Biology Question

  

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Some questions to help you get started; feel free to discuss anything from the book that interested you!!  
Have you tried to explain science to people with no science education? How do you approach this challenge? How do you prevent the kinds of misconceptions that Henrietta’s family were left with?
The first mention of Henrietta Lacks’ family says that they refused to give a postmortem sample of her tissues and were angry about not receiving any financial compensation. Did this surprise you, given that the introduction discusses how important these cells have been?
Why did so few books correctly name Henrietta Lacks? Why did they try to include her name and information?
What are some of your initial thoughts about reading this book?  Have you ever read a book like this?  What other books have you read that take a similar approach to a person’s life and impact on others?
Prologue:
The articles in Ebony and Jet found by Rebecca Skloot said that the Lacks family had only recently learned that her cells were still alive, 25 years after Henrietta’s death. They then understood that she was being studied, but not why. How do you think these experiences contributed to the family’s outlook on medicine and science?
Ch. 1:
Why did David Lacks take Henrietta to the public wards at Johns Hopkins instead of a closer hospital?
What did Henrietta’s first doctor assume the source of the lump on her cervix was? What bias did this show?
Based on Henrietta’s medical history, what can you infer about her life and personality? How would you describe her feelings about doctors?
Ch. 2:
What are the connotations of the term “home-house?” What does this term suggest about the values of the Lacks family?
Compare the medical terms describing Elsie’s condition with the terms used by Henrietta’s friends and family. What are the connotations of the two sets of terms?
Ch. 3:
How did doctors justify using patients in public hospital wards as medical research subjects without obtaining their consent or offering them financial compensation? Do you agree or disagree with their reasoning?
Analyze the consent statement that Henrietta signed (p. 31). Based on this statement, do you believe TeLinde and Gey had the right to obtain a sample from her cervix to use in their research?
Do you think Henrietta would have given explicit consent to have a tissue sample used in medical research if she had been asked? Do you think she would have understood what was being asked of her? Explain your answers.
How informed should consent be? The standard is to write consent forms at a fourth grade reading level. Do you think that level is correct and appropriate? Why?
Were cells taken only from black patients? Were black patients generally treated differently from white patients in the early 1950s?
Ch. 4:
Gey chose to give away samples of HeLa to his colleagues almost immediately. Do you think this was a good decision?
What is the implication of the author’s decision to use the term “birth” to describe the initial growth of HeLa cells?EARLY PRAISE
FOR
The IMMORTAL LIFE of HENRIETTA LACKS
“Skloot makes a remarkable debut with this multilayered story about
‘faith, science, journalism, and grace.’ ”
-PUBLISHERS WEEKLY (starred review)
“Heartbreaking and powerful, Rebecca Skloot’s sensitive account tells of the
enduring, deeply personal sacrifice of this African American woman and
her family and, at long last, restores a human face to the cell line that pro­
pelled 20th-century biomedicine. A stunning illustration of how race,
gender, and disease intersect to produce a unique form of social vul­
nerability, this is a poignant, necessary, and brilliant book.”
-ALONDRA NELSON, Columbia University; editor of
Technicolor: Race, Technology and Everyday Life
“The Immortal Life of Henrietta Lacks takes the reader on a remarkable
journey-compassionate, troubling, funny, smart, and irresistible. Along
the way, Rebecca Skloot will change the way you see medical science and
lead you to wonder who we should value more-the researcher or the re­
search subject? Ethically fascinating and completely engaging- I couldn’t
-DEBORAH BLUM,
recommend it more.”
author of T he Poisoner’s Handbook
“This is a science biography like the world has never seen …Ladies and
gentlemen, meet Henrietta Lacks.Chances are, at the level of your DNA,
your inoculations, your physical health and microscopic well-being, you’ve
-MELISSA FAY GREENE,
already been introduced.”
author of Praying for Sheetrock and T here Is No Me Without You
“Remarkable … The portrayal of Lacks’s full life makes the story come
alive with her humanity and the palpable relationship between race, sci­
-PAULAJ.GIDDINGS,
ence, and exploitation.”
author of Ida, a Sword Among Lions; Elizabeth A. Woodson
1922 Professor, Afro-American Studies, Smith College
“This book is extraordinary. As a writer and a human being, Skloot stands
way, way out there ahead of the pack.”
