We spoke this week with Rebecca Skloot, author of “The Immortal Life of Henrietta Lacks.” A longtime science writer with a commitment to narrative, Skloot has written for The New York Times Magazine; O, The Oprah Magazine; and Discover, among other publications. Her book recounts the story of an African-American tobacco farmer whose cancer cells have transformed medical research again and again in the decades since her death. Showing how the cells came to be taken without Lacks’ knowledge, Skloot follows the family’s struggle to understand Henrietta’s legacy and to come to terms with her treatment. In these excerpts from our chat, Skloot talks about folding a multi-narrative structure into a single arc, her reluctant use of the first person, and readers who assume she made up parts of the book.

Skloot used the film “Hurricane” as a model for the multi-narrative structure of “The Immortal Life of Henrietta Lacks.” Above is her coded system breaking down the stories of both (click to enlarge).

Skloot used the film “Hurricane” as a model for the multi-narrative structure of “The Immortal Life of Henrietta Lacks.” Above is her coded system breaking down the stories of both (click to enlarge).

When you turned the book in, what were your hopes for it, and have they changed given its success?

My hope when I turned the book in – which I think is the hope of any writer when they turn their book in – is that it would get out there into the world. I know so many writers who’ve spent decades of their lives working on books that are incredible and that don’t ever get press coverage, or the book just doesn’t take off because of the time of year that it’s published or because of the other books published at the same time. There are so many factors that are out of the writer’s control.

I knew all that going in, but for me, the story itself – just the facts of this story – were so incredible, I always felt like if I could get them out to people, if people could read them and learn this information, they’d have the same reaction I did, which was “Oh, my God. I have to tell people about this.”

As a writer, one of the things that I thought a lot about and that weighed on me as I wrote and revised was wanting to do justice to the story. The simple facts of the story and the narrative of the story are so amazing that I felt in some ways like the only thing I could have done was to screw it up. And so much of my job was to take this incredible natural story and tell it in a way that let readers experience it in the way it really happened, to bring it to life as much as I could while staying out of its way.

And now that you’ve met your original goal?

My hope is that it keeps going. I’m thrilled that it’s still on The New York Times bestseller list. How many months out are we? Like six months – so I’m thrilled that it’s still there.

A lot of people say, “So now that you did this, what’s next?” But I’m still working on this one. I still feel like it’s part of my job to keep it alive and get it out to more readers.  I’m moving the day after tomorrow, and I’ll take a few weeks to settle down. And then I’m going to be on the road once the academic school year starts, basically September through December, talking about the book at schools and doing events.

Henrietta Lacks’ story has been a part of your life since you were a teenager, and you’ve researched her life and its aftermath for more than a decade. Were there ever crisis points at which you doubted your story, or wondered if you would actually be able to tell it?

It’s not so much that I thought, “I can’t do it.” There were crisis points, though, and a lot of them had to do with being completely overwhelmed by the story. There were so many places where I wondered, “How is it humanly possible to put this all in one book?” There are so many different storylines, and so many different amazing things that happened, and there’s the science, too. Figuring out the structure of the book was maddening, and it took me a very long time.

I never really felt like, “I can’t do it.” It was more like, “I may be 90 by the time I finish it.” I was so determined it just didn’t cross my mind to quit. One of my closest friends is a writer also, and there were many times when I called or sent him emails and said, “Oh, my God. I can’t do it. I’m never going to finish this thing.” It was mostly the feeling of the size and scope of it. My dad was a big supporter – both my parents were – and he would say, “It wouldn’t have been like you to pick a small straightforward book as your first book. Of course you picked this complicated, monumental story.” So it is sort of my personality to do something like that.

My mother’s helpful piece of advice was, “When you sit down to eat an elephant, don’t think of it as eating the entire elephant. Think of it as eating one bite, and then another bite, and another bite.”

Until you’re 90.

Exactly! Those were more the things that I wrestled with. For any writer, when you’re sitting down and looking at this vast, complicated project, it can be really daunting. Also, I felt the burden of history. I was lucky to start working on it long enough ago that Henrietta’s immediate family was still alive. Her husband was alive; her cousins she grew up with were alive. There were actually a lot of people who remembered her and the time, and George Gey, but they were dying as I was doing my research.

There was one time when I had interviewed a guy who was just an incredibly important source for the book, and he died soon after. There was another time when I had been scheduled to interview a guy, and he died before we could talk. So I constantly had this feeling of scrambling to get the story before it disappeared. And then also being aware as time went on that I was the only person with this information.

The combination of the sheer complexity of the narrative combined with that feeling of wanting to do justice to the history – that was rough sometimes.

