Friday, November 11, 2011

Peach toenails

Recently finished these two books,
NYT book review

NYT book review


      Coincidentally, both center on groundbreaking research of the 20th century and the flawed, brilliant scientists behind it, as well as the social circumstances that deep inform, sway and even misguide the manner is which the data is collected and interpreted. Masters of Sex (terrible title, terrible cover) was recommended by my friend Amy who said it's especially fun to read because much of the research was conducted in St Louis, so the book is full of familiar StL places. Masters and Johnson did their early work at Washington University, where I spent five years in training. That part was excellent and enjoyable, as was learning about these interesting, troubled people.
[NB: this book doesn't contain anything graphic or salacious... much like Masters and Johnson themselves, of whom the Washington Post wrote: "No two people have ever talked so candidly about sex as much Masters and Johnson and continued to be so unsexy."]
       Henrietta Lacks is also an interesting book; it is the story of the world's first and most famous cell line HeLa (name taken from the letters of her name - cells taken from her cervical tumor); the woman herself; the scientist who grew her cells and distributed them; the impact on medicine and science (immeasurable); and the Lacks family, who is still grappling with the paradox that HeLa cells are still used around the world for research and they do not have reliable access to healthcare. Informed consent, medical ethics, healthcare access, the welfare of the individual versus society, the right of ownership over one's tissue and genetic information - all are addressed. I highly recommend, though the writing is somewhat artless and I was irked the author made herself and her research part of the story. ["We'd {the author and Deborah Lacks, Henrietta's daughter} form a deep personal bond, and slowly, without realizing it, I'd become a character in her story, and she in mine."]

     One part of the narrative resounded with me:

 [Mary is a research assistant who grew HeLa cells while Henrietta herself was dying.  She attended the autopsy in order to procure more tissue for research.]

The official cause of Henrietta's death was terminal uremia: blood poisoning from the buildup of toxins normally flushed from the body in urine.  The tumors had completely blocked her urethra, leaving doctors unable to pass a catheter into her bladder to empty it.  Tumors the size of baseballs nearly replaced her kidneys, bladder, ovaries and uterus.  And her other organs were so covered in small white tumors it looked like someone had filled with her pearls.
Mary stood beside Wilbur, waiting as he sewed her abdomen closed.  She wanted to run out of the morgue and back to the lab, but instead, she stared at Henrietta's arms and legs - anything to avoid looking into her lifeless eyes.  Then Mary's gaze fell to Henrietta's feet, and she gasped: Henrietta's toenails were covered in chipped bright red nail polish.
"When I saw those toenails," Mary told me years later, "I nearly fainted.  I thought, O jeez, she's a real person.  I started imagining her sitting in her bathroom painting those toenails, and it hit me for the first time those cells we'd been working with all this time and sending all over the world, they came from a real woman.  I'd never thought of it that way."
    I had a similar experience as a first year resident, sans the fright or disgust of autopsy proceedings.  I was performing an autopsy on a elderly woman who was enrolled in a dementia project which chronicled her decline; following her death, she donated her body to the study so that neuroscientists could study her brain.  (Novelist and native St Louisan Jonathan Franzen chronicled his father's participation in this program in a New Yorker article and his struggle with dementia in the (partly) fictional novel The Corrections).  As I was performing the external examination, I noticed she had pearlescent peach nail polish on her toes. [The toenails are painted peach, I dictated later.]  The skull was opened and I saw, not the normal tightly opposed sinuous coils of the brain called gyri, but sagging ribbons of grey cortex that fell away from each other: a withered brain that weighed about two-thirds of normal, if that.  And I glanced at her toenails, meticulously painted, and knew she had not painted them.  She probably could not have fed herself at the end of her life.  Someone who loved her very much had cared for her feet, trimming her toenails and painting them peach, a display of gentle kindness and joie de vivre during what must have been a very sad time.
     And so too was I moved by evidence of exquisitely poignant tenderness and profound humanity, manifested by the most banal and unlikely source, toenails.

My mother cut her mother-in-law's, my grandmother's, toenails for years on Thursday nights while watching ER (their standing TV/pedicure date night).

Whose feet I am taking care of? Do the people I love have the equivalent of peach toenails?  This is how I think about caretaking, selflessness, spiritual nourishment, and love.

3 comments:

  1. Beautiful and so moving! (And there is a great RadioLab podcast about the HeLa cells with audio interviews with the daughter...you should look it up)

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  2. Very touching and thought provoking blog tonight Julie. I'm glad I started following before you wrote it. It resonates. ~Julie Kowalski

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  3. Thanks all! It was a moment of real beauty for me that I carry forward.

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