David drove Henrietta nearly twenty miles to get [to Hopkins], not because they preferred it, but because it was the only major hospital for miles that treated black patients. This was the era of Jim Crow—when black people showed up at white-only hospitals, the staff was likely to send them away, even it if meant they might die in the parking lot. (15)
Skloot includes this important backstory to give us context for Henrietta's story, but also to remind us that the era of institutionalized discrimination is not long gone. Segregation is illegal today, but Henrietta was treated in 1951, when separate facilities were the norm in the south. Though we can't know if Henrietta's actual treatment at Hopkins was affected by her race, we do know that the legacy of racism still affects African American communities. Just check out the latest from Baltimore, where Henrietta lived.
There's no way of knowing whether or how Henrietta's treatment would have differed if she'd been white. According to Howard Jones, Henrietta got the same care any white patient would have; the biopsy, the radium treatment, and radiation were all standard for the day. But several studies have shown that black patients were treated and hospitalized at later stages of their illnesses than white patients. And once hospitalized, they got fewer pain medications, and had higher mortality rates. (64)
Skloot does emphasize that we have no way of knowing if Henrietta was subjected to a lower standard of care than a white woman, and she does share information to suggest that every effort was made to relieve her pain. But the averages are a good reminder of how race can affect medical treatment and its level of success. Cancers were discovered in their later stages, when they were more difficult to treat, partly because poor black families had less access to adequate medical facilities, and partly because they had very little confidence in the medical community. Skloot said that for Henrietta, going into Hopkins was like going into a foreign country, and she avoided it if possible. She didn't follow up on recommendations for treatment of her syphilis and gonorrhea.
I told her about the four maps, and she threw a box of lard onto the shelf. "Now we got the four-map syndrome," she said. "They keep trying to push us off the earth, but God won't let them." (72)
Skloot tells Courtney Speed how difficult it was to find Turner Station since it was no longer represented on Baltimore maps. Speed addresses a more symbolic and personal reason for the omission: the once robust and mostly black community had been pushed out by corporations and left to fade from memory. Speed wants to keep the historical memory of the area alive.
Black scientists and technicians, many of them women, used cells from a black woman to help save the lives of millions of Americans, most of them white. And they did so on the same campus—and at the very same time—that state officials were conducting the infamous Tuskegee syphilis studies. (97)
There's a lot of irony running through this book, but this tops them all. Skloot explains how the first HeLa cell factory was established at the Tuskegee Institute. While the establishment there gave black scientists and techs new employment opportunities, it didn't really open up the benefits of research to a more diverse population. And the moment a for-profit biotech company began trading in HeLa cells, these black scientists lost their jobs.
"You know, white folks and black folks all buried over top of each other in here. I guess old white granddaddy and his brothers was buried in here too. Really no tellin who in this ground now." Only thing he knew for sure, he said, was that there was something beautiful about the idea of slave-owning white Lackses being buried under their black kin. (122)
Skloot learns that the Lacks family has white ancestors, white slave-owners having children with their female slaves. But the only form of equality that the black Lackses experienced was when they were buried in the same family graveyard. Though the anonymity of the family cemetery brings grief to Deborah (her mother's grave is unmarked), it also offers a kind of comfort that segregation can't exist here.
Everyone I talked to swore race relations were never bad in Clover. But they also said Lacks Town was only about twelve miles from the local Lynch Tree, and that the Ku Klux Klan held meetings on a school baseball field less than ten miles from Clover's Main Street until well into the 1980s. (124)
Skloot raises an important question here: does the perception of racial tension diminish the more a person's exposed to it? It seems to be the case in Lacks Town, Henrietta's impoverished hometown, which seems to have been surrounded by the worst examples of racist behavior. This desensitization might be a coping mechanism, but it doesn't make the injustice disappear.
"She married a Puerto Rican somewhere in New York. Since she could pass, she disowned her blackness—converted to Puerto Rican because she didn't want to be black no more." (126) (Gary's explanation of Henrietta's sister Lillian and her "conversion")
Racial identification can be complicated and fluid, and this certainly seems to be the case with Henrietta's sister Lillian. Cousin Gary explains that Lillian felt her blackness to be a burden and that she had the option of choosing another race because of her light skin. It may seem odd that the Lacks family would use the term "converted" in this case, but it's not a bad way to see it. Lillian certainly does leave her family and culture behind in the hopes of having an easier better future.
It was a story of white selling black, of black cultures "contaminating" white ones with a single cell in an era when a person with "one drop" of black blood had only recently gained the legal right to marry a white person. It was also the story of cells from an uncredited black woman becoming one of the most important tools in medicine. (197)
Skloot's sweeping characterization of the HeLa story is both poetic and right on the money—and tells us exactly why Henrietta's story captured her attention in the first place. The story of Henrietta Lacks and HeLa addresses not only the issue of racial exploitation and demonization, but also that of a patient's humanity and his or her right to compassionate care and privacy. Pretty clever how she links the "contamination" of the cells to the "one drop" policy of racial identification.
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)
Skloot includes the story of Moore to show how differently things could go for a patient if he or she has the privilege of knowledge and money. And in this case, race. The question implied is this: would John Moore's case have garnered so much attention and effort if he were poor and black? In the end it didn't matter; he lost his case.
"We all black and white and everything else—this isn't a race thing. There's two sides to the story, and that's what we want to bring out. Nothing about my mother is truth if it's about wantin to fry the researchers. It's not about punish the doctors or slander the hospital. I don't want that." (250)
Deborah's attitude is really generous and classy, considering the situation. She's trying to rise above racial politics and money. She knows that if revenge is her motive, it dishonors her mother's memory.