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7th Decade Thoughts

Thoughts about books, politics and history (personal and otherwise), pictures I've taken and pictures I've edited.

Friday, June 11, 2010

The Immortal Cells of Henrietta Lacks by Rebecca Skloot

In 1951 a woman died in Johns Hopkins Hospital in Baltimore of cervical cancer. The cancer had been “particularly virulent”, and though she was treated with the latest protocols for cervical cancer, she never had much of a chance. A surgeon at Hopkins took samples of her tumor and put the cells in a petri dish for researchers trying to cultivate human cells in the laboratory. These cells grew and reproduced as no other before and few since had done and they have been used by researchers ever since. They came along just in time to provide the medium for testing the first polio vaccine and have been “workhorse” cells ever since, used in research on herpes, leukemia, influenza, hemophilia, Parkinson’s, lactose intolerance, sexually transmitted diseases , and much more—even the effect on human cells of working in sewers.

The woman was Henrietta Lacks. She was black and poor, the descendent of slaves and sharecroppers who grew tobacco in Maryland and Virginia. Her cells, according to conventions of the time, were called HeLa (first two letters of first and last name). The researchers at Hopkins shared the cells with colleagues at other institutions and those researchers shared or sold them further. They survived just fine sent in the mail it was discovered. Soon HeLa cells were used all over the world and far more HeLa cells existed than Henrietta Lacks had ever had. It was years before the discovery that her tumor was HPV, the fast growing cervical cancer which young girls are advised to get a vaccine for now, and that that accounted for their "immortality".

Rebecca Skloot heard this story in a college class and found a passion as she attempted to understand how it happened that so much medical research depended on the cells of a single woman but also who this woman was, how she had lived and what descendents she had left. She was not the first researcher interested in HeLa and the woman who was the tissue donor—though of course “donor” is probably not the correct term since Henrietta Lacks was never consulted. And many of those who wrote about HeLa also tried to find Henrietta’s family with the result that the Lacks, who grew up on stories of the Tuskegee Institute syphilis research[1] and rumors that Hopkins—founded as a charity hospital— kidnapped black people at night and subjected them to hideous medical experiments, suspected on the one hand that Henrietta might have been tortured or even killed and on the other resented the fact that others had made money off her cells and they had got nothing. So they either refused to talk to reporters or researchers or they ranted about the commercialization of their relative’s cells which had benefitted everyone but them.

Rebecca set her sights on Deborah Lacks, Henrietta’s daughter, and spent 10 years getting to know her and the family Henrietta had left and attempting to help them get recognition for a relative who had provided so much to medical science. The result is a fascinating book in which Skloot tells the story of the Lacks family as well as the story of the HeLa cells and their role in medical research and the evolving medical ethics story surrounding the use of human tissue in research. The relationship Skloot developed with the Lacks was extraordinary: she overcame endless suspicions of white people, reporters, researchers, profiteers, etc. to become a real friend to Deborah and her family. She tells their story in their own voices—and clearly it was not easy to both explain their ideas and feelings and clearly communicate their values to the audience, nor was it easy to gain their trust and cooperation. I can’t imagine many writers going to the lengths Skloot went to get a story that nevertheless honors and doesn’t exploit those whose story it is. Winning over the Lacks klan required more than most writers would be willing to give of themselves.

In addition Skloot provides lively and engaging narrative, full of interesting personalities, that results from her  extensive research on the use of human cells in medical research and the ethical issues surrounding that use. I couldn’t put the book down—and before reading this I’d never have said I was very interested in either cell research or medical ethics.

Most readers will probably be surprised to learn that while medical ethics, especially protecting the privacy of patents has come a long way since Henrietta Lacks’ cells first appeared on the scene, it is still not illegal for human tissue to be used without the informed consent of the patient. It’s an ongoing debate on which Skloot presents a variety of positions so that the readers understand the complexity of the issues involved.

For a nonfiction book on a significant current topic, this one can’t be beat. It’s a page turner, full of human interest but never at the expense of the facts or the issues.


[1] The Tuskegee Syphilis Study is one of the most horrendous examples of research carried out in disregard of basic ethical principles of conduct. The publicity surrounding the study was one of the major influences leading to the codification of protection for human subjects. [From the Tuskegee Institute website, http://www.tuskegee.edu/global/story.asp?s=1207598]

Wednesday, June 09, 2010

A Partisan's Daughter by Louis de Bernières

Good but not great book. Not as good as other de Bernières books. A 40-year-old man stops for what he thinks is a prostitute. Turns out to be a young woman from Yugoslavia (whose father was a partisan during the war) whom he subsequently visits over a considerable time. He's unhappily married to the "white lump" and visits Rosa frequently thereafter in the run down flat where she pays rent in the name of an old tenant. She serves him tea and tells him stories of her life. Gradually he falls seriously in love, though he's too afraid to tell her so or make an advance. One disastrous night ends the possibilities. She leaves. He never sees her again, but tells the story in his old age when he discloses her last message making it clear that she too loved him.

Tuesday, June 01, 2010

The Storm of War by Andrew Roberts

This is the first one-volume history of World War II that I’d really place in a category of reevaluation by an author who views the war from a comfortable distance in time, but then I’m not expert, not even, really, an amateur aficionado even though I’ve read a lot about the war, including biographies of the personalities and memoirs by the participants.

