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The results of Henrietta’s biopsy showed she had cervical cancer.
Jones’s boss, gynecologist Richard TeLinde, was researching cervical cancer. As was common practice at the time, he conducted experiments on patients from the public wards, often without their knowledge. At Hopkins, many public ward patients were black. Doctors saw this practice as fair because the public ward patients couldn’t pay in full. At the time of Henrietta’s biopsy, TeLinde wanted to compare healthy cervical tissue with the two types of cervical cancer in order to prove that the cervical cancers were the same.
TeLinde worked with George Gey, the head of tissue culture at Hopkins, who, with his wife Margaret, was attempting to grow a line of “immortal” human cells. “Immortal” in this case means a cell line that continues to divide indefinitely, replenishing itself.
When Henrietta learned that her growth was cancer, she decided not to tell anyone in order not to upset her family. She told Day she needed to return to Hopkins for medicine.
Before treatment, Henrietta signed a form consenting to any operation under anesthetic that her doctors deemed necessary. The next day, she underwent radium treatment, which involved sewing tubes of radium into her cervix. While Henrietta was under anesthesia, the surgeon took samples of both healthy cervical tissue and tissue from her tumor in order to give them to George Gey. No one told Henrietta about the tissue samples.
Gey’s assistant, Mary Kubicek, prepared the cell cultures and labeled them HeLa for “Henrietta Lacks.”
Meanwhile, Henrietta appeared to recover well from her radium treatment. Her doctors discharged her two days later after removing the radium tubes and instructed her to return in two and a half weeks for a second round of treatment.
About two days after Henrietta was discharged, Mary noticed that the cell culture of Henrietta’s cancerous cells had not only survived but also continued to grow at a rapid rate. George told his colleagues that he may have grown the first “immortal” human cells and agreed to share them when his colleagues asked for samples.
Henrietta returned home and quickly got back to her old routine. She spent weekends in Clover, cooked for her family, and went dancing with her cousin Sadie when Day worked nights. Sadie told Skloot that Henrietta was a fun person whom everyone liked except for Ethel, the wife of her cousin Galen.
Henrietta’s daughter Elise required extra assistance. When Henrietta became pregnant with Joe, she no longer could take care of Elsie the way she needed. Her doctors recommended that Elsie be institutionalized, and Elsie was sent to Crownsville State Hospital, where Henrietta visited her once a week.
After Henrietta’s second radium treatment, she had to start X-Ray therapy, which required going to Hopkins every weekday. She had to go to her cousin Margaret’s house near Hopkins to wait for Day to pick her up after his night shift. She assured Margaret and Sadie that she was no longer sick.
Around this time, Henrietta was horrified to learn that a side effect of her treatment was infertility. Although Jones and TeLinde insist that they told all their patients about the fertility loss, Henrietta insisted no one had told her, and that she wouldn’t have agreed to the treatments had she known. To make matters worse, she contracted gonorrhea—likely from Day—which interacted with the side effects from the radiation therapy. Walking to Margaret’s house became more difficult, and she soon had to take a cab. Over time, the radiation burned almost all the skin on her abdomen.
In 1999, Skloot contacted Roland Pattillo, a professor of gynecology who had organized the HeLa Cancer Control Symposium at Morehouse School of Medicine, to see if he could help with her research. Pattillo explained that the family had suffered a lot from the media attention surrounding HeLa cells, and that Deborah, Henrietta’s daughter, had nearly died of a stroke caused by the stress. Before agreeing to give Skloot the Lacks family’s contact information, he quizzed her on the history of white scientists using black Americans as the subjects of unethical experiments. This list included the Tuskegee syphilis study, in which doctors allowed black men with syphilis to die preventable deaths in order to study the disease. The doctors chose black subjects because they believed black people were more likely to have syphilis. Eventually, Pattillo gave Skloot Deborah’s phone number and advised her to be patient.
When Skloot called Deborah, she was surprised to find that Deborah seemed enthusiastic about the idea of a book. Skloot explained that she wanted the book to have information on who Henrietta was because no one seems to know much about her beyond the cells. Deborah said that above all she wanted to understand who her mother was and how her cells helped science. When Deborah had to leave, she asked Skloot to call again. However, the next day Deborah said her brothers said to write her own book and not to talk to Skloot. Deborah suggested that Skloot talk to the men of the family, and gave her the phone numbers of her father, her brother Lawrence, and her brother David “Sonny” Jr.
Skloot tried to contact the men but was unsuccessful. When she managed to get ahold of Day, he hung up on her.
George Gey appeared on Baltimore television on April 10, 1951 to discuss how the cells he had cultured could eventually help cure cancer. Because he wanted to help cure cancer, he sent vials of HeLa cells to any scientist who wanted them by plane. HeLa cells helped research because scientists could perform experiments on them that would be impossible to perform on a human.
Even though HeLa cells quickly became invaluable to scientific research, they didn’t enter the pop culture consciousness. By 1951 the public had a suspicion of cell culturing because of its association with the eugenicist Alexis Carrel, a Nobel Prize winning scientist. In 1912, Carrel had claimed to create an immortal culture of cells from a chicken’s heart. Popular news media and Carrel himself made sensational claims about the heart cells, sparking fear in the public. However, scientists could not replicate Carrel’s experiment, and Carrel died while awaiting trial for collaborating with the Nazis.
