack plaques on a stainless-steel tray. Another wheeled Henrietta into the small colored-only operating room on the second floor, with stainless-steel tables, huge glaring lights, and an all-white medical staff dressed in white gowns, hats, masks, and gloves.
With Henrietta unconscious on the operating table in the center of the room, her feet in stirrups, the surgeon on duty, Dr. Lawrence Wharton Jr., sat on a stool between her legs. He peered inside Henrietta, dilated her cervix, and prepared to treat her tumor. But first—though no one had told Henrietta that TeLinde was collecting samples or asked if she wanted to be a donor—Wharton picked up a sharp knife and shaved two dime-sized pieces of tissue from Henrietta’s cervix: one from her tumor, and one from the healthy cervical tissue nearby. Then he placed the samples in a glass dish.
Wharton slipped a tube filled with radium inside Henrietta’s cervix, and sewed it in place. He sewed a plaque filled with radium to the outer surface of her cervix and packed another plaque against it. He slid several rolls of gauze inside her vagina to help keep the radium in place, then threaded a catheter into her bladder so she could urinate without disturbing the treatment.
Even though they noted that Henrietta make a quick recovery and was in good health after the procedure, things easily could have gone very wrong when introducing a harmful substance like radium inside of her. It wasn’t like they put in the radium for a short amount of time either; they had to keep it in place and make sure she could still urinate with the tube of radium still inside her vagina, which makes me wonder what could have happened if the tube moved around at all or if it was left inside of her for too long.
When Wharton finished, a nurse wheeled Henrietta back into the ward, and Wharton wrote in her chart, “The patient tolerated the procedure well and left the operating room in good condition.” On a separate page he wrote, “Henrietta Lacks … Biopsy of cervical tissue … Tissue given to Dr. George Gey.”
A resident took the dish with the samples to Gey’s lab, as he’d done many times before. Gey still got excited at moments like this, but everyone else in his lab saw Henrietta’s sample as something tedious—the latest of what felt like countless samples that scientists and lab technicians had been trying and failing to grow for years. They were sure Henrietta’s cells would die just like all the others.
Though Henrietta’s samples became a medical anomaly, saving countless future lives, the way the samples were taken was unethical. Because she was in the dark about it, she couldn’t be compensated for the valuable research being done on her cells.
The question of whether the harvesting of the HeLa cells was ethical can only be considered under this context: Gey and his researchers harvested samples from thousands of people, and it was chance that Henrietta Lacks’ cells were the ones they were looking for. Would the debate about morality be different if she were a wealthy white woman? And if this were the case, would there have been a bigger deal made about it? One would have to look to see if there have been similar events like this in the past to hopefully discern an answer.
The fact that her cells weren’t normal and grew at an alarming rate makes the situation even worse, because at that point Henrietta should have been very aware of what was happening and should have been consulted beforehand to make sure she was okay with the cells being tested.
Gey’s twenty-one-year-old assistant, Mary Kubicek, sat eating a tuna-salad sandwich at a long stone culture bench that doubled as a break table. She and Margaret and the other women in the Gey lab spent countless hours there, all in nearly identical cat-eye-glasses with fat dark frames and thick lenses, their hair pulled back in tight buns.
At first glance, the room could have been an industrial kitchen. There were gallon-sized tin coffee cans full of utensils and glassware; powdered creamer, sugar, spoons, and soda bottles on the table; huge metal freezers lining one wall; and deep sinks Gey made by hand using stones he collected from a nearby quarry. But the teapot sat next to a Bunsen burner, and the freezers were filled with blood, placentas, tumor samples, and dead mice (plus at least one duck Gey kept frozen in the lab for more than twenty years after a hunting trip, since it wouldn’t fit in his freezer at home). Gey had lined one wall with cages full of squealing rabbits, rats, and guinea pigs; on one side of the table where Mary sat eating her lunch, he’d built shelves holding cages full of mice, their bodies filled with tumors. Mary always stared at them while she ate, just as she was doing when Gey walked into the lab carrying the pieces of Henrietta’s cervix.
“I’m putting a new sample in your cubicle,” he told her.
Mary pretended not to notice. Not again, she thought, and kept eating her sandwich. It can wait till I’m done.
Mary knew she shouldn’t wait—every moment those cells sat in the dish made it more likely they’d die. But she was tired of cell culture, tired of meticulously cutting away dead tissue like gristle from a steak, tired of having cells die after hours of work.
Why bother? she thought.
Gey hired Mary for her hands. She was fresh out of college with a physiology degree when her adviser sent her for an interview. Gey asked Mary to pick up a pen from the table and write a few sentences. Now pick up that knife, he said. Cut this piece of paper. Twirl this pipette.
Mary didn’t realize until months later that he’d been studying her hands, checking their dexterity and strength to see how they’d stand up to hours of delicate cutting, scraping, tweezing, and pipetting.
By the time Henrietta walked into Hopkins, Mary was handling most of the tissue samples that came through the door, and so far all samples from TeLinde’s patients had died.
At that point, there were many obstacles to growing cells successfully. For starters, no one knew exactly what nutrients they needed to survive, or how best to supply them. Many researchers, including the Geys, had been trying for years to develop the perfect culture medium—the liquid used for feeding cells. The recipes for Gey Culture Medium evolved constantly as George and Margaret added and removed ingredients, searching for the perfect balance. But they all sounded like witches’ brews: the plasma of chickens, purée of calf fetuses, special salts, and blood from human umbilical cords. George had rigged a bell and cable from the window of his lab across a courtyard to the Hopkins maternity ward, so nurses could ring any-time a baby was born, and Margaret or Mary would run over and collect umbilical cord blood.