Moving on to the structure a little bit: in one interview, you mention the book “Fried Green Tomatoes” and the movie “Hurricane” as inspiration for structure, and it’s apparent that such an attentive approach to the story made it comprehensible for readers. Did you give anything up in exchange for adopting the model you did?

[Laughs.] A few years of my life?

Really – no, I don’t think so. I knew that the structure was going to have to be complicated, and I’m just very into structure. I think structure is one of the most important tools a writer has. When I teach, my students get so sick of me harping on structure, structure, structure. I read and dissect a lot of things. I teach John McPhee’s stuff because he uses these very complicated structures you can pull apart. Structure is all about making the story more rich.

What I thought all along was that if I couldn’t find a way to do a structure that jumped around in time like that and told all three narratives at the same time, I’d lose a lot of the story, because the story of the cells and what happened to Henrietta take on such a different weight if you learn about them at the same time that you’re learning about the science, the scientists and her family, what happened to them and where they are now. To me, it was that I would have lost those things if I couldn’t have done the more complicated structure. But there was never a point where I thought, “I have to leave out this one really important part of the story because it doesn’t fit in this structure.”

There were some hard decisions, like where do you put the backstory of Elsie, Deborah’s sister? You really don’t get that story until pretty late in the book. Those were conscious decisions about what could wait, but I never felt like that was a sacrifice.

You have a triple narrative running in the book. Did you worry about showing change or transformation within each of the three narratives?

No, definitely not. I actually feel like the book has three narratives woven together, but the storyline for me is the story of Deborah. You meet me before you meet Deborah, but I’m only a vehicle to get to Deborah, to show where she is today and the impact that all of this has had on her. That was very much one of the reasons I was in the book – to show the way she responded to me and the impact I had on her, with us traveling together, her going into laboratories to see her mother’s cells for the first time and learning some really hard information that had some essentially life-threatening effects on her.

The story is about a lot of things, and there is an undercurrent of the impact journalists have on peoples’ lives. So I felt like I couldn’t leave it out for a lot of reasons, but in terms of the narrative arc of the book, for me, it was really the story of Deborah: her struggle to learn who her mother was, to come to terms with the cells. To essentially move on from them and let go of the cells and her memory of her mother as a traumatic thing and to get to the place where she does in the end, where she’s pretty happy about the cells.

That’s the big narrative arc with a climax, and the rest of it is, in a sense, backstory that’s woven in throughout, as chronological narrative. They do each have their own ups and downs as narratives, but as far as feeling like all the parts had to have a climactic moment,  I felt like Deborah took care of all that, and it would have felt forced to do it any other way, because it didn’t happen with the other ones.

You’ve explained on your site why you put yourself in the story, a practice you often discourage in your teaching. Did you develop a rule for yourself about how present to be?

Basically my rule for first person in the book was that it’s only there if it’s relevant to their story. I spent so much time fighting against being in the book, thinking, “It’s not my story, it’s their story. It’s not about me.” And I was right, it’s not. It’s just that I became a character in their story. So many other journalists, doctors and various other people came before me in similar circumstances, wanting something from the family related to the cells. I realized I couldn’t leave that out. Then there would be this obvious question: “Well, what about you?” And what happened with me was in some ways much more complicated and potentially dangerous than it was with any of the other journalists, because there was so much time together and because Deborah got so involved.

For that reason, I could never leave it out, but in my head, the way that I always thought about my role was as a character in their story, not as me telling my own story of my quest to find this stuff out. That made it challenging, because for me, writing the first scenes, where I’m first trying to get in touch with the family, Deborah’s not there yet. And so I really struggled with those — what those are about to me is the family’s resistance and trying to understand where that came from.

So you don’t learn anything about my backstory unless it’s relevant to Deborah or to the family’s story in some way. In the prologue, you learn that I didn’t come from a religious background, that I came from the Pacific Northwest, and that I’m white – and those are specifically juxtaposed against Deborah. You don’t really learn that much about me as a character outside of their story. That was what I constantly had in my head, that it only belonged if it was something relevant to their story.

At first, I was barely present in any of the first-person parts of the book, because I was really holding back and not wanting to have it be about my emotions. It took a lot of revising to let myself have some reactions. Some of that was my editor. When she read the first version that I gave to her, she was like, “OK, you seem like a psychopath in this scene, because Deborah just threw you against the wall, and she’s screaming at you, and you don’t react. You have to react.” My editor drew out a little of that emotional stuff that I was really hesitant to put in.

What advice would you give to someone looking to tackle a big, comprehensive story like this that spans decades?

