Discussing The Immortal Life of Henrietta Lacks by Rebecca Sloot
Optional Book Discussion:Water for Elephants
Optional Book Discussion:Water for Elephants
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Discussion Questions for The Immortal Life of Henrietta Lacks
Back in March, I read The Immortal Life of Henrietta Lacks by Rebecca Skloot. I was so impacted by the story that I decided to choose it as a reading selection for my book club. However, as much as I searched, I was unable to find a published discussion guide for the book to facilitate a discussion. So my friends Robin, Angela, and I collaborated and came up with a list of the following discussion questions, which I hope might help anyone else out there looking on the internet for a discussion guide for this book:
The Immortal Life of Henrietta Lacks - Discussion Questions
1. The passage in which the initial fated cells were removed from Henrietta Lacks’s body reads as follows (see page 33):
“With Henrietta unconscious on the operating table in the center of the room, her feet in stirrups, the surgeon on duty, Dr. 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-sized 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.”
Bearing in mind that those two tissue samples removed from Henrietta were not removed in an attempt to treat her cancer, but rather purely for purposes of research, was it wrong for the doctor to remove the sample tissue in the first place? Was it wrong for Dr. Gey to collect those samples for the purpose of trying to grow them in controlled conditions? Does the end – i.e., the immeasurable benefit to humankind resulting from those tissue samples – justify the means – i.e., removing tissue from a person without their consent or knowledge?
2. Discuss the process of taking these cancerous cells and growing them in the “auger” or medium that allowed them to continue to multiply. Was it her human cell line?
(Note: As genetic knowledge has increased HeLa is: not really a human cell line at all because it involves a genetic fusion of a papilloma virus and Henrietta’s cervical cells. The hybrid has its own genome and attempts have been made to have the cell line recognized as a species in its own right. Of course this cell line also contaminated other cell lines in labs around the world. In a Feb. 2010 paper, HeLa was found as a contaminant of 106 out of 306 cell lines tested.
3.
Did you get the impression that Henrietta was treated any differently than a rich, white woman would have been (assuming the hospital was also collecting cell samples)?
4. How do you feel about knowing that you still do not have total control over your body once you go to see a doctor? If you discovered that tissue routinely removed from your body at some point in the past went on to significantly benefit science and research, would you feel that you should somehow be compensated? What do you think is more important – a person’s personal rights over their own tissue, or contributing to science and research for the benefit of all humankind?
5. Was it a good thing for the members of the Lacks family that the author wrote this book? Was this attempt different from previous attempts to write about the Lacks family and Henrietta in particular?
6. How much impact on the Lacks family members’ long term lives did Henrietta’s early demise have? Do you think that her children’s lives would have turned out significantly different had Henrietta not died so young?
7. Was it hubris, lack of “patient experience,” or frankly, sheer stupidity on the part of the researchers who contacted the family later for blood/DNA samples, to think the family understood what they were doing and why were they doing it?
8. Why has the discovery of the existence of HeLa cells been so difficult for the Lacks family? Discuss the family’s ignorance and their lack of medical knowledge. Why did it take until 2001, 50 years after Henrietta’s death, for a researcher at John Hopkins to show Deborah the cells and tell her these weren’t Henrietta’s regular cells, just trillions of cancerously transformed cells, and that there was never going to be a clone of her mother?
9. Do you think the family is owed money for the sale of the HeLa cells? Do you agree with their feeling that they should be compensated?
10. Do you think that the attitude among some of the Lacks family members that they should be monetarily compensated for Henrietta’s contribution to science is born out of their poverty and/or oppression based on their race? Do you think if the family were financially comfortable, white, and not the subjects of regular discrimination that their feelings of being owed compensation might be different?
11. When the doctor of the patient, Mr. Moore, lied to him about the financial value of his cells, do you think the doctor behaved unethically, and the court should have ruled against him?
12. What did the author hope to accomplish by writing this book? Did she accomplish what she set out to do? To what do you attribute the family’s change of heart regarding the HeLa cells?
13. Was the presence of the author in the book disruptive or appropriate?
14. How realistic was the characterization, especially of Deborah and Zakariyya? Would you want to meet any of them? Did you like them?
15. What life lessons can be learned from this account?
16. Do you think the bad things that happened to the family were based on their race, particularly in regards to Elsie (Henrietta’s daughter who was institutionalized) and Henrietta’s hospital care? Was it forgivable based on the time period or should amends be made?
