Race Gender Class Medicine Capitalism
As invaluable as HeLa cells are to biomedical progress, Lacks’s story also raises questions about privacy, consent, and inequality in medicine.
WHO TELLS OUR STORIES?
“The stories about Lacks and her cells illustrate the inextricability of medical scientific research from social existence as well as cultural production, economics, law, religious beliefs and practices, geopolitics, and pretty much any other aspect of human experience we can think of,” Priscilla Wald, American Quarterly.
In February 1951 an African American woman named Henrietta Lacks Hospital. She did not know that the symptoms that had brought her there signaled an exceptionally aggressive cervical cancer or that the mutating cells that were killing her would enable one of the most significant developments in twentieth-century medical science. Lacks had surgery, and, consistent with contemporary practice, her cells were sent to researchers in the hospital. She had not signed a consent form, but at the time such forms were not conventional; her cells were fair game for the researchers. As it happened, the unusual robustness of these cells enabled them to survive and reproduce in a petri dish. It was the breakthrough for which the medical researchers George and Margaret Gey had been waiting.
This immortal cell line, which they labeled HeLa for the "donor" from whom the cells had come, allowed for unprecedented experimentation. HeLa cells were instrumental in the development of the polio vaccine; they allowed scientists to study the effects of space travel and radiation exposure, and they have been used in medical research for diseases such as HIV. Anyone working in a biology lab for the past half-century is likely to have worked with, or at least encountered, some incarnation of HeLa cells, yet in 1951 they were the material of an unprecedented biological entity produced in a laboratory.
WHAT MAKES CELLS IMMORTAL?
THE UNRESOLVED QUESTIONS IN THE LACKS CASE INVOLVES DEFINITIONS:
WHAT IS A CELL LINE?
WHAT IS A CELL LINE'S RELATION TO THE HUMAN DONOR?
The creation of an immortal human cell line (cells that can survive and reproduce outside the human body) was an important advance for scientific medicine. But it raised legal and ethical questions for which there were not yet answers. Three decades after the creation of the HeLa cell line, the courts tried to resolve that question in a landmark legal case involving the Mo cell line, named for John Moore, a white man whose cells, like Lacks's, were discovered to have unusual properties and were therefore converted into a cell line. Unlike HeLa, the Mo cell line was patented, and the researcher and the hospital profited from it. Moore had not been informed about the worth of his cells and had not consented to their use, and he sued the hospital and the researchers. The case turned on the question of the ownership of the cells, and, despite going through several courts, that question remains fundamentally unresolved. Efforts to resolve it have manifested profound anxieties surrounding the definitions of life and of the human that rapid advances in biotechnology have amplified.
WHAT IS HUMAN?
WHAT DOES IT MEAN TO DEVELOP LABORATORY TECHNIQUES THAT INVOLVE THE PRODUCTION, USE, AND MARKETING OF LIVING ORGANISMS?
The new life form that the Geys brought into existence in their tissue culture laboratory, a converted janitors' quarters in the hospital, summoned the possibilities and dangers of human beings tampering with the essence of life forms that had long intrigued the literary imagination, from Mary Shelley's Frankenstein to Nathaniel Hawthorne's "Rappaccini's Daughter" and beyond. It raised the specter of the slippery definitions of life and the human and the long history of abuses that relied on and amplified that slipperiness.
In the wake of World War II, rapid technological advances in such areas as cybernetics, robotics, neuropsychology, and genetics all challenged conventional biological definitions of "the human," while political theorists as diverse as Hannah Arendt and Frantz Fanon observed how readily human beings could be deprived of their status as human along with their allegedly natural rights. Both returned to eighteenth-century ideas about natural rights to make sense of what they saw as the failure of human rights. Grounding rights in nature rather than historical precedent represented, for Arendt, an abnegation of human agency and responsibility. The category of "displaced persons" in the years after World War I dramatized the contingency of natural (or human) rights and dignity on the nation-state. There was nothing "natural" about rights, and the terrible lesson embodied by displaced persons was that "the world found nothing sacred in the abstract nakedness of being human." The systematic and dehumanizing violence of the Nazi camps followed logically from that recognition.