-MARY ROACH, author of Stiff and Bonk
Copyright© 20IO by Rebecca Skloot
All rights reserved.
Published in the United States by Crown Publishers,
an imprint of the Crown Publishing Group,
a division of Random House, Inc., New York.
www.crownpublishing.com
CROWN and the Crown colophon are registered
trademarks of Random House, Inc.
Portions of this work appeared, sometimes in different form, in
“Taking the Least of You,” The New York Times Magazine,
copyright© 2006 by Rebecca Skloot; “Henrietta’s Dance,”
johns Hopkins Magazine, copyright© 2000 by Rebecca Skloot;
“Enough with Patenting the Breast Cancer Gene,” Slate’s
Double X, copyright© 2009 by Rebecca Skloot.
Library of Congress Cataloging-in-Publication Data
Skloot, Rebecca, I972The immortal life of Henrietta Lacks I Rebecca Skloot.
p.
em.
Includes bibliographical references and index.
r. Lacks, Henrietta, I920-I9P -Health.
2. Cancer-Patients­
Virginia-Biography. 3· AfricanAmerican women-History.
4· Human experimentation in medicine-United States-History.
5· HeLa cells. 6. Cancer-Research. 7· Cell culture. 8. Medical
ethics. I. Title.
RC265.6.L24S55
2oo9
6I6′ .02774092-dc22
[B]
Printed in the United States ofAmerica
DESIGN BY BARBARA STURMAN
Photographs on pages ii-iii, II, 87, and I79
copyright© 20IO OmarA. Quintero.
IO 9 8 7 6 5 4
For my family:
My parents, B etsy and Floyd; their spouses, Terry and B ev erly;
my brother and sister-in-law, Matt and Renee;
and my wonderful nephews, Nick and Justin.
They all did without me for far too long because of this book,
but nev er stopped b eliev ing in it, or me.
And in lov ing memory of my grandfather,
James Rob ert Lee ( 1 9 1 2-200 3 ) ,
who treasured books more than anyone I ‘ve known.
Con t e n ts
A Few Words About This Book
ix
Prologue: The Woman in the Photograph
D eb orah’s Voice
9
Part One
Ll FE
1. The Exam . .. 1951
2. Clover . . 1920-1942
13
18
.
3. D iagnosis and Treatment .. 1951
27
4. The B irth of HeLa . . 1951
34
.
.
5. ” Blackness Be Spreadin All Inside”
6. ” Lady’s on the Phone”
.
.
.
. 1951
.
49
1999
.
42
7. The D eath and Life of Cell Culture … 1951
56
8. “A Miserable Specimen ”
9. Turner Station … 1999
63
.
.
.
1951
67
10. The Other Side of the Tracks … 1999
77
11. “The D ev il of Pain Itself”
83
.
. 1951
.
Part Two
DEATH
12. The Storm .
.
.
1951
13. The HeLa Factory .
89
.
93
. 1951-1953
14. Helen Lane . . . 1953-1954
lOS
15. “Too Young to Remember” . . 1951-1965
110
16. “Spending Eternity in the Same Place ”
. 1999
118
. 1954-1966
127
.
17. Illegal, I mmoral, and D eplorable
.
.
.
.
Contents
vm
18. ” Strangest Hybrid ” .. .1960-1966
19. ” The Mos t Critical Time on This Earth Is Now” . . .
1966-1973
137
144
20. The HeLa Bomb …1966
152
21. Night Doctors .. 2000
158
22. ” The Fame She So Richly Des erv es ” .. .1970-1973
170
.
Part Thre e
IMMORTA LITY
23. ” It’s Alive ”
.
. .1973-1974
179
24. ” Leas t They Can D o ” …1975
19 1
25. ” Who Told You You Could Sell My Spleen ? ” …1976-1988
199
26. Breach of Priv acy …1980-1985
207
27. The Secret of Immortality … 1984-1995
2 12
28. After London …1996-1999
218
29. A Village of Henriettas …2ooo
232
30. Z akariyya . .. 2ooo
241
31. Hela, Goddess of Death …2ooo-2oo1
250
32. ” All That’s My Mother” . .2001
259
.
33. The Hospital for the Negro Ins ane
.
