Welcome back to The DO Book Club! For August, I read The Immortal Life of Henrietta Lacks by Rebecca Skloot. If you’ve read this one, please share your thoughts in the comments below. And if you’d like to write a book review for a future month, please email Andy Brown at firstname.lastname@example.org.
In 1951, a 31-year-old African-American woman named Henrietta Lacks died of cervical cancer at The Johns Hopkins Hospital in Baltimore. She received no obituary and was buried in an unmarked grave in a small cemetery in Virginia. Prior to her death, during a tumor removal operation, a doctor extracted two pieces of tissue from her cervix (one cancerous and one healthy) for research purposes, without her consent.
This was then and is now a fairly common, and legal practice, though debates over the ethics of it continue to this day. In 2017, the Department of Health and Human Services considered requiring federally funded scientists to get patient consent before using cells, tissue or DNA for research, but ultimately decided against it.
But back in 1951, Henrietta’s cancerous cells—unlike all previous samples, including her healthy cells—didn’t die once they were put in culture. In fact, they grew with “mythological intensity” (p. 40) and could be forced to divide with much less effort than what was required for other human cells.
Having an unlimited supply of immortal human cells opened up avenues for research that had previously never been conceivable. A cell biologist at Hopkins started sending “HeLa cells” to labs around the world, kicking off a medical science revolution that included the first measured impact of space travel on human cells and the discovery that we have 46 chromosomes and not 48. HeLa cells are still “one of the most commonly used cell lines in laboratories around the world” (p. 312).
All the while, Henrietta’s family lived in abject poverty and was only informed of her impact on science thanks to one relative’s fortuitous conversation with a researcher who had worked with the cells. This book tells the concurrent histories of those cells and the Lacks family.
Interesting tidbits for DOs
Just months after Henrietta died in 1951, the world’s biggest polio epidemic broke out. Schools closed and the public clamored for a vaccine. The same Hopkins biologist who had discovered the immortal quality of HeLa cells, George Gey, quickly realized he was sitting on a “gold mine” (p. 94).
Gey infected the cells with poliovirus and found them to be more susceptible to it than any other cultured cells had been, making them the perfect subjects for (then) unprecedentedly urgent and mass-produced vaccine testing. Shortly after this revelation, the National Foundation for Infantile Paralysis (now March of Dimes) launched a HeLa cell production factory at the Tuskegee Institute in Alabama, which led to not only the development of a polio vaccine, but also a booming cell production industry that helped launch the field of virology.
But while there have been several tons’ worth of HeLa cells produced since 1951, the Lacks family has yet to see any part of the profits, and many are unable to afford health insurance. The book provides ample details on the rocky relationship between the Lacks family and Hopkins, but Henrietta’s cousin Cootie summed it up well when she said “[Henrietta’s] cells lived longer than her memory” (p. 118).
If you’re like me, you’ll get 200 pages in and wonder, “how were her cells so different?” Skloot explains on page 217 that nobody knew the answer until the early 1990s:
“… a scientist at Yale used HeLa to discover that human cancer cells contain an enzyme called telomerase that rebuilds their telomeres … indefinitely. This explained the mechanics of HeLa’s immortality: telomerase constantly rewound the ticking clock at the end of Henrietta’s chromosomes.”
Again though, there was a disconnect between these discoveries and the Lacks family’s involvement and understanding for many years. When Henrietta’s late daughter Deborah, who was not highly educated, started providing blood samples for a Hopkins lab upon request in the 1970s, the doctor in charge offered no real explanations for what her blood was being used for. He instead handed her a textbook on medical genetics that made a brief mention of Henrietta.
“Reading magazines took Deborah a long time because she had to stop often to look up words in her dictionary. Now she sat in the clinic gripping [the] book, not even trying to read the words” (p. 188).
This is a complicated story, which I think is probably evident in this review. It’s a story of how tissue samples harmlessly collected during surgery sparked a boom in scientific knowledge, but it’s also a story of a human being and her family, who was never in the loop on any of it and feels left out to this day. The ethical quandaries woven through this story are not easy to sort out, as Skloot admits, and by the end, you are likely to have a lot on your mind.
All told, it is an important historical read for anyone involved in health care, and Skloot did a great job of explaining the fascinating timeline of Henrietta’s immortal life, which began 100 years ago this month in 1920.
For September, The DO Book Club will be reading Fallible: A memoir of a young physician’s struggle with mental illness by Kyle Bradford Jones, MD. We encourage all who are interested to read along! If you are unable to get out to a local library or bookstore due to COVID-19, we recommend checking out eBook options for rent or purchase.
As a reminder, if you read The Immortal Life of Henrietta Lacks or any previous Book Club selection and want your reflections to be shared in future posts, or want to write your own book review for a future month, please leave a comment below or email email@example.com.