THE HELA CELLS CIRCULATED WIDELY.
SO DID STORIES OF THEIR CREATION AND DONOR.
George Gey worked to safeguard Lacks's privacy, but in 1966 Stanley Gartler, a geneticist working with cell lines, discovered that the unusually robust HeLa cells had contaminated other cell lines. Genetic differences offered a way to distinguish among cell lines, so he queried Gey about the donor's identity and racial background. His contention got considerable attention among scientists when he publicly announced his findings at a 1967 conference, because the contamination of cell lines potentially invalidated the results of scores of experiments, involving years of research and billions of dollars. A 1971 article in the Journal of Obstetrics and Gynecology, with the gynecologist who had treated Lacks as the lead author, identified her in print, and when the geneticist Walter Nelson-Rees began to publish lists of contaminated cell lines, beginning with a 1974 Science article, the mainstream media increasingly picked up the controversy, making HeLa's donor widespread public knowledge by the mid-1970s.
The identification of the donor of the cell line resulted in an anthropomorphizing of the cells that made apparent the anxious efforts to comprehend this new life form as well as the cultural biases that structured those efforts. HeLa cells were "surreptitiously . . . taking over cultures and laboratories here and abroad," capable, because of their virulence, of '"taking over the world'" if "'allowed to grow uninhibited.'" How, wondered one journalist, "did this HeLa cell become a monster amidst the Pyrex?" Implicitly answering his own question, he notes, "In life, the HeLa source had been black and female. Even as a single layer of cells in a tissue culture laboratory, she remains so" and explains that "a chart listing the genetic markers of the whole Lacks family—will be used worldwide in something of a laboratory manhunt to track down renegade HeLa cultures.” The cell that had been so useful in scientific research is now "on the wanted list and the charge is interfering with the orderly progress of science.” Articles routinely proclaimed the "immortality" of the young mother from Baltimore. As one headline announced, "She's dead—but her cancer cells live on," and the article describes how "Mrs. Lacks' body grew wildly in Dr. Gey's culture test tubes."
GENDER + RACE
Henrietta Lacks adds human drama and poignancy to the story of the creation of the cell line, but each new telling of the story has reanimated the cells. A review of Michael Gold's 1986 Conspiracy of Cells, for example, describes how "a living legacy from a Baltimore woman who died of cancer" strangely "impeded" the "laudable aims in the early 1970s [of] detente with the Soviet Union and the conquest of cancer." And a 1997 documentary about Lacks and the creation of the HeLa cell line elicited a flurry of journalistic commentary that showed how a racialized, gendered, and sexualized characterization of the cell line dovetailed with the prevailing Cold War terms of political demonization. "In the 1960s, the cells became the enemy within," as one reviewer observes, "contaminating every other cell [line] in America and effectively wasting four years and billions of dollars in research. In the 1970s, Hela got into espionage, infiltrating the Soviet Union and destroying its cancer research too."
Another recounts how a researcher discovered the contamination of cell lines he had purchased from the Soviet Union and notes that "Henrietta had got through the Iron Curtain by infecting other lines.... ultimately Henrietta has defeated the scientists who used her." And a third quips, "Scientists call them HeLa cells. Non-scientists call them She. . . . She was an invaluable lab animal. And she escaped. Extraordinarily virulent, invasive, and vigorous, the HeLa cells reached and ruined scientific experiments from America to Russia. (You would swear she had a sense of humour. Leonard Hayflick, testing his own baby's tissue, found a black enzyme. Mrs. Hayflick protested her innocence. It was Henrietta.)" These comments reproduce as they reflect on the continuing narrative in which the HeLa cells take human form as an insidious, conniving, promiscuous African American woman. Part human and part animal, the anthropomorphized cells also take the form of a spy with questionable Cold War allegiances—an American agent, perhaps, but not fully trustworthy because of "her" volatility. "She" defies control, as the traits of Lacks's malignant cells fuse with her racial identity, which make her national allegiances suspect. "She" even has a sense of humor that constitutes a threat to the white American family.