.. 2001
268
34. The Medical Records . ..2001
279
35. Soul Cleans ing …2001
286
36. Heav enly Bodies . ..2001
294
37. ” Nothing to B e Scared Ab out ” … 2001
297
38. The Long Road to Clover …2009
305
Where They Are Now
311
Afterword
315
Acknowledgments
329
Notes
338
Index
359
A Few Word s
Abo u t
This B ook
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 inter­
views with family and friends of Henrietta Lacks, as well as with law­
yers, ethicists, scientists, and j ournalists who’ve written about the
Lacks family. I also relied on extensive archival photos and documents,
scientific and historical research, and the personal j ournals of Henri­
etta’s daughter, Deborah Lacks .
I’ve done my best to capture the language with which each per­
son 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 .” I n 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
x
A Few Words About This Book
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. I n those scenes, dialogue is either
deduced from the written record or quoted verbatim as it was re­
counted to me in an interview. Whenever possible I conducted mul­
tiple 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 pe­
riod of time.
The history of Henrietta Lacks and the HeLa cells raises impor­
tant 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 de­
bate 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 .
The
IMMORTAL
Ll FE
of
HENRIETTA
LACKS
We must not see any person as an abstraction.
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.
– ELIE WIESEL
from The Nazi Doctors and the Nuremberg Code
PROLOGUE
The Woman
in the
Photograph
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
2
P ROLOGUE
cells from her cervix living on forever-bought, sold, p ackaged, 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 grav­
ity, 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 3 5o 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
1 988, thirty-seven years after her death, when I was sixteen and sitting
in a community college biology class. My instructor, Donald Defier, a
gnomish balding man, paced at the front of the lecture hall and flipped
on an overhead proj ector. He pointed to two diagrams that appeared
on the wall behind him. They were schematics of the cell reproduc­
tion cycle, but to me they just looked like a neon-colored mess of ar­
rows, 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 a t 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
Defier’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.
The Woman in the Photograph
3
Yes, Defier 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 en­
zymes 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 cyto­
plasmic factories work 24/7, cranking out sugars, fats, proteins, and
energy to keep the whole thing running and feed the nucleus. The nu­
cleus 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 j obs, whether that’s controlling your heartbeat or helping
your brain understand the words on this page.
D efier 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 per­
fectly 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 can­
cer. Mitosis goes haywire, which is how it spreads .
” We learned that by studying cancer cells in culture,” D efier said.
He grinned and spun to face the board, where he wrote two words in
enormous print: HENRIETTA LACKS.
Henrietta died in 19 5 I from a vicious case of cervical cancer, he
4
P ROLOGUE
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, ” D efier 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 her­
pes, leukemia, influenza, hemophilia, and Parkinson’s disease; and
they’ve been used to study lactose digestion, sexually transmitted dis­
eases, appendicitis, human longevity, mosquito mating, and the nega­
tive cellular effects of working in sewers. Their chromosomes and
proteins have been studied with such detail and precision that scien­
tists 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 , ” D efier 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 D efier 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 , ” h e said, ” but n o one knows anything
about her. ”
After class, I ran home and threw myself onto my bed with my
The Woman in the Photograph
5
biology textbook. I looked up ” cell culture” in the index, and there
she was, a small p arenthetical:
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 repro­
ducing 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.
Defier, 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 con­
fused 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 s eventies. Ebony quoted Henrietta’s husband saying, “All I re­
member 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 with­
out 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 o f Henrietta’s family: her oldest son
sitting at his dining room table in Baltimore, looking at a genetics
6
P ROLOGUE
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 beau­
tiful, 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 p oint she’d been dead for twenty-five years .
All of the stories mentioned that scientists had begun doing re­
search 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 re­
porters, 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.
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 B altimore looking for
Henrietta’s husband, D avid L acks, 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 fro m – someone’s daughter, wife, and mother.
I couldn’t have imagined it then, but that phone call would mark
the beginning of a decadelong adventure through scientific laborato­
ries, hospitals, and mental institutions, with a cast of characters that
would include N obel laureates, grocery store clerks, convicted felons,
and a p rofessional con artist. While trying to make sense of the his­
tory 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 b oth physically and metaphorically, and I’d even­
tually find myself on the receiving end of something that looked a lot
The Woman in the Photograph
7
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 h e r story, and s h e in mine.
D eborah 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; Debo­
rah’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 j our­
nalist 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 p ath. 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, j ournalism, 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.
