HeLa Seminar

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1. Jessica Ramich
   Sep 11, 2012 @ 15:19:38

   1. The doctor figured it was a sore from syphilis. In the 1930s, many white people believed that black people were a “notoriously syphilis-soaked race.”

   2. Henrietta first went to a local hospital where the doctor thought the lump was syphilis. When the syphilis test came back negative, the doctor sent her to John Hopkins. David drove Henrietta nearly 20 miles to get to John Hopkins not because they preferred it but because it was the only major hospital for miles that treated black patients. Hopkins segregated black patients into colored wards.

   3. People would not use words like epilepsy, mental retardation, or neurosyphilis to describe Elsie’s condition until years later. Instead, people referred to her as “simple” or “touched.”
   The terms used by the medical field are more precise and place the disease burden on deformities or dysfunctions of the body. The terms used by Henrietta’s friends and family make Elsie seem non-intelligent and intellectually unstable. It is unfortunate that Elsie’s family did not understand or acknowledge the severity of her mental health because this (along with racial inequality) may have prevented her from getting proper healthcare.

   4. Howard Jones was the gynecologist at Hopkins who sent a small sample of Henrietta’s lump for the original diagnosis.
   Richard TeLinde was Jones’ boss and one of the top cervical cancer experts in the country. They were involved in a nationwide heated debate over what quantified as cervical cancer, and how best to treat it. TeLinde believed carcinoma in situ was simply an early stage of invasive carcinoma, that if left untreated would eventually become deadly. He treated carcinoma in situ aggressively, often removing the cervix, uterus, and most of the vagina. He argued this would drastically reduce cervical cancer deaths, but his critics called it extreme and unnecessary.
   He started a study in which he used data from patients from public wards of Hopkins without their knowledge to demonstrate that women who began with carcinoma in situ eventually developed invasive carcinoma. He believed that since the patients were treated for free in the public wards, it was fair to use them as research for repayment. The study found that 62% of women with invasive cancer first had carcinoma in situ.
   TeLinde thought if he could find a way to grow living samples from normal cervical tissue and both types of cancercous tissue he could compare all three and prove that carcinoma in situ and invasive carcinoma looked and behaved similarly in the laboratory.

   5. George Gey was the head of tissue culture research at Hopkins. He and his wife were trying to grow malignant cells outside the body, hoping to use them to find cancer’s cause and cure. They were determined to grow the first immortal human cells; a continuously dividing line of cells all descended from one original sample, cells that would constantly replenish themselves and never die.
   TeLinde offered Gey a supply of cervical cancer tissue in exchange for trying to grow some cells.

   6. According to the book, doctors often withheld information from the patients with the intention of not confusing or upsetting the patient with frightening terms they might not understand. “Doctors knew best, and most patients didn’t question that.” Black people in general didn’t question white people’s professional judgment at all.
   The term “benevolent” is defined as “well meaning and kindly.”
   The term “deception” is defined as “the act of making someone believe something that is not true.”
   How can lying to someone ever be seen as kind? In the case of medical benevolent deception, patients could get second opinions of their disease state if they knew what was wrong with them. These second opinions could lead to more tolerable symptoms or cure of disease.

   7. HeLa cells could be grown on a massive scale and were cheaper than using monkey cells. HeLa cells could grow in suspension, meaning they weren’t limited by space and could continue to divide until they ran out of culture medium. (The more medium, the more cell division) HeLa cells grew much faster due to their malignancy than normal cells, and therefore produced results faster.

   8. During the Tuskegee syphilis study US Public Health Service researchers at the Tuskegee Institute decided to study how syphilis killed from infection to death. They recruited hundreds of black men with syphilis and watched them die slow, painful, and preventable deaths, even after realized penicillin could cure them.
   A HeLa distribution lab was set up at the Tuskegee institute in hopes of providing hundreds of jobs, training, and opportunity for young black scientists. The HeLa cells at this institute were used to prove Salk’s polio vaccine effective at the very same time as the syphilis study.
   It is very ironic that the same institute was taking advantage of black Americans in 2 different studies. The more ironic nature of this is that the Tuskegee institute was one of the most prestigious black universities in the country, yet it took advantage of black people by using them as science projects! It is also ironic because Charles Bynum, the director of “negro activities” at the institute was a civil rights activist yet he supported using HeLa’s cells without her knowledge.