The other ingredients weren’t so easy to come by: George visited local slaughterhouses at least once a week to collect cow fetuses and chicken blood. He’d drive there in his rusted-out old Chevy, its left fender flapping against the pavement, shooting sparks. Well before dawn, in a rundown wooden building with a sawdust floor and wide gaps in the walls, Gey would grab a screaming chicken by the legs, yank it upside down from its cage, and wrestle it to its back on a butcher block. He’d hold its feet in one hand and pin its neck motionless to the wood with his elbow. With his free hand, he’d squirt the bird’s chest with alcohol, and plunge a syringe needle into the chicken’s heart to draw blood. Then he’d stand the bird upright, saying, “Sorry, old fella,” and put it back in its cage. Every once in a while, when a chicken dropped dead from the stress, George took it home so Margaret could fry it for dinner.
Like many procedures in their lab, the Gey Chicken Bleeding Technique was Margaret’s creation. She worked out the method step-by-step, taught it to George, and wrote detailed instructions for the many other researchers who wanted to learn it.
Finding the perfect medium was an ongoing experiment, but the biggest problem facing cell culture was contamination. Bacteria and a host of other microorganisms could find their way into cultures from people’s unwashed hands, their breath, and dust particles floating through the air, and destroy them. But Margaret had been trained as a surgical nurse, which meant sterility was her specialty—it was key to preventing deadly infections in patients in the operating room. Many would later say that Margaret’s surgical training was the only reason the Gey lab was able to grow cells at all. Most culturists, like George, were biologists; they knew nothing about preventing contamination.Margaret taught George everything he knew about keeping cultures sterile, and she did the same with every technician, grad student, and scientist who came to work or study in the lab. She hired a local woman named Minnie whose sole job was washing the laboratory glassware using the only product Margaret would allow: Gold Dust Twins soap. Margaret was so serious about that soap, when she heard a rumor that the company might go out of busi-ness, she bought an entire boxcar full of it.
Margaret patrolled the lab, arms crossed, and leaned over Minnie’s shoulder as she worked, towering nearly a foot above her. If Margaret ever smiled, no one could have seen it through her ever-present surgical mask. She inspected all the glassware for spots or smudges, and when she found them—which was often—she’d scream, “MINNIE!” so loud that Mary cringed.
Mary followed Margaret’s sterilizing rules meticulously to avoid her wrath. After finishing her lunch, and before touching Henrietta’s sample, Mary covered herself with a clean white gown, surgical cap, and mask, and then walked to her cubicle, one of four airtight rooms George had built by hand in the center of the lab. The cubicles were small, only five feet in any direction, with doors that sealed like a freezer’s to prevent contaminated air from getting inside. Mary turned on the sterilizing system and watched from outside as her cubicle filled with hot steam to kill anything that might damage the cells. When the steam cleared, she stepped inside and sealed the door behind her, then hosed the cubicle’s cement floor with water and scoured her workbench with alcohol. The air inside was filtered and piped in though a vent on the ceiling. Once she’d sterilized the cubicle, she lit a Bunsen burner and used its flame to sterilize test tubes and a used scalpel blade, since the Gey lab couldn’t afford new ones for each sample.
Only then did she pick up the pieces of Henrietta’s cervix—forceps in one hand, scalpel in the other—and carefully slice them into one-millimeter squares. She sucked each square into a pipette, and dropped them one at a time onto chicken-blood clots she’d placed at the bottom of dozens of test tubes. She covered each clot with several drops of culture medium, plugged the tubes with rubber stoppers, and labeled each one as she’d labeled most cultures they grew: using the first two letters of the patient’s first and last names.
After writing “HeLa,” for Henrietta and Lacks, in big black letters on the side of each tube, Mary carried them to the incubator room that Gey had built just like he’d built everything else in the lab: by hand and mostly from junkyard scraps, a skill he’d learned from a lifetime of making do with nothing.
George Gey was born in 1899 and raised on a Pittsburgh hillside overlooking a steel mill. Soot from the smokestacks made his parents’ small white house look like it had been permanently charred by fire and left the afternoon sky dark. His mother worked the garden and fed her family from nothing but the food she raised. As a child, George dug a small coal mine in the hill behind his parents’ house. He’d crawl through the damp tunnel each morning with a pick, filling buckets for his family and neighbors so they could keep their houses warm and stoves burning.
Gey paid his way through a biology degree at the University of Pittsburgh by working as a carpenter and mason, and he could make nearly anything for cheap or free. During his second year in medical school, he rigged a microscope with a time-lapse motion picture camera to capture live cells on film. It was a Frankensteinish mishmash of microscope parts, glass, and 16-millimeter camera equipment from who knows where, plus metal scraps, and old motors from Shapiro’s junkyard. He built it in a hole he’d blasted in the foundation of Hopkins, right below the morgue, its base entirely underground and surrounded by a thick wall of cork to keep it from jiggling when street cars passed. At night, a Lithuanian lab assistant slept next to the camera on a cot, listening to its constant tick, making sure it stayed stable through the night, waking every hour to refocus it. With that camera, Gey and his mentor, Warren Lewis, filmed the growth of cells, a process so slow—like the growth of a flower—the naked eye couldn’t see it. They played the film at high speed so they could watch cell division on the screen in one smooth motion, like a story unfolding in a flip book.
It took Gey eight years to get through medical school because he kept dropping out to work construction and save for another year’s tuition. After he graduated, he and Margaret built their first lab in a janitor’s quarters at Hopkins—they spent weeks wiring, painting, plumbing, building counters and cabinets, paying for much of it with their own money.
Margaret was cautious and stable, the backbone of the lab. George was an enormous, mischievous, grown-up kid. At work he was dapper, but at home he lived in flannels, khakis, and suspenders. He moved boulders around his yard on weekends, ate twelve ears of corn in one sitting, and kept barrels full of oysters in his garage so he could shuck and eat them any-time he wanted. He had the body of a retired linebacker, six feet four inches tall and 215 pounds, his back unnaturally stiff and upright from having his spine fused so he’d stop throwing it out. When his basement wine-making factory exploded on a Sunday, sending a flood of sparkling burgundy through his garage and into the street, Gey just washed the wine into a storm drain, waving at his neighbors as they walked to church.
