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It was no surprise that she hadn't come back all those times for follow-up. For Henrietta, walking into Hopkins was like entering a foreign country where she didn't speak the language. She knew about harvesting tobacco and butchering a pig, but she'd never heard the words cervix or biopsy. She didn't read or write much, and she hadn't studied science in school. She, like most black patients, only went to Hopkins when she thought she had no choice.

Henrietta lay back on the table, feet pressed hard in stirrups as she stared at the ceiling. And sure enough, Jones found a lump exactly where she'd said he would. If her cervix was a clock's face, the lump was at 4 o'clock. He'd seen easily a thousand cervical cancer lesions, but never anything like this: shiny and purple (like "grape Jello," he wrote later), and so delicate it bled at the slightest touch. Jones cut a small sample and sent it to the pathology lab down the hall for a diagnosis. Then he told Henrietta to go home.

Soon after, Howard Jones dictated notes about Henrietta and her diagnosis: "Her history is interesting in that she had a term delivery here at this hospital, September 19, 1950," he said. "No note is made in the history at that time or at the six weeks' return visit that there is any abnormality of the cervix."

Yet here she was, three months later, with a full-fledged tumor. Either her doctors had missed it during her last exams—which seemed impossible—or it had grown at a terrifying rate.

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Henrietta Lacks was born Loretta Pleasant in Roanoke, Virginia, on August 1, 1920. No one knows how she became Henrietta. A midwife named Fannie delivered her in a small shack on a dead-end road overlooking a train depot, where hundreds of freight cars came and went each day. Henrietta shared that house with her parents and eight older siblings until 1924, when her mother, Eliza Lacks Pleasant, died giving birth to her tenth child.

Henrietta's father, Johnny Pleasant, was a squat man who hobbled around on a cane he often hit people with. Johnny didn't have the patience for raising children, so when Eliza died, he took them all back to Clover, Virginia, where his family still farmed the tobacco fields their ancestors had worked as slaves. No one in Clover could take all ten children, so relatives divided them up—one with this cousin, one with that aunt. Henrietta ended up with her grandfather, Tommy Lacks.

Tommy lived in what everyone called the home-house, a four-room wooden cabin that once served as slave quarters, with plank floors, gas lanterns, and water Henrietta hauled up a long hill from the creek. The home-house stood on a hillside where wind whipped through cracks in the walls. The air inside stayed so cool that when relatives died, the family kept their corpses in the front hallway for days so people could visit and pay respects. Then they buried them in the cemetery out back.

Henrietta's grandfather was already raising another grandchild that one of his daughters left behind after delivering him on the home-house floor. That child's name was David Lacks, but everyone called him Day, because in the Lacks country drawl, house sounds like hyse, and David sounds like Day. No one could have guessed Henrietta would spend the rest of her life with Day—first as a cousin growing up in their grandfather's home, then as his wife.

Like most young Lackses, Day didn't finish school: He stopped in the fourth grade because the family needed him to work the tobacco fields. But Henrietta stayed until the sixth grade. During the school year, after taking care of the garden and livestock each morning, she'd walk two miles—past the white school where children threw rocks and taunted her—to the colored school, a three-room wooden farmhouse hidden under tall shade trees.

At nightfall the Lacks cousins built fires with pieces of old shoes to keep the mosquitoes away, and watched the stars from beneath the big oak tree where they'd hung a rope to swing from. They played tag, ring-around-the-rosy, and hopscotch, and danced around the field singing until Grandpa Tommy yelled for everyone to go to bed.

Henrietta and Day had been sharing a bedroom since she was 4 and he was 9, so what happened next didn't surprise anyone: They started having children together. Their son Lawrence was born just months after Henrietta's 14th birthday; his sister, Lucile Elsie Pleasant, came along four years later. They were both born on the floor of the home-house like their father, grandmother, and grandfather before them. People wouldn't use words like epilepsy, mental retardation, or neurosyphilis to describe Elsie's condition until years later. To the folks in Clover, she was just simple. Touched.

Henrietta and Day married alone at their preacher's house on April 10, 1941. She was 20; he was 25. They didn't go on a honeymoon because there was too much work to do, and no money for travel. Henrietta and Day were lucky if they sold enough tobacco each season to feed the family and plant the next crop. So after their wedding, Day went back to gripping the splintered ends of his old wooden plow as Henrietta followed close behind, pushing a homemade wheelbarrow and dropping tobacco seedlings into holes in the freshly turned red dirt.

A few months later, Day moved north to Turner Station, a small black community outside Baltimore where he'd gotten a job working in a shipyard. Henrietta stayed behind to care for the children and the tobacco until Day made enough money for a house and three tickets north. Soon, with a child on each side, Henrietta boarded a coal-fueled train from the small wooden depot at the end of Clover's Main Street. She left the tobacco fields of her youth and the hundred-year-old oak tree that shaded her from the sun on so many hot afternoons. At the age of 21, she stared through the train window at rolling hills and wide-open bodies of water for the first time, heading toward a new life.

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