The Immortal Life of Henrietta Lacks (18 page)

When I arrived in Clover, race was still ever-present. Roseland was “the nice
colored
fellow” who ran Rosie’s before it shut down; Bobcat was “the
white
man” who ran the mini-mart; Henrietta went to St. Matthew’s, “the
colored
church.” One of the first things Cootie said when I met him was, “You don’t act strange around me cause I’m black. You’re not from around here.”

Everyone I talked to swore race relations were never bad in Clover. But they also said Lacks Town was only about twelve miles from the local Lynch Tree, and that the Ku Klux Klan held meetings on a school baseball field less than ten miles from Clover’s Main Street until well into the 1980s.

Standing in the cemetery, Cliff told me, “The white Lackses know their kin all buried in here with ours cause they family. They know it, but they’ll never admit it. They just say, ‘Them Black Lackses, they ain’t kin!’”

     
W
hen I went to visit Carlton and Ruby Lacks, the oldest white Lackses in Clover, they smiled and chitchatted as they led me from their front door into a living room filled with pastel-blue overstuffed chairs and Confederate flags—one in each ashtray, several on the coffee table, and a full-sized one on a stand in the corner. Like Henrietta and Day, Carlton and Ruby were first cousins before they became husband and wife. They were both related to Robin Lacks, the father of Albert, Ben, and Winston Lacks, which made them Henrietta and Day’s distant cousins.

Carlton and Ruby had been married for decades and had more children, grandchildren, and great-grandchildren than they could count. All they knew for sure was that there were more than one hundred of them. Carlton was a frail man in his late eighties, with skin so pale it looked almost translucent. Tufts of hair like overgrown cotton sprouted from his head, brow, ears, and nostrils as he sat in his easy chair, mumbling about his years working the bank at a tobacco warehouse.

“I wrote out the checks,” he said, mostly to himself. “I was the tobacco king.”

Ruby was in her late eighties too, with a sharp mind that seemed decades younger than her frail body. She talked right over Carlton, telling me about their grandfather who’d farmed the Lacks Plantation, and their relation to Ben and Albert Lacks. When I mentioned that Henrietta came from Lacks Town, Ruby straightened in her chair.

“Well, that was colored!” she snapped. “I don’t know what you talking about. You’re not talking about coloreds are you?”

I told her I wanted to learn about both the white and black Lackses.

“Well, we never did know each other,” she said. “The white and the black didn’t mix then, not like they do now, which I can’t say I like because I don’t think it’s for the best.” She paused and shook her head. “Mixing them like that, during school and church and everything, they end up white and black get together and marry and all… I just can’t see the sense in it.”

When I asked how she and Carlton were related to the black Lackses, they looked at each other from across the coffee table like I’d asked if they were born on Mars.

“My daddy’s uncle kept a lot of the colored Lackses as slaves,” Ruby said. “That must be where they got their name. Evidently they took it when they left the plantation. That’s the only thing I can figure.”

Later, I asked Henrietta’s sister Gladys what she thought of their theory. Though she’d lived about a mile from Carlton and Ruby Lacks most of her ninety years, Gladys said she’d never heard of them.

“Black and white Lacks is kin,” Gladys said, “but we don’t mix.”

She pointed under the couch where I was sitting.

“Get Lillian’s letter,” she said to her son Gary.

As far as Gladys knew, all of Henrietta’s other siblings were dead, except maybe Lillian, the youngest. The last anyone had heard from Lillian was a letter she’d sent sometime in the eighties, which Gladys kept in a shoebox under the couch. In it, Lillian wrote, “I heard daddy died in a fire,” and she asked if it was true. It was: He’d died in 1969, two decades before she sent that letter. But what Lillian really wanted to know was who’d been talking to people about her life. She’d won the lottery, she said, and she believed someone was trying to kill her because white folks had been coming around asking questions about her life in Clover and her family, especially Henrietta. “They knew things I didn’t even know,” she wrote. “I don’t think anybody should talk about other people.” No one in the family had heard from her since.

“Lillian converted to Puerto Rican,” Gladys said, holding the letter to her chest.

I looked at Gary, who sat beside her.

“Lillian’s skin was real light, even lighter than mom’s,” Gary explained. “She married a Puerto Rican somewhere in New York. Since she could pass, she disowned her blackness—converted to Puerto Rican because she didn’t want to be black no more.”

17
Illegal, Immoral, and Deplorable

A
s HeLa grew like crabgrass in laboratories around the world, a virologist named Chester Southam had a frightening thought: What if Henrietta’s cancer cells could infect the scientists working on them? Gey and several others had already shown that some rats grew tumors when injected with live HeLa. Why not humans?

Researchers were breathing in the air around HeLa cells, touching them and transferring them from vial to vial, even eating lunch at lab tables beside them. One had used them to grow a vaccine for a common-cold-like virus, which he’d injected—along with bits of HeLa—into more than four hundred people. Yet no one knew whether a person could actually catch cancer from HeLa or other cancer cells.

“There is the possible danger,” Southam wrote, “of initiating neo-plastic disease by accidental inoculation during laboratory investigation, or by injection with such cells or cell products if they should be used for production of virus vaccine.”

Southam was a well-respected cancer researcher and chief of virology at Sloan-Kettering Institute for Cancer Research. He and many other scientists believed that cancer was caused by either a virus or an immune system deficiency, so Southam decided to use HeLa to test those theories.