Gey was a reckless visionary—spontaneous, quick to start dozens of projects at once, filling the lab and his basement at home with half-built machines, partial discoveries, and piles of junkyard scraps only he could imagine using in a lab. Whenever an idea hit him, he sat wherever he was—at his desk, kitchen table, a bar, or behind the wheel of his car—gnawing on his ever-present cigar and scribbling diagrams on napkins or the backs of torn-off bottle la-bels. That’s how he came up with the roller-tube culturing technique, his most important invention.
It involved a large wooden roller drum, a cylinder with holes for special test tubes called roller tubes. The drum, which Gey called the “whirligig,” turned like a cement mixer twenty-four hours a day, rotating so slowly it made only two full turns an hour, sometimes less. For Gey, the rotation was crucial: he believed that culture medium needed to be in constant motion, like blood and fluids in the body, which flow around cells, transporting waste and nutrients.
When Mary finally finished cutting the samples of Henrietta’s cervix and dropping them in dozens of roller tubes, she walked into the incubator room, slid the tubes one at a time into the drum, and turned it on. Then she watched as Gey’s machine began churning slowly.
Henrietta spent the next two days in the hospital, recovering from her first radium treatment. Doctors examined her inside and out, pressing on her stomach, inserting new catheters into her bladder, fingers into her vagina and anus, needles into her veins. They wrote notes in her chart saying, “30-year-old colored female lying quietly in no evident distress,” and “Patient feels quite well tonight. Morale is good and she is ready to go home.”
Before Henrietta left the hospital, a doctor put her feet in the stirrups again and removed the radium. He sent her home with instructions to call the clinic if she had problems, and to come back for a second dose of radium in two and a half weeks.
Meanwhile, each morning after putting Henrietta’s cells in culture, Mary started her days with the usual sterilization drill. She peered into the tubes, laughing to herself and thinking, Nothing’s happening. Big surprise. Then, two days after Henrietta went home from the hospital, Mary saw what looked like little rings of fried egg white around the clots at the bottoms of each tube. The cells were growing, but Mary didn’t think much of it—other cells had survived for a while in the lab.
But Henrietta’s cells weren’t merely surviving, they were growing with mythological intensity. By the next morning they’d doubled. Mary divided the contents of each tube into two, giving them room to grow, and within twenty-four hours, they’d doubled again. Soon she was dividing them into four tubes, then six. Henrietta’s cells grew to fill as much space as Mary gave them.
Still, Gey wasn’t ready to celebrate. “The cells could die any minute,” he told Mary.
But they didn’t. They kept growing like nothing anyone had seen, doubling their numbers every twenty-four hours, stacking hundreds on top of hundreds, accumulating by the millions. “Spreading like crabgrass!” Margaret said. They grew twenty times faster than Henrietta’s normal cells, which died only a few days after Mary put them in culture. As long as they had food and warmth, Henrietta’s cancer cells seemed unstoppable.
Soon, George told a few of his closest colleagues that he thought his lab might have grown the first immortal human cells.
To which they replied, Can I have some? And George said yes.
I do not this that Henriattas family had a positive or negative involvement in her care. She did not really tell anyone in her family about what was going on other than that she was going to be okay and the doctors were taking care of her.
Question 4: The aspects of Henrietta’s care that raise concerns for me is that the doctors didn’t really listen to her the first time she told them something didn’t feel right, and how she felt pain in her abdomen. They kind of brushed it off and said how they didn’t find anything wrong with her just from one scan/test. It was also concerning that they left radium inside of her cervix, because to me that doesn’t seem safe and like something could easily go wrong. In a way, I feel like she was more of a guinea pig to try out different cancer treatments. I don’t think that Henrietta’s family was truly involved in her care or treatments because she really didn’t tell them a whole lot. None knew of the pain or side effects of her radiation, and she didn’t make it a big deal. We can see how in paragraph 131, Henrietta never told her family the results of her biopsy, which is something you’d tell your family or close friends. She also played it off and was saying how she was fine and the doctor was going to fix her.
Henrietta knew nothing about her cells growing in a laboratory. After leaving the hospital, she went back to life as usual. She’d never loved the city, so almost every weekend she took the children back to Clover, where she worked the tobacco fields and spent hours churning butter on the steps of the home-house. Though radium often causes relentless nausea, vomiting, weakness, and anemia, there’s no record of Henrietta having any side effects, and no one remembers her complaining of feeling sick.
I am concerned by Henrietta now knowing anything about what the doctors were doing with her cells in the lab.
When she wasn’t in Clover, Henrietta spent her time cooking for Day, the children, and whichever cousins happened to be at her house. She made her famous rice pudding and slow-cooked greens, chitlins, and the vats of spaghetti with meatballs she kept going on the stove for whenever cousins dropped by hungry. When Day wasn’t working the night shift, he and Henrietta spent evenings at home, playing cards and listening to Bennie Smith play blues guitar on the radio after the kids went to sleep. On the nights Day worked, Henrietta and Sad-ie would wait until the door slammed, count to one hundred, then jump out of bed, put on their dancing clothes, and sneak out of the house, careful not to wake the children. Once they got outside, they’d wiggle their hips and squeal, scampering down the street to the dance floors at Adams Bar and Twin Pines.
“We used to really swing out heavy,” Sadie told me years later. “We couldn’t help it. They played music that when you heard it just put your soul into it. We’d two-step across that floor, jiggle to some blues, then somebody maybe put a quarter in there and play a slow music song, and Lord we’d just get out there and shake and turn around and all like that!” She giggled like a young girl. “It was some beautiful times.” And they were beautiful women.
Henrietta had walnut eyes, straight white teeth, and full lips. She was a sturdy woman with a square jaw, thick hips, short, muscular legs, and hands rough from tobacco fields and kitchens. She kept her nails short so bread dough wouldn’t stick under them when she kneaded it, but she always painted them a deep red to match her toenails.
Henrietta spent hours taking care of those nails, touching up chips and brushing on new coats of polish. She’d sit on her bed, polish in hand, hair high on her head in curlers, wearing the silky slip she loved so much she hand-washed it each night. She never wore pants, and rarely left the house without pulling on a carefully pressed skirt and shirt, sliding her feet into her tiny, open-toed pumps, and pinning her hair up with a little flip at the bottom, “just like it was dancin toward her face,” Sadie always said.