DEBORAH’s VoicE
When people ask-and seems like people always be askin
to where I can’t never get away from it-! 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 in medical facilities,
in all the computers and the Internet everywhere.
When I go to the doctor for my checkups I always say my
mother w as HeLa. They get all excited, tell me stuff like
how her cells helped make my blood pressure medicines
and antidepression 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 w ant to know who my mother was.
I920S. 1930s. 1940s. 1950s. 1960s. I970S. 1980s. 1990s. 2000S
1951
1
Th e Exam
O n January 29, 1 9 5 1 , 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, Henri­
etta. A few minutes earlier she’d j umped out of the car, pulled her
j acket 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 H enrietta 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 doc­
tor need to have a look. ”
14
PART O N E: LIFE
For more than a year Henrietta had been telling her closest girl­
friends 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 Jesus aren’t them but some pains .”
When sex first started hurting, she thought it had something to do
with baby Deborah, who she’d j ust 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
a gam.
“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 Henri­
etta’s husband D avid anything about it. Then, four and a half months
The Exam
15
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 herself 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 opening 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 doc­
tor. I’m bleedin and it ain’t my time. ”
Her local doctor took one look inside her, saw the lump, and fig­
ured 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 1 889 as a charity hospital for the sick and poor, and it covered more
than a dozen acres where a cemetery and insane asylum once sat in
East B altimore. The public wards at Hopkins were filled with pa­
tients, 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 maj or 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,
16
PART O N E: L I F E
h i s deep v oice softened by a faint Southern accent. When h e walked
into the room, Henrietta told him about the lump . Before examin­
ing her, he flipped through her chart – a quick sketch of her life, and
a litany of untreated conditions :
Sixth o r sevent h grad e education; housewife and mother of five.
B reat hing difficult since childhood due to recurrent throat in­
fections and deviated septum in patient ‘s nose. Physician rec ­
ommended surgical repair. Patient declined . Patient had one
toothac he for nearly five years; tooth ev entually extracted wit h
several others . Only anxiety is oldest daught er who is epileptic
and can’t talk . Happy household . Very occasional d rinker. Has
not t raveled . Well nouris hed, cooperative. Patient was one of ten
s iblings . One died of car accident, one from rheumatic heart,
one was poisoned . U nexplained vaginal bleeding and blood in
urine during last two pregnancies; p hys ic ian recommended
sickle c ell test . Patient declined . Been with husband since ag e 15
and has no liking for sexual intercourse. Patient has asympto­
matic neurosyphilis but canc elled syphilis treat ments, said she
felt fine. Two months prior to current visit, aft er delivery of fifth
c hild, p atient had significant blood in urine. Tests showed areas
of increased cellular activity in t he c erv ix. Physician recom­
mended diagnostics and referred to specialist for ruling out infec ­
tion or cancer. Patient canceled appointment . One month prior
to current visit, patient tested positive for gonorrhea. Patient re­
call ed to clinic for t reat ment . No response.
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 ab out
harv esting t obacco 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 mos t black patients , only went to
Hopkins when she thought she had no choice.
The Exam
17
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 o n the table, feet pressed hard i n stirrups a s 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 diag­
nosis . 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 1 9, 1 9 5 0, ” 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.
I920S. I9}0S. 1940S. 1950s. 1960s. 1970s. 1980s. 1990s
.
.!OOOS
1920-1942
2
Clover
H enrietta Lacks was born Loretta Pleasant in
Roanoke, Virginia, on August r , 1920. No one knows how she be­
came 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 to­
bacco 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 grand­
father, 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,
Clover
19
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 D avid sounds like Day.
Young Day was what the Lacks family called a sneak baby: a man
named Johnny Coleman 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
20
PART O N E: L I F E
climbed the rafters o f their grandfather’s tobacco barn t o 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 wal­
nuts 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 . Cole­
man made the b oys 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 D ay 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 any­
thing else they could sink. They threw rocks to scare away the poi­
sonous 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 lit­
tle 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 below 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
Clover
21
of South Boston – home of the nation’s second-largest tobacco mar­
ket, 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 leav es, then fight
sleep as long as they could before giving in to the rhythm of the
horses. Like farmers from all ov er Virginia, Tommy Lacks and the
grandchildren rode through the night to bring their crops to South
B oston, where they’d line up at dawn – one wagon behind the next­
waiting for the enormous green wooden gates of the auction ware­
house to open.
