Summary: Epigraph

The book begins with a quotation from Nobel Laureate and Holocaust survivor Elie Wiesel, from his forward to the book The Nazi Doctors and the Nuremberg Code . The quote emphasizes the importance of never seeing people as abstractions and remembering that they are individuals with an inner life.

Summary: Prologue

Rebecca Skloot first encountered the name of Henrietta Lacks in a community college biology course. Her professor explained that scientists know what causes cancer because of a cell sample taken from a woman named Henrietta Lacks, who died from cervical cancer. Her cells were the first human cells kept stable in a laboratory, and now have been alive longer than Lacks herself. These cells allowed for many medical breakthroughs. However, the professor had no other information about Lacks other than that she was black.

Skloot tried to learn more about Henrietta Lacks, but discovered many sources didn’t even use her correct name. She encountered a few magazine articles with interviews from Henrietta’s family, who felt taken advantage of by the medical community and seemed confused about what Henrietta’s cells had been used for. As Skloot studied writing in graduate school, she envisioned writing a biography of both the cells and Henrietta Lacks herself.

Skloot notes that in the course of writing the book she and Henrietta’s daughter Deborah formed a friendship. Deborah believes fate and the spirit of Henrietta led Skloot to write the book.

Summary: Deborah’s Voice

The book contains a secondary prologue quoted directly from Deborah Lacks, Henrietta’s second daughter. In the quote, Deborah says that when she tells her doctors that her mother is Henrietta Lacks, they get excited and tell her about how her mother’s cells helped science. However, they never explain how her mother’s cells accomplished this. Deborah also notes that her family is still extremely poor although people have profited from her mother’s cells. She used to get angry about this, but now all she wants is to understand who her mother was.

Summary: Chapter 1

In 1951, Henrietta went to the gynecologist at Johns Hopkins Hospital after finding a knot on her cervix. She’d first noticed it soon after giving birth to her fourth child, Deborah. A few months after giving birth to her fifth child, Joe, she began to bleed when it wasn’t her period, and then went to the doctor, who referred her to a gynecologist at Johns Hopkins. Although Johns Hopkins was twenty miles away from where Henrietta lived, it was the closest hospital that treated black patients.

When Howard Jones, the gynecologist, performed the examination, he found a small, purple lump on Henrietta’s cervix. Jones looked through Henrietta’s medical records and noticed multiple health concerns that Henrietta never followed up on. He noted that Henrietta had recently given birth at Hopkins, and there had been no sign of the growth, which meant it grew extremely quickly.

Summary: Chapter 2

Henrietta was born Loretta Pleasant, the ninth child of Johnny and Eliza Lacks Pleasant. After Eliza died giving birth to her tenth child, Henrietta and her siblings went to live with their grandfather, Tommy Lacks, in Clover, Virginia, where they were divided up between various aunts and uncles. Tommy farmed tobacco on the same plot of land that his enslaved ancestors once did.

Tommy also looked after another grandchild, David “Day” Lacks, whom Henrietta would eventually marry. The two children grew up together, helping out on the farm. They, along with the other Lacks children, helped Tommy bring the tobacco to auction, riding in the wagon with the tobacco leaves.

Henrietta and Day had shared a room since they were four years old, and when Henrietta was fourteen she gave birth to their first son, Lawrence. At eighteen, she gave birth to her daughter Elsie, who was born with mental disabilities. The couple got married two years later, in 1941.

Later that year, their cousin, Fred Garrett returned to Clover from Turner Station, Maryland. He had gone to work at Bethlehem Steel’s Sparrows Point mill, which was booming from the demand caused by World War II. A small community of black workers had grown in Turner Station, about twenty miles from Baltimore. Initially, Day went to work for the mill with plans to send for Henrietta and the children when he earned enough money. After Fred was drafted into the war, he sent his money to Henrietta so that they could join Day in Turner Station.

Analysis: Epigraph–Part 1, Chapter 2

Skloot opens the biography with an epigraph that both introduces one of the central themes from the book and asks an unsettling question about American doctors. The source of this epigraph, a Holocaust survivor introducing a book about medical experimentation in Nazi Germany, creates a comparison between the doctors in this book and the Nazi doctors tried at Nuremberg. We might not usually think of American doctors and researchers as having much in common with such notoriously cruel war criminals, but this quotation asks us to consider the parallels, particularly in the way dehumanization continues to enable the medical research in this book. By choosing this epigraph, Skloot encourages the reader to notice that American injustice precipitated the way American medicine failed the Lacks family. The idea that doctors must never forget the individuality and inner life of their patients presents an important standard for medical care that readers must keep in mind as Skloot chronicles the Lack family’s experiences. As we follow Henrietta’s treatment and the way researchers think about her cells, we must ask ourselves whether these doctors understand that Henrietta has an inner life.

The prologue and the section from Deborah’s point-of-view introduce the book’s two distinct but interwoven narratives: Skloot’s attempt to learn Henrietta’s story, and Deborah’s desire to learn more about her mother. These two narrative threads highlight the fact that, previously, Henrietta had been erased from stories about her own cells. When Skloot first learned about HeLa cells and the woman behind them, she was surprised and confused by Henrietta’s relative anonymity, indicating that her interest in the story has always been more concerned with Henrietta than than HeLa cells. Additionally, the fact that Skloot couldn’t find anything about Henrietta despite the cells’ ubiquity highlights how much HeLa cells have eclipsed Henrietta’s memory. Deborah’s prologue furthers these themes. Rather than paraphrasing Deborah’s words, Skloot uses an extended quotation from Deborah, allowing a Lacks family member to directly frame how we read the story. This inclusion emphasizes and attempts to correct the way the family’s perspective has been minimized and erased. Deborah’s description of how doctors happily discuss Henrietta’s cells without considering how Deborah may feel about the cells suggests that the personal side of Henrietta’s story doesn’t often cross the mind of those who work with her cells.

Chapter 1 demonstrates the multiple barriers Henrietta faced in receiving medical care. Segregation laws forced Henrietta to travel twenty miles just to go to a hospital that would treat her, which meant that she had to carefully consider the necessity of every trip. Race, therefore, played a major factor in Henrietta’s access to healthcare. In addition, this distance explains why Henrietta may have waited nearly a year before seeing a doctor about the lump on her cervix. The extended list of medical conditions she never sought follow-up treatment for supports this reading because it implies she avoided going to the hospital as much as possible. Furthermore, she had five children, two of them infants, suggesting that she likely had to prioritize domestic and maternal responsibilities over her own health. Although Howard Jones observes that the cancer must have grown quickly, these multiple factors that kept Henrietta from seeking early treatment also explain the severity and size of the tumor he discovered.

The details in Chapter 2 demonstrate the roles that racism and poverty played in Henrietta’s life in order to contextualize her story. First, we see that Henrietta’s childhood didn’t offer her safe and healthy choices. Most of her family still lived in the same place her enslaved ancestors did, which suggests that the Lacks family didn’t have the resources to change jobs or move. Her family’s one source of income, working with tobacco, involved Henrietta interacting with carcinogenic substances from a young age. Although nicotine didn’t cause Henrietta’s cancer, its prominence in her childhood still underscores that all members of the Lacks family had to work in unhealthy conditions to survive. In addition, the lack of adult oversight caused Henrietta to start having children at an extremely young age with a cousin of hers, calling into question how much agency she had in her sexual and reproductive life, and to what extent these circumstances dictated the direction of her life. Henrietta’s background made her structurally vulnerable, meaning that her race, gender, and poverty very seriously limited the options available to her.