17. How does the setting figure into the book? Is the setting a character? Does it come to life? Did you feel you were experiencing the time and place in which the book was set? How did you feel at the end when Clover was gone? Do you think this was an allegory for Henrietta’s family’s travails?
18. How realistic is it for Courtney Speed, the grocery store owner in Turner Station, to start a museum?
19. Discuss the medical breakthroughs from HeLa cells. Have your attitudes or ideas towards medical research changed in any way due to reading this book?
20. Ownership of genetic material is still a vexed issue. Many human genes have been patented and a battle is currently being fought through the U.S. courts between doctors and a biotech company owning the patents for genes used in breast-cancer research screening. What are your thoughts about research and patents in this now “profit making” industry?
Back in March, I read The Immortal Life of Henrietta Lacks by Rebecca Skloot. I was so impacted by the story that I decided to choose it as a reading selection for my book club. However, as much as I searched, I was unable to find a published discussion guide for the book to facilitate a discussion. So my friends Robin, Angela, and I collaborated and came up with a list of the following discussion questions, which I hope might help anyone else out there looking on the internet for a discussion guide for this book:
The Immortal Life of Henrietta Lacks - Discussion Questions
1. The passage in which the initial fated cells were removed from Henrietta Lacks’s body reads as follows (see page 33):
“With Henrietta unconscious on the operating table in the center of the room, her feet in stirrups, the surgeon on duty, Dr. 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-sized 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.”
Bearing in mind that those two tissue samples removed from Henrietta were not removed in an attempt to treat her cancer, but rather purely for purposes of research, was it wrong for the doctor to remove the sample tissue in the first place? Was it wrong for Dr. Gey to collect those samples for the purpose of trying to grow them in controlled conditions? Does the end – i.e., the immeasurable benefit to humankind resulting from those tissue samples – justify the means – i.e., removing tissue from a person without their consent or knowledge?
2. Discuss the process of taking these cancerous cells and growing them in the “auger” or medium that allowed them to continue to multiply. Was it her human cell line?
(Note: As genetic knowledge has increased HeLa is: not really a human cell line at all because it involves a genetic fusion of a papilloma virus and Henrietta’s cervical cells. The hybrid has its own genome and attempts have been made to have the cell line recognized as a species in its own right. Of course this cell line also contaminated other cell lines in labs around the world. In a Feb. 2010 paper, HeLa was found as a contaminant of 106 out of 306 cell lines tested.
3.
Did you get the impression that Henrietta was treated any differently than a rich, white woman would have been (assuming the hospital was also collecting cell samples)?
4. How do you feel about knowing that you still do not have total control over your body once you go to see a doctor? If you discovered that tissue routinely removed from your body at some point in the past went on to significantly benefit science and research, would you feel that you should somehow be compensated? What do you think is more important – a person’s personal rights over their own tissue, or contributing to science and research for the benefit of all humankind?
5. Was it a good thing for the members of the Lacks family that the author wrote this book? Was this attempt different from previous attempts to write about the Lacks family and Henrietta in particular?
6. How much impact on the Lacks family members’ long term lives did Henrietta’s early demise have? Do you think that her children’s lives would have turned out significantly different had Henrietta not died so young?
7. Was it hubris, lack of “patient experience,” or frankly, sheer stupidity on the part of the researchers who contacted the family later for blood/DNA samples, to think the family understood what they were doing and why were they doing it?
8. Why has the discovery of the existence of HeLa cells been so difficult for the Lacks family? Discuss the family’s ignorance and their lack of medical knowledge. Why did it take until 2001, 50 years after Henrietta’s death, for a researcher at John Hopkins to show Deborah the cells and tell her these weren’t Henrietta’s regular cells, just trillions of cancerously transformed cells, and that there was never going to be a clone of her mother?
9. Do you think the family is owed money for the sale of the HeLa cells? Do you agree with their feeling that they should be compensated?
10. Do you think that the attitude among some of the Lacks family members that they should be monetarily compensated for Henrietta’s contribution to science is born out of their poverty and/or oppression based on their race? Do you think if the family were financially comfortable, white, and not the subjects of regular discrimination that their feelings of being owed compensation might be different?
11. When the doctor of the patient, Mr. Moore, lied to him about the financial value of his cells, do you think the doctor behaved unethically, and the court should have ruled against him?
12. What did the author hope to accomplish by writing this book? Did she accomplish what she set out to do? To what do you attribute the family’s change of heart regarding the HeLa cells?