“Hennie made life come alive—bein with her was like bein with fun,” Sadie told me, staring toward the ceiling as she talked. “Hennie just love peoples. She was a person that could really make the good things come out of you.”
But there was one person Henrietta couldn’t bring out any good in. Ethel, the wife of their cousin Galen, had recently come to Turner Station from Clover, and she hated Henrietta—her cousins always said it was jealousy.
“I guess I can’t say’s I blame her,” Sadie said. “Galen, that husband of Ethel’s, he was likin Hennie more than he like Ethel. Lord, he followed Hennie! Everywhere she go, there go Ga-len—he tried to stay up at Hennie house all the time when Day gone to work. Lord, Ethel was jealous—made her hateful to Hennie somethin fierce. Always seemed like she wanted to hurt Hennie.” So Henrietta and Sadie would giggle and slip out the back to another club anytime Ethel showed up.
When they weren’t sneaking out, Henrietta, Sadie, and Sadie’s sister Margaret spent evenings in Henrietta’s living room, playing bingo, yelling, and laughing over a pot of pennies while Henrietta’s babies—David Jr., Deborah, and Joe—played with the bingo chips on the carpet beneath the table. Lawrence was nearly sixteen, already out having a life of his own. But one child was missing: Henrietta’s oldest daughter, Elsie.
Before Henrietta got sick, she took Elsie down to Clover every time she went. Elsie would sit on the stoop of the home-house, staring into the hills and watching the sunrise as Henrietta worked in the garden. She was beautiful, delicate and feminine like Henrietta, who dressed her in homemade outfits with bows and spent hours braiding her long brown curls. Elsie never talked, she just cawed and chirped like a bird as she waved her hands inches from her face. She had wide chestnut eyes that everyone stared into, trying to understand what went on in that pretty head. But she just stared back, unflinching, her eyes haunted with fear and sadness that only softened when Henrietta rocked her back and forth.
Sometimes Elsie raced through the fields, chasing wild turkeys or grabbing the family mule by the tail and thrashing against him until Lawrence pulled her off. Henrietta’s cousin Peter always said God had that child from the moment she was born, because that mule never hurt her. It was so mean it snapped at air like a rabid dog and kicked at the wind, but it seemed to know Elsie was special. Still, as she grew, she fell, she ran into walls and doors, burned herself against the woodstove. Henrietta made Day drive her and Elsie to revival meetings so preachers in tents could lay hands on Elsie to heal her, but it never worked. In Turner Station, sometimes Elsie bolted from the house and ran through the street screaming. By the time Henrietta got pregnant with baby Joe, Elsie was too big for Henrietta to handle alone, especially with two babies. The doctors said that sending Elsie away was the best thing. So now she was living about an hour and a half south of Baltimore, at Crownsville State Hospital—formerly known as the Hospital for the Negro Insane.
Henrietta’s cousins always said a bit of Henrietta died the day they sent Elsie away, that losing her was worse than anything else that happened to her. Now, nearly a year later, Henrietta still had Day or a cousin take her from Turner Station to Crownsville once a week to sit with Elsie, who’d cry and cling to her as they played with each other’s hair.
Henrietta had a way with children—they were always good and quiet when she was around. But whenever she left the house, Lawrence stopped being good. If the weather was nice, he’d run to the old pier in Turner Station, where Henrietta had forbidden him to go. The pier had burned down years earlier, leaving tall wooden pilings that Lawrence and his friends liked to dive from. One of Sadie’s sons nearly drowned out there from hitting his head on a rock, and Lawrence was always coming home with eye infections that everyone blamed on the water being contaminated by Sparrows Point. Anytime Henrietta got word that Lawrence was at the pier, she’d storm down there, drag him out of the water, and whip him.
“Ooooh Lord,” Sadie said once, “Hennie went down there with a switch. Yes Lord. She pitched a boogie like I never seen.” But those were the only times anyone could ever remember seeing Henrietta mad. “She was tough,” Sadie said. “Nothin scared Hennie.”
For a month and a half, no one in Turner Station knew Henrietta was sick. The cancer was easy to keep secret, because she only had to go back to Hopkins once, for a checkup and a second radium treatment. At that point the doctors liked what they saw: her cervix was a bit red and inflamed from the first treatment, but the tumor was shrinking. Regardless, she had to start X-ray therapy, which meant visiting Hopkins every weekday for a month. For that, she needed help: Henrietta lived twenty minutes from Hopkins, and Day worked nights, so he couldn’t take her home after radiation until late. She wanted to walk to her cousin Margaret’s house a few blocks from Hopkins and wait there for Day after her treatments. But first she’d have to tell Margaret and Sadie she was sick.
Henrietta told her cousins about the cancer at a carnival that came to Turner Station each year. The three of them climbed onto the Ferris wheel as usual, and she waited till it got so high they could see across Sparrows Point toward the ocean, till the Ferris wheel stopped and they were just kicking their legs back and forth, swinging in the crisp spring air.
“You remember when I said I had a knot inside me?” she asked. They nodded yes. “Well, I got cancer,” Henrietta said. “I been havin treatments down at John Hopkins.”
“What?!” Sadie said, looking at Henrietta and feeling suddenly dizzy, like she was about to slide off the Ferris wheel seat.
“Nothin serious wrong with me,” Henrietta said. “I’m fine.”
And at that point it looked like she was right. The tumor had completely vanished from the radium treatments. As far as the doctors could see, Henrietta’s cervix was normal again, and they felt no tumors anywhere else. Her doctors were so sure of her recovery that while she was in the hospital for her second radium treatment, they’d performed reconstructive surgery on her nose, fixing the deviated septum that had given her sinus infections and headaches her whole life. It was a new beginning. The radiation treatments were just to make sure there were no cancer cells left anywhere inside her.
