[Hopkins] was built in 1889 as a charity hospital for the sick and poor, and it covered more than a dozen acres where a cemetery and insane asylum once sat in East Baltimore. The public wards at Hopkins were filled with patients, most of them black and unable to pay their medical bills. (15)
Although Hopkins intended his hospital to be a boon to the poor of Baltimore, it led to a very dangerous situation. Scientists and doctors believed that such impoverished patients should be grateful for any treatment, and shouldn't mind it if they were used for a little experiment here and there.
She knew about harvesting tobacco and butchering a pig, but she'd never heard the words cervix or biopsy. She didn't read or write much, and she hadn't studied science in school. She, like most black patients, only went to Hopkins when she thought she had no choice. (16)
Skloot points out how Henrietta's life experience disadvantaged her in her final medical crisis. She was at the mercy of the doctors who had no intention of explaining to her exactly what was happening to her body.
Like most young Lackses, Day didn't finish school: he stopped in the fourth grade because the family needed him to work the fields. But Henrietta stayed until the sixth grade. During the school year, after taking care of the garden and livestock every morning, she'd walk two miles—past the white school where children threw rocks and taunted her—to the colored school, a three-room wooden farmhouse hidden under tall shade trees [...]. (20)
Being poor meant kids had to leave school early to help support their families; being black meant that what schooling they did get was inferior to white children. It's a one-two punch for the Lacks kids.
[Gey's] mother worked the garden and fed her family from nothing but the food she raised. As a child, George dug a small coal mine in the hill behind his parents' house. He'd crawl through the damp tunnel each morning with a pick, filling buckets for his family and neighbors so they could keep their houses warm and stoves burning. (38)
The Lackses aren't the only poor people in this story. Skloot tells us that George Gey, the cell culturist who produced the HeLa line, had to overcome a less than privileged beginning. We don't learn much more about Gey's childhood, but we can see from this passage that poverty in white neighborhoods in Pittsburgh looked different than black poverty in segregated Clover, Virginia.
The research subjects didn't ask questions. They were poor and uneducated, and the researchers offered incentives: free physical exams, hot meals, and rides into town on clinic days, plus fifty-dollar burial stipends for their families when the men died. (50)
Skloot describes the circumstances of the Tuskegee syphilis study, which ran until 1972. She highlights exactly the characteristics that made the "study" seriously unethical: taking advantage of a poor minority group, dangling incentives in front of them, withholding information about risk. Not to mention that many people died excruciating and highly preventable deaths while researchers just took notes. The breaking of this story in 1972 led people to question how vulnerable populations might be protected from exploitation like this.
The newspaper article where I'd gotten Henrietta's address quoted a local woman, Courtney Speed, who owned a grocery store and created a foundation dedicated to building a Henrietta Lacks museum. But when I got to the lot where the grocery store was supposed to be, I found a gray, rust-stained mobile home, its broken windows covered with wire. (69)
Guess what? This was the right place, what passes for a grocery store in present-day Turner Station. After the town's boom during WWII, companies bulldozed homes to make room for a giant power plant and other industry, ruining the town as a place to live. 1300 people, mostly black, were left homeless. Turner Station was a shell of a town; stores and cafes—and jobs—had been replaced by drug dealers and housing projects. Another result of the poverty/racism mashup.
The dividing line between Lacks Town and the rest of Clover was stark. On one side of the two-lane road from downtown, there were vast, well-manicured rolling hills, acres and acres of wide-open property with horses, a small pond [...] and a white picket fence. Directly across the street stood a small one-room shack about seven feet wide and twelve feet long; it was made of unpainted wood, with large gaps between the wallboards where vines and weeds grew. (78)
Skloot experiences firsthand the effects of poverty in Henrietta's hometown. The Lackses literally lived on the wrong side of the tracks; no white picket fence version of the American Dream for them. Skloot invites us to imagine what the future of the Lacks family might have been if they'd lived just a few yards away across the street. Can't imagine it? That's because they probably wouldn't have been allowed to live there.
[…] Sonny and Lawrence were still busy trying to figure out how to get money from Hopkins. They didn't know that on the other side of the country, a white man named John Moore was about to begin fighting the same battle. Unlike the Lacks family, he knew who'd done what with his cells, and how much money they'd made. He also had the means to hire a lawyer. (198)
Henrietta's sons focus their frustration on what they need most—money. While some readers might fault them for being motivated by money, Skloot reminds us that John Moore, a white man from whom a lucrative cell line had been generated, also went after monetary compensation. It's not about money-grubbing: it's about making the scientific community sit up and listen to patients. Moore had what the Lackses didn't—money to hire a lawyer, and enough education to understand what was going on. And being white, he probably wasn't as afraid to challenge the powers that be.
At some point, Zakariyya noticed an ad seeking volunteers for medical studies at Hopkins, and he realized he could become a research subject in exchange for a little money, a few meals, sometimes even a bed to sleep on. When he needed to buy eyeglasses, he let researchers infect him with malaria to study a new drug. (208)
The great irony of Henrietta's youngest child having to sell his body to science isn't lost on the reader. Infected by malaria?? That's desperation. The cycle of poverty in Zakariyya's case is made worse by early abuse and psychological and physical problems, most of which started because of his mother's death. No wonder he feels anger at everyone else profiting off his mother except him.
Crownsville averaged one doctor for every 225 patients, and its death rate was far higher than its discharge rate. Patients were locked in poorly ventilated cell blocks with drains on the floors instead of toilets. Black men, women, and children suffering with everything from dementia to tuberculosis to "nervousness," "lack of self-confidence," and epilepsy were packed into every conceivable space, including windowless basement rooms and barred-in porches. (275)
Crownsville is a prime example of a shameful institution that miserably failed a vulnerable population. Skloot tells us that the "inmates" of Crownsville were not only ill, but also poor, black, and neglected by their families—the perfect storm for institutionalized racism and abuse. So why didn't these patients just go on Medicaid or Medicare? Oh, wait. Those programs didn't exist until 1965. Poor patients were stuck with places like Crownsville, where little if any treatment took place.
[…] the last thing he remembered before falling unconscious under the anesthesia was a doctor saying his mother's cells were one of the most important things that had ever happened to medicine. Sonny woke up more than $125,000 in debt because he didn't have health insurance to cover the surgery. (306)
The irony of this situation seems to have escaped the surgeons, who are genuinely impressed to have Henrietta's son on the operating table, though they're totally oblivious to his financial situation. Props to the hospital for treating him even though he was uninsured, but seriously—it doesn't seem fair.