The Immortal Life of Henrietta Lacks.

I mentioned this on Twitter earlier, but The Wire: The Complete Series on DVD is just $73 today on amazon through that link. Disclaimer: I don’t own it, because I’m buying episodes to watch on my iPad (which will cost me more in the long run, actually).

Rebecca Skloot’s The Immortal Life of Henrietta Lacks (currently just $8 in paperback on amazon) is, by far, the best nonfiction book I’ve read since The Ballad of the Whiskey Robber, weaving together a scientific breakthrough, a personal tragedy, and Skloot’s own difficult effort in gathering the information required to write the book into a single compelling narrative that succeeds despite the lack of a definitive resolution or even clear “good” and “bad” sides to the central conflict.

Henrietta Lacks was a poor African-American woman who died very young of cervical cancer in 1951, after receiving radiation treatments at Johns Hopkins that started too late to save her very aggressive form of the disease. A researcher at the school had been trying for some time to grow a long-lasting culture of human cells without success, but the sample he took from Lacks’ cancer turned out to be, as the book’s title implies, immortal, launching a scientific revolution that is partially responsible for many medical miracles we take for granted today – and a commercial revolution from the sale of these “HeLa” cells that has paid her descendents a grand total of zero dollars.

In 1951, there were no laws on medical privacy nor were there laws or even good guidelines on informing patients about what might happen to tissues or fluids collected from them during treatment; a doctor or hospital could use extra samples for research and the patient wouldn’t even know about it, let alone require compensation. A lengthy medical case decided in 1990, Moore v. Regents of the University of California, would later establish that the patient has no right to financial remuneration from such usage (unless, of course, he established those rights in advance, such as by patenting any unique genes*), but in Lacks’ era there were no such rules, nor even understanding that these biological samples could have substantial financial value. (The researcher in the Moore case, David Golde, comes off as particularly sleazy in Skloot’s retelling. He took his own life in 2004.)

*This part resonated a little more strongly with me, as my daughter and I do share a unique mutation that causes an inborn error of metabolism called 3MCC, in which the third step in the breakdown of the essential amino acid leucine produces the “wrong” waste product. (The disease isn’t unique, but our mutation had not been seen before. We’re special like that.) I’m largely asymptomatic beyond an inability to build muscle mass, but my daughter has been hospitalized once for a metabolic crisis and has now been a vegetarian for almost three years to avoid excessive protein intake. I’m still trying to get an answer from Children’s Hospital in Boston on their policies in this area.

What’s worse in this case, however, is that Lacks’ family – widower, siblings, and children – were completely unaware that her tissues had been taken, were being used in research, or had generated millions of dollars in value for others. The family, still poor, still mostly uneducated, and without health insurance, learned about HeLa in the 1970s, and it created a mixture of emotions ranging from fear to anger to wonder (including whether their mother could “feel” what was being done to these cells) that opens up windows on to racial inequalities, , medical ethics debates, and the conflict between public good and privacy rights.

Skloot herself worked on this book for nearly a decade, largely because the Lacks family, scarred by past media attention and con artists looking to latch on to their plight, resisted her efforts to interview them for the book. She eventually forged a strong friendship with Henrietta’s daughter Deborah, a fascinating woman whose emotional growth was probably stunted by losing her mother at such a young age yet who abounds with manic energy that drives her (and Skloot) forward on the research path. Deborah never seems to think of the compensation question, but simply wants to learn about her mother and about what has happened to her cells, perhaps to create a connection that was denied to her when her mother died.

The Lacks family gives the book the narrative structure it needs – the rise of HeLa cells from their origins to a major scientific breakthrough would make for a nice pamphlet, but doesn’t have the drama to drive a work of narrative non-fiction. Following the Lacks family’s struggles from losing Henrietta, from media coverage of the HeLa cells, and from their outrage at how their mother’s cells were used without consent, compensation, or even the correct name (she was often referred to as “Helen Lane” in medical journals), makes the book so powerful. The book requires no knowledge of science beyond a high school biology class, as Skloot provides sufficient explanation of cell structure and replication for anyone to follow along, and her presentation of the ethical issues involved is extremely balanced and surprisingly dispassionate for someone who became very close to the human subjects of her research. As easy as it is to react to the Lacks saga by arguing that her family should at least have been paid after the fact, Skloot points out through her story that it’s not even clear who would pay her (the oncologist who harvested the cells didn’t profit personally from them), and that many of the leaps made through the use of HeLa cells for testing, like Jonas Salk’s polio vaccine, relied in no small part on the easy availability of these cells. It’s as complicated as any good story should be, informative, emotionally involving without resorting to sentimentality, and gives you enough of both sides to make you angry and make you question your own outrage as you read.