   9. HeLa cells were used to:
   – study how viruses such as herpes, measles, mumps, fowl pox, and equine encephalitis entered cells, reproduced, and spread
   – develop methods to freeze cells without damaging or changing them, making it possible to send cells around the world , store cells between experiments, and suspend cells in various states of being
   – simplify and standardize the technique of tissue culturing in order to be able to compare and repeat experiments preformed in other laboratories
   – clone individual cells
   – discover normal human cells have 46 chromosomes

   10. He found that 18 of the most commonly used cell cultures had one thing in common: they all contained a rare genetic marker called glucose-6-phosphate dehydrogenase-A (G6PD-A), which was present almost exclusively in black Americans. This meant that HeLa contaminated the cell lines. HeLa cells could float through the air on dust particles and contaminate other cultures. If every cell used in the many studies conducted in the past years were contaminated with HeLa it would mean millions of dollars were wasted. This also meant that normal cells didn’t spontaneously become cancerous – they were simply taken over by HeLa.

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2. Hiten Patadia
   Sep 12, 2012 @ 03:49:57

   1) What did Henrietta Lack’s first doctor assume the source of the lump on her cervix was? What stereotype or bias might this assumption be based on?
   When the doctor examined Henrietta for the first time it was assumed that she had contracted syphilis. I believe the doctor’s bias was based on her race. I think it was based on the social dynamics during this time period, which somehow influenced the doctor’s decision to assume that African Americans could easily contract a vicious STD.
   2) Why did David Lacks take Henrietta to the public wards at Johns Hopkins instead of a closer hospital?
   Due to the socioeconomic status of blacks at this time, many hospitals denied admittance of African Americans. Hospital’s assumed that if you were black, you didn’t have enough money to afford proper healthcare. Day drove Henrietta to “John” Hopkins Medical Center, which was around 20 miles away from their home.
   3) Compare the medical terms describing Elsie’s condition with terms used by Henrietta’s friends and family. What are the connotations of the two sets of terms?
   Medical terms related to Elsie’s conditions could be described as “Mental Retardation” or “Neurosyphilis”, but the terms used by the family used were “Simple.”
   I think using the description of mental retardation definitely has a negative connotation towards it. I mean it medically makes sense, but in society it may be taken the wrong way the way it is used. Also at this time period, with education levels so low, the description mental retardation, could be taken for something far worse than what it is. I think the term “Simple” or even slow, may have a better connotation towards it, and having a simple phrase describing a complex scenario may be better socially accepted.
   4) Summarize Dr. TeLinde’s position in the debate over the treatment of cervical cancer.
   Dr. TeLinde was involved with a debate to determine what qualifies a patient with cervical cancer and how to approach treatment. Dr. TeLinde supported the view that carcinoma in situ was an early stage carcinoma and took the extreme view to remove the cervix, and uterus. His colleagues saw that this was an effective method but believed that this treatment was too extreme and taking a safer route may be in the patient’s best interest.
   5) What Dr. Gey hope to accomplish with HeLa cells?
   Dr. Gey worked at Johns Hopkins with his wife with tissue growth research. The basis of their research was “simple”, grow immortal human cells, which had been completely unsuccessful until they got their hands on Henrietta’s cervical tissue cells.
   6) In your own words, explain the paradox of “benevolent deception.”
   During this time period, patients were usually uneducated and weren’t familiar with medical terms. A population of uneducated patients could pose large difficulty for doctors, thus provoking doctors to withhold medical information time to time. Benevolent sort of has a connotation of being charitable, and deception has a negative connotation, which could mean going behind someone’s back.
   I think this term could be defined as doctors going behind patient’s backs in order to protect them from information to protect them. They must have thought that the less the patient knew the better off they are.
   7) What characteristics of HeLa cells made them ideal for use in polio vaccine trials?
   HeLa cells were ideal because they had potential to be grown on a large scale (due to their intrinsic characteristics of cancer cells) and it could be done at a sensible cost. The reproducibility of these cells were also a great attribute along with the ability to produce results quicker than other cells.
   8)Explain the inherent irony of the fact that the Tuskegee HeLa production lab was operating at the same time of the infamous syphilis study was being conducted.
   The Tuskegee Institute was located in Tuskegee because it would provide funding, jobs and training opportunities for young black scientists. There after, was turned in a production machine of HeLa cells to approximately 6 Trillion cells a week. And with those cells, it helped produce the Salk vaccine. The irony lies within the syphilis study where they would study black men and watch them suffer, and die even though they had potential to treat the disease.
   Trying to help the black community through profit making, but watching the black men die because they had a disease which could have been cured.
   9) Explain the contribution that HeLa made to the emerging field of genetics.
   Helped treat many difference viruses such as; herpes, measles, mumps, fowl pox, equine encephalitis. HeLa cells helped show each one of the cells entered cells, how they reproduce and spread.
   With HeLa cells, the ability to reproduce/clone cells was discovered and it was found out that human cells had 46 chromosomes.
   10) What did Dr. Gartler discover about eighteen of the most commonly used cell cultures?
   The rare genetic marker known as GDPD-A, only present in African Americans.