In February 1954, Southam loaded a syringe with saline solution mixed with HeLa. He slid the needle into the forearm of a woman who’d recently been hospitalized for leukemia, then pushed the plunger, injecting about five million of Henrietta’s cells into her arm. Using a second needle, Southam tattooed a tiny speck of India ink next to the small bump that formed at the HeLa injection site. That way, he’d know where to look when he reexamined the woman days, weeks, and months later, to see if Henrietta’s cancer was growing on her arm. He repeated this process with about a dozen other cancer patients. He told them he was testing their immune systems; he said nothing about injecting them with someone else’s malignant cells.

Within hours, the patients’ forearms grew red and swollen. Five to ten days later, hard nodules began growing at the injection sites. Southam removed some of the nodules to verify that they were cancerous, but he left several to see if the patients’ immune systems would reject them or the cancer would spread. Within two weeks, some of the nodules had grown to two centimeters—about the size of Henrietta’s tumor when she went in for her radium treatments.

Southam eventually removed most of the HeLa tumors, and those he didn’t remove vanished on their own in a few months. But in four patients, the nodules grew back. He removed them, but they returned again and again. In one patient, Henrietta’s cancer cells metastasized to her lymph nodes.

Since those patients had all had cancer to begin with, Southam wanted to see how healthy people reacted to the injections, for comparison’s sake. So, in May 1956, he placed an ad in the Ohio State Penitentiary newsletter:
Physician seeks 25 volunteers for cancer research
. A few days later he had ninety-six volunteers, which quickly increased to 150.

He chose the Ohio prison because its inmates had cooperated in several other studies without resistance, including one in which they’d been infected with a potentially deadly disease called tularemia. Research on inmates would come under scrutiny and start being heavily regulated about fifteen years later, because they’d be considered a vulnerable population unable to give informed consent. But at the time, prisoners nationwide were being used for research of all kinds—from testing chemical warfare agents to determining how X-raying testicles affected sperm count.

Southam began injecting prisoners in June 1956 using HeLa cells that his colleague, Alice Moore, carried from New York to Ohio in a handbag. Sixty-five prisoners—murderers, embezzlers, robbers, and forgers—lined up on wooden benches for their injections. Some wore white hospital garb; others came off work gangs wearing blue dungarees.

Soon tumors grew on the prisoners’ arms just as they’d grown in the cancer patients. The press ran story after story about the brave men at the Ohio Penitentiary, praising them as “the first healthy human beings ever to agree to such rigorous cancer experiments.” They quoted one man saying, “I’d be lying if I said I wasn’t worried. You lie there on your bunk knowing you’ve got cancer in your arm. … Boy, what you think about!”

Again and again reporters asked, “Why did you volunteer for this test?”

The prisoners’ replies were like a refrain: “I done a girl a great injustice, and I think it’ll pay back a little bit what I did to her.”

“I believe the wrong that I have done, in the eyes of society, this might make a right on it.”

Southam gave multiple cancer cell injections to each prisoner, and unlike the terminally ill patients, those men fought off the cancer completely. And with each new injection, their bodies responded faster, which seemed to indicate that the cells were increasing the inmates’ immunity to cancer. When Southam reported his results, the press hailed them as a tremendous breakthrough that could someday lead to a cancer vaccine.

In the coming years, Southam injected HeLa and other living cancer cells into more than six hundred people for his research, about half of them cancer patients. He also began injecting them into every gynecologic surgery patient who came to Sloan-Kettering’s Memorial Hospital or its James Ewing Hospital. If he explained anything, he simply said he was testing them for cancer. And he believed he was: Since people with cancer seemed to reject the cells more slowly than healthy people did, Southam thought that by timing the rejection rate, he might be able to find undiagnosed cases of cancer.

In a statement he’d later repeat again and again during hearings about his research, Southam wrote, “It is, of course, inconsequential whether these are cancer cells or not, since they are foreign to the recipient and hence are rejected. The only drawback to the use of cancer cells is the phobia and ignorance that surrounds the word
cancer
.“

Because of that “phobia and ignorance,” Southam wrote, he didn’t tell patients the cells were cancerous because he didn’t want to cause any unnecessary fear. As he would say, “To use the dreaded word ‘cancer’ in connection with any clinical procedure on an ill person is potentially deleterious to that patient’s well-being, because it may suggest to him (rightly or wrongly) that his diagnosis is cancer or that his prognosis is poor. … To withhold such emotionally disturbing but medically nonpertinent details … is in the best tradition of responsible clinical practice.”

But Southam wasn’t their doctor, and he wasn’t withholding upsetting health information. The deception was for his benefit—he was withholding information because patients might have refused to participate in his study if they’d known what he was injecting. And Southam probably would have continued doing this for years had he not made an arrangement on July 5, 1963, with Emanuel Mandel, director of medicine at the Jewish Chronic Disease Hospital in Brooklyn, to use the hospital’s patients for his research.

The plan was that Mandel would have doctors on his staff inject twenty-two JCDH patients with cancer cells for Southam. But when he instructed his staff to give the injections without telling patients they contained cancer cells, three young Jewish doctors refused, saying they wouldn’t conduct research on patients without their consent. All three knew about the research Nazis had done on Jewish prisoners. They also knew about the famous Nuremberg Trials.

     
S
ixteen years earlier, on August 20, 1947, a U.S.-led international war tribunal in Nuremberg, Germany, had sentenced seven Nazi doctors to death by hanging. Their crime was conducting unthinkable research on Jews without consent—sewing siblings together to create Siamese twins, dissecting people alive to study organ function.

The tribunal set forth a ten-point code of ethics now known as the Nuremberg Code, which was to govern all human experimentation worldwide. The first line in that code says, “The voluntary consent of the human subject is absolutely essential.” The idea was revolutionary. The Hippocratic Oath, written in the fourth century BC, didn’t require patient consent. And though the American Medical Association had issued rules protecting laboratory animals in 1910, no such rules existed for humans until Nuremberg.