FAQ
For Rebecca Skloot’s answers to frequently asked questions about her book,The Immortal Life of Henrietta Lacks, check out the numerous radio and television interviews available on the Press coverage page of this site.
Here you will find a list of the most commonly asked questions and answers about writing, the Lacks family, the science of HeLa cells, The Immortal Life, and more. Questions have been gathered into categories to make it easy for you to find the information you’re looking for – see table of contents below. This page will be periodically updated with new reader questions and Rebecca Skloot’s answers.
Have a Question? Use This Table of Contents to Help You Find the Answer:
On The Immortal Life of Henrietta Lacks:
Yes. Oprah Winfrey and Alan Ball will be producing the film version of The Immortal Life for HBO. I’m a consultant on the film, as is the Lacks family, which they’re very excited about. Learn more about the upcoming film. Harpo and HBO plans to go into production for the film within the next year; so far no actors have been cast – as soon as they are, that information will be posted here.
The combination of Oprah, Alan Ball and HBO is a dream team for me. I’ve always been a huge fan of everyone involved, and I think HBO is the perfect home for this movie. Several people have asked why I went with HBO instead of a big screen major motion picture version, and there are several reasons. HBO makes some of the best and smartest movies out there these days, particularly when it comes to complex true stories that mix science, ethics, and real human stories. It was very important to me that the film find a home that would do justice to the family’s story, the science, and the scientists — I have no doubt HBO, Oprah, and Ball will do just that. I’m very excited for it.
This is the story of how cells taken from a black woman without her knowledge became one of the most important advances in medicine and launched a multibillion-dollar industry, with drastic consequences for her family. It’s inextricably linked to the troubling history of research conducted on African Americans without their consent, and many people—particularly African Americans—are hungry to learn Henrietta’s story and how it fits into that history.
For decades, the story of Henrietta Lacks and the HeLa cells has been held up as “another Tuskegee,” the story of a racist white scientist who realized a black woman’s cells were valuable, stole them from her, then got rich selling them—perhaps even withholding treatment for her cancer in order to be sure the cells would grow. But none of that is true. Henrietta got the standard cervical cancer treatment for the day, and no one knew her cells would be valuable. George Gey gave them away for free and never profited directly from them (they were later used commercially by others). In 1951 when Henrietta showed up at Hopkins, taking tissue samples from patients without consent had been standard practice for decades. Henrietta’s cells were taken as part of a study on cervical cancer for which researchers were taking samples from any woman who walked into Hopkins with cervical cancer, regardless of race. Henrietta wasn’t targeted because her cells were known to be valuable, or because they were trying to grow cells from a black person. Gey didn’t even know she was black until after the cells grew.
That said, race did play an important role in the story: During the Jim Crow era, Hopkins was a segregated charity hospital—patients in the “public” ward where Henrietta was treated were there because they were either black or poor (often both). They couldn’t get treated elsewhere. And the prevailing attitude then was that since “charity cases” were treated for free, doctors were entitled to use them in research, whether the patients realized it or not. Henrietta’s doctor once wrote, “Hopkins, with its large indigent black population, had no dearth of clinical material.” That attitude was widespread at the time.
But this story is just as much about issues of class and economic injustice. Many people have asked me, “Would those cells have been taken from her if she’d been white?” The answer is yes, if she’d been white and poor. Many of the difficulties Henrietta’s family faced came down to issues of class: their lack of access to education; their inability to afford health care despite the fact that their mother’s cells helped lead to so many important medical advances. The Lacks family often says, “If our mother was so important to medicine, why can’t we get health insurance?” That question gets at the heart of what many readers find most upsetting about the Lacks family’s story.
Some of that depends on each individual reader, because there are a lot of potential messages from the book: it’s about trust, race and medicine, class, access to education and health care, it’s also the story of a family and the impact that losing a mother can have on her children, and much more.