Within the big sweep of history, there usually is – not necessarily a moment, but there is a story that’s not the whole sweep of history that you can use to hold it all together, and then some of the sweep of history can be told in flashbacks.

One of the things that often doesn’t work about big sweeping books like that is that they start in the beginning, and they tell the whole thing, and there isn’t the narrative or the central character or characters in the book that you follow through the entire story as you learn the history. I think that narrative exists in every story in some way, and finding it even in a multiple-part narrative is really important.

And organization, that was one thing that I didn’t know about early on and wished that I had. I didn’t have any sense of just the sheer volume of stuff I was going to accumulate related to the book and how important it was to organize it thematically and narratively, to have narrative in mind at all times as I accumulated things. Eventually, I went back and I cataloged everything that I gathered and put things on color-coded index cards. I had a system for using key words for coding things that I could search on my computer.

Watching for thematic and narrative elements and trying to organize your materials will save a lot of time and help you look at the story in a narrative way. It’s really easy to get caught up in the day-to-day reporting and the details, everything you’re gathering, and not sit back and think, “What’s the actual story?”

I’m always looking for narrative with every story that I write. All great stories tell a sweeping story through one small story. Among other things, my book is the history of tissue culture and the evolution of bioethics told through the story of a family. With “Seabiscuit,” it’s the story of a horse, but you learn the history of racing. All great nonfiction does that. In “The Orchid Thief,” you learn everything about the world of orchids through this one guy. It’s looking for that one family, that one person, that one moment that will help hold everything together.

Fiction provided your structure for this particular book, but in addition to the writers you just mentioned, can you name other nonfiction authors who’ve inspired you?

I think in terms of character, Alec Wilkinson, he’s a New Yorker writer. He did this incredible little book – I’m sure it was a New Yorker story before it became a book – it’s called “Moonshine.” I’m sure it’s out of print, but you can get it used. It’s just a brilliant character study. In everything he writes, he’s very good at using voices to make three-dimensional characters. I think he’s fabulous.

Also Burkhard Bilger, who’s at The New Yorker. He was at Discover for a long time, and he does a lot of science writing. He’s a great narrative writer. And Anne Fadiman – “The Spirit Catches You and You Fall Down” was a great influence on me in part because of the content. It’s a similar story.

That was the book I most thought of when reading yours.

In some ways, it’s an obvious comparison. I read that book when I was in grad school, and I was like, “She gets it!” Part of what spoke to me about that book was that she tells this incredibly complicated story of the clash between the family and the world of medicine, and she doesn’t demonize either side. I think that’s really important, and it’s not always done in science writing.

And there’s John McPhee – I’ve read everything he’s written, and as I said, I dissect his stuff a lot. He thinks about structure in such a direct, almost methodical way. It’s a mechanical thing, structure. It’s something that’s artistic, but it’s also a puzzle.

One of the biggest influences, who I think was an incredible science writer, was Randy Shilts – he did “And the Band Played On.” He was really talented at weaving story and science. Deborah Blum, too.  She’s done a lot of great books. “Love at Goon Park” is wonderful. And also Jonathan Wiener. Lewis Thomas is one of those that I say every time someone asks this question. Linguistically, he just wrote about science in such a beautiful way.

Is there anything about the book that you’re surprised no one has asked yet?

Not exactly, but one thing has cropped up now and then – not in interviews, but every once in a while online or at readings. As someone who has spent 11 years working on a book like this, I find it fascinating. When you write nonfiction in a way that will hopefully read like fiction, with scenes and dialog, there’s an assumption that you made it up or made some things up. When I do Q&As, people in the audience will ask, “So how much liberty did you have to take?” Not did you take any, but how much? There’s this assumption that it’s impossible to recreate history in a way that reads like a story.

And I actually talk about this in the end notes and in the little note at the beginning of the book, where I say that none of this is made up, it’s all documented fact, which is why it took me so long to write the book. In the opening scene it’s raining, and the room looks a certain way, and her husband is parked outside under an oak tree. The weather came from the weather bureau. I saw archival pictures of the tree and took it to an expert, who said “Yes, that’s an oak.” I saw archival photos of the room.

Rebuilding that kind of narrative uses historical documents and interviews where you cross-source it. There’s just one moment in the book that only had one person who recalled it, and I said that in the book. But other than that, multiple sources verified all the information.

I think it’s interesting that people assume that when they read dialogue that took place in the 1950s, it was made up, because I wasn’t there. But in fact there are ways you can recreate that accurately in reporting. It is absolutely possible to recreate nonfiction in a narrative way and still be factual. It takes a heck of a long time, but it’s worth it.

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