2/17/12

Henrietta Lacks Lives!


THE IMMORTAL LIFE OF HENRIETTA LACKS

By Rebecca Skloot

Crown, 2011, ISBN: 978-1400052172

The next time your doctor hands you a HIPAA form, think of Henrietta Lacks. It that name rings no bells, you’re not alone, though she’s indirectly responsible for some of the most important medical breakthroughs of our time, including a vaccine for polio. Even most medical researchers know her only as HeLa, the name of the world’s most important cell culture. So who was Henrietta Lacks? That is the question medical journalist Rebecca Skloot sets out to answer. This is a non-fiction book that reads like a novel colliding with a gripping episode of CSI. What’s the crime, you ask? The ongoing tragedy of racial and class injustice in America.

The basic story is simple enough. Henrietta Lacks was an African-American woman who came of age in a backwater Virginia town. She eventually relocated to Baltimore, where her husband (and cousin) David “Day” Lacks followed the Great Migration north during World War II, to the Sparrows Point steel mill that hired black laborers. Henrietta bore five children and shortly after her last, Joe (now Zakaryya Bari Abdul Rahmann), she went to Johns Hopkins Hospital, which took in black charity cases. At first, gynecologist Howard Jones found no cause for the pain about which Harriet complained, but before 1951 ended, Lacks was dead from uterine cancer. An autopsy revealed a body filled with pearl-sized tumors, the source of her excruciating demise. As was standard practice during the day, doctors took several tissue and tumor samples from the body before Lacks was laid to rest.

What happened next was—depending on one’s beliefs—either a fortuitous fluke or a miracle. Dr. George Gey had been trying for a decade to grow cells in his lab, to no avail. His entire research model was suspect, courtesy of a 1912 hoax in which Dr. Alexis Carrel claimed to have cloned chicken cells. (Carrel faked the results, the medical equivalent of Piltdown Man.) Much to the astonishment of Gey and lab assistant Mary Kubiak, however, Henrietta’s cells began to divide and replicate the moment they were suspended in culture. Since 1951, HeLa cells have been shipped all over the world and have been the subject of thousands of medical experiments. Henrietta’s cells continue to replicate to this day. They are also the only ones that have ever behaved this way, and no one really knows why.

Skloot tells the cellular story with a clarity that made me wish she had been my high school biology teacher. After her lucid account, you will come to see HeLa as a literal lifesaver for millions. But the question remains: Who was Henrietta Lacks? And that story is often as painful as Henrietta’s final days. Skloot begins with the obvious: In 1951, nobody gave a damn who she was—she was just another black charity case in a Jim Crow city. The researchers thrilled to work on her cells never asked about the donor; stories circulated that her name was Helen Lane. Even worse, none of Henrietta’s family knew of the existence of her cells until 1973, nor thought much about the times they were asked for blood samples that they thought were cancer-screening tests. It took a 1975 Rolling Stone article to reveal that the HeLa line was contaminated in the 1960s and that the blood samples were used to identify Harriet’s DNA from the intruders. It was then that the Lacks family also learned that HeLa was sold around the globe, though the family never realized a dime in these transactions.

Skloot puts a face to the cell line. After a hard fought battle to win the family’s trust—no easy feat for a 27-year-old white gal—she forensically reconstructs Harriet’s life, from her childhood and adolescence in Clover, Virginia, to her final days. Like all lives, it was filled with joys and sorrows; being a poor black woman, there were more of the latter than the former. Skloot does a superb job of unearthing the details of not just Harriet’s life, but also those of her extended family. It is a story of race, poverty, and class, one in which the principals of the medical field inhabit a different world governed by different ideologies than that of underclass (and undereducated) black folks. One of the book’s many delights is observing the intellectual development of Deborah, Harriet’s fourth child, who wants to discover the truth about her mother. But there are some gulfs that can’t be overcome, like the ones that lie between the dispassion of the lab and the everyday racism that drove Zakaryya to cold fury, or between the empirical world of science and the faith-based world of evangelical Christianity. To some in the Lacks family, Henrietta’s cells are a literal form of immortality, imbued with her consciousness and will.

Skloot is a participant observer of the most-noble sort, a writer who helps heal a lot of mistrust and hurt. (She’s even set up a Henrietta Lacks memorial foundation.) Although she’s clearly sympathetic to the Lacks family, she’s also an empiricist. Skloot even-handedly tells the story of Henrietta’s cells, and leaves open all questions of whether the ends justify the means in medical research. As I warn students, it is a mistake to impose the values of the present upon past actors. Informed consent laws did not come into being until 1957, and the National Institute of Health had no research review boards until 1966. Gey and his research team may have been insensitive, but they were well within the ethical operating parameters of their day. And, as Skloot also shows, morality is even muddier when it comes to bodily materials removed in the operating room. Do individuals own discarded tissues and cells? Lawsuits are pending, but to date the courts have ruled that these things are akin to garbage tossed in the local landfill and scavenged by others. That’s hardly a satisfactory answer for patients or physicians, as it leaves ambiguous the question of privacy versus research/public good. That HIPAA form you’ve signed a hundred times is one of the many ways doctors seek to protect themselves. Call it a small measure of posthumous respect for Harriet Lacks.