13. Was the presence of the author in the book disruptive or appropriate?
14. How realistic was the characterization, especially of Deborah and Zakariyya? Would you want to meet any of them? Did you like them?
15. What life lessons can be learned from this account?
16. Do you think the bad things that happened to the family were based on their race, particularly in regards to Elsie (Henrietta’s daughter who was institutionalized) and Henrietta’s hospital care? Was it forgivable based on the time period or should amends be made?
17. How does the setting figure into the book? Is the setting a character? Does it come to life? Did you feel you were experiencing the time and place in which the book was set? How did you feel at the end when Clover was gone? Do you think this was an allegory for Henrietta’s family’s travails?
18. How realistic is it for Courtney Speed, the grocery store owner in Turner Station, to start a museum?
19. Discuss the medical breakthroughs from HeLa cells. Have your attitudes or ideas towards medical research changed in any way due to reading this book?
20. Ownership of genetic material is still a vexed issue. Many human genes have been patented and a battle is currently being fought through the U.S. courts between doctors and a biotech company owning the patents for genes used in breast-cancer research screening. What are your thoughts about research and patents in this now “profit making” industry?
Water for Elephants Discussion Questions
Though he may not speak of them, the memories still dwell inside Jacob Jankowski's ninety-something-year-old mind. Memories of himself as a young man, tossed by fate onto a rickety train that was home to the Benzini Brothers Most Spectacular Show on Earth. Memories of a world filled with freaks and clowns, with wonder and pain and anger and passion; a world with its own narrow, irrational rules, its own way of life, and its ownway of death. The world of the circus: to Jacob it was both salvation and a living hell.
Jacob was there because his luck had run out --- orphaned and penniless, he had no direction until he landed on this locomotive "ship of fools." It was the early part of the Great Depression, and everyone in this third-rate circus was lucky to have any job at all. Marlena, the star of the equestrian act, was there because she fell in love with the wrong man, a handsome circus boss with a wide mean streak. And Rosie the elephant was there because she was the great gray hope, the new act that was going to be the salvation of the circus; the only problem was, Rosie didn't have an act --- in fact, she couldn't even follow instructions. The bond that grew among this unlikely trio was one of love and trust, and ultimately, it was their only hope for survival.
Surprising, poignant, and funny, Water for Elephants is that rare novel with a story so engrossing, one is reluctant to put it down; with characters so engaging, they continue to live long after the last page has been turned; with a world built of wonder, a world so real, one starts to breathe its air. top of the page
1. To what extent do the chapters concerning the elderly Jacob enhance the chapters recounting the young Jacob's experiences with the Benzini Brothers circus? In what ways do the chapters about the young Jacob contribute to a deeper understanding of the elderly Jacob's life?
2. How does the novel's epigraph, the quote from Dr. Seuss's Horton Hatches the Egg, apply to the novel? What are the roles and importance of faithfulness and loyalty in Water for Elephants? In what ways does Gruen contrast the antagonisms and cruelties of circus life with the equally impressive loyalties and instances of caring?
3. Who did you, upon reading the prologue, think murdered August? What effect did that opening scene of chaos and murder have on your reception of the story that follows?
4. In connection with Jacob's formal dinner with August and Marlena in their stateroom, Jacob remarks, "August is gracious, charming, and mischievous" (page 93). To what extent is this an adequate characterization of August? How would you expand upon Jacob's observation? How would you characterize August? Which situations in the novel reveal his true character?
5. August says of Marlena, "Not everyone can work with liberty horses. It's a God-given talent, a sixth sense, if you will" (page 94). Both August and Jacob recognize Marlena's skills, her "sixth sense," in working with the horses. In what ways does that sixth sense attract each man? How do August and Jacob differ in terms of the importance each places on Marlena's abilities?
6. After Jacob puts Silver Star down, August talks with him about the reality of the circus. "The whole thing's illusion, Jacob," he says, "and there's nothing wrong with that. It's what people want from us. It's what they expect" (page 104). How does Gruen contrast the worlds of reality and illusion in the novel? Is there anything wrong with pandering to people's need for illusion? Why do we crave the illusions that the circus represents?
7. Reflecting on the fact that his platitudes and stories don't hold his children's interest, the elderly Jacob notes, "My real stories are all out of date. So what if I can speak firsthand about the Spanish flu, the advent of the automobile, world wars, cold wars, guerrilla wars, and Sputnik --- that's all ancient history now. But what else do I have to offer?" (page 110). How might we learn to appreciate the stories and life lessons of our elders and encourage people younger than ourselves to appreciate our own?