But about two weeks after her second radium treatment, Henrietta got her period—the flow was heavy and it didn’t stop. She was still bleeding weeks later on March 20, when Day began dropping her off each morning at Hopkins for her radiation treatments. She’d change into a surgical gown, lie on an exam table with an enormous machine mounted on the wall above her, and a doctor would put strips of lead inside her vagina to protect her colon and lower spine from the radiation. On the first day he tattooed two black dots with temporary ink on either side of her abdomen, just over her uterus. They were targets, so he could aim the radiation into the same area each day, but rotate between spots to avoid burning her skin too much in one place.
After each treatment, Henrietta would change back into her clothes and walk the few blocks to Margaret’s house, where she’d wait for Day to pick her up around midnight. For the first week or so, she and Margaret would sit on the porch playing cards or bingo, talking about the men, the cousins, and the children. At that point, the radiation seemed like nothing more than an inconvenience. Henrietta’s bleeding stopped, and if she felt sick from the treatments, she never mentioned it.
But things weren’t all good. Toward the end of her treatments, Henrietta asked her doctor when she’d be better so she could have another child. Until that moment, Henrietta didn’t know that the treatments had left her infertile.
Warning patients about fertility loss before cancer treatment was standard practice at Hop-kins, and something Howard Jones says he and TeLinde did with every patient. In fact, a year and a half before Henrietta came to Hopkins for treatment, in a paper about hysterectomy, TeLinde wrote:
The psychic effect of hysterectomy, especially on the young, is considerable, and it should not be done without a thorough understanding on the part of the patient [who is] entitled to a simple explanation of the facts [including] loss of the reproductive function. … It is well to present the facts to such an individual and give her ample time to digest them. … It is far bet-ter for her to make her own adjustment before the operation than to awaken from the anes-thetic and find it a fait accompli.
In this case, something went wrong: in Henrietta’s medical record, one of her doctors wrote, “Told she could not have any more children. Says if she had been told so before, she would not have gone through with treatment.” But by the time she found out, it was too late.
Then, three weeks after starting X-ray therapy, she began burning inside, and her urine came out feeling like broken glass. Day said he’d been having a funny discharge, and that she must have given him that sickness she kept going to Hopkins to treat.
“I would rather imagine that it is the other way around,” Jones wrote in Henrietta’s chart after examining her. “But at any rate, this patient now has … acute Gonorrhea superimposed on radiation reaction.”
Soon, however, Day’s running around was the least of Henrietta’s worries. That short walk to Margaret’s started feeling longer and longer, and all Henrietta wanted to do when she got there was sleep. One day she almost collapsed a few blocks from Hopkins, and it took her nearly an hour to make the walk. After that, she started taking cabs.
One afternoon, as Henrietta lay on the couch, she lifted her shirt to show Margaret and Sadie what the treatments had done to her. Sadie gasped: The skin from Henrietta’s breasts to her pelvis was charred a deep black from the radiation. The rest of her body was its natural shade—more the color of fawn than coal.
“Hennie,” she whispered, “they burnt you black as tar.”
Henrietta just nodded and said, “Lord, it just feels like that blackness be spreadin all inside me.”
Eleven years after learning about Henrietta in Defler’s classroom—on my twenty-seventh birthday—I stumbled on a collection of scientific papers from something called “The HeLa Cancer Control Symposium” at Morehouse School of Medicine in Atlanta, one of the oldest historically black colleges in the country. The symposium had been organized in Henrietta’s honor by Roland Pattillo, a professor of gynecology at Morehouse who’d been one of George Gey’s only African-American students.
When I called Roland Pattillo to see what he knew about Henrietta, I told him I was writing a book about her.
“Oh you are?” he said, laughing a slow, rumbling laugh that said, Oh child, you have no idea what you’re getting into. “Henrietta’s family won’t talk to you. They’ve had a terrible time with the HeLa cells.”
It had probably been traumatic for them to realize that their family’s members cells were being researched and tested on at medical facilities all around the country, and the last thing they’d want to do is contribute to more stories and articles about the events.
“You know her family?” I said. “Can you put me in touch with them?
“I do have the ability to put you in touch with them, but you need to answer a few questions, starting with ‘Why should I?’ “
For the next hour, Pattillo grilled me about my intentions. As I told him about the history of my HeLa obsession, he grumbled and sighed, letting out occasional mmmmmms and wellllllls.
Eventually he said, “Correct me if I’m wrong, but you are white.” “Is it that obvious?”
“Yes,” he said. “What do you know about African-Americans and science?”
I told him about the Tuskegee syphilis study like I was giving an oral report in history class: It started in the thirties, when U.S. Department of Public Health researchers at the Tuskegee Institute decided to study how syphilis killed, from infection to death. They recruited hundreds of African-American men with syphilis, then watched them die slow, painful, and preventable deaths, even after they realized penicillin could cure them. The research subjects didn’t ask questions. They were poor and uneducated, and the researchers offered incentives: free physical exams, hot meals, and rides into town on clinic days, plus fifty-dollar burial stipends for their families when the men died. The researchers chose black subjects because they, like many whites at the time, believed black people were “a notoriously syphilis-soaked race.”
The public didn’t learn about the Tuskegee study until the seventies, after hundreds of men enrolled in it had already died. The news spread like pox through black communities: doctors were doing research on black people, lying to them, and watching them die. Rumors started circulating that the doctors had actually injected the men with syphilis in order to study them.
The lacks family was not eager to talk to Skloot about the Hela cells because they thought she didn’t understand the true history of African Americans in medicine and the treatment they received from medical professionals. Other researchers had taken advantage of them for their skin color and they did not feel that they were being properly represented by the medical field for their contributions, especially from the advances that were made on diseases when using the African American people as test subjects.
“What else?” Pattillo grumbled.
I told him I’d heard about so-called Mississippi Appendectomies, unnecessary hysterectomies performed on poor black women to stop them from reproducing, and to give young doctors a chance to practice the procedure. I’d also read about the lack of funding for research into sickle-cell anemia, a disease that affected blacks almost exclusively.