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3. Natale Dabulewicz
   Sep 12, 2012 @ 16:11:47

   1. What did Henrietta Lack’s first doctor assume the source of the lump on her cervix was? What stereotype or bias might this assumption be based on?
   -The doctor thought the lump on her cervix was from syphilis. This was a common disease among African Americans because they generally did not have access to healthcare. Syphilis is a curable disease with penicillin, but because they had no money or places that would treat them many African Americans just had to deal with the disease. In turn their children had to live with it, as syphilis can cause birth defects to babies in the womb.
   2. Why did David Lacks take Henrietta to the public wards at Johns Hopkins instead of a closer hospital?
   -Henrietta first went to her local doctor. He tested her lump and as soon as he discovered it wasn’t syphilis he referred her to Johns Hopkins. Also, Johns Hopkins was “the only major hospital for miles that treated black patients.” They separated the white wards form the African Americans. They didn’t have many choices of where to go when they were sick, especially since they could not afford their health care.
   3. Compare the medical terms describing Elsie’s condition with terms used by Henrietta’s friends and family. What are the connotations of the two sets of terms?
   -In medical terms, Elise would have been described as having epilepsy, mental retardation, or neurosyphilis. The people of Lacks town said she was simple and ‘touched.’ “She came into the world so fast, Day hadn’t even gotten back with the midwife when Elsie shot right out and hit her head on the floor. Everyone would say maybe that was what left her mind like an infant’s.” When someone says mental retardation many people associate this with negative thoughts such as they cannot function in society. When people with of neurosyphillis, they probably think of ‘dirty’ people that sleep around. The Lacks town words such as ‘touched’ could go either way, some people may think it could mean touched by god, but others could mean that she was cursed.
   You don’t learn until later on in the book that Elsie was probably just deaf from the syphilis and had no way to communicate. She in fact may not have been mentally retarded at all, but she was never given a chance to learn sign language or function in the world. It is unfortunate that she may have made an impact in the world if she had proper medical care and had not been institutionalized.
   4. Summarize Dr. TeLinde’s position in the debate over the treatment of cervical cancer.
   Dr. TeLinde believed that every stage of cervical cancer was dangerous. He believed that “in situ” or non-invasive tumors were eventually going to become invasive and spread. Many doctors disbelieved him as they didn’t understand how cancer cells can grow and multiply almost infinitely. Dr. TeLinde performed many hysterectomies in order to save many women’s lives. Many doctors believed that these were unnecessary and that he was blowing a small tumor out or proportion.
   5. What did Dr. Gey hope to accomplish with HeLa cells?
   -Dr. Gey was hoping to develop the first ‘immortal’ human cells. This had been done about 10 years earlier with mice cells, but the Gey’s wanted to go above and beyond and create this with human cells. Gey would take any cells he could get his hands on in order to culture them and see how they would grow. Once Gey had the HeLa cells he hoped to conquer cancer. He was looking for ways to ‘damage’ cancer or completely wipe it out. To do this Gey was willing to send HeLa cells all around the world so scientists could use them for research.
   6. In your own words, explain the paradox of “benevolent deception.”
   -The scientists from the 50’s and probably even a while after the 50’s did not even consider that patients could have a right to their own tissues. The scientists were not malicious in their use of the HeLa cells, but they simply were unconscious to the fact that there was a person behind the cells. They believed that if they were using the cells for good that the patient wouldn’t need to know what was going on. The fact that there still aren’t any laws against using tissues that have been stored for years is also a little frightening to me. I believe if cells are being used for good or bad, the patient should at least be aware.
   7. What characteristics of HeLa cells made them ideal for use in polio vaccine trials?
   – Cells had to be susceptible to the virus in order for them to be infected to see if the vaccine was truly working. HeLa cells were more susceptible to the polio virus than any cultured cell had ever been, making it perfect for testing the vaccine.
   8. Explain the inherent irony of the fact that the Tuskegee HeLa production lab was operating at the same time of the infamous syphilis study was being conducted.
   -The fact that the HeLa production lab was opening the same time as the syphilis studies was almost used as a cover up for what was going on. They were mixing ethical testing (just using cells), with unethical testing (purposely injecting humans with a disease and refusing them treatment.) If they could use HeLa cells to test the polio vaccine they certainly could have used the same cells for testing syphilis and the treatments for it instead of making people suffer.
   9. Explain the contribution that HeLa made to the emerging field of genetics.
   -HeLa was the first cell line to be ‘genetically mapped.’ This was done to cure the problem of HeLa contamination, but it turned into a much bigger project as they realized they could use gene mapping for many other reasons.
   10. What did Dr. Gartler discover about eighteen of the most commonly used cell cultures?
   -He discovered that they were ‘contaminated’ with HeLa cells. They all had a common enzyme marker that was usually only found in African Americans. He realized that the cell cultures were probably only growing because they actually had Hela in them. It was this discovery and contamination that prompted scientists to begin gene mapping.

