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On January 29, 1951, David Lacks sat behind the wheel of his old Buick, watching the rain fall. He was parked under a towering oak tree outside Johns Hopkins Hospital with three of his children—two still in diapers—waiting for their mother, Henrietta. A few minutes earlier she’d jumped out of the car, pulled her jacket over her head, and scurried into the hospital, past the “colored” bathroom, the only one she was allowed to use. In the next building, under an elegant domed copper roof, a ten-and-a-half-foot marble statue of Jesus stood, arms spread wide, holding court over what was once the main entrance of Hopkins. No one in Henrietta’s family ever saw a Hopkins doctor without visiting the Jesus statue, laying flowers at his feet, saying a prayer, and rubbing his big toe for good luck. But that day Henrietta didn’t stop.
She went straight to the waiting room of the gynecology clinic, a wide-open space, empty but for rows of long straight-backed benches that looked like church pews.
“I got a knot on my womb,” she told the receptionist. “The doctor need to have a look.”
For more than a year Henrietta had been telling her closest girlfriends something didn’t feel right. One night after dinner, she sat on her bed with her cousins Margaret and Sadie and told them, “I got a knot inside me.”
“A what?” Sadie asked.
“A knot,” she said. “It hurt somethin awful—when that man want to get with me, Sweet Jesus aren’t them but some pains.”
When sex first started hurting, she thought it had something to do with baby Deborah, who she’d just given birth to a few weeks earlier, or the bad blood David sometimes brought home after nights with other women—the kind doctors treated with shots of penicillin and heavy metals.
Henrietta grabbed her cousins’ hands one at a time and guided them to her belly, just as she’d done when Deborah started kicking.
“You feel anything?”
The cousins pressed their fingers into her stomach again and again.
“I don’t know,” Sadie said. “Maybe you’re pregnant outside your womb—you know that can happen.”
“I’m no kind of pregnant,” Henrietta said. “It’s a knot.”
“Hennie, you gotta check that out. What if it’s somethin bad?”
But Henrietta didn’t go to the doctor, and the cousins didn’t tell anyone what she’d said in the bedroom. In those days, people didn’t talk about things like cancer, but Sadie always figured Henrietta kept it secret because she was afraid a doctor would take her womb and make her stop having children.
About a week after telling her cousins she thought something was wrong, at the age of twenty-nine, Henrietta turned up pregnant with Joe, her fifth child. Sadie and Margaret told Henrietta that the pain probably had something to do with a baby after all. But Henrietta still said no.
“It was there before the baby,” she told them. “It’s somethin else.”
They all stopped talking about the knot, and no one told Henrietta’s husband anything about it. Then, four and a half months after baby Joseph was born, Henrietta went to the bathroom and found blood spotting her underwear when it wasn’t her time of the month.
She filled her bathtub, lowered herself into the warm water, and spread her legs. With the door closed to her children, husband, and cousins, Henrietta slid a finger inside herself and rubbed it across her cervix until she found what she somehow knew she’d find: a hard lump, deep inside, as though someone had lodged a marble just to the left of the opening to her womb.
Henrietta climbed out of the bathtub, dried herself off, and dressed. Then she told her husband, “You better take me to the doctor. I’m bleedin and it ain’t my time.”
Her local doctor took one look inside her, saw the lump, and figured it was a sore from syphilis. But the lump tested negative for syphilis, so he told Henrietta she’d better go to the Johns Hopkins gynecology clinic.
Hopkins was one of the top hospitals in the country. It was built in 1889 as a charity hospital for the sick and poor, and it covered more than a dozen acres where a cemetery and insane asylum once sat in East Baltimore. The public wards at Hopkins were filled with patients, most of them black and unable to pay their medical bills. David drove Henrietta nearly twenty miles to get there, not because they preferred it, but because it was the only major hospital for miles that treated black patients. This was the era of Jim Crow—when black people showed up at white-only hospitals, the staff was likely to send them away, even if it meant they might die in the parking lot. Even Hopkins, which did treat black patients, segregated them in colored wards, and had colored-only fountains.
So when the nurse called Henrietta from the waiting room, she led her through a single door to a colored-only exam room—one in a long row of rooms divided by clear glass walls that let nurses see from one to the next. Henrietta undressed, wrapped herself in a starched white hospital gown, and lay down on a wooden exam table, waiting for Howard Jones, the gynecologist on duty. Jones was thin and graying, his deep voice softened by a faint Southern accent. When he walked into the room, Henrietta told him about the lump. Before examining her, he flipped through her chart—a quick sketch of her life, and a litany of untreated conditions:
Sixth or seventh grade education; housewife and mother of five. Breathing difficult since childhood due to recurrent throat infections and deviated septum in patient’s nose. Physician recommended surgical repair. Patient declined. Patient had one toothache for nearly five years; tooth eventually extracted with several others. Only anxiety is oldest daughter who is epileptic and can’t talk. Happy household. Very occasional drinker. Has not traveled. Well nourished, cooperative. Patient was one of ten siblings. One died of car accident, one from rheumatic heart, one was poisoned. Unexplained vaginal bleeding and blood in urine during last two pregnancies; physician recommended sickle cell test. Patient declined. Been with husband since age 15 and has no liking for sexual intercourse. Patient has asymptomatic neuro syphilis but cancelled syphilis treatments, said she felt fine. Two months prior to current visit, after delivery of fifth child, patient had significant blood in urine. Tests showed areas of increased cellular activity in the cervix. Physician recommended diagnostics and referred to specialist for ruling out infection or cancer. Patient canceled appointment. One month prior to current visit, patient tested positive for gonorrhea. Patient recalled to clinic for treatment. No response.
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.
Jones listened as Henrietta told him about the pain, the blood. “She says that she knew there was something wrong with the neck of her womb,” he wrote later. “When asked why she knew it, she said that she felt as if there were a lump there. I do not quite know what she means by this, unless she actually palpated this area.”
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. He described it as an eroded, hard mass about the size of a nickel. If her cervix was a clock’s face, the lump was at four 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, Jones sat down and 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.