“It’s interesting that you called when you did,” he said. “I’m organizing the next HeLa conference, and when the phone rang, I’d just sat down at my desk and typed the words Henrietta Lacks on my screen.” We both laughed. It must be a sign, we said; perhaps Henrietta wanted us to talk.
“Deborah is Henrietta’s baby girl,” he said, very matter-of-fact. “The family calls her Dale. She’s almost fifty now, still living in Baltimore, with grandchildren of her own. Henrietta’s husband is still alive. He’s around eighty-four—still goes to the clinics at Johns Hopkins.” He dropped this like a tease.“ Did you know Henrietta had an epileptic daughter?” Pattillo asked. “No.”
“She died at fifteen, soon after Henrietta’s death. Deborah is the only daughter left,” he said. “She came near a stroke recently because of the agony she’s gone through regarding inquiries into her mother’s death and those cells. I won’t be a part of anyone doing that to her again.”
I started to speak, but he interrupted me.
“I need to go see patients now,” he said abruptly. “I’m not ready to put you in touch with the family yet. But I think you’re honest about your intentions. We will talk again after I think. Call back tomorrow.”
After three straight days of grilling, Pattillo finally decided to give me Deborah’s phone number. But first, he said, there were a few things I needed to know. He lowered his voice and rattled off a list of dos and don’ts for dealing with Deborah Lacks: Don’t be aggressive. Do be honest. Don’t be clinical, don’t try to force her into anything, don’t talk down to her, she hates that. Do be compassionate, don’t forget that she’s been through a lot with these cells, do have patience. “You’ll need that more than anything,” he told me.
Moments after hanging up the phone with Pattillo, his list of dos and don’ts in my hand, I dialed Deborah’s number, then paced as her phone rang. When she whispered hello, I blurted out, “I’m so excited you answered because I’ve been wanting to talk to you for years! I’m writing a book about your mother!”
“Huh?” she said.
I didn’t know that Deborah was nearly deaf—she relied heavily on lip reading and couldn’t follow anyone who talked fast.
I took a deep breath and tried again, forcing myself to sound out every syllable. “Hi, my name is Rebecca.”
“How ya doin?” she said, weary but warm. “I’m very excited to talk to you.”
“Mmmhmm,” she said, like she’d heard that line many times before.
I told her again that I wanted to write a book about her mother and said I was surprised no one seemed to know anything about her, even though her cells were so important for science.
Deborah sat silent for a long moment, then screamed, “That’s right!” She giggled and started talking like we’d known each other for years. “Everything always just about the cells and don’t even worry about her name and was HeLa even a person. So hallelujah! I think a book would be great!”
This was not what I’d expected.
I was afraid to say anything that might make her stop talking, so I simply said, “Great.” And that was the last word I spoke until the end of our call. I didn’t ask a single question, just took notes as fast as I could.
Deborah crammed a lifetime of information into a manic and confusing forty-five minutes that jumped without warning, and in no particular order, from the 1920s to the 1990s, from stories of her father to her grandfather, cousins, mother, and total strangers.
“Nobody never said nothing,” she told me. “I mean, where my mother clothes at? Where my mother shoes? I knew about her watch and ring, but it was stolen. That was after my brother killed that boy.” She talked about a man she didn’t name, saying, “I didn’t think it was fit for him to steal my mother medical record and autopsy papers. He was in prison for fifteen years in Alabama. Now he sayin John Hopkin killed my mother and them white doctors experimented on her cause she was black.
“My nerve broke down,” she said. “I just couldn’t take it. My speech is coming back a little better—I almost had two strokes in two weeks cause of all that stuff with my mother cells.”
Then suddenly she was talking about her family history, saying something about “the Hospital for Crazy Negroes” and her mother’s great-grandfather having been a slave owner. “We all mixed. And one of my mother sisters converted to Puerto Rican.”
Again and again, she said, “I can’t take it anymore,” and “Who are we supposed to trust now?” More than anything, she told me, she wanted to learn about her mother and what her cells had done for science. She said people had been promising her information for decades and never delivering it. “I’m sick of it,” she said. “You know what I really want? I want to know, what did my mother smell like? For all my life I just don’t know anything, not even the little common little things, like what color she like? Did she like to dance? Did she breastfeed me? Lord, I’d like to know that. But nobody ever say nothing.”
She laughed and said, “I tell you one thing—the story’s not over yet. You got your work cut out for you, girl. This thing’s crazy enough for three books!”
Then someone walked through her front door and Deborah yelled straight into the receiver, “Good morning! I got mail?” She sounded panicked by the idea of it. “Oh my God! Oh no! Mail?!”
“Okay, Miss Rebecca,” she said. “I got to go. You call me Monday, promise? Okay, dear. God bless. Bye-bye.”
She hung up and I sat stunned, receiver crooked in my neck, frantically scribbling notes I didn’t understand, like brother = murder, mail = bad, man stole Henrietta’s medical records, and Hospital for Negro Insane?
When I called Deborah back as promised, she sounded like a different person. Her voice was monotone, depressed, and slurred, like she was heavily sedated.
“No interviews,” she mumbled almost incoherently. “You got to go away. My brothers say I should write my own book. But I ain’t a writer. I’m sorry.”
I tried to speak, but she cut me off. “I can’t talk to you no more. Only thing to do is convince the men.” She gave me three phone numbers: her father; her oldest brother, Lawrence; and her brother David Jr.’s pager. “Everybody call him Sonny,” she told me, then hung up. I wouldn’t hear her voice again for nearly a year.
I started calling Deborah, her brothers, and her father daily, but they didn’t answer. Finally, after several days of leaving messages, someone answered at Day’s house: a young boy who didn’t say hello, just breathed into the receiver, hip-hop thumping in the background.
When I asked for David, the boy said, “Yeah,” and threw the phone down. “Go get Pop!” he yelled, followed by a long pause. “It’s important. Get Pop!” No response.
