A review of “The Immortal Life of Henrietta Lacks,” by Rebecca Skloot, and some personal observations on the HeLa cell line

A few months ago, I found the book, The Immortal Life of Henrietta Lacks, by Rebecca Skloot, on the New Releases shelf of a local bookstore. Interestingly, it’s become a best seller. The book tells the story of the derivation of the most important cell line in biological sciences, HeLa. What interested me was not that the book was written—the story needed to be told, and it’s important it didn’t come out in bits and pieces—but that it achieved such a popularity. An auspicious beginning for a popularly-oriented book about a scientific subject. Perhaps we need more of them. As a virologist whose professional career was dedicated to elucidating the details of the lives of viruses, and familiar with HeLa cells, I was drawn immediately to the book. I grabbed it, thumbed through it, and took it home.

The book tells the story of how HeLa cells got their start. Taken from the cervical carcinoma of a black woman, Henrietta Lacks, (the name of the cells was derived from the first two letters of her first and last name) who grew up in the tobacco-farming region of southern Virginia, and later moved to an industrial suburb of Baltimore, the cells were put into culture (that is, grown in a glass vessel) in the lab of Dr. George Gey at Johns Hopkins Medical School in Baltimore in the early 1950s. They were the first human cell line to grow well in culture, and in the ensuing 60 years, they’ve been distributed to laboratories all over the world.

The book is well-written and a good read, but it isn’t a textbook, nor should it be treated as an objective account. Written more as an odyssey, Ms. Skloot puts herself immediately in the picture: she details her discovery of the cells, her fascination with the donor of the cells through the name, her research for the story, and meeting the family of Ms. Lacks, particularly her daughter, Deborah. It’s a personal account; a memoir if you will.

The cervical carcinoma of Henrietta Lacks is frequently described as “aggressive” or “fast-growing,” or some other similar term, and it is that vitally important characteristic of the cells that is the driving force behind this story. The tumor took the life of Ms. Lacks within a few months of diagnosis, even in the face of heavy radiation treatment at Johns Hopkins. But those aggressive cells also formed the basis of an industry and gave the world an important tool for medical research, a tool that continues to be used today. Many other “aggressive” cells, invariably derived from tumors, have been put in culture since then, but HeLa was the first, and the most important.

The cells were taken during a gynecological exam without Henrietta Lacks’s permission. Back in the 50s, the ethics of doing scientific research on materials taken from patients wasn’t well developed, and removing something in that manner was deemed perfectly acceptable. Johns Hopkins didn’t violate any laws, and didn’t pay the Lacks family for the cells. Neither has any company which made money and established a reputation selling the cells. Parenthetically, I find it interesting that the New York Times Book Review chooses to emphasize this aspect of the story in its one-sentence summary in its Best Seller listings. Had I written that sentence, I would be much more inclined to emphasize the importance of the cells to medical research.

And that’s really the crux of the story of HeLa cells. Their importance to medical research can’t be overestimated. (Sorry. I hate to use clichés, but that one fits.) The cells have been used in so many different phases of medical research, I couldn’t list them here even if I knew all of them. Many are discussed in the book.

I worked with HeLa cells several times in my career. This isn’t unusual; virtually every virologist on the face of the planet has. Viruses can grow only in living cells, and HeLa cells, being so well-known and easy to work with, were a natural to use to grow viruses almost as soon as they became available. The first time I worked with them was in the early 60’s as a college undergraduate in a course on “tissue culture.” (It was called “tissue culture” then, but it’s more accurate to call it “cell culture.” Culturing tissues is a different matter.) At that time, the HeLa cell line was about 10 years old and well established in the scientific community. Cells become a “cell line” when they grow and grow and grow and take on a life of their own. We made our own liquid culture medium then, but now you can buy it from several manufacturers. All we had to do was take some cells from one flask, plop them into another flask, and they’d grow. Then, a few days later, after they’d formed a single layer of cells over the bottom of the flask, we’d go through the same process and make more flasks. As cell culture goes, that’s about as simple as it gets. I used to joke that we could spread HeLa cells out on a desk top and they’d grow.

Since then, I’ve used HeLa cells in several different research applications: clinical, to isolate viruses from patients, environmental, to grow viruses that are transmitted by water and sewage, even in AIDS research. You just can’t get away from them. They’re everywhere.

Back when I started working with them, we didn’t know the real name of the person from whom the cells had been taken. Ms. Skloot goes into exceptional detail about the name, how it developed, and the other fictitious names, all He__ La__ based, that were put forward. (Spawned a lot of tasteless jokes, too.) The most common name we heard was that of Helen Lane, a name apparently devised by Dr. Gey, perhaps to deflect attention from the real person. At the time, we believed it. Other names also drifted in and out of fashion, including the story (now obviously apocryphal but totally unbelievable even then) that he’d named the cells after his “favorite” actress, Hedy Lamarr. Dr. Gey deserves credit for devising a fictitious name, a small, though insufficient attempt at confidentiality and a faint stab in an ethical direction, but in today’s research milieu, cell lines shouldn’t be named after the donor. Just a number, or perhaps a descriptive appellation should be sufficient.

But, at the same time, that name—HeLa—devised according to a simple formula and dropped so casually into the lexicon of scientific research, has now become a password into a far larger world of biological and molecular research than anyone in Dr. Gey’s lab could ever have imagined at the time. It’s a catchword for so many things, things that have gone right, and ethical considerations that have gone powerfully wrong. But it’s a name we can hold onto, a name that satisfies our cell-phone-text-based need for a short, one word summary of the entire picture. HeLa. Could anything be simpler?

Another interesting point: if Dr. Gey hadn’t given the cells a designation based on the patient’s name, would we have this story at all? I wonder if her name would be lost by now.

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