Tag Archives: medical research

Book Review: The Immortal Life of Henrietta Lacks by Rebecca Skloot

This was one of those books I just picked up almost at random as I was browsing round a Waterstones in Covent Garden one day. Having looked at the endorsements on the front cover, I was surprised as to why I hadn’t heard of it before. It seems to have garnered lots of praise and accolades yet I can’t recall a single reviewer ever mentioning it, nor had I seen it mentioned in the press. After buying it, it came back to mind recently when I noted it being mentioned in Adam Rutherford’s Creation.

What we have here is science told as a narrative. It is not only the narrative of the events and discoveries that were made, but also the narrative of the uncovering of the story. So while it starts out as a biography of Henrietta Lacks (prefaced by a personal story of how Skloot became interested in Henrietta) it expands its scope and becomes a part autobiography of Skloot’s battles to be able to tell Henrietta’s story, and that of her family.

Henrietta Lacks was a black American woman who died in 1954. The crux of the story is what happened shortly before she died. You see, she died young. She died of cancer. After her diagnosis a biopsy was taken from her cervix and the cells grown in culture. It is those cells that are the heart of the story. From here, we go back a short time and tell the story, as far as it is known of Henrietta’s life, growing up and getting married in the American state of Maryland.

The cells that were taken from her body were capable of being grown in a laboratory, something that scientists had been aiming for but had not been successful with. With these cells (named HeLa), it enabled labs across the world to be able to a variety of tests without doing them on living humans. After all, even though they were cancerous, they were still human cells and behaved as such. Skloot tells us the story of 20th century medicine from the cells’ point of view, both the good and the bad. Many of the greatest developments seen in the last 60 years have involved the HeLa cells in one way or another. Sometimes this was unintentional as it turns out that where other cells were grown in cultivation they were in fact contaminated by HeLa.

Coupled with this is the story of the Lacks family and their struggle to come to terms with Henrietta’s legacy. It was years before they even realised that her cells were being used for research purposes. When they did, this was around the time that details were emerging of the Tuskegee syphilis scandal where, if you’ve not heard it before (I confess I hadn’t), black people in America were deliberately infected with syphilis under the guise of free healthcare. So there was deep suspicion over what Henrietta’s cells were being used for and also who was profiting from them. Skloot’s role here was not only as someone researching a book but also of the one who helped the Lacks family, especially Henrietta’s daughter Deborah, understand what happened.

The book ranges over a number of diverse topics. One of those that I noted in particular was the development of medical ethics; not so much in theory, but the practice. For the descriptions (and yes, as a warning, they are quite graphic – particularly at the start of the book) may well strike you as particularly barbaric. The reason why this jars against a modern sensibility is that when the facts surrounding the lack of consent about what was done with Henrietta’s cells became more widely known within the medical community it spurred people into action.

As an aside, I encountered a slight confluence of issues as I read this, as I was also watching the American tv show, The Wire, during the same period of time as I was reading this (actually, I’ve been on The Wire all year; the book took about 3 weeks to read). But they are both predominantly based in the city of Baltimore and have a huge amount to say, in microcosm, of the state of racism in America in the last half a century or so.

One of the things that becomes clear, though whether this was the author’s intention, I’m not sure, was the sheer barbarism that still persists within what passes for a national healthcare service within America. One of the ongoing battles the Lacks has had, and a cause of their major gripes were that the vast leaps in scientific work as a result of Henrietta’s cells did not allow them the financial means to be able to pay for their healthcare. The USA remains a country so backwards that if you go to a hospital, they have the audacity to present you with a bill – which the rich usually pay for through insurance and the poor are made to go without. The concept of universal healthcare which is free at the point of need still hasn’t made the journey across the Atlantic.

The book has apparently become a standard text in some university courses on cell biology. That’s not because the science is overly technical, though what is there is excellently communicated, but because it is a story of one aspect of modern science that has rippled far beyond the Maryland origins of one bereaved family. C.P. Snow famously espoused the notion of the two cultures: humanities and sciences. Here, Skloot has woven the two together to make a fabric that is stronger than either and makes for a fabulous piece of writing. It is educating, enthralling and overall one of the best pieces of writing I have had the pleasure of reading. It was only because of the more immediate need to heed the words of Harry Leslie Smith that this missed out on being my top book of 2014.

Book Review: Stem Cells – A Very Short Introduction by Jonathan Slack

It feels like some time since I picked up one of the Very Short Introductions (VSI). This has, I think, been sat on my shelf for over a year now, as I plucked it off the shelf of one of my local bookshops with the simple thought, “I don’t really understand much about stem cells. I read about them in the news occasionally. Maybe I ought to plug a hole in my knowledge.”

A year from having bought it, that thought has barely changed. Any time the issue of stem cells appears on the news or is discussed in terms of ethics, I have felt myself at a loss through being under-informed. So how well did Jonathan Slacks’ book do in filling in this particular family of gaps in my understanding?

We begin with the basic question of ‘what is a stem cell?’ To answer this we get a crash course in terminology. It’s worth paying attention here as most of the book is written with fluent use of this. Though, as a mathematician, one might expect me to complain that biology is often the science of obfuscation by making up complicated words for relatively simple things! Thankfully, a useful glossary is provided at the back of the book. At times, one is forced to turn to this 2-3 times per sentence so that even though this is a short introduction at a little over 110 pages, one has read some parts several times over before the linguistic spaghetti is unravelled to render a paragraph comprehensible.

Slack defines a stem cell not by any inherent characteristic, but by the potential of what it does. He is also keen to stress that stem cells do not occur naturally in the body but are instead derived from cells that do occur naturally.

It is the natural step to look then in detail at the kind of stem cells most people have heard of, embryonic stem cells. Slack goes into some detail about basic cell biology and how embryonic stem cells are created and cultivated.

From here, he looks at the next class of stem cells, which he refers to as induced pluripotent stem cells (iPS cells). These are better known as adult stem cells though Slack expresses some disdain for the term. He gives a brief guide over how they are produced, though in so doing he throws around the names of various proteins and enzymes without much detail.

The question then is, what can be done with them? This is the realm where stem cells tend to make the news as though they were some kind of miracle cure. They’re not. Many treatments he describes as ‘aspirational’ which is another way of saying ‘unproven’. Nonetheless, stem cells can and do have their uses in some treatments. He picks up on the most widely known stem cell treatment, though it’s not often known as such, bone marrow transfers. Slack also outlines other uses, such as testing drugs on particular types of cells which can’t be tested in vivo (that is, in a living patient) but can be tested in vitro (in a petri dish). An example would be using stem cells to create cells that occur in the heart and then test to see if any new drugs cause an adverse reaction in the heart.

The book does have a couple of curious features, however. The first is that Slack tries to draw a distinction between scientists and clinicians. I think this is an idiosyncratic phraseology, whereby instead of meaning “scientists” I think he means to refer to “research scientists” since, of course, clinicians are just a subgroup of scientists. The other, which is perhaps more of a failing of the book, is its diminution of ethics. By all means, it gets mentioned, but for a more well-rounded account I think the matter could have been dealt with in a slightly less dismissive manner than Slack chooses here.

In spite of the linguistic befuddlement and the downplayed ethics, I think I did learn a lot from this. As I write this on the morning of the 9th of August, I noticed a stem cell related story in the news today. This book has enabled me to better understand such stories, which as to mean that it has achieved its aim of educating.