This certifies that HELEN FRANCES LAWRENCE, sex FEMALE
was born to JOHN DENISON LAWRENCE and VIRGINIA MATILDA LAWRENCE
on SATURDAY at SIX TEN PM, this EIGHTEENTH day of AUGUST, 1990
at the MONTFORT HOSPITAL in OTTAWA, ONTARIO
and will die of CANCER
Not everyone got tested at birth, and Tina hadn’t. Not getting tested had been her parents’ choice, but in university it had become her choice. She and Helen were hanging out in Helen’s dorm room, alone, lying side by side on her bed. It was the only comfortable place in the room.
“Has the CANCER prediction changed the way you live your life, Helen?” Tina asked.
“Has being a lesbian changed the way you live your life?” Helen asked.
“Has being a super-bitch changed the way you live yours?”
They kissed for a bit.
“I was joking about the super-bitch part,” said Tina.
Helen and Tina were at the mall near their house, because it was Tina’s thirtieth birthday, and she suddenly wanted to know. It was stupid not to, she’d decided. Helen had agreed to pay the $250 dollars for the prediction as a birthday present. Tina pulled the credit card out of the machine, passing it back to Helen with one hand as she stuck her finger in the machine with the other. A sample was taken, her blood was analyzed, and a print-out was produced. “AIRPLANE,” it said.
“Nice!” said Tina, excited. She showed her prediction to Helen. “Mine’s better! AIRPLANE’s way more better than CANCER.”
“You’ll probably just get hit on the head by an airplane,” said Helen, “and it’s not going to be nearly as cool as you think it is.”
“A toy airplane?” said Tina.
“Nope.” said Helen.
Tina laughed and noticed the display on the machine still read “INSERT FINGER.” “Hey,” she said, “It’s still gonna do a reading. Quick, put your finger in!” She grabbed Helen’s finger and pulled it toward the machine.
Helen shrugged. “You want a piece of paper with ‘CANCER’ on it, it’s yours.” She put her finger in, and a few seconds later, the machine spit out a piece of paper. Tina grabbed it.
A moment later she looked up, confused. “Sweetie,” she said, “this doesn’t say ‘CANCER.’ It says ‘SUICIDE.’”
“What?” said Helen, snatching the paper out of her hand and reading it herself. SUICIDE. She looked up at Tina, anger clouding her features.
“My parents told me I’d have cancer since forever, and it turns out SUICIDE is how I’m going to die?”
Tina took Helen’s hand in hers, trying to calm her down. “Sweetie, please, come on, maybe it’s—”
Helen cut her off. “I can’t believe it,” she said. “Why wouldn’t they tell me? I’m a grown woman, for God’s sake.”
She already had her phone out, dialing her parents. As it was ringing, she turned to Tina. “Before I do me, I’m gonna kill them,” she said.
Helen’s parents denied everything, and sincerely. Her father pulled out the birth certificate from the closet to prove it. Helen had never seen it before, but there, printed on the form, was the diagnosis: CANCER. The hospital had even attached the original prediction card with a staple.
“It must’ve been a mix-up at the hospital,” her father said, “some other girl’s blood got tested instead of yours. It’s happened before. You could sue.”
Helen brought the certificate home to show Tina. They were sitting on the edge of their bed, side-by-side. Tina turned the birth certificate and card over in her hands.
“Prediction cards haven’t really changed much since you were born,” said Tina.
“I’ve always avoided cancer,” said Helen. “I avoided smoking, I wore sunscreen, I limited red meat in my diet.” She sighed. “I really love red meat.”
“It doesn’t change anything,” said Tina. “Suicide doesn’t necessarily mean you’ll die early. Maybe it’s assisted suicide when you’re super old.”
Helen flopped backward onto the bed, staring at the ceiling. “Do you want to get some dinner?” she asked.
“It’s only two,” said Tina.
Twenty minutes later they were at a steakhouse.
Helen pointed at Tina with her fork, her mouth full of steak, medium rare. “Maybe I will sue,” she said, around the meat. It sounded like “Eaibe a ill oue”.
“Gross,” said Tina.
Helen and Tina found an attorney in the phone book, Jack Bradshaw, Attorney At Law. “I ONLY GET PAID WHEN YOU DO,” his ad said. He went with Helen to personally oversee her testing, and again: SUICIDE. Jack smiled at her. “Open and shut case,” he said.
“That’s the kind I like!” said Helen.
Six months later Helen was on the stand. Her birth certificate had matched the records the hospital had submitted to the government when she was born, so it was simply a matter of running Helen through the courtroom machine. She watched from the stand as Jack continued his prosecutorial patter, building up the test for the jury.