When they arriv ed, 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 cov ered 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 priv ate 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 almost to the ceiling.
Night at the warehous e was a time of booze, gambling, prostitu­
tion, 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 har­
v est and set out on the long j ourney home. Any cousins who’d
stayed behind in Clov er knew a wagon ride into South Boston meant
treats for ev eryone – a hunk of cheese, maybe, or a slab of bologna –
22
PART O N E : L I F E
so they waited for hours o n Main Street t o follow the wagon t o 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, j ewelry store, doctor’s office, hard­
ware 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
proj ector, which clicked like a metronome through the whole movie.
As Henrietta and D ay 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 D ay, but sometimes she cheered for an­
other cousin, Crazy Joe Grinnan. Crazy Joe was what their cousin
Clover
23
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 sum­
mer 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, ” H ennie,
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 b oiling ! ” 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 hap­
pened next didn’t surprise anyone: they started having children to­
gether. 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
24
PART O N E: LIFE
out of wedlock, but for some reason Henrietta never was, even as ru­
mors 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 punch­
ing – which just made him bleed more. Eventually Joe’s father wres­
tled 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 D ay 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 j ealous because Henrietta was prettier. But Gladys
always insisted D ay would be a no-good husband.
Henrietta and Day married alone at their preacher’s house on
April 1 0, 1 94 1 . 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 compa­
nies were supplying free cigarettes to soldiers, so the market was boom­
ing. 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 1 94 1 , their cousin Fred Garret
came barreling down the dirt road beside their field. He was just back
from B altimore for a visit in his slick ‘ 3 6 Chevy and fancy clothes .
Only a year earlier, Fred· and his brother Cliff had been tobacco farm-
Clover
25
ers in Clover too. For extra money, they’d opened a ” colored ” con­
venience store where most customers paid in IOUs; they also ran an
old cinderblock juke j oint where Henrietta often danced on the red­
dirt floor. Everybody put coins in the j ukebox 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 B ethle­
hem 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 B altimore.
In the late 1 8oo s, when Sparrows Point first opened, Turner Sta­
tion was mostly swamps, farmland, and a few shanties connected with
wooden boards for walkways. When demand for steel increased dur­
ing World War I, streams of white workers moved into the nearby
town of Dundalk, and B ethlehem Steel’s housing barracks for black
workers quickly overflowed, pushing 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 1 94 1 , Japan bombed Pearl Harbor, and it was
like Turner Station had won the lottery: the demand for steel skyrock­
eted, as did the need for workers . The government poured money into
Turner Station, which began filling with one- and two-story housing
proj ects, many of them pressed side by side and back-to-hack, 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 3o,ooo workers. B ethlehem Steel was a
gold mine in a time flush with poverty, especially for black families
26
PART ONE: L I F E
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 intq town, Fred bought D ay a bus ticket to B alti­
more. They agreed Henrietta would stay behind to care for the chil­
dren and the tobacco until D ay 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 . B efore he left, Fred gave D ay all
the money he’d saved, saying it was time to get Henrietta and the chil­
dren 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.
1920s. 1930s. 1940S. 1950s. 1960s. 1970s. 1980s. 1990s. 2000S
1951
3
Diagnosis and
Treatment
A fter 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 cate­
gorized based on the type of cell they start from. Most cervical can­
cers 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
28
PART O N E : L I F E
most famous clinical gynecology textbooks, which i s 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 1 9 5 1 , 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.
C ervical 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 1 9 5 1 , most doctors i n 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 be­
lieved carcinoma in situ was simply an early stage of invasive carci­
noma 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 1 94 1 ,
when George Papanicolaou, a Greek researcher, published a paper de­
scribing a test he’d developed, now called the Pap smear. It involved
scraping cells from the cervix with a curved glass pipette and examin­
ing 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 other­
wise: they caused no physical symptoms and weren’t palpable or vis-
Diagnosis and Treatment
29
ible 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
r
5 ,ooo 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 re­
moved 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 hyster­
ectomies” by documenting what wasn ‘t cervical cancer and by urging
surgeons to verify smear results with biopsies before operating. He
also hoped to prove that women with carcinoma in situ needed aggres­
sive 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 maj or 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
30
PART O N E : L I F E
scientists believed that since patients were treated for free in the pub­
lic wards, it was fair to use them as research subj ects as a form of pay­
ment. And as Howard Jones once wrote, ” H opkins, with its large
indigent black population, had no dearth of clinical material . ”
I n 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 con­
stantly replenish themselves and never die. Eight years earlier – in
1 94 3 – 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 p erson.
