A journalist named Rebecca Skloot recounts learning about an African American woman named Henrietta Lacks, who died in 1951 of cervical cancer, but whose cancerous cells became the first immortal human cell line, called HeLa. Rebecca explains that HeLa made possible some of the most important discoveries of the 21st century, but that we know little about the woman behind them. Rebecca then introduces Deborah Lacks, Henrietta’s daughter, and a key figure in Rebecca’s quest.
Rebecca narrates Henrietta’s first visits to Johns Hopkins hospital, where doctors first tell her she is fine, but eventually diagnose her with cervical cancer and treat her with radiation. Skloot explains that Johns Hopkins was one of the best hospitals in the country, but that it subscribed to deeply racist practices when it came to treating African Americans. She then traces Henrietta’s lineage back to the town of Clover, VA, explaining how Henrietta met her husband (and cousin), Day. The two first had a daughter named Elsie, who was mentally impaired, and who eventually died in an asylum called Crownsville.
Rebecca explains more about cervical cancer research and treatments in the 1950s, before moving on to the practice of cell culturing, which was in its early stages at this time. Doctors such as George Gey (who worked at Hopkins) were seeking to create a breed of human cells that could regenerate eternally—an immortal cell line—but were having no success. Then Gey is given a sample of Henrietta’s cervical tissue by her doctors (and without her knowledge), and her cancer cells begin growing at an extraordinary rate. As her cells flourish, however, Henrietta continues to decline.
We jump to 1999, when Rebecca begins attempting to contact the Lackses; she is cautiously aided by Professor Roland Pattillo, an academic at Morehouse College who knows the Lackses, but fears that Rebecca is another white journalist out to exploit them. Rebecca begins calling Deborah every day, as well as two of her brothers, Lawrence and Sonny. Back in 1951, George Gey begins publicizing HeLa, and sending it to many different researchers around the world, but he does not make any financial profit from this. Henrietta, meanwhile, gets worse and worse, until the doctors pronounce her tumor inoperable.
Rebecca travels to Baltimore, where the Lackses live, and encounters Courtney Speed, a local woman determined to publicize Henrietta’s story. Still, though, the Lackses refuse to meet with Skloot. Meanwhile in September 1951, Henrietta is in agony, and she dies the next month. The doctors at Hopkins pressure Day into allowing them to autopsy her in order to study her cells further. Her family buries her in an unmarked grave. HeLa continues to thrive, aiding researchers in creating a polio vaccine, and leading to the first ever operation to mass-produce human cells. Scientists begin using the cells to study viruses, human genetics, drugs, environmental stress, and vitamins. Journalists begin wondering about Henrietta’s identity, and eventually an article is written about her using the wrong name: Helen Lane.
Without their mother, Henrietta’s children suffer under an abusive cousin—especially Henrietta’s youngest child, Joe, who quickly becomes a juvenile delinquent. Rebecca continues to explore Henrietta’s heritage, especially noticing that though her family is descended from white plantation owners and enslaved women, the clan is strictly divided into white Lackses and black Lackses, who never mix.
We learn more about unethical research practices of the day, as emblemized by Chester Southam, who injected HeLa and other cancer cells into patients without their knowledge, and was eventually reprimanded by the New York Medical Board of Regents. This case started a debate over questions of medical consent. As this conflict rages, HeLa becomes evermore widespread, contaminating hundreds of other cell lines.
Henrietta’s children grow up and begin having children of their own; Joe, however, is convicted for murder and sentenced to fifteen years. In prison, he converts to Islam and changes his name to Zakariyya. In the present day, Rebecca finally gets to meet Lawrence, Sonny, and Day, all of whom are furious over the fact that others are profiting off of Henrietta’s cells while they live in poverty. Rebecca recounts when the family first found out about HeLa, and describes their shock and confusion. Eventually Hopkins contacts them to study their own genetic information, but never explains why; the fearful Deborah believes that they are testing to see if she will die like her mother.
Rebecca begins exploring the controversy over profiting from another person’s tissues, which quickly made its way into the court system, but did little to help the Lackses. They continue to struggle in the 1980s, even as scientists keep making advances using HeLa. Eventually the BBC contacts them to make a documentary about Henrietta and her family, following them to a conference that Pattillo has organized in their honor. An opportunist named Cofield, however, learns about the family and tries to take advantage of them (as he is a distant relative), first pretending to help them sue Hopkins, but then eventually suing them for millions of dollars. The suit is dismissed, but the Lackses are terrified.
In the present day, at long last, Deborah agrees to talk with Rebecca. On their first meeting, Rebecca gives Deborah a gift: a picture of Henrietta’s chromosomes, colored and hundreds of thousands of times magnified, taken by researcher Christoph Lengauer. Rebecca struggles to gain Deborah’s trust, but it is a difficult process. Eventually Deborah takes Rebecca to meet the still-fearsome Zakariyya; he softens, however, when Deborah gives him Lengauer’s picture to keep.
Rebecca learns more about Deborah, her paranoia, her medical problems, and her desperate desire to understand what has happened to her mother and sister. Along with Zakariyya, they eventually visit Lengauer’s lab, where Henrietta’s children see their mother’s living cells. Lengauer expresses regret over the medical establishment’s treatment of Henrietta, and Zakariyya thanks him. Deborah calls it “a miracle.”
Eventually Deborah and Rebecca travel to Crownsville to learn more about Elsie. They find her records, and even a picture, but learn that she suffered terribly before her death. That night, Deborah finally allows Rebecca to read Henrietta’s medical records, but Deborah becomes deeply anxious, even breaking out in hives. On their way back, they stop at the house of a Lacks cousin named Gary. He prays to God to take the burden of HeLa off of Deborah and give it to Henrietta, as Deborah sobs. The next day, Deborah visits the hospital, and learns that she nearly had a stroke.
Indeed, Deborah eventually does have a stroke; but her medical crisis “ease[s] tension in the family.” Rebecca visits them a few months later to see one of the Lacks grandbabies be baptized. While she’s there the preacher—Deborah’s husband—asks Rebecca to tell the story of Henrietta to the congregation, and she does so. A few more months go by, and Rebecca finishes her book. After repeatedly contacting Deborah, however, she learns that Deborah has died of a heart attack. At the time of her death, though, many of her grandchildren were finishing high school, and even college. Rebecca believes that Deborah died happy, and remembers that she was looking forward to reuniting with Elsie and Henrietta in Heaven.