8. Looking at himself in the mirror, the old Jacob tries "to see beyond the sagging flesh." But he claims, "It's no good. . . . I can't find myself anymore. When did I stop being me?" (page 111). How would you answer that question for Jacob or any individual, or for yourself?
9. In what ways and to what degree do Uncle Al's maneuvers and practices regarding the defunct Fox Brothers circus reflect traditional American business practices? How would you compare his behavior with that of major businessmen and financiers of today? What alternative actions would you prefer?
10. As he lies on his bedroll, after his night with Barbara and Nell, Jacob cannot empty his mind of troubling visions and he reflects that "the more distressing the memory, the more persistent its presence" (page 143). How might the elderly Jacob's memories corroborate or contradict this observation? What have been your experiences and observations in this regard?
11. In his Carnival of the Animals, Ogden Nash wrote, "Elephants are useful friends." In what ways is Rosie a "useful" friend? What is Rosie's role in the events that follow her acquisition by Uncle Al?
12. After Jacob successfully coaches August in Polish commands for Rosie, he observes, "It's only when I catch Rosie actually purring under August's loving ministrations that my conviction starts to crumble. And what I'm left looking at in its place is a terrible thing" (page 229). What is Jacob left "looking at," how does it pertain to August's personality and Jacob's relationship with August, and what makes it a "terrible thing"?
13. How did you react to the redlighting of Walter and Camel, and eight others, off the trestle? How might we see Uncle Al's cutthroat behavior as "an indictment of a lifetime spent feigning emotions to make a buck" (in the words of one reviewer)?
14. After the collapse of the Benzini Brothers circus and Uncle Al's having "done a runner" (page 314), Jacob realizes, "Not only am I unemployed and homeless, but I also have a pregnant woman, bereaved dog, elephant, and eleven horses to take care of" (page 317). What expectations did you entertain for Jacob and Marlena's --- and their menagerie's --- future after they leave the Benzini Brothers circus? How do the elderly Jacob's memories of Marlena and their life together confirm or alter those expectations?
15. At the end of the novel, Jacob exclaims, "So what if I'm ninety-three? . . . why the hell shouldn't I run away with the circus?" (page 331). What would you project to be the elderly Jacob's experiences after he runs away with the circus the second time? How does his decision reflect what we have learned about his early years?
16. Sara Gruen has said that the "backbone" of her novel "parallels the biblical story of Jacob," in the book of Genesis. On the first night after his leaving Cornell, for example, Jacob --- as did his biblical namesake --- lies "back on the bank, resting my head on a flat stone" (page 23). In what other ways does Water for Elephants parallel the story of the biblical Jacob? How do the names of many of the characters reflect names of characters in the biblical account?
17. In the words of one reviewer, Water for Elephants "explores . . . the pathetic grandeur of the Depression-era circus." In what ways and to what extent do the words "pathetic grandeur" describe the world that Gruen creates in her novel?
These book-group discussion questions were prepared by Hal Hager, of Hal Hager & Associates, Somerville, New Jersey.
Jacob was there because his luck had run out --- orphaned and penniless, he had no direction until he landed on this locomotive "ship of fools." It was the early part of the Great Depression, and everyone in this third-rate circus was lucky to have any job at all. Marlena, the star of the equestrian act, was there because she fell in love with the wrong man, a handsome circus boss with a wide mean streak. And Rosie the elephant was there because she was the great gray hope, the new act that was going to be the salvation of the circus; the only problem was, Rosie didn't have an act --- in fact, she couldn't even follow instructions. The bond that grew among this unlikely trio was one of love and trust, and ultimately, it was their only hope for survival.
Surprising, poignant, and funny, Water for Elephants is that rare novel with a story so engrossing, one is reluctant to put it down; with characters so engaging, they continue to live long after the last page has been turned; with a world built of wonder, a world so real, one starts to breathe its air. top of the page
1. To what extent do the chapters concerning the elderly Jacob enhance the chapters recounting the young Jacob's experiences with the Benzini Brothers circus? In what ways do the chapters about the young Jacob contribute to a deeper understanding of the elderly Jacob's life?
2. How does the novel's epigraph, the quote from Dr. Seuss's Horton Hatches the Egg, apply to the novel? What are the roles and importance of faithfulness and loyalty in Water for Elephants? In what ways does Gruen contrast the antagonisms and cruelties of circus life with the equally impressive loyalties and instances of caring?
3. Who did you, upon reading the prologue, think murdered August? What effect did that opening scene of chaos and murder have on your reception of the story that follows?