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 hap ­
pened t o walk into Hopkins with cervical cancer. Including Henrietta.
Diagnosis and Treatment
31
O n February 5 , 1 9 5 1 , after Jones got Henrietta’s
biopsy report back from the lab, he called and told her it was malig­
nant. 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 t o the admissions desk and told the recep­
tionist 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 procedu res and u nder
any anaesthetic either local or general that they may
deem necessary in the proper surgical care and
treatment of:
_____________
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 physi­
cians 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 Henri­
etta 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,
32
PART O N E : L I F E
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 I 8 oos, headlines na­
tionwide 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 prob­
lems 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 I 90os, when a surgeon named Howard Kelly visited Marie and
Pierre Curie, the couple in France who’d discovered 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 pock­
ets and regularly traveled the world collecting more. By the 1 940s, sev­
eral studies – one of them conducted by Howard Jones, Henrietta’s
physician – showed that radium was safer and more effective than sur­
gery 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 B altimore 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 B rack plaques on a stainless-steel tray. An­
other 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 .
Diagnosis and Treatment
33
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 Henri­
etta, 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 cer­
vix, 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.
When Wharton finished, a nurse wheeled Henrietta back into the
ward, and Wharton wrote in her chart, “The patient tolerated the pro­
cedure well and left the operating room in good condition. ” On a sep­
arate page he wrote, ” H enrietta 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 .
I 9 2 0S . 1 9 3 0s . 1 940S . 1 9 5 0s . 1 960s . 1 9 70s . 1 9 8 0s . 1 990s . 2 000S
1951
4
Th e Birth
of H e la
G ey’s twenty-one-year-old assistant, Mary Ku­
bicek, 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 us­
ing 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
The Birth of He La
35
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 cul­
ture, 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.
G ey 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 success­
fully. 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 Cul­
ture 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, puree 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 court­
yard to the Hopkins maternity ward, so nurses could ring anytime a
36
PART O N E: L I F E
baby was born, and Margaret o r 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 motion­
less 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 chick­
en’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 B leeding
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. B acteria 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 cul­
tures 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 j ob was washing the laboratory
The Birth of HeL a
37
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 business, she bought an en­
tire 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 s miled, no one could have seen it through her ever-present sur­
gical 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 work­
bench 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
38
PART O N E: L I F E
o n the side o f 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 j unkyard scraps, a skill he’d learned from a life­
time of making do with nothing.
G eorge Gey was born in I 899 and raised on a
Pittsburgh hillside overlooking a steel mill. Soot from the smoke­
stacks made his parents’ small white house look like it had been per­
manently 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 cam­
era to capture live cells on film. It was a Frankensteinish mishmash
of microscope parts, glass, and I 6-millimeter camera equipment from
who knows where, plus metal scraps, and old motors from Sha­
piro’s j unkyard. 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 j iggling when
streetcars 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 unfold­
ing in a flip book.
It took Gey eight years to get through medical school because he
The Birth of HeLa
39
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
j anitor’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 dap ­
per, 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 anytime he wanted. He had the body of a retired
linebacker, six feet four inches tall and 2 1 5 pounds, his back unnatu­
rally stiff and upright from having his spine fused so he’d stop throw­
ing 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 j ust 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 doz­
ens of proj ects 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 labels. That’s how
he came up with the roller-tube culturing technique, his most impor­
tant 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, ro­
tating 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
40
PART O N E: L I F E
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.
H enrietta spent the next two days in the hos­
pital, 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
”
vein s . They wrote notes in her chart s aying, 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. ”
B efore Henrietta left the hospital, a doctor put her feet in the stir­
rups again and removed the radium . He sent her home with instruc­
tions 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 surp rise. Then, two days after Henrietta went home from the hos­
pital, Mary saw what looked like little rings of fried egg white around
the clots at the b ottoms 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 survivin g , 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,
The Birth of HeLa
41
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 9 20S . 1 9 3 0S . 1 940s . 1 9 5 0s . 1 960s . I 970S . 1 9 80s . 1 990s . 2 000S
I9J I
5
” B l a ck n ess B e
S pr e ad i n A l l
Insid e ”
H enrietta 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 ane­
mia, there’s no record of Henrietta having any side effects, and no one
remembers her complaining of feeling sick.