It’s also about the fact that there are people behind every one of the billions of biological samples that are used in research every day. I can’t count the number of e-mails I’ve gotten from researchers who say that they heard me talking on the radio or read the book and had this very powerful reaction of saying “Oh wow, I had no idea. I did my dissertation on HeLa cells, I work with them every day in my lab—I owe a lot of my career to Henrietta’s cells, and I never once stopped to think about where they came from, whether she had given consent, or whether her family might care about that.” These are questions that scientists don’t often think about. I also hear researchers saying that after learning the story of the HeLa cells, they no longer complain about the regulation of science and the mountains of forms they have to fill out for every study they want to do. In the book, you find out the history behind those forms, why they’re now required, and why it is important. Those are crucial take-home messages.
But this is also a story about the fact that there are human beings behind every biological sample in a laboratory, and behind every scientist as well. The scientists in the HeLa story have long been demonized in ways that weren’t factually accurate, so I hoped to set that record straight.
About The Lacks Family:
Henrietta’s children and grandchildren read The Immortal Life of Henrietta Lacks before it came out as part of the fact-checking process. They were very happy with it—they didn’t object to any information in the book or ask me to remove or change anything, other than pointing out some dates or other small factual things that needed fixing. Some of the story is still painful for Henrietta’s children, but they’re pleased that the story is out there getting a wide public response; they’re also happy to know about the amazing science that Henrietta’s cells contributed to, which they are very proud of. For the younger generations of Lackses, it was a way to learn about their history: Their family didn’t talk much about what happened to Henrietta or her children. So the younger generation knew little about Henrietta and the cells. They didn’t know what Henrietta had contributed to science, or what her children went through in the process.
The Lacks family often comes to public events where I speak about the book — sometimes they just sit quietly in the audience and listen, other times they answer questions or give talks themselves. They also travel extensively now giving talks of their own. Without fail audiences greet Henrietta’s family with cheers and standing ovations. They thank Henrietta’s family for her contributions to science and share stories of how they personally benefited from her cells. They say things like, “I’m alive today because of a cancer drug Henrietta’s cells helped develop.” Scientists often stand up saying, “Here’s what I did with your mother’s cells, and thank you, I’m sorry that this has been hard for you and that no one told you what was going on.” Scientists and general readers stand in long lines waiting for their autographs. I believe that the enormous public response to the book has been positive for the family, that there’s been some healing through that process for them. But they are still struggling financially as portrayed in the book and hope that will change.
The family has benefited from the book in several different ways, including the closure I mentioned above. When it came to money, I didn’t want to potentially benefit from the family and their story without doing something in return. So I set up The Henrietta Lacks Foundation, a 501c3 nonprofit charity, as a way I could give something back to the Lacks family and other similarly needy families, as well to encourage others to make similar contributions. I donate to the foundation from the proceeds of my book and related speaking events, as well as the film version of the book, in addition to my many other fundraising activities for the foundation. I run the foundation as its president as an unpaid volunteer. The foundation has been in existence since January 2010, and anyone can donate via The Henrietta Lacks Foundation’s website. We receive regular donations from the general reading public and individual scientists who feel that they have benefited from HeLa cells in some way and want to do something in return for the family.
Among other things, the foundation provides scholarship funds for descendants of Henrietta Lacks, so they can get the education that Henrietta and her family didn’t have access to. It also aims to help provide health care coverage for Henrietta’s children. So far the foundation has given out more than 28 grants to cover tuition and books for Henrietta’s grandchildren, great grandchildren, and great-great grandchildren who are now working toward high school, undergraduate, graduate, and trade degrees; also for medical and dental assistance. The foundation’s mission is to offer assistance to others in situations similar to the Lacks family as well. For more information, visit HenriettaLacksFoundation.org, or see this New York Times article about Rebecca Skloot’s efforts with the Henrietta Lacks Foundation and details of several of the grants given to date.
In addition to the funds the Lacks family has received from the foundation, Henrietta’s sons are paid consultants on the HBO film version of The Immortal Life, and they and other members of Henrietta’s family regularly appear as paid speakers at events related to The Immortal Life. If you would like to invite them to speak, or if you would like to invite me to speak, please e-mail the details of your request to Miriam Feuerle at Lyceum Agency: miriam [AT] lyceumagency [DOT] com, or call her at 503.467.4621.