The Fixer.

New mock draft is up. Updated top 25 pro prospects list goes up on Tuesday, followed by another projected first round on Friday.

Free Brandon Belt.

”So sleep now, without fear for your life, and if you should ever manage to get out of prison, keep in mind that the purpose of freedom is to create it for others.”

Bernard Malamud’s The Fixer won the Pulitzer Prize for Fiction in 1967, a bit surprising given the award’s focus on works that deal with the American experience. The Fixer is a fictionalized account of the arrest and trial of Menahem Mendel Beilis, a Russian Jew falsely accused of the murder of a young Ukrainian boy for the purposes of some arcane blood ritual. Malamud indicated that Bok was also inspired by the Dreyfuss and Vanzetti affairs, but the case in his novel is undeniably Beilis’.

The fixer of the title is Yakov Bok, a Jewish carpenter who leaves the countryside for the city of Kiev after his wife leaves him for another man. While in Kiev, he finds a job working for an anti-Semitic factory owner, with an apartment included in a district forbidden to Jews. When the boy’s corpse is discovered, Bok – who had once chased the boy out of the factory’s brickyard – becomes an unlikely suspect given the accusations because he’s alienated from God and his own religion, but he finds himself steamrolled in a Kafka-esque legal process designed to produce a confession or a guilty verdict.

While in prison for the remainder of the book – the novel ends as Bok heads for his long-delayed trial – the fixer endures numerous physical and psychological torments, but finds or develops an inner strength that previous to his arrest he lacked or simply didn’t know he had. Even through attempts to dehumanize him and force him to confess, he retains some vestige of freedom by choosing not to submit – the only choice he’s allowed in the unconscionable conditions of his imprisonment. That becomes his victory even before the ultimate victory of an acquittal. (Beilis was acquitted amid an international outcry over his arrest and trial; Dreyfuss was also exonerated after Émile Zola’s famous “J’accuse!” editorial. Vanzetti and his co-conspirator Sacco were executed, although their guilt is still in question; shortly before Malamud wrote The Fixer, historian Francis Russell published a major book on the case called Tragedy in Dedham that concluded that Vanzetti was innocent.)

Malamud’s work covered not just anti-Semitism but prejudice, injustice, corruption, and mob mentality in the midst of the U.S. civil rights movement and barely two decades after the end of the Holocaust while also exploring how the human spirit can survive in unbearable circumstances. Bok himself is harsh and unlikable during the brief period before his arrest, but becomes sympathetic because of the cartoonishly evil nature of his captors. (His one ally of sorts is eliminated far too soon from the novel’s pages, making most of the book’s second half even bleaker than the first.) But despite the often graphic descriptions of Bok’s life in solitary confinement and the faint hope of any redemption or rescue, The Fixer was compelling because of its bigger themes, ones that probably apply just as well in Bosnia or Rwanda or even today in the Middle East. Malamud’s irreligious Jew stands in for every oppressed people throughout human history.

Incidentally, Beilis himself wrote a memoir of his imprisonment and trial called The Story of My Sufferings that appears to be long out of print and probably in the public domain. I imagine it’s a difficult read, but I hope its historical significance encourages some e-book publisher to put it out there in electronic form.

Next up: I won’t have much time to read this week, so I picked Graham Greene’s brief “entertainment” The Captain and the Enemy.

The Dolphin People.

Latest posts on ESPN.com are on three prep prospects for the draft and on Michael Ynoa and Ian Krol. I’ll be on AllNight on ESPN Radio tonight live at 1:27 am EDT, and am tentatively scheduled to be on ESPNEWS on Monday at 2:40 pm EDT.