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 sp ent 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 Sadie
would wait until the door slammed, count to one hundred, then j ump
out of bed, put on their dancing clothes, and sneak out of the house,
“Blackness Be Spreadin All Inside ”
43
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 B ar 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 fu ll lips. She
was a sturdy woman with a square j aw, 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 b rushing on new coats of polish. She’d sit on her bed, pol­
ish 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
j ust 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 j ealousy.
” I guess I can’t say’s I blame her, ” Sadie said. ” Galen, that hus­
band of Ethel’s, he was likin Hennie more than he like Ethel. Lord, he
44
P A R T O N E: L I F E
followed Hennie ! Everywhere she go, there g o Galen – he tried to
stay up at Hennie house all the time when Day gone to work. Lord,
Ethel was j ealous – made her hateful to Hennie somethin fierce. Al­
ways 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 sis­
ter Margaret spent evenings in Henrietta’s living room, playing bingo,
yelling, and laughing over a pot of pennies while Henrietta’s babies ­
David Jr. , D eborah, and Joe – played with the bingo chips on the car­
pet beneath the table. Lawrence was nearly sixteen, already out having
a life of his own. But one child was missing: Henrietta’s oldest daugh­
ter, 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 gar­
den. 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 D ay drive her and Elsie to revival
meetings so preachers in tents could lay hands on Elsie to heal her, but
“Blackness Be Spreadin All Inside ”
45
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 Law­
rence 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 treat­
ment. 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
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PART O N E : L I F E
shrinking. Regardless, she had t o 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 D ay 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
spnng 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 doc­
tors 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, Henri­
etta 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
“Blackness Be Spreadin All Inside ”
47
inside her vagina to protect her colon and lower spine from the radia­
tion. 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 radia­
tion 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 an­
other child. Until that moment, Henrietta didn’t know that the treat­
ments had left her infertile.
Warning patients about fertility loss before cancer treatment was
standard p ractice at Hopkins, 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 hysterec­
tomy, 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 [wh o is] entitled to a
simple explanation of the facts [including] loss of the reproduc­
tive function . . . . It is well to present the facts to such an indi­
vidual and give her ample time to digest them. . . . It is far better
for her to make her own adjustment before the operation than
to awaken from the anesthetic 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.
48
PART O N E : L I F E
Says i f 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, ” L ord, it just feels like that black­
ness be spreadin all inside me. ”
I 9 20S . I 9 } 0S . 1 940s . 1 9 5 05 . 1 960s . 1 970s . 1 9 80s . 1 990s . 2000S
1999
6
“Lad y ‘s on
the Phon e ”
E leven years after learning about Henrietta in
Defier’s classroom – on my twenty-seventh birthday – I stumbled on
a collection of scientific papers from something called “The HeLa
Cancer C ontrol 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 Henri­
etta, I told him I was writing a book about her.
” O h 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 . ”
” 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 ? ‘ ”
50
PART O N E : L I F E
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, ” h e said. “What d o 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. Depart­
ment 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 subj ects didn’t ask questions .
They were poor and uneducated, and the researchers offered incen­
tives : 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 subj ects 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 seven­
ties, after hundreds of men enrolled in it had already died. The news
spread like pox through black communities : doctors were doing re­
search on black people, lying to them, and watching them die. Rumors
started circulating that the doctors had actually inj ected the men with
syphilis in order to study them.
” 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 orga­
nizing the next He La conference, and when the phone rang, I’d just
“Lady ‘s on the Phone ”
51
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 Henri­
etta wanted us to talk.
” Deborah is Henrietta’s baby girl, ” he said, very matter-of-f�ct.
“The family calls her Dale. She’s almost fifty now, still living in B alti­
more, with grandchildren of her own. Henrietta’s husband is still alive.
He’s around eighty-four – still goes to the clinics at Johns Hopkins . ”
H e dropped this like a tease .
” Did you know Henrietta had a n 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.
M oments 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
52
PART O N E : L I F E
.
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 D eborah 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 halleluj ah ! I think a
book would be great ! ”
T…
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