“Lady’s on the phone,” he yelled, “come on …”
The first boy breathed into the receiver again as a second boy picked up an extension and said hello.
“Hi,” I said. “Can I talk to David?” “Who this?” he asked. “Rebecca,” I said.
He moved the phone away from his mouth and yelled, “Get Pop, lady’s on the phone about his wife cells.”
Years later I’d understand how a young boy could know why I was calling just from the sound of my voice: the only time white people called Day was when they wanted something having to do with HeLa cells. But at the time I was confused—I figured I must have heard wrong.
A woman picked up a receiver saying, “Hello, may I help you?” She was sharp, curt, like I do not have time for this
I told her I was hoping to talk to David, and she asked who was calling. Rebecca, I said, afraid she’d hang up if I said anything more.
“Just a moment.” She sighed and lowered the phone. “Go take this to Day,” she told a child. “Tell him he got a long-distance call, somebody named Rebecca calling about his wife cells.”
The child grabbed the phone, pressed it to his ear, and ran for Day. Then there was a long silence.
“Pop, get up,” the kid whispered. “There’s somebody about your wife.” “Whu …”
“Get up, there’s somebody about your wife cells.” “Whu? Where?”
“Wife cells, on the phone … get up.” “Where her cells?”
“Here,” the boy said, handing Day the phone. “Yeah?”
“Hi, is this David Lacks?” “Yeah.”
I told him my name and started to explain why I was calling, but before I could say much, he let out a deep sigh.
“Whanowthis,” he mumbled in a deep Southern accent, his words slurred like he’d had a stroke. “You got my wife cells?”
“Yeah,” I said, thinking he was asking if I was calling about his wife’s cells.
“Yeah?” he said, suddenly bright, alert. “You got my wife cells? She know you talking?” “Yeah,” I said, thinking he was asking if Deborah knew I was calling.
“Well, so let my old lady cells talk to you and leave me alone,” he snapped. “I had enough ’a you people.” Then he hung up.
On April 10, 1951, three weeks after Henrietta started radiation therapy, George Gey appeared on WAAM television in Baltimore for a special show devoted to his work. With dramatic music in the background, the announcer said, “Tonight we will learn why scientists believe that cancer can be conquered.”
The camera flashed to Gey, sitting at a desk in front of a wall covered with pictures of cells. His face was long and handsome, with a pointed nose, black plastic bifocals, and a Charlie Chaplin mustache. He sat stiff and straight-backed, tweed suit perfectly pressed, white handkerchief in his breast pocket, hair slicked. His eyes darted off-screen, then back to the camera as he drummed his fingers on the desk, his face expressionless.
“The normal cells which make up our bodies are tiny objects, five thousand of which would fit on the head of a pin,” he said, his voice a bit too loud and stilted. “How the normal cells become cancerous is still a mystery.”
He gave viewers a basic overview of cell structure and cancer using diagrams and a long wooden pointer. He showed films of cells moving across the screen, their edges inching further and further into the empty space around them. And he zoomed in on one cancer cell, its edges round and smooth until it began to quiver and shake violently, exploding into five cancer cells.
At one point he said, “Now let me show you a bottle in which we have grown massive quantities of cancer cells.” He picked up a clear glass pint-sized bottle, most likely full of Henrietta's cells, and rocked it in his hands as he explained that his lab was using those cells to find ways to stop cancer. He said, “It is quite possible that from fundamental studies such as these that we will be able to learn a way by which cancer cells can be damaged or completely wiped out.”
To help make that happen, Gey began sending Henrietta’s cells to any scientist who might use them for cancer research. Shipping live cells in the mail—a common practice today—wasn’t done at the time. Instead, Gey sent them via plane in tubes with a few drops of culture medium, just enough to keep them alive for a short time. Sometimes pilots or stewards tucked the tubes in their shirt pockets, to keep the cells at body temperature as if they were still in an incubator. Other times, when the cells had to ride in the cargo hold, Gey tucked them into holes carved in blocks of ice to keep them from overheating, then packed the ice in cardboard boxes filled with sawdust. When shipments were ready to go, Gey would warn recipients that the cells were about to “metastasize” to their cities, so they could stand ready to fetch the shipment and rush back to their labs. If all went well, the cells survived. If not, Gey packaged up another batch and tried again.
He sent shipments of HeLa cells to researchers in Texas, India, New York, Amsterdam, and many places between. Those researchers gave them to more researchers, who gave them to more still. Henrietta’s cells rode into the mountains of Chile in the saddlebags of pack mules. As Gey flew from one lab to another, demonstrating his culturing techniques and helping to set up new laboratories, he always flew with tubes of Henrietta’s cells in his breast pocket. And when scientists visited Gey’s lab to learn his techniques, he usually sent them home with a vial or two of HeLa. In letters, Gey and some of his colleagues began referring to the cells as his “precious babies.”
The reason Henrietta’s cells were so precious was because they allowed scientists to perform experiments that would have been impossible with a living human. They cut HeLa cells apart and exposed them to endless toxins, radiation, and infections. They bombarded them with drugs, hoping to find one that would kill malignant cells without destroying normal ones. They studied immune suppression and cancer growth by injecting HeLa cells into immune-compromised rats, which developed malignant tumors much like Henrietta’s. If the cells died in the process, it didn’t matter—scientists could just go back to their eternally growing HeLa stock and start over again.
Despite the spread of HeLa and the flurry of new research that followed, there were no news stories about the birth of the amazing HeLa cell line and how it might help stop cancer. In Gey’s one appearance on television, he didn’t mention Henrietta or her cells by name, so the general public knew nothing of HeLa. But even if they had known, they probably wouldn’t have paid it much mind. For decades the press had been reporting that cell culture was going to save the world from disease and make man immortal, but by 1951 the general public had stopped buying it. Cell culture had become less a medical miracle than something out of a scary science-fiction movie.
It all started on January 17, 1912, when Alexis Carrel, a French surgeon at the Rockefeller Institute, grew his “immortal chicken heart.”