“Fix? Nothing broken can ever truly be fixed again. … None of this can ever be fixed, and it will all lead to more breakage, more pain. Nothing can change that.” I said goodnight to the professor and went to my hammock. He was right – broken things couldn’t be put back together the way they used to be.

The Dolphin People, by the author writing under the pseudonym Torsten Krol, is a bleak adventure/survival story told by a young boy, Erich, whose family ends up seeking refuge from a remote Amazonian tribe that has had little contact with outsiders. These natives, called the Yayomi, believe that Erich and his family are dolphin-gods who have taken human form, but their superstitions have limits and it becomes clear that this ruse can’t last forever, leading the “dolphin people” to try to plan a dangerous escape.

The hitch is that Erich’s family is … well, complicated. His mother loses her wits after a few days in the isolation of the Yayomi commune, probably a lot faster than reality would have it. His stepfather is a former Nazi (the book is set in 1946) who still believes in the party’s ethnic cleansing policies. And his younger brother has a rare genetic condition that puts him in obvious danger once it’s revealed.

The cover of The Dolphin People is covered with laudatory pull quotes from other authors and from major newspapers, full of adjectives that seemed to reflect the content of a different book. For example:

“funny,” “witty,” “riotously funny:” Those came from three different reviews, but if there was humor in this book, I missed it entirely. It was dry and matter-of-fact, and unless you find the odd ways in which some of the characters meet their ends funny, it was humorless.

“wild,” “absurd,” “bizarre:” It’s a strange setup, to be sure, but part of what made the book work was that Krol, having created his universe, largely abides by its laws. The characters are not that well-developed, but they do behave in reasonable ways, and he even states in a postscript Q&A that he researched primitive South American tribes to make Yayomi culture and customs as realistic as possible.

“written with relentless, breakneck velocity:” Absolutely. The book flew by in a way that few novels have for me. I had a flight to Vegas while I was reading this and read 150 pages in the 100 minutes between boarding and disembarking. That’s Rowling-Christie-Wodehouse territory.

“gruesome:” There are two unpleasant deaths, and one example of severe violence, but Krol doesn’t linger on any of them, avoiding the lurid approach and dealing more with the aftermath. I don’t see “gruesome” as any sort of compliment for a serious novel, so that adjective seemed completely out of place.

“honest:” I have no idea what that really means when describing a novel. It’s fiction. He made the whole thing up.

“thought-provoking:” I would genuinely like to agree with this adjective, as Krol was clearly after some Big Themes in The Dolphin People, but I’m split on whether he achieved them or whether they were worth tackling. I mean, Nazis are bad – we’ve established that by now, right? Human experimentation is also bad, right? The novel loses too much time to anachronistic arguments along those lines, and it detracts from what I think Krol was trying to explore about prejudice.

The real failing of the novel, for me, was the extraordinary number of coincidences and plot conveniences Krol employed to keep things moving forward. They get to the Yayomi village and, hey, whaddya know, there’s a German already there who can translate for them! They need a diversion that would allow them to escape with the Yayomi pursuing them and, hey, whaddya know, we’re just a few weeks away from the once-every-seven-years rainfall that produces massive flooding! Little of what Erich and his family do is organic, and maybe that was Krol’s point – that we are largely powerless in the face of nature and chance – but given his emphasis on prejudices and how many ideas, superstitions, and mores Erich finds among the Yayomi mirror those of our own society. If you focus on those points, and enjoy a good survival story, The Dolphin People is a very quick read without the empty calories of your standard John Grisham novel, but there was enough lacking here that I wouldn’t give it a “highly recommended” tag.

(Full disclosure – I received a review copy of this book from the publisher.)

Next up: I’ve already finished Laura Kasischke’s In a Perfect World and just started Aldous Huxley’s Island, both of which were also review copies. Island was Huxley’s follow-up to Brave New World.

On race and baseball.

This BP Unfiltered post from Kevin Goldstein is a must read.

My own experiences inside the game did, unfortunately, expose me to some of that unpleasant side of human behavior as well, and I was glad to see Kevin address it head on as he did.