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4. Peter Aiello
   Sep 12, 2012 @ 17:33:38

   1. What did Henrietta Lack’s first doctor assume the source of the lump on her cervix was? What stereotype or bias might this assumption be based on?
   The doctors assumed the lump on Henrietta’s cervix was from some sort of sexually transmitted infection – all without performing the proper tests to determine otherwise. They did this because she was African American and automatically assumed that because she did have a past history of STI’s that that was the case this time. These physicians were very much showing a bias in this situation not only because of her past medical history but also because of her race. In this case, the proper diagnosis was not achieved initially because of social influences that clouded a professional opinion.
   2. Why did David Lacks take Henrietta to the public wards at Johns Hopkins instead of a closer hospital?
   David Lacks took Henrietta to the public wards at Johns Hopkins not because of its groundbreaking research, but because it was the closet hospital to them that accepted African American patients.
   3. Compare the medical terms describing Elsie’s condition with terms used by Henrietta’s friends and family. What are the connotations of the two sets of terms?
   The medical terminology used to describe Elsie’s condition such as autism, mental retardation, and/or neurological disorder were simply not used by the general public for year after these events unfolded. Her family described her as “simple minded” which has the connotation that she was stupid and an unfit member of society at the time. Her family nor the clinicians taking care of Elsie made mention of the fact that she had a mental illness – it was discerned from the conversations that she was a person who would not be a positive asset to society – one that society did not need to help.
   4. Summarize Dr. TeLinde’s position in the debate over the treatment of cervical cancer.
   Dr. TeLinde believed that all types of cervical cancer would eventually become aggressive and could lead to death even the in situ carcinoma which at the time was not considered dangerous and was not aggressively treated. Dr. TeLinde was of the opinion that all cancer should be treated as aggressively as possible to prevent the complications of malignancy – an idea that was not widely accepted in this time period.