“My client, who has suffered irreparable damages to her life on account of the maliciously incorrect cancer prediction supplied to her upon birth, asks for very little. Thirty years of her life—thirty years!—have been spent fighting to avoid a particular death—a death, as I will prove to the court’s satisfaction, that wasn’t even in the cards. She asks only for compensation for those wasted years—those wasted chances—so that she might finally live what’s left of her life as was originally intended.”
In the audience, Tina rolled her eyes, but then caught herself and stared straight ahead.
Jack turned from the jury and looked at Helen. “Helen, if you would now insert your finger, we will prove that the reading supplied and recorded by the doctors and staff at Montfort Hospital was wrong. Whether these people were acting with deliberate malice or not is irrelevant. All that matters is the prediction, the real prediction. Helen, if you would.”
Helen stuck her finger in the machine; a piece of paper was produced. Jack read it, and though Helen knew where this was going, she still thought his feigned reaction of surprise seemed . . . sincere?
“Well, would you look at that,” Jack said. “Despite what Montfort Hospital would have you believe, my client will not die of cancer. As you can see, ladies and gentlemen, she will die—”
Jack he held up the card to the jury.
“—of DNA BREAKDOWN.”
Jack turned to Helen, making significant eye contact. “I submit this prediction card produced under the eyes of the court as Exhibit A, and the prosecution rests.”
There wasn’t much you could say to argue against a prediction done in a courtroom on the court’s machine. The defense used their time to focus mainly on the degree of their culpability. After only a few minutes of deliberation, the jury came back. Helen had won.
“I don’t know what you did, but you took a damn big risk doing it.” Jack shouted at them, a few blocks from the courthouse. He was furious; his entire face was red.
“I don’t know what happened,” Helen said, but Jack spoke over her. “A lesser attorney would’ve stumbled, would’ve cost you a hell of a lot of credibility.” He glared at her. “Why not just say you were going to die of DNA BREAKDOWN in the first place? Why fake ‘SUICIDE’”—he did air quotes around the word with his fingers—“for my benefit?”
“The other machines both said SUICIDE,” Tina said.
“The machines don’t give different answers,” snapped Jack, “and at this point I don’t care.” He turned back to Helen. “The hospital did mess up, and we won, but for God’s sake if you’re ever in a lawsuit again, don’t lie to your attorney.” He pushed his way past them and stormed off.
Tina and Helen stared at each other.
“What do we do now?” asked Helen. “I’m three million dollars richer.”
Tina shrugged, and after a moment, turned and saw Jack walking rapidly away from them.
“It didn’t say you were so rude in your ad!” she shouted.
The money had come in a lump sum, so Helen and Tina had spent the next six months on vacation, travelling the world, seeing places they’d both dreamed of visiting. There were a lot of rail trips and cruises in deference of Tina’s AIRPLANE prediction, but neither of them minded. “Everyone is classier on a train,” Tina said.
“That cruise ship will go well with my dress,” Helen said.
They were both trying to have a good time.
They’d use a machine whenever they found one that took cash and wasn’t too public. They’d used thirty-five machines so far. Tina’s prediction was always the same. Helen’s wasn’t. It was now the fourth day of their final cruise, a twelve-day journey taking them from Australia back to Canada. They’d found a machine on board, some distance from most of the popular and interesting parts of the ship. Tina put her cash and finger into the machine. “AIRPLANE” came out. Tina started feeding in the bills for Helen.
“You’re up,” she said.
Helen put her finger in. So far on their trip, Helen had received NECROSIS, LOSS OF VITAL FLUIDS, APOPTOSIS (“the natural death of cells”, Tina announced, reading from her phone), DNA BREAKDOWN, ATTACK, INFECTION, MURDER, ACID EXPLOSION, SUICIDE, and CANCER. She’d actually gotten CANCER far more often than anything else, which made her think it was blind luck that it hadn’t been that prediction that turned up in the courtroom.
Her prediction came out: CANCER.
Tina was already feeding more the bills into the machine. “Once more,” she said, “for real this time.” Helen stuck her finger in again, and again a slip of paper came out.
“DEVOURED BY NEIGHBOUR,” Helen read, surprised. It was a new one. She passed it to Tina, who read it.
“Do you think that means Mr. Ross?” said Tina.
When they were home, Tina plotted Helen’s results on a graph. The non-CANCER results they got didn’t show any trends, but CANCER itself definitely seemed to be showing up less and less often.
“What do you think that means?” asked Tina when she showed Helen her graph and data.
