The Immortal Life of Henrietta Lacks | Study Guide

Rebecca Skloot

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The Immortal Life of Henrietta Lacks | Part 1, Chapter 3 : Diagnosis and Treatment (1951) | Summary

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Summary

Dr. Richard TeLinde, a cancer specialist, is the boss of Dr. Howard Jones, Henrietta's doctor at Hopkins. Dr. Jones, working with Dr. TeLinde, has been studying the differences between carcinoma in situ (cancer in place, on the surface of the tissue) and invasive cancer. When Dr. Jones discovers Henrietta has cancer of the cervix, he calls Henrietta, but she doesn't tell anyone what he says. She goes to the hospital for treatment, telling Day and her cousins she is basically fine. She agrees to surgery and treatment, and receives treatment via tubes and patches of radium sewn to her cervix. Doctors later find out handling radium causes cancer.

Dr. TeLinde uses public ward patients for research because he figures "since patients were treated for free in the public wards, it was fair to use them as research subjects" in exchange for treatment. However, patients don't know they are participating in research. Dr. Jones says the "indigent black population" is a particularly rich source of "clinical material." The Pap smear, a test for precancerous cells on the cervix, has been invented at this point, but many doctors don't know how to interpret the results, and patients like Henrietta never have the test done. When Henrietta is treated for her cancer, "although no one had told her that TeLinde was collecting samples or asked if she wanted to be a donor," a sample taken from Henrietta's cervical tumor as well as one from the healthy tissue on the cervix are given to George Gey, who is the head of tissue culture research at Hopkins. Gey is attempting to grow cells to study cervical cancers, but up to this point, has had no success keeping the cells alive long enough to study. His goal is to grow immortal cells, which will not die and will allow researchers to study cancers to find a cure for them.

Analysis

While Dr. TeLinde's impulse to save lives and avoid unnecessary hysterectomies is admirable, his use of public ward patients without their permission would today be seen as unethical. At the time, there was no law against using patients for research without their informed consent. There were consent forms for treatment, as Henrietta had signed, but there was no language on her consent form about donating tissue for research.

In addition to the ethical questions raised by Dr. TeLinde's use of patients for research without their knowledge or consent, there are racial overtones to this practice. Hopkins had many poor black patients, mainly because it was one of the only hospitals that would treat black people. Henrietta's presence in the "colored" ward virtually guarantees her tissue will be sampled, and since she is poor and black, doctors see no reason to ask first. At the time poor black patients are treated as if they are less than human; they are not given the option to agree or disagree to whatever a doctor decides to do. Henrietta, who has never questioned a white doctor before and does not do so at this point, remains unaware of much of what is being done to treat her or how ineffective it will be. She figures the doctors know what they're doing.

The limits of cell research and cancer research are also part of the story in this chapter. George Gey has not been able to keep cells alive long enough to compare different levels of cervical cancer. He is not confident Henrietta's cells will work, but he samples them anyway and sends them off to the lab. Because he needs to find immortal cells, he'll take any cells he can "get his hands on."

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