This is the question I get more often than any other. The answer is that no research institutions, universities, or companies have given money to the Lacks family directly, and they likely never will. There is concern among research organizations that giving money to the Lacks family would set a legal precedent: If they pay Henrietta’s family for use of HeLa cells, what about the millions of other people whose cells and tissues have been used in research? Who pays them, and how much? One of my hopes in setting up the foundation was that some of those companies and research institutions might feel that donating to a foundation in Henrietta’s name would let them recognize her contribution to science and the impact it had on her family, without concern for setting a legal precedent. So far that hasn’t happened. You can hear me answer this and other related questions in more detail in numerous interviews on the Media page of this site, particularly the interview with Tavis Smiley.
Soon after the publication of The Immortal Life, Hopkins released this statement about Henrietta Lacks and the HeLa cells, which addresses questions about the cells being taken without consent and the fact that Hopkins did not financially benefit from the cells, but does not address the use of Henrietta’s children in research without consent, or the release of Henrietta’s medical records to the press. Hopkins has recently taken several steps to honor Henrietta’s contribution to science and further the public conversation about issues raised by the book: The entire entering freshman class at Hopkins in 2010 was required to read The Immortal Life for university-wide discussion. In addition, Hopkins launched an annual Henrietta Lacks Memorial Lecture Series, and established the Henrietta Lacks East Baltimore Health Sciences Scholarship to support promising graduates of Paul Laurence Dunbar High School. It is a $40,000 scholarship ($10,000 per year for up to four years) that will be awarded annually to one exceptional graduate who chooses to pursue a career in health or science, with hopes of educating and inspiring the next generation of physicians, nurses, scientists, and health science professionals. And The Johns Hopkins Urban Health Institute established The Henrietta Lacks Award for Community-University Collaboration, a $15,000 annual award recognizing outstanding collaborations that focus on objectives like poverty elimination, social justice, neighborhood redevelopment and community health and well-being. More information is available on Johns Hopkins’ website.
A group at Hopkins has also worked closely with the Lacks family and the Henrietta Lacks Foundation to ensure that members of Henrietta’s family get their healthcare needs taken care of.
The story of the HeLa cells isn’t just about cells being taken from a woman without consent. There’s much more to it: No one told her family that the cells existed until the ’70s, when scientists wanted to do research on her children to learn more about the cells. Her children were then used in research without their consent, and without having their most basic questions about the cells answered (questions such as, “What is a cell?” and “What does it mean that Henrietta’s cells are alive?”). This was very frightening, particularly for Henrietta’s daughter Deborah. The science all had a very scary sci-fi quality to it, so she had a very hard time distinguishing what was reality and what wasn’t when it came to science. She worried that there were clones of her mother walking around that she might bump into. And she worried that what the research scientists were doing to her mother’s cells somehow caused her mother pain in the afterlife. She’d say, “If scientists are shooting my mother’s cells to the moon and injecting them with chemicals, can she rest in peace?” For her, these existential questions were really difficult.
There were other things that the family found upsetting. At one point, Henrietta’s medical records were released to a reporter and published without her family’s permission, which was very traumatizing for her children. Henrietta’s sons particularly were very angry when they learned that people were buying and selling Henrietta’s cells, which helped launch a multibillion-dollar industry, yet her family had no money. To this day, they can’t afford health insurance.
The Lacks family has gotten to a point where they try to separate what happened with Henrietta’s cells from what happened to them. Henrietta’s cells have been this incredible benefit to science and her family really sees that as a miracle, and they are now able to say, “We think that they’re incredible, and they’ve done wonderful things and that makes us happy. We’re very glad that her cells are out there and being used in the way that they are. We wish it didn’t happen the way that it did. We wish they’d told us, we wish they’d asked, because we would have said yes. We wish they’d explained things to us when we asked, we wish they hadn’t released her medical records.” There were a lot of things the Lacks family were unhappy about in terms of the way that they were treated, but the way they think about the cells definitely does not reflect a feeling that Henrietta was being enslaved. It’s more a feeling of her being an angel. In life Henrietta was this woman who lived to take care of everybody, and so to the family it makes perfect sense that she’s doing that in death, too. They don’t see the cells themselves as a dark or negative thing.