2/15/12

Cronenberg Plays it Safe in a Dangerous Method


A DANGEROUS METHOD (2011)

Directed by David Cronenberg

Recorded Picture Company, 99 mins. R (nudity, sadomasochism)

* * ½

David Cronenberg’s latest directorial project takes us inside the personal lives of Sigmund Freud (Viggo Mortensen), Carl Jung (Michael Fassbender), and Jung’s patient-turned-psychiatrist, Sabrina Spielrein (Keira Knightley). My feeling about this film can be summed up by a concept from psychology: ambivalence.

The film opens with the bourgeois Jung entrenched in a private sanitarium. The neophyte psychiatrist is about to try Freud’s controversial talk therapy on a particularly difficult subject: Spielrein, a spitfire of madness who contorts her body into shapes that strain her physique, and rockets between moments of razor-sharp lucidity and impulsive wildness. We might as well get this out of the way: Knightley’s not just the weak link in the cast; she’s more like a broken one. To put it even more directly, she’s dreadful–one of the worst performances I’ve seen since Kevin Costner as Robin Hood. She’s supposed to have animal magnetism, but she looks anorexic; her acting is so single-note histrionic that we simply don’t believe in her when she’s supposed to be “cured” and on the path to revamping psychoanalysis in her native Russia. She had an affair with Carl Jung in real life, but it’s hard to fathom their relationship on the screen.

The interesting dynamic is the one between Freud and Jung, Freud being the Father figure that Jung must slay in order to develop his own myth- and symbol-based analytical methods and break from his mentor’s mono-causal link between neurosis and sexuality. Mortensen is as good as Knightley is bad; he plays Freud as a man ferociously protective of his intellectual turf, silently devastated by what he perceives as Jung’s betrayal, and yet a surprisingly loyal and caring friend. It’s also a delicious irony to see the man who wrote about sex all the time as the most conventionally moral character in the film.

As for Jung, Fassbender portrays him as a bourgeois hypocrite–happy to live in the lap of luxury courtesy of the money of his wife Emma (Sarah Gadon), whilst being unfaithful to her. He is outwardly the picture of Swiss Calvinism, but his first conquest is Spielrein, who gets her jollies by being dominated and whipped. Soon, we no longer know which is bigger, Jung’s impact on the field of psychoanalysis or his ego.

In the film, you’ll vote for ego. The script is adapted from a stage play, which was adapted from John Kerr’s scholarly treatise of Jung. Think a copy of a copy. At 99 minutes, you’re not going to learn much about the intellectual disputes between Freud and Jung; these come in hints and dribbles, but never depth. Vincent Cassel makes an appearance as Otto Gross, a drug-addled psychiatrist driven by an unfettered id. He’s mainly here, though, to act as the devil on Jung’s shoulder that encourages him to act upon passion and impulse. Cassel has a certain rakish charm, but the ideas he puts forth is all surface and no depth. In sum, this is a non-intellectual film about intellectuals. It’s as if Cronenberg either did not trust filmgoers to unravel the world of ideas, or that he felt them incapable of doing so.

Perhaps he’s right, but it makes for rather tepid filmmaking from a man who directed such edgy films as Dead Ringers (1988), Naked Lunch (1991), and A History of Violence (2005). I suspect Cronenberg hoped that the sadomasochism theme would supply the danger implied in the film’s title, but Knightley can’t deliver on that promise and, in the end, only Jung’s bourgeois comfort seems the least bit imperiled. The film’s luscious exteriors simply can’t compensate for detachment that feels as cool as an Alpine lake any time Mortensen isn’t on screen. This speaks volumes. You know that a film lacks spark when you’re waiting for Sigmund Freud to appear and pick up the pace!

2/13/12

Religion Has No Place in Politics


I thought we were done with this nonsense. In 1960, John Kennedy had to deflect fears that his primary loyalty resided in Rome, not in the US Constitution. Some voters charged that JFK would consult the pope before he made important decisions, and quite a few nervous Protestants reprised anti-Catholic rhetoric that was straight out of the Gilded Age. After eking out a narrow victory, Kennedy allayed fears in a masterful inaugural speech in which he told Americans that “here on earth, God’s work must surely be our own.” In 1962, the Supreme Court struck down school prayer; in 1973, it said that a woman had the right to make her own reproductive decisions. Too bad the court didn’t go the whole nine yards and demand that all references to God be struck from US currency, official documents, political speeches, the NFL, and patriotic songs. The court left enough wiggle room for that old demagogue Ronald Reagan to put God back in the voting booth without requiring proof of residency.