TeLinde and Jones’s practice of using public ward patients for research demonstrates the way medical attitudes of the time devalued the poor. The idea that public ward patients owed doctors their bodies for research if they couldn’t pay demonstrates a transactional model of medicine that values life as long as it is profitable. Wealthy patients who could afford to pay, therefore, received medical care without strings attached. Furthermore, the secret nature of this arrangement meant that patients could not make informed decisions about whether they were willing to participate in research in exchange for free medical care. The secrecy also implies a lack of respect for the autonomy and intelligence of these patients, and suggests that their personal preferences didn’t matter. This demonstrates the dehumanization of poor communities by doctors and researchers. In addition, because many of Hopkins’ public ward patients were black, this discrimination takes on a racial dimension. Poor black patients had even fewer choices in hospitals because of segregation, and thus were more likely to be used in research without their knowledge. Henrietta fell into this intersection of race and poverty, meaning doctors and scientists were especially likely to devalue and undermine her agency.
Miscommunication permeates Henrietta’s hospital experience, demonstrating that she could not have given informed consent for them to take her cells. The consent form Henrietta signed specified that doctors could perform any operation deemed “necessary,” but did not include an explanation of what that operation would be necessary for. From TeLinde’s perspective, taking a tissue sample from Henrietta was necessary for his research, but it was not necessary for Henrietta’s cancer treatment. The form’s slippery wording did not clarify the distinction between treatment and research, and neither informed Henrietta that a researcher could take a tissue sample from her nor explicitly forbade it. The hospital’s consent form was neither informative nor forthcoming, which means it wasn’t designed to help patients make an informed choice before signing it. While we cannot know whether or not Jones or TeLinde told Henrietta about losing her fertility, the hospital’s consistent miscommunication at least offers the possibility that Henrietta may not have understood it if they did. Regardless of intent, the hospital’s wording around treatments, side effects, and consent at the time was not conducive to patient comprehension.
The way Henrietta downplayed her illness suggests that she placed a greater value on her family’s well being than her own. She did not tell Day she had cancer, which denied her the emotional support of her husband in favor of protecting his feelings. After her radium treatment, she made a point to promptly return to her daily routine, prioritizing her role as a caretaker and mother over rest and recuperation. In life and in severe illness, familial and social demands and expectations of being a mother and wife superseded her own health and emotional wellbeing. Even in the role of the mother, Henrietta did not get to make her own decisions. The way others convinced her to give up Elsie also plays into the narrative of Henrietta having to minimize her own desires in order to fulfill other obligations. Henrietta loved Elsie and wanted to continue caring for her, but other family members and doctors convinced her to prioritize caring for her healthy children. Henrietta’s steep sacrifices demonstrate how mothers from communities of color are often forced by poverty to prioritize others’ needs over their own.
As Skloot tries to make contact with the family, Pattillo’s quiz serves to purposes: to signal the depth of the trauma the Lacks family has faced, and also to provide the reader with a context from which to understand that trauma. Because Pattillo explained that the Lacks had a troubled relationship with journalists asking about HeLa cells, his quiz reads as a protective measure. From this, Skloot could understand that contacting the Lacks family would be delicate and something she had to do with care and consideration. Skloot’s conversation with Pattillo not only explains how she came into contact with the Lacks family, but also outlines historical information that is crucial to a more nuanced understanding the family’s predicament. Just as Pattillo wanted to know that Skloot understood the historical context of white science profiting from black patients, readers should be aware of this history in order to understand the Lacks family’s reactions and fear. Throughout the book, Skloot chooses which conversations and details to include very deliberately in order to simultaneously represent the facts and contextualize why they matter.
The phone call with Deborah introduces the division between Deborah and her brothers. From the call with Pattillo, we know that Deborah’s previous interactions with journalists negatively impacted her health, and so we can infer that her enthusiasm came not from the idea of a book but from Skloot’s particular approach. As introduced in the two prologues, Skloot’s desire to figure out who Henrietta was dovetails with Deborah’s desire to learn more about her mother. Therefore, Deborah’s reluctance the following day can be attributed to her succumbing to her brothers’ pressure and not necessarily to a change of heart. For Deborah, her hunger for information and understanding about what happened to Henrietta supersedes her desire to have control and ownership over the narrative. Her brothers’ insistence that she write her own book, even if she doesn’t have the information or tools to do so, demonstrates that they primarily want the family to regain control over the story of Henrietta’s cells. At times, these two desires contradict one another and provide an additional source of conflict throughout the book.
The Alexis Carrel anecdote introduces a sinister side to the history of cell culturing and also harkens back to the epigraph. Although TeLinde and Gey’s research on cancer and cell cultures were reportedly for society’s benefit, Carrel reminds us that benevolence is not guaranteed in all scientific research. As a eugenicist, Carrel believed that cell culture and scientific progress should be targeted to benefit and extend the lives of white people. Although Carrel’s chicken heart ultimately proved a hoax, he still was a respected scientist who won a Nobel Prize, and therefore a major part of the mainstream scientific establishment. That a mainstream scientist worked for the Nazis also merits note because, as the epigraph reminds us, we cannot assume a clear separation between the Nazi doctors and the scientific mainstream. The eugenicist history of tissue culture, when paired with Henrietta’s vulnerability as a poorer black woman, gives TeLinde and Gey’s use of Henrietta’s cells an unsettling undertone.
Ace your assignments with our guide to The Immortal Life of Henrietta Lacks!