That said, they are still quite upset about the issue of money and the fact that others have profited from the cells and her family hasn’t, which is still the case today. The Lacks family is still hoping that the many research organizations and companies that have profited from HeLa cells will do something to honor Henrietta and recognize what her family went through. See the earlier question above about the response from Hopkins and companies for more on that issue.
Dr. Roland Pattillo, a professor at Morehouse School of Medicine and his wife, Pat, bought a marker for Henrietta’s grave on May 29, 2010. There was a beautiful unveiling ceremony that was attended by the Lacks family. Please read a beautiful post by scientist David Kroll, who also attended the ceremony. His post is filled with beautiful photos of the day and a tribute to all Henrietta’s cells did for science.
On Writing The Immortal Life of Henrietta Lacks:
The prologue of the book tells the story of how I learned about Henrietta’s cells for the first time when I was sixteen, but it doesn’t really go into why that story grabbed me to the extent that it did. I think that’s because it wasn’t until after the book was published that I began to understand why the story had such an impact on me. When I first learned about Henrietta’s cells in Mr. Defler’s biology class, the first questions I asked him were whether she had any children, what they thought about Henrietta’s cells living on all these years after her death, and what did the fact that she was black have to do with it all?
I realize now that my questions weren’t obvious ones for a sixteen-year-old to ask, but something was happening in my life that I think primed me to ask questions about the cells. That same year, my father had gotten sick with a mysterious illness no one was able to diagnose. He’d gone from being my very active and athletic dad to being a man who had problems thinking, and he spent all of his time lying in our living room because he couldn’t walk. It turned out that a virus had caused brain damage, and he eventually enrolled in an experimental drug study. Since he couldn’t operate a car, I drove him to and from the hospital several times a week and sat with him and many other patients as they got experimental treatments. So I was in the midst of watching my own father go through research and was experiencing the hopes that can come from science, but also the frustration and fear. It was a frightening time, the research didn’t help him, and in the end the study was dissolved without fulfilling promises it made to the patients about access to treatment. The experience really taught me about the wonder and hope of science, but also the complicated and sometimes painful ways it can affect people’s lives.
I was in the middle of that experience when my teacher mentioned that Henrietta’s cells had been growing in labs decades after her death. So I asked the questions I did because I was a kid wrestling with watching my own father being used as a research subject. But I couldn’t shake the questions Henrietta’s cells raised in my mind, and nearly a decade later when I took my first writing class, my curious obsession with Henrietta was the first thing I wrote about.
I fought against being in the book for years. Part of how I won the trust of the family was by telling Henrietta’s daughter Deborah that she could come with me when I did my research, that I would teach her about her mother and the HeLa cells. So we spent a lot of time traveling together. When I came home from reporting trips filled with stories about my time with the Lacks family, my agent, friends, editor, and family all had the same reaction: They’d say, “You have to put that in the book, because the family’s response to you is part of the story—it shows how deeply they’ve been affected by Henrietta’s cells and their legacy.” Deborah Lacks eventually started saying the same thing (she’d sometimes shake her fist at me and say, “Don’t you make me be in that book by myself! You’re part of the story now too—Henrietta’s gonna get mad and come get you if you try to leave yourself out of there!”). But I still resisted for years, saying, “I don’t belong in this story—it’s the Lacks family’s story, not mine.”
I teach writing, and I always harp on my students, telling them, “stop inserting yourself into other people’s stories.” But eventually it became clear to me that part of the Lacks family story was about the many people—scientists, con artists, journalists, you name it—who had come to them over the years wanting something from them related to the HeLa cells. Without realizing it, I had become a character in the Lacks family’s story, because I was another one of those people. I was a reporter who’d impacted Deborah Lacks’s life in many direct ways, putting her into situations—like visiting laboratories at Hopkins and the institution where her sister died—that she wouldn’t have otherwise been in, sometimes in ways that proved very difficult for her. In the end, I realized it would be dishonest of me to leave myself out of the book. It wasn’t about me inserting myself into their story, it was about admitting that I had become a character in their story without realizing it. It was, in a sense, disclosure. But I always held on tight to the knowledge that it was their story, and I tried to write it accordingly.