Scientists had been trying to grow living cells since before the turn of the century, but their samples had always died. As a result, many researchers believed it was impossible to keep tissues alive outside the body. But Carrel set out to prove them wrong. At age thirty-nine he’d already invented the first technique for suturing blood vessels together, and had used it to perform the first coronary bypass and develop methods for transplanting organs. He hoped someday to grow whole organs in the laboratory, filling massive vaults with lungs, livers, kidneys, and tissues he could ship through the mail for transplantation. As a first step, he’d tried to grow a sliver of chicken-heart tissue in culture, and to everyone’s amazement, it worked. Those heart cells kept beating as if they were still in the chicken’s body.
Months later, Carrel won a Nobel Prize for his blood-vessel-suturing technique and his contributions to organ transplantation, and he became an instant celebrity. The prize had nothing to do with the chicken heart, but articles about his award conflated the immortal chick-en-heart cells with his transplantation work, and suddenly it sounded like he’d found the fountain of youth. Headlines around the world read:
CARREL’S NEW MIRACLE POINTS WAY TO AVERT OLD AGE! …
SCIENTISTS GROW IMMORTAL CHICKEN HEART …
DEATH PERHAPS NOT INEVITABLE
Scientists said Carrel’s chicken-heart cells were one of the most important advances of the century, and that cell culture would uncover the secrets behind everything from eating and sex to “the music of Bach, the poems of Milton, [and] the genius of Michelangelo.” Carrel was a scientific messiah. Magazines called his culture medium “an elixir of youth” and claimed that bathing in it might make a person live forever.
But Carrel wasn’t interested in immortality for the masses. He was a eugenicist: organ transplantation and life extension were ways to preserve what he saw as the superior white race, which he believed was being polluted by less intelligent and inferior stock, namely the poor, uneducated, and nonwhite. He dreamed of never-ending life for those he deemed worthy, and death or forced sterilization for everyone else. He’d later praise Hitler for the “energetic measures” he took in that direction.
Carrel’s eccentricities fed into the media frenzy about his work. He was a stout, fast-talking Frenchman with mismatched eyes—one brown, the other blue—who rarely went out without his surgeon’s cap. He wrongly believed that light could kill cell cultures, so his laboratory looked like the photo negative of a Ku Klux Klan rally, where technicians worked in long black robes, heads covered in black hoods with small slits cut for their eyes. They sat on black stools at black tables in a shadowless room with floors, ceilings, and walls painted black. The only illumination came from a small, dust-covered skylight.
Carrel was a mystic who believed in telepathy and clairvoyance, and thought it was possible for humans to live several centuries through the use of suspended animation. Eventually he turned his apartment into a chapel, began giving lectures on medical miracles, and told reporters he dreamed of moving to South America and becoming a dictator. Other researchers distanced themselves, criticizing him for being unscientific, but much of white America embraced his ideas and saw him as a spiritual adviser and a genius.
Reader’s Digest ran articles by Carrel advising women that a “husband should not be induced by an oversexed wife to perform a sexual act,” since sex drained the mind. In his best-selling book, Man, the Unknown, he proposed fixing what he believed was “an error” in the U.S. Constitution that promised equality for all people. “The feebleminded and the man of genius should not be equal before the law,” he wrote. “The stupid, the unintelligent, those who are dispersed, incapable of attention, of effort, have no right to a higher education.”
His book sold more than two million copies and was translated into twenty languages. Thousands showed up for Carrel’s talks, sometimes requiring police in riot gear to keep order as buildings filled to capacity and fans had to be turned away.
Through all of this, the press and public remained obsessed with Carrel’s immortal chick-en heart. Each year on New Year’s Day, the New York World Telegram called Carrel to check on the cells; and every January 17 for decades, when Carrel and his assistants lined up in their black suits to sing “Happy Birthday” to the cells, some newspaper or magazine retold the same story again and again:
CHICKEN HEART CELLS ALIVE TEN YEARS … FOURTEEN YEARS … TWENTY …
Each time, the stories promised the cells would change the face of medicine, but they never did. Meanwhile, Carrel’s claims about the cells grew more fantastical.
At one point he said the cells “would reach a volume greater than that of the solar system.” The Literary Digest reported that the cells could have already “covered the earth,” and a British tabloid said they could “form a rooster … big enough today to cross the Atlantic in a single stride, [a bird] so monstrous that when perched on this mundane sphere, the world, it would look like a weathercock.” A string of best-selling books warned of the dangers of tissue culture: one predicted that 70 percent of babies would soon be grown in culture; another imagined tissue culture producing giant “Negroes” and two-headed toads.
But the fear of tissue culture truly found its way into American living rooms in an episode of Lights Out, a 1930s radio horror show that told the story of a fictional Dr. Alberts who’d created an immortal chicken heart in his lab. It grew out of control, filling the city streets like The Blob, consuming everyone and everything in its path. In only two weeks it destroyed the entire country.
The real chicken-heart cells didn’t fare so well. In fact, it turned out that the original cells had probably never survived long at all. Years after Carrel died awaiting trial for collaborating with the Nazis, scientist Leonard Hayflick grew suspicious of the chicken heart. No one had ever been able to replicate Carrel’s work, and the cells seemed to defy a basic rule of biology: that normal cells can only divide a finite number of times before dying. Hayflick investigated them and concluded that the original chicken-heart cells had actually died soon after Carrel put them in culture, and that, intentionally or not, Carrel had been putting new cells in the cul-ture dishes each time he “fed” them using an “embryo juice” he made from ground tissues. At least one of Carrel’s former lab assistants verified Hayflick’s suspicion. But no one could test the theory, because two years after Carrel’s death, his assistant unceremoniously threw the famous chicken-heart cells in the trash.
Either way, by 1951, when Henrietta Lacks’s cells began growing in the Gey lab—just five years after the widely publicized “death” of Carrel’s chicken heart—the public image of immortal cells was tarnished. Tissue culture was the stuff of racism, creepy science fiction, Nazis, and snake oil. It wasn’t something to be celebrated. In fact, no one paid much attention to it at all.
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