Flash forward to 2012, where you’d think that every Republican candidate has been handpicked by the Creator. Even worse, religion keeps popping up in ways that threaten American freedoms. Just recently American bishops forced Barack Obama, a president as pliable as Gumby, to back down on a regulation that would make religious-based hospitals and businesses offer contraceptive benefits in employee healthcare plans. This, the bishops argued, is antithetical to Catholic doctrine and violated principles of religious freedom. No—it doesn’t. The first amendment guarantees personal religious rights, but the Constitution is grounded in the separation of church and state. It’s time to make this explicit and find those seeking to mix religion and politics in violation of the Constitution. There is no place whatsoever for religion in the civic life of Americans.

It is, of course, deeply ironic that Catholic bishops would presume to lecture anyone on such issues. Entrusting moral principles to those who tried to whitewash the church’s pedophilia past is akin to asking Lizzie Borden for advice on axe etiquette. The bishops apparently slept through logic as well as ethics. A public institution is precisely that; Catholics may teach and preach as they wish within the private confines of their churches, but once they open their doors to the broader public, these institutions are no longer private. We have all manner of regulations within the public realm—ask Amish people who have to have reflective triangles on buggies traversing public highways, or Jewish butchers who must meet food inspection codes when they prepare kosher meat. In the case of a Catholic hospital, for instance, an attempt to impose Catholic dogma violates the religious freedom of non-Catholic employees. If that hospital wishes to hire and treat only Catholics, fine, but it should not get any taxpayer money, nor should it be certified. Moreover, any religious leader using the pulpit to influence public opinion should forfeit the tax-exempt status of the church and be forced to register it as a political organization.

Let me repeat: There is no place for religion in American civic life—as John Kennedy tried to tell us. I don’t say this because I’m anti-religion. I’m not. I’m anti-your religion. I’m anti-Rick Santorum’s religion, anti-Mitt Romney’s religion, anti-Pat Robertson’s religion, anti-Elijah Muhammad’s religion, anti-Moshe Hersch’s religion, and anti every other religion you can name insofar as that faith system seeks to dominate public policy. Americans are not “one nation under God,” as devilish a phrase as ever devised by man. We are many nations under many different deities and the moment we express preference for any one of them, none of us have religious freedom. The GOP right is fond of evoking the Founding Fathers, but apparently not even that “historian” Newt Gingrich grasps what they had in mind when they constitutionally forbade the establishment of an official religion in America. What would the USA look like under an official religion? Probably a lot like Massachusetts Bay Colony under the Puritans—a land of imposed orthodoxy that was unwelcoming to Quakers, mainstream Anglicans, Baptists, Catholics, and Native religions. Perhaps one prone to throwing out ecumenical thinkers such as Roger Williams, or uppity women such as Anne Hutchinson. Or maybe one that launches periodic witch hunts. The Founding Fathers understood that Roger Williams was ultimately correct: freedom of conscience and political freedom were incompatible with state-sanctioned religion.

It’s so easy and pious-sounding to evoke God in political life. It’s also facile, heretical, and dangerous. I raise the question: If we are to be one nation under God, whose god? Rick Santorum thinks that life begins at conception; I think it’s just a bunch of cells. Which of us is correct? Catholics think God doesn’t want anyone to use birth control. I find such an idea morally reprehensible in a planet of seven billion people, nearly half of whom live in abject poverty. Who is correct? I have many private spiritual beliefs; some might find a few of them ridiculous. Fine. I find the Catholic doctrine of transubstantiation absurd, and to say that I find the back-story behind the Book of Mormon hard to swallow grossly underestimates my position. In my view, a lot of Southern Baptists are Pharisees with funny accents, and any black preacher who opposes gay marriage ought to hang his head low enough to read a good history of the civil rights movement! Who is right?

Who indeed? The greatest heresies ever committed are by those who presume to speak for God. Religion takes place in the realm of faith, things unseen and improvable. It seeks to help us apprehend that which we cannot entirely comprehend; that is, religion as practiced by humans is at best a glimpse into mysteries that pass human understanding. To claim more is to presume some Americans know the mind of God, a view that most faiths would consider heretical.

But Americans can read the Constitution. That’s the beauty of a nation under law rather than under God—there is one standard for all, be that person a Baptist, a Mormon, a Jew, a Muslim, a freethinker, or a Catholic bishop. American society can only function as a secular one that protects private beliefs, but also demands public decorum and collective rights. The day that Americans decide to place Jehovah or Allah or Jesus or the pope or the Angel Moroni in the Oval Office will be our day of reckoning. Expect plagues of locusts, not heavenly trumpets.