In terms of when I realized I had to be in the story: It happened as a result of a scene (now in the book) in which Deborah nearly had a stroke from some particularly traumatizing information, and one of her cousins spontaneously performed something that looked a lot like an exorcism in an attempt to physically transfer the psychic burden of the cells from Deborah into me.
It’s amazing and it’s exhausting to work on a book over such a long period. One of the things people often ask me is, “Don’t you wish you had done this faster? Why did it take so long?” Reporting a story for so long changes your understanding of it. If I had written this book five years ago, it wouldn’t have worked. I wouldn’t have understood the story the way I came to—it’s a complicated story with many different threads, and it’s one that has historically been told in a way that demonized science. I really wanted to tell all sides of the story in a balanced way, so I spent extensive time researching the science and the scientists, and the evolution of bioethics, as well as Henrietta, her cells, and her family.
The book traces so many different narratives, it was a logistical and organizational nightmare. Just the sheer volume of material was overwhelming to sort through—if you go onto a scientific database and type the word “HeLa,” it’s like typing “and” in Google: you get thousands and thousands of hits, because there are so many research papers done with HeLa cells. Trying to sort out from that what was essential took a lot of time. Then organizing it all into a larger narrative was another challenge. I used a large wall with index cards and corkboards.
The other big reason it took ten years to write was the challenge of winning the trust of the Lacks family, which became part of the story, as I discuss below. When I started working on this book, I thought it was going to be a story about HeLa cells and the woman behind them. I had no idea that it would also become a book about the impact those cells had on her family.
It was never a question for me whether I’d do it. The idea of taking and rewriting someone’s language was just so wrong to me, and inaccurate—rewritten quotes aren’t what they said. And the family’s language is so much a part of who they are. They have beautiful ways of talking about things. Here’s one example that stands out for me: a cousin of Henrietta’s was describing one of Henrietta’s young love interests, a big, burly guy, and she said he’s “an over-average man.” It’s so perfect, and it’s something I never would have come up with myself as a description. Changing it would have only weakened its descriptive and poetic power.
I asked one of Henrietta’s cousins what she thought about me using the family’s dialect in the book and she said to me, “If you pretty up how people spoke and change the things they said, that’s dishonest. It’s taking away their lives, their experiences, and their selves.” I agree with that.
On The Science of HeLa Cells, Tissue Research, and Ethics:
Since the ’50s, if researchers wanted to figure out how cells behaved in a certain environment, or reacted to a specific chemical, or produced a certain protein, they turned to HeLa cells. They did that because, despite being cancerous, HeLa still shared many basic characteristics with normal cells: They produced proteins and communicated with one another like normal cells, they divided and generated energy, they expressed genes and regulated them, and they were susceptible to infections, which made them an optimal tool for synthesizing and studying any number of things in culture, including bacteria, hormones, proteins, and, especially, viruses.
Viruses reproduce by injecting bits of their genetic material into a living cell, essentially reprogramming the cell so it reproduces the virus instead of itself. When it came to growing viruses—as with many other things—the fact that HeLa was malignant just made it more useful. HeLa cells grew much faster than normal cells, and therefore produced results faster. HeLa is a workhorse: It’s hardy, it’s inexpensive, and it’s everywhere. Today, it’s even possible for scientists to genetically alter HeLa cells to make them behave like other cells—a heart cell, for example. So being cancer cells isn’t the limitation most people expect that it would be, though there are some things you definitely wouldn’t use HeLa cells for, including any vaccine creation, since you wouldn’t want to inject cancer cells along with a vaccine.
In the 1950s when Henrietta’s cells grew, the concept of informed consent that we have today didn’t exist. People were routinely used in research without their knowledge. Scientists knew very little about the basic functioning of cells—they couldn’t have imagined that someday those cells would be valuable, that someday researchers could look inside them at Henrietta’s DNA and learn things about her and her children and grandchildren. It was a completely different mind-set than the one we have now, but it was not ill-intended or unethical by the standards of the day. George Gey, the scientist who first grew the cells, was devoted to curing cancer. He took cells from himself and his own kids. He never sold the HeLa cells, he never tried to patent them or anything else, including equipment he invented that’s still used around the world that could have made him large amounts of money. Gey was pretty impoverished, but he spent his own money in the lab. Taking cells from patients was absolutely standard practice worldwide in the ’50s. In many ways, it still is today.
