In her extensive acknowledgements at the end of her book, The immortal life of Henrietta Lacks, Rebecca Skloot thanks “Heather at The Book Store, who tracked down every good novel she could find with a disjointed structure, all of which I devoured while trying to figure out the structure of this book.” Interesting that she looked at novels, particularly given our recent discussion regarding non-fiction that reads like fiction, but more on that later …
Many of you will have heard of the book, or, if not, of Henrietta Lacks, or of her HeLa cells? It’s a sort of hybrid biography-cum-science book about an African-American woman named Henrietta Lacks who died in 1951, and the immortal HeLa cell line that was and continues to be cultured from her cervical cancer cells. As Skloot writes, “these cells have transformed modern medicine.” The book was published in the USA in 2010. It won multiple awards, including, says Wikipedia, the National Academies Communication Award for “best creative work that helps the public understanding of topics in science, engineering or medicine”. In addition, the paperback edition was on the New York Times Bestseller List for 75 weeks.
I’ve described the book as hybrid, because the story (or biography) of Henrietta Lacks is just one of its threads. It also interrogates the complex intersection between race, class and ethics in medical research as well as broader ethical ramifications of issues like “informed consent” and the commercialisation of human tissue. Skloot, herself, says early in the book,
The Lackses challenged everything I thought I knew about faith, science, journalism, 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.
If you haven’t guessed it by now, then, this book is another example of those non-fiction books that I like so much in which authors author takes us on their journey of discovery, in this case to understand the people and the science, the ethics and the law, behind this astonishing story. Skloot wasn’t the first so tell it, however – something she makes clear during our journey. Earlier stories include Michael Rogers’ 1976 article in Rolling Stone, and the 1997 BBC documentary, The way of all flesh, which you can watch on YouTube. I’m not going to spend a lot of time on the story of the cells, so if you want to know about them – read the book and/or watch this video.
Skloot explains her own fascination with Henrietta, from being introduced to her cells in high school, through those HeLa cells being “omnipresent” throughout her biology degree, to when she was in graduate school studying writing “and became fixated on the idea of someday telling Henrietta’s story”. It’s not surprising then that this book has been extensively researched – as evidenced by the Notes and Acknowledgements. (These two chapters make great reading in themselves.) It took around 10 years to write, not just because of this extensive research. A major issue which Skloot had to confront was the understandable suspicion and anger of the Lacks’ family, whose help she needed if she were to tell this story properly and with integrity. Their story is bound up in a long invidious history of research carried out on African-Americans, which is also detailed in the book.
“What do you mean, ‘everybody else’?!”
So, the structure. The book is divided into three parts – Life, Death, Immortality. In the first two parts, the story is told in two roughly alternating, chronological threads – one telling the story of Henrietta Lacks, her cells, and her family, from 1920 to 1973; the other tracking the early days of Skloot’s research from 1999 to 2000. In the third part, the two tracks coalesce into one chronological thread, starting from 1973 when the late Henrietta’s daughter-in-law, Bobbette, discovers quite accidentally via a friend’s brother-in-law, that Henrietta’s cells were being used in scientific research and had been since 1951. Until that point, no-one in the family had known that Henrietta’s cells were still “alive” and being used in research all over the world:
“What?!” Bobbette yelled, jumping up from her chair. “What you mean you got her cells in your lab?”
He held his hands up, like Whoa, wait a minute. “I ordered them from a supplier just like everybody else.”
“What do you mean, ‘everybody else’?!” Bobbette snapped. “What supplier? Who’s got cells from my mother-in-law?”
She is, to put it mildly, horrified – and rushes to tell her husband and thence the family.
Here, though, I’m going to return to the issue of writing non-fiction like fiction. There’s the use of narrative structure, of plot lines, to create some sort of tension for the reader – in this case it largely revolves around the lives and reactions of the family, particularly Deborah – while we are also learning drier “stuff” about the history and ethics of cell culture and medical research. The dialogue I’ve just shared is part of the main plot line concerning the family’s discovery of what had been happening to Henrietta’s cells.
Then there’s the use of evocative, descriptive language. Skloot doesn’t overdo this, staying, in the main, direct and focused – but there are enough little flourishes to keep the writing interesting, like “HeLa grew like crabgrass” or “tufts of hair like overgrown cotton sprouted from his head”. The imagery draws from the area in which it is set. And, there’s the use of dialogue. Skloot did carry out a lot of interviews over her decade-long research and often makes clear when she’s quoting from those – but not all dialogue comes from that research. Some is imagined – or what critics call “representative”. No-one, for example, would have recorded Henrietta’s exact words when she visited her gynecologist, but Skloot writes:
“I got a knot on my womb,” she told the receptionist. “The doctor need to have a look”.
How much more interesting that is to read than, say, “Henrietta visited her gynaecologist, telling the receptionist that she had pain in her womb that needed to be investigated.” I know what I’d rather read. Not only is dialogue more engaging, but if the writer gets the voice right it enhances our understanding of the character. One of the delights of this book, in fact, is our getting to “know” members of Henrietta’s family, and the dialogue plays a significant role in this. Not non-fiction readers, however, approve of this approach.
As I’ve already said, I’m not going to write a lot about the content of this book, fascinating though it is. It has been written about extensively; there are interviews with Skloot on the web; and for background there’s that BBC documentary. The book is now nearly a decade old. Cell research has moved on, but the story of the intersection of race and class with science and ethics is still relevant. Moreover, this is a book of history – the history of medicine. Close to home for me, for example, was learning that HeLa cells were involved in identifying the connection between the HPV virus and cervical cancer, and thence the development of the vaccine with which my reading group’s daughters were among the first in the world to be vaccinated.
All this makes the book well worth reading. There were, admittedly, times when the cell science got the better of me (and other non-scientific members of my reading group) but not enough to turn us off. Skloot’s courage, warmth and empathy with people out of her ken, the trust those initially fearful, angry people came to place in her, and her ability to tread the fine line between judgement and analysis when discussing actions of the past make this a special read. No-one in my reading group regretted this choice for our schedule. A fine way to end the year.
The immortal life of Henrietta Lacks
Sydney: Picador, 2010
ISBN: 9781742626260 (ePub)