   5. What Dr. Gey hope to accomplish with HeLa cells?
   Dr. Gey hoped to accomplish making the first immortal human cell line – a line of cells that were derived from a human origin that could survive multiple cycles of cell division. He hoped that these immortal cells could be used to study diseases on humans that were once thought of as impossibly to study on actual patients. This would open up doors to cancer research, information about bacterial and viral infections, and development of vaccines.
   6. In your own words, explain the paradox of “benevolent deception.”
   Physicians in this time period regarded themselves as possessing the highest level of medical knowledge. Patients, they believed, did not need to fully understand what was happening to them, because, if they did they may deprive themselves of lifesaving treatment. Physicians thought that they were doing their patients a service by withhold information from the patient that they might not fully understand and that could lead the patient to making a decision against receiving treatment. It was thought by physicians that they should not let the patient cause harm to themselves – and they would be doing this if they revealed all of this information.
   7. What characteristics of HeLa cells made them ideal for use in polio vaccine trials?
   They were able to be infected with the polio virus and could be easily mass produced without the expense of using monkey cells (which would require lots of animals at a great cost).
   8. Explain the inherent irony of the fact that the Tuskegee HeLa production lab was operating at the same time of the infamous syphilis study was being conducted.
   The manufacturing of HeLa at the Tuskegee lab was a major milestone for the African American scientists working at this facility. What is ironic is the syphilis study was one of the most tragic moments in science when thousands of patients were placed in a scientific study with no informed consent – most were African American patients. The HeLa cells that the scientists were working on were also from an African American patient that did not give informed consent to allow her cells to be used.
   9. Explain the contribution that HeLa made to the emerging field of genetics.
   HeLa cells were the first immortal cell line that allowed scientists to study certain diseases on human cells that otherwise would not have been possible. HeLa cells allowed experiments that just could not be conducted on patients who were living – giving scientists a window into diseases that may have had a genetic component but never could be linked o that because there was not the ability to study these diseases in human cells.
   10. What did Dr. Gartler discover about eighteen of the most commonly used cell cultures?
   Dr. Gartler discovered that most of the cell culture lines came from African American patients because they all contained glucose 6-phosphate dehydrogenase, a marker present exclusively in African American cells. This again showed that a disproportionate number of patients who had their cell lines harvested came from an undereducated (at the time) race – a very telling sign that many of these patients did not know what they were consenting to – if there were even offered consent at all.

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5. Alexander Prokopienko
   Sep 12, 2012 @ 20:49:37

   1. What did Henrietta Lack’s first doctor assume the source of the lump on her cervix was? What stereotype or bias might this assumption be based on?
   Henrietta’s local doctor thought that the “knot” was a sore from Syphilis, but she tested negative. The stereotype is that African Americans were carriers and prone to an abundance of sexually transmitted diseases. This is highlighted in the Tuskegee study of African American patients with Syphilis that were allowed to die, despite the medical staff knew about penicillin.
   2. Why did David Lacks take Henrietta to the public wards at Johns Hopkins instead of a closer hospital?
   John Hopkins was the only major medical center that would treat “colored” people, and they had a public ward to treat uninsured/impoverished patients.
   3. Compare the medical terms describing Elsie’s condition with terms used by Henrietta’s friends and family. What are the connotations of the two sets of terms?
   The medical terms included mental retardation, neurosyphilis and epilepsy. Henrietta’s family and friends would describe Elsie as “simple, or “touched” with the mind of an infant. The medical connotations are a lot more rigid and emotionally empty, where the family and friends were more understanding.
   4. Summarize Dr. TeLinde’s position in the debate over the treatment of cervical cancer.
   At that time the medical field believed that there were to forms of cervical cancer. The first being an invasive carcinoma that needed to be treated aggressively and the second being a non-invasive carcinoma that was not serious. However Dr. TeLinde believed that non-invasive carcinoma was simply an early presentation of invasive carcinoma.
   5. What Dr. Gey hope to accomplish with HeLa cells?
   Dr. Gey and his wife Margaret wanted to find the cause and cure of cancer.
   6. In your own words, explain the paradox of “benevolent deception.”
   Benevolent deception is the practice of doctors withholding information about a medical issue from the patient. This was done in order not to confuse or frighten patients with terms they didn’t understand. This theory of benevolent deception with knowingly withholding information from patients is counter intuitive to having patients be actively involved in their own medical care. It’s unethical to not inform the patient in terms they understand about the treatment they are receiving.
   7. What characteristics of HeLa cells made them ideal for use in polio vaccine trials?
   HeLa cells were virulent and could grow in suspension at impressively fast rates. They were the perfect cells to be grown in mass production because they were susceptible to the polio virus.
   8. Explain the inherent irony of the fact that the Tuskegee HeLa production lab was operating at the same time of the infamous syphilis study was being conducted.
   The Tuskegee HeLa production was being conducted by African American scientists and technician who were primarily women. The inherent irony is that at the same time the infamous Tuskegee Syphillis study was being conducted with African Americans unethically not treated with Penicillin.
   9. Explain the contribution that HeLa made to the emerging field of genetics.
   HeLa cells allowed scientist for the first time to discover that there were 46 human chromosomes and not 48 as previously thought. This discovery helped scientist to begin classifying genetic diseases like Down Syndrome.
   10. What did Dr. Gartler discover about eighteen of the most commonly used cell cultures?
   HeLa cells were present and contaminating 18 of the most commonly used cell culture lines. Scientist originally thought that their cells were spontaneously mutating into cancer cells, but in reality HeLa cells had become airborne and infected the cell lines.