The scientific community has been very open to learning the story of the HeLa cells. I think the general public often thinks that scientists feel there was something to hide in the story, but that’s not the case at all. I often hear from scientists who are very happy that this story is out there and being discussed.
No, nothing has formally changed in terms of the regulation of tissue research, but there is much more public awareness of the fact that research happens on tissues without consent, and there’s a public discussion about this on a much larger scale than has happened before. There also does seem to be a shift happening in the way questions about tissue-research ethics are being handled.
It’s important to be clear about the type of tissue research that does and does not require consent: If a researcher takes tissues specifically for research and the “donor’s” name is attached, federal law requires that researcher to get informed consent from the donor. But if the tissue is taken for some other purpose—a routine biopsy, or a fetal blood test—as long as the patient’s identity is removed from the sample, consent isn’t required to use the leftover tissue for research. You can read about the legal debate surrounding tissue research and the current state of the laws regarding consent and disclosure of possible commercial benefit in this New York Times Magazine story, in which I wrote about many of the legal cases mentioned in the book.
Several of those legal cases were still pending when the book was published—some of those have since been ruled on in ways that indicate the courts are leaning toward requiring consent. But as of the publication of the paperback edition of The Immortal Life of Henrietta Lacks, there have been no changes in the laws governing tissue research; so as of today there is still no requirement for consent for most tissue research, and the law as I described it in the book’s Afterword is still in place. You can learn more about one of these recently settled cases, involving the Havasupai tribe, and hear Rebecca discuss the status of these laws in this PBS segment below.
On Writing and Publishing:
And the tour more than lived up to my expectations. Everywhere I go, events have been standing room only. People come who have read the book and people come who haven’t, and they all have questions and we’re talking about the stuff that, when I wanted to write the book, I wanted to get out, to tell her story and spur conversation about all this. It’s exhausting, but it’s so exciting at the same time.
For Students and Educators:
I suggest that anyone considering adopting the book for classroom or university-wide use visit the First Year Experience (FYE) page of this site to see information and comments from other schools that have adopted The Immortal Life. So far more than 60 schools have adopted it as their common read, and I hear amazing responses from students. I think one of the things that really makes The Immortal Life powerful for students is that the story is so personal for them. Everyone in the world has benefited personally from HeLa cells in some way, and there’s always a point in the book when readers realize this, whether it’s because they’ve gotten vaccines developed using HeLa cells, were conceived through IVF, or any number of other things. Students often tell me that their mother or father is alive because their cancer was treated with a drug made using HeLa cells … that they didn’t lose their parents in part because Deborah and her siblings lost their mother, and the world benefited from that. You can see a video on the above-mentioned FYE page of this site with students talking about their responses to the book.
I also suggest that anyone considering adopting the book visit the Teaching page of this site to see the many educational resources available to accompany it, as well as photos of students interacting with me and the book and with the Lacks family (who often come to school events with me or solo), and quotes from teachers about their experiences with it.
Writing and Speaking:
Because of the large volume of speaking requests I get, I am not able to visit book groups in person or by phone or Skype, though I appreciate the interest. Please see the many resources on the Reading Group page of this site for enriching your discussions, including a reading group guide, links to videos of me answering frequently asked questions about the book, and links to a special features page, with audio and video footage related to the book (including actual recordings of scenes you read about in the book so you can hear the characters’ voices and scenes as they unfolded).
I do travel extensively to speak at schools, conferences, and other events world wide, and most of those events are open to the public. You can visit the Events page of this site to see if I’m speaking in a town near you.
If you would like to invite me to speak, please e-mail the details of your request to my speaking agent, Miriam Feuerle at Lyceum Agency: miriam [AT] lyceumagency [DOT] com, or call her at 503.467.4621.
If You Still Have Questions:
The Henrietta Lacks Foundation
The Henrietta Lacks Foundation strives to provide financial assistance to needy individuals who have made important contributions to scientific research without their knowledge or consent.
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