4. In connection with Jacob's formal dinner with August and Marlena in their stateroom, Jacob remarks, "August is gracious, charming, and mischievous" (page 93). To what extent is this an adequate characterization of August? How would you expand upon Jacob's observation? How would you characterize August? Which situations in the novel reveal his true character?
5. August says of Marlena, "Not everyone can work with liberty horses. It's a God-given talent, a sixth sense, if you will" (page 94). Both August and Jacob recognize Marlena's skills, her "sixth sense," in working with the horses. In what ways does that sixth sense attract each man? How do August and Jacob differ in terms of the importance each places on Marlena's abilities?
6. After Jacob puts Silver Star down, August talks with him about the reality of the circus. "The whole thing's illusion, Jacob," he says, "and there's nothing wrong with that. It's what people want from us. It's what they expect" (page 104). How does Gruen contrast the worlds of reality and illusion in the novel? Is there anything wrong with pandering to people's need for illusion? Why do we crave the illusions that the circus represents?
7. Reflecting on the fact that his platitudes and stories don't hold his children's interest, the elderly Jacob notes, "My real stories are all out of date. So what if I can speak firsthand about the Spanish flu, the advent of the automobile, world wars, cold wars, guerrilla wars, and Sputnik --- that's all ancient history now. But what else do I have to offer?" (page 110). How might we learn to appreciate the stories and life lessons of our elders and encourage people younger than ourselves to appreciate our own?
8. Looking at himself in the mirror, the old Jacob tries "to see beyond the sagging flesh." But he claims, "It's no good. . . . I can't find myself anymore. When did I stop being me?" (page 111). How would you answer that question for Jacob or any individual, or for yourself?
9. In what ways and to what degree do Uncle Al's maneuvers and practices regarding the defunct Fox Brothers circus reflect traditional American business practices? How would you compare his behavior with that of major businessmen and financiers of today? What alternative actions would you prefer?
10. As he lies on his bedroll, after his night with Barbara and Nell, Jacob cannot empty his mind of troubling visions and he reflects that "the more distressing the memory, the more persistent its presence" (page 143). How might the elderly Jacob's memories corroborate or contradict this observation? What have been your experiences and observations in this regard?
11. In his Carnival of the Animals, Ogden Nash wrote, "Elephants are useful friends." In what ways is Rosie a "useful" friend? What is Rosie's role in the events that follow her acquisition by Uncle Al?
12. After Jacob successfully coaches August in Polish commands for Rosie, he observes, "It's only when I catch Rosie actually purring under August's loving ministrations that my conviction starts to crumble. And what I'm left looking at in its place is a terrible thing" (page 229). What is Jacob left "looking at," how does it pertain to August's personality and Jacob's relationship with August, and what makes it a "terrible thing"?
13. How did you react to the redlighting of Walter and Camel, and eight others, off the trestle? How might we see Uncle Al's cutthroat behavior as "an indictment of a lifetime spent feigning emotions to make a buck" (in the words of one reviewer)?
14. After the collapse of the Benzini Brothers circus and Uncle Al's having "done a runner" (page 314), Jacob realizes, "Not only am I unemployed and homeless, but I also have a pregnant woman, bereaved dog, elephant, and eleven horses to take care of" (page 317). What expectations did you entertain for Jacob and Marlena's --- and their menagerie's --- future after they leave the Benzini Brothers circus? How do the elderly Jacob's memories of Marlena and their life together confirm or alter those expectations?
15. At the end of the novel, Jacob exclaims, "So what if I'm ninety-three? . . . why the hell shouldn't I run away with the circus?" (page 331). What would you project to be the elderly Jacob's experiences after he runs away with the circus the second time? How does his decision reflect what we have learned about his early years?
16. Sara Gruen has said that the "backbone" of her novel "parallels the biblical story of Jacob," in the book of Genesis. On the first night after his leaving Cornell, for example, Jacob --- as did his biblical namesake --- lies "back on the bank, resting my head on a flat stone" (page 23). In what other ways does Water for Elephants parallel the story of the biblical Jacob? How do the names of many of the characters reflect names of characters in the biblical account?
17. In the words of one reviewer, Water for Elephants "explores . . . the pathetic grandeur of the Depression-era circus." In what ways and to what extent do the words "pathetic grandeur" describe the world that Gruen creates in her novel?
These book-group discussion questions were prepared by Hal Hager, of Hal Hager & Associates, Somerville, New Jersey.
