Cervical carcinomas are divided into two types: invasive carcinomas, which have penetrated the surface of the cervix, and noninvasive carcinomas, which haven't. The noninvasive type is sometimes called "sugar-icing carcinoma," because it grows in a smooth layered sheet across the surface of the cervix, but its official name is carcinoma in situ, which derives from the Latin for "cancer in its original place."
In 1951 most doctors in the field believed that invasive carcinoma was deadly, and carcinoma in situ wasn't. So they hardly treated it. But Richard Wesley TeLinde, head of gynecology at Hopkins and one of the top cervical cancer experts in the country, disagreed—he believed carcinoma in situ was simply an early stage of invasive carcinoma that, left untreated, eventually became deadly. So he treated it aggressively, often removing the cervix, uterus, and most of the vagina. He argued that this would drastically reduce cervical cancer deaths, but his critics called it extreme and unnecessary.
TeLinde thought that if he could find a way to grow living samples from normal cervical tissue and both types of cancerous tissue—something never done before—he could compare all three. If he could prove that carcinoma in situ and invasive carcinoma looked and behaved similarly in the laboratory, he could end the debate, showing that he'd been right all along, and doctors who ignored him were killing their patients. So he called George Gey (pronounced "guy"), head of tissue culture research at Hopkins.
Gey and his wife, Margaret, had spent the last three decades working to grow malignant cells outside the body, hoping to use them to find cancer's cause and cure. But most of the cells died quickly, and the few that survived hardly grew at all. The Geys 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. They didn't care what kind of tissue they used, as long as it came from a person.
So when TeLinde offered Gey a supply of cervical cancer tissue in exchange for trying to grow some cells, Gey didn't hesitate. And TeLinde began collecting samples from any woman who happened to walk into Hopkins with cervical cancer. Including Henrietta.
Jones called Henrietta on February 5, 1951, after getting her biopsy report back from the lab, and told her the tumor was malignant. Henrietta didn't tell anyone what Jones said, and no one asked. She simply went on with her day as if nothing had happened, which was just like her—no sense upsetting anyone over something she could just deal with herself.
The next morning Henrietta climbed from the Buick outside Hopkins again, telling Day and the children not to worry.
"Ain't nothin' serious wrong," she said. "Doctor's gonna fix me right up."
Henrietta went straight to the admissions desk and told the receptionist she was there for her treatment. Then she signed a form with the words operation permit at the top of the page. It said:
I hereby give consent to the staff of The Johns Hopkins Hospital to perform any operative procedures and under any anaesthetic either local or general that they may deem necessary in the proper surgical care and treatment of:
Henrietta printed her name in the blank space. A witness with illegible handwriting signed a line at the bottom of the form, and Henrietta signed another.
Then she followed a nurse down a long hallway into the ward for colored women, where Howard Jones and several other white physicians ran more tests than she'd had in her entire life. They checked her urine, her blood, her lungs. They stuck tubes in her bladder and nose.
Henrietta's tumor was the invasive type, and like hospitals nationwide, Hopkins treated all invasive cervical carcinomas with radium, a white radioactive metal that glows an eerie blue. So the morning of Henrietta's first treatment, a taxi driver picked up a doctor's bag filled with thin glass tubes of radium from a clinic across town. The tubes were tucked into individual slots inside small canvas pouches hand-sewn by a local Baltimore woman. One nurse placed the pouches on a stainless steel tray. Another wheeled Henrietta into the small colored-only operating room, with stainless steel tables, huge glaring lights, and an all-white medical staff dressed in white gowns, hats, masks, and gloves.
With Henrietta unconscious on the operating table in the center of the room, her feet in stirrups, the surgeon on duty, Lawrence Wharton Jr., sat on a stool between her legs. He peered inside Henrietta, dilated her cervix, and prepared to treat her tumor. But first—though no one had told Henrietta that TeLinde was collecting samples or asked if she wanted to be a donor—Wharton picked up a sharp knife and shaved two dime-size pieces of tissue from Henrietta's cervix: one from her tumor, and one from the healthy cervical tissue nearby. Then he placed the samples in a glass dish.
Wharton slipped a tube filled with radium inside Henrietta's cervix, and sewed it in place. He then sewed a pouch filled with radium to the outer surface of her cervix and packed another against it. He slid several rolls of gauze inside her vagina to help keep the radium in place, then threaded a catheter into her bladder so she could urinate without disturbing the treatment.
When Wharton finished, a nurse wheeled Henrietta back into the ward, and a resident took the dish with the samples to Gey's lab, as he'd done many times before. Gey still got excited at moments like this, but everyone else in his lab saw Henrietta's sample as something tedious—the latest of what felt like countless samples that scientists and lab technicians had been trying and failing to grow for years.