Roberts’ thesis is that the Allies did not so much win the war as Hitler lost it, in large part by making independent judgments based on intuition and ideology. He was not a military strategist and didn’t trust anyone who was. The smarter his generals, the more likely he was to fire them, as he did von Rundstedt and Guderian more than once, or ignore them when he didn’t like their advice as he often did von Manstein who was maybe his best strategist.

According to Roberts, Hitler’s biggest misjudgment was invading Russia in June of 1941 thereby forcing Germany to fight thereafter on two fronts. He had already made a major error in not pursuing the British Expeditionary Force (BEF) who made the historic evacuation from Dunkirk—which the German army could had prevented had Hitler not called them off. He had not invaded England, having lost the air war of 1940 (The Battle of Britain). He had not beefed up his Navy—especially the submarines which tied up Atlantic shipping until 1943 but thereafter hadn’t the wherewith all (submarines mainly) to continue—or his Air Force whose fighter planes were clearly inferior to Britain’s. (He didn’t halt airplane design or manufacturing but did force a new fighter to be made into a bomber which left him vulnerable in Russia.) He left all that hanging and went after the USSR, seeking “lebensraum” for the German people and success where Napoleon had failed.

Hitler’s second biggest error according to Roberts was declaring war on the United States in December 1941 in the wake of Pearl Harbor. He was not under treaty obligations to Japan to do so and probably would not have felt bound by the treaty had he been so. But declaring war allowed Roosevelt to marshal the enormous (comparatively speaking) resources of the US (war materiel, oil, manufacturing capability) to aid the Western Allies as had not been possible before due to widespread isolationist feeling in the US. Roosevelt had maneuvered some deals already to aid Britain and the Allies, but had no trouble putting the might of the industrial US behind the Allies once Hitler had declared war.

Another major error was Hitler’s campaign to rid the continent of Europe of its Jews. Here was a clear case of ideology trumping strategy. Laying aside all moral issues, Hitler tied up resources and wasted valuable personnel, loyal citizens who could have been badly needed soldiers and workers. Roberts tackles the Holocaust head on in this book, and not only in practical terms.

In fact, Roberts doesn’t skirt moral issues at all in this book, though he finds that some of the conventional moral outrage in the years following 1945 has been misplaced, namely the dropping of the atomic bomb which undoubtedly saved many Allied lives and shorted by war by years. He also questions the condemnation of the fire bombing of Dresden, pointing out legitimate ways in which the city was a military target and asserting that more recent estimates of the number of casualties suggest far fewer were killed than, for instance, Vonnegut assumed in Slaughterhouse Five.

One of the more interesting moral issues he raises is that of the policy of saturation bombing which resulted in far more destruction of German cities than the the Germans inflicted on London or Antwerp. He found little disagreement with the policy at the time, either in the military or among allied populations. Roberts believes that it was only mass destruction of German cities and complete disruption of civil life that ultimately erased the Prussian military tradition which  led Germany to start major wars twice in half a century and replaced it with a profoundly non-military-oriented society which hesitates even to participate in NATO missions today.

Generally too Andrews reassesses the ongoing debate on the effectiveness of bombing generally and decides that the post-war analysis which found the bombing relatively ineffective to be somewhat short-sighted.

Another major thread in this book is the role of the USSR. The book is full of the kind of statistics that can only be accumulated and analyzed objectively long after the war, but the statistics show what everyone now recognizes but rarely talks about in this world war, that the major destruction and death occurred in Russia. I have not read Beevor’s Stalingrad (which has been on my list for awhile) but I was impressed by Roberts’ coverage of the decisive battles of Stalingrad and Kursk in 1943. In assessing major errors of decision makers, Roberts, like most others, judges Stalin's major error to have been trusting Hitler, pointing out that Stalin otherwise never trusted anyone.

An interesting point that Roberts makes throughout this book is that of the cooperation among the Allies which, painful as it was in many ways, was a key to their success. Not only did the Axis not have that kind of cooperation, there was not even the free expression of ideas among the German decision makers since Hitler made all decisions and always punished his generals when they made independent decisions. "Strategic Retreat" was just not in his vocabulary. His closest generals, Keitel and Jodl, were among the least effective thinkers and strategists. Interestingly as tenuous as was the negotiations among Churchill, Roosevelt, and Stalin, Roberts found that Stalin listened to his generals and oversaw far more productive cooperation with his advisors than did Hitler.

But speaking of alliances, Roberts writes extensively on British and American cooperation—and the seething egos which often underlay cooperative decisions. There were a bunch of egos among the Allies: effective strategists like Montgomery and Paton who usually had to be forced to share and who competed rigorously with each other and generals like Mark Clark who were also self-aggrandizing but less effective. Roberts acknowledges MacArthur as another ego, but actually says relatively little about him. I wasn’t entirely happy with his treatment of Stillwell—or indeed of the whole China situation. In the Far East, Andrews focuses mostly on General William Slim, about whom I knew little, seeing him as one of the underappreciated heroes of the war.

I recommend this book whole-heartedly as a one-volume history of WWII which reassesses the war from a distance in time not achieved by those who actually participated or grew up in its wake revering "The Greatest Generation". It is told from a British perspective and as such possibly minimizes the war in the Pacific some, but he brings to the fore the strategic “Germany first” decision which the US and Britain agreed upon. Of course that was made possible also by Hitler’s strategic mistake in declaring war on the US in 1941.