Just like scores of other premedical students all striving to get acceptance to medical school, I volunteered and did research during college. I elected to work in the Virology department because I wanted to study viruses like HIV, RSV, and SARS that were causing havoc on our society. I do recall that we used HeLa cells frequently in our research. In fact, most scientists in that department used HeLa cells on a regular basis regardless of the focus of their projects. I didn’t think much of the cells and I definitely never thought of where or from whom those cells may have come from. They were simply a day to day part of my research, just like assays used for western blots. It wasn’t until I learned of the publication of the book, The Immortal Life of Henrietta Lacks [Amazon link], that I came to learn about the incredible back story of these amazing HeLa cells. I believe that this book has valuable lessons to teach us clinicians about our patients, how we relate to our patients, and the significant roles we inadvertently play in their lives.
The book is written in first person perspective by Rebecca Skloot, a journalist who develops an interest in the woman who is the originator of the HeLa cell line, Henrietta Lacks. The book is a nonfiction narrative detailing the intensive research she underwent to fully understand the personal life and scientific legacy of Henrietta. She describes scientific discoveries made over the years while developing the cell line and those discoveries made because of the cell line. She also raises insights that cause the reader to think deeply about race, racism, ethics, vulnerable populations, and medicine. Ultimately, the book is a contrasting tale of the monumentous discoveries made by the cells compared to the deep hardships her family endured.
It is clear from the book that the doctors who took the original biopsy leading to the cell line did not immediately realize the scientific breakthrough they held in their hands. It is also true that they practiced medicine in a different societal climate compared to our times and the concept of informed consent did not exist. Regardless, those doctors forever changed the course of the lives of those related to Henrietta Lacks. Over the decades of miscommunication and incomplete communication, the family suffered by not fully understanding what cancer is, how it is spread, and the likelihood that it would recur. The family developed suspicion, anger, frustration, and hostility towards the medical community.
We clinicians, especially those in emergency medicine will literally encounter thousands of patients in our lifetimes. In the ED, we are in a unique and challenging position where we meet these patients and their families often at their most vulnerable and scared moment of their lives. Perhaps we interact with them only for 5 minutes until the code is declared, or perhaps we interact with them over 3 days, as often we do for those patients “boarding” in the department. Though these events are routine for us, it is not the case for the patients and their families. If we do not take caution in how we approach and think about our patients, we could easily repeat these mistakes of doctors past. I also believe it would be naive to feel that when we reflect on our society decades from now that we will not find ethical dilemmas by our current medical community. Therefore, it is important to always have the skill and thought process to reflect upon ourselves as doctors and our relationship with patients.
Learning Points for Medical Education
- The patient is a person, and their families are people with emotion.
- Always strive for transparency in medical decision making.
- Communicate with patients and families at the literacy level that they can understand and comprehend.
- Appreciate the deep trust we have to earn and maintain from our patients as physicians.
“Of all the patients you see over the course of your career, not one will remember what you looked like.
Very few will remember what you said.
But every single one of them will remember how you made them feel.”
– Michael Luchessi MD, Chairman of ED & CMO, SUNY Downstate Medical Center, Brooklyn, NY
Disclaimer: Neither I nor this website have any affiliations, financial or otherwise, with the book or Amazon.com.