MEDICINE APRIL 7, 2010
by Rebecca Skloot
Crown Publishers, 369 pp., $26
Twenty-two years ago, when she was a teenager, Rebecca Skloot was sitting, lost and bored, in a community college science class, when her instructor—describing the origins of the first immortal human cell line—printed the words “Henrietta Lacks” on the blackboard. He told the students that the cell line, HeLa, came from Lacks, and then casually added that “[s]he was a black woman.” Skloot remembers thinking, “there has to be more to the story”; later, the teacher’s offhand comment seeded this elegant and admirable book.
In The Immortal Life of Henrietta Lacks, Skloot brings a forgotten woman and her children out of the shadows, and shows us the wonder and the terror of a common laboratory workhorse: the immortal, wildly prolific, invasive cancer cells that scientists took from her cervix. Henrietta was a beautiful, sweet-tempered woman who was born Loretta Pleasant in Roanoke, Virginia in 1920. How she became Henrietta, Skloot tells us, no one knows. Her mother died in labor with her tenth child in 1924; her father, John Pleasant, lame, impatient, and unable to care for his ten children, took them back to the tiny, now-obliterated town of Clover, Virginia, and farmed them out to other relatives. They lived in a dilapidated wooden shack, once a slave cabin, called the "home-house" by Henrietta's family-members. Henrietta's first cousin, Day, who also lived there, gave Henrietta her first of five children at the age of fourteen. He also gave her gonorrhea, neurosyphilis, and the most vicious case of cervical cancer her Johns Hopkins physician (the same one who later took her cells) had ever seen.
The purple, friable tumor, which Henrietta, feeling an internal mass, discovered herself, killed her eight months after diagnosis, in October, 1951. She died in agony at Johns Hopkins, burnt black from the radium they had used to try and halt the tumor, terrified that the children she left behind would suffer. She was right. Left in the care of a bitter and resentful woman named Ethel, the three youngest were beaten and nearly starved. Another child, a delicately pretty, epileptic and feeble-minded girl sent to an asylum for the “Negro Insane,” but cherished and watched over by her mother, was never visited by anyone again after Henrietta's death. She endured mistreatment and neglect until she died at fifteen.
Henrietta’s cancer cells, taken by her physician at Johns Hopkins without her knowledge or permission, became the most successful immortal cell line in medical history. Grown and re-grown an uncounted number of times, they have been used in cancer and vaccine research, shot into space, and mixed with animal cells to produce cellular chimeras. Floating on dust, Henrietta’s cells have also contaminated countless other cell lines, invalidating research results: scientists who think they've developed a treatment, say, for esophageal cancer may be actually working with Henrietta's cervical cells, which aren't at all the same thing.
So indurate and predatory are HeLa cells that some evolutionary biologists have argued that they form a new species analogous to the infectious cancers, spread by biting, that threaten the entire population of Tasmanian devils. HeLa cells are descended from human cancer cells, but they seem to have taken on a life, or an evolutionary trajectory, of their own.
Still, without this cell line, many of the drugs and vaccines of today might not exist. Jonas Salk used HeLa cells to develop polio vaccine in the 1950s; monkey cells, Skloot tells us, were “too expensive” to be grown on the massive scale needed to test that vaccine for its efficacy. The polio virus killed HeLa cells, but Salk's vaccine protected them: this was the first indication that Salk’s vaccine worked.
The saddest part of the story is that the woman who gave rise to this medical miracle was as powerless as her cells were strong. Raised with her cousin Day, she bore her first child at fourteen on the floor of the sagging “home-house." Day ran around with other women; Henrietta put pretty shoes on her tiny feet with their red-lacquered toenails and went out dancing when she could. She was “a very good condition person,” said one of the few relatives that remembered her. “She just lovey dovey, always smilin, always takin care of us when we come to the house. Even after she got sick, she never was a person who say ‘I feel bad and I’m going to take it out on you.’ ” Other women, including the appalling Ethel, were jealous of her good looks, her laughter, the way she had with men.
But even the lovely Henrietta couldn’t keep her husband at home, and what he brought back killed her. Henrietta’s cervical cancer, researchers later discovered, contained DNA from a strain known as Human Papilloma Virus 18—one of the most virulent HPV strains of all. Henrietta was powerless to fight off this strain, and to protect her vulnerable children. Zakariyya, her angry youngest son, puts it this way: “Maybe her cells have done good for some people, but I woulda rather had my mother. If she hadn’t been sacrified, I mighta growed up to be a lot better person than I am now.”
Deborah, Henrietta’s volatile daughter, is obsessed by her mother’s death and the way the world has forgotten that HeLa cells came from this one particular human being. All along her journeys with Skloot, hunting for fragments of Henrietta’s history, Deborah insists that what angers her is not the fortunes that scientists have made off her “mother cells,” but the indifference to Henrietta’s humanity. She also resents her family’s lack of health insurance, which sent her brother Sonny into crippling debt after surgery, and which forced her to go without the medical care that she—suffering from a congerie of illnesses including high blood pressure and diabetes—desperately needed. Skloot is too delicate to hammer the point, but it is impossible to miss the irony. Skloot financed research on this book with student loans, endured months of suspicion by Henrietta’s family, and traveled alone to places it must have taken courage to visit. At one point cousin Gary, looking at Deborah’s hive-blotched face and wandering, unsteady eyes, holds an impromptu faith-healing and casts the burden of the “mother cells” off Deborah and onto Skloot, who—despite her religious skepticism—could only accept it. Skloot carried the burden with grace, and produced a more lyrical and perfect telling of this story.
But there is a final, inescapable complication in the very title of the book. HeLa cells do not represent an immortalized Henrietta. They are in fact her death, grown from the vicious purple thing that killed her, now transformed and made immortal by science. Thanks to Rebecca Skloot, we may now remember Henrietta—who she was, how she lived, how she died. But HeLa cells are not normal: they are a wildly fulminate version of the cells that we all carry. Injected, they cause cancer. However useful, however priceless, they are uncanny, murderous things.
Wendy Orent is the author of Plague: The Mysterious Past and Terrifying Future of the World's Most Dangerous Disease.