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6. Jena Hallenbeck
   Sep 15, 2012 @ 21:11:57

   1. What did Henrietta Lack’s first doctor assume the source of the lump on her cervix was? What stereotype or bias might this assumption be based on?
   Her first doctor assumed the lump was a Syphilis sore. A common racial stereotype during this time period may have been that African Americans were often afflicted with sexually transmitted diseases

   2. Why did David Lacks take Henrietta to the public wards at Johns Hopkins instead of a closer hospital?
   David Lacks brought Henrietta to the public wards because it was one of the few major hospitals at that time that treated African American patients and did so for free.

   3. Compare the medical terms describing Elsie’s condition with terms used by Henrietta’s friends and family. What are the connotations of the two sets of terms?
   Medically speaking Elsie had conditions that were not fully understood at the time. Diagnoses such as neurosyphilis, mental retardation and epilepsy may have been used to describe her condition by medical personnel in the future. But because of the time frame in which this happened her condition was not fully understood and she was institutionalized at an early age. Henrietta and her family described Elsie as “simple” which made reference to her intellectual ability when in reality it was a medical impairment, not her IQ, that made her “slow.”

   4. Summarize Dr. TeLinde’s position in the debate over the treatment of cervical cancer.
   Dr. TeLinde disagreed that only invasive carcinomas should be treated aggressively. He believed that “in-situ” cancers were early stages of invasive carcinoma and therefore should be treated to prevent rapid progression.

   5. What Dr. Gey hope to accomplish with HeLa cells?
   Dr. Gey spent three decades attempting to grow malignant cells outside of the body that would reproduce and replenish their own stock. He wanted to use them for cancer research and possibly discover a cure.

   6. In your own words, explain the paradox of “benevolent deception.”
   “Benevolent deception” is the act of withholding information from a patient believing that it is in their best interest. It is believed to be in their best interest because some doctors believe patients will not understand certain diagnoses/terms and it is better not to confuse or upset them. This practice is highly unethical and goes against the model that patients should be their own advocates. How do we expect patients to be fully invested in their health if we do not believe they have the ability to understand it?

   7. What characteristics of HeLa cells made them ideal for use in polio vaccine trials?
   HeLa cells were susceptible to the poliovirus which made them ideal to the study of the virus. The HeLa cells also can reproduce at a fast rate and therefore replenish their own stock. This made fast and effective research possible.

   8. Explain the inherent irony of the fact that the Tuskegee HeLa production lab was operating at the same time of the infamous syphilis study was being conducted.
   The Tuskgee production lab was employed by young black scientists and technicians working fervently to produce HeLa cells. Because the mass production of HeLa cells was so important to scientific and medical advancement these scientist were actually helping save millions of lives. Ironically, at the time these African Americans were working so hard to save lives many African Americans were being used in a secret 40-year government study. The Tuskgee study purposely withheld Syphilis treatment in order to study the disease. This led to death, serious medical implications of many of those in the study and spread of the disease. This would become one of the most infamous exampled of unethical behavior

   9. Explain the contribution that HeLa made to the emerging field of genetics.
   HeLa cells made one of the greatest advancements in the field of genetics -identifying humans have 46 chromosomes. This groundbreaking discovery led to the ability to study chromosomal disorders.

   10. What did Dr. Gartler discover about eighteen of the most commonly used cell cultures?
   Dr. Gartler discovered that HeLa cells had contaminated these cell cultures. He was able to determine this because they all contained a rare genetic marker found exclusively in African Americans called glucose-6-phosphate dehydrogenase-A (G6PD-A). Due to HeLa’s ability to thrive and radical growth it was able to spread quickly and therefore contaminate these other cell cultures.

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