“I have no idea,” Helen said, in a small voice. “I have no idea what any of this means.”
Tina took Helen’s hand. “Maybe we really should go to the hospital,” she said.
They ended up going to the same hospital that they’d sued, the same hospital she’d been born in. Helen said it’d be easier that way. After waiting in the emergency room, the doctor at Montfort Hospital introduced himself as Doctor Peters, and said that he was extremely busy and that he didn’t believe in Helen’s story of multiple predictions. “Nobody gets different results from the machine,” he said.
“Try me,” Helen said.
The first result was CANCER. Tina thought that’d get a reaction, but Doctor Peters apparently had no idea of Helen’s history with the hospital, which was probably for the best. He ran a second test right away, and this time the result was “DNA BREAKDOWN.” Peters brought in another doctor and they ran the test again: ACID EXPLOSION. They wheeled in another machine and got CANCER, then NECROSIS, then CANCER, then CANCER again, then ATTACK. The doctors all huddled in a tight circle, talking quickly and quietly.
“Told you,” Helen said.
Later that evening, Doctor Peters sat at his computer and went through Helen’s blood report. When he took the sample he’d told Helen and Tina that he’d be looking very carefully at it for clues as to what might be happening. He’d said that nothing like this happening had ever been recorded. He’d said to Helen that at this juncture, she shouldn’t be taking any of her predictions too seriously just yet.
“That’s funny,” said Helen.
As he brought up the first image and saw Helen’s cellular walls, Peters blinked. It was obvious that Helen had lymphoma and it was bad: the irregular shapes of the cancerous cells were spread throughout her blood. This was very far along and likely spreading to other organs beyond the one it had started in. She’d be starting chemotherapy immediately. She was young. She could make it.
He sighed, flipping through the pages of the report, pausing on another image of the flattened cancer cells. Seeing she had cancer was simple. The question was, why was she getting multiple readings?
Cancer didn’t come close to explaining the odd readings from the machines. Plenty of people had cancer, and plenty of people died from it, and they all had just the one single prediction. What is it in this blood that’s so special? Helen’s predictions were inconsistent, but not random. They seemed to be coming from a small set of possible deaths, as if the machine was seeing more than one fate for her. She’s only going to die once, Peters thought. How do you reconcile cancer with being eaten by a neighbor? How does “attack” square with “suicide” and “DNA breakdown”? The only DNA breakdown he knew that could possibly be considered an attack was—
Doctor Peters suddenly leaned back from his computer and stared at the ceiling, shocked, his mind racing.
The only DNA breakdown that could be an attack was cellular death, induced by neighboring cells. What else do cells do? Cells die; cells commit suicide; infected or damaged cells are attacked and their useful elements absorbed by neighboring cells. Necrosis and apoptosis both could refer specifically to cellular death. Heck, even ACID EXPLOSION could refer to lysosome-mediated apoptosis and the acid hydrolase enzymes they contained. He stared at his computer, the image of Helen’s blood still on the screen. Everything fit. The machine wasn’t producing cause-of-death predictions for his patient, one Helen Frances Lawrence, born August 18, 1990.
It was predicting results for her cells.
Tina lay on top of Helen: a full-body hug. It was dark outside, and the lights in the room had been turned off.
“They’re eventually gonna notice I’m here and kick me out,” she whispered.
“This is the cancer ward,” Helen whispered back. “We get a pass. You’re staying right here with me.”
Tina gave Helen a squeeze. “Make sure there’s nothing wrong with you, okay? I don’t want my sweetie to leave me.” Tina’s voice quivered.
“Oh my God,” said Helen, “if you start to cry I’m going to push you off the bed. I’m serious. I will push you off the bed.”
“I’m not crying! I was just being sincere with someone who means a lot to me and who might have a serious disea—hey! Stop it!”
“You cry at TV commercials,” Helen said, pulling her back into a hug.
Early that morning, Doctor Peters met with his patient. He was rumpled, unshaven, and exhausted. He walked into Helen’s room, surprised to find Tina already there, sitting beside her. He glanced at the clock on the wall. Visiting hours already?
“Helen, I’d like to speak with you privately if I could,” he said.
“Anything you say to me you can say in front of her,” Helen said. Tina smiled. “Go for it,” she said.
He cleared his throat. “Helen, I examined your blood sample last night. There are abnormal cells in the bloodstream, and I’m sorry: It’s cancer. It’s already advanced quite a bit, and the cells have metastasized and are in your bloodstream. We’ll likely find some elsewhere too. I want to begin treatment immediately.”
Tina squeezed Helen’s hand. Helen squeezed back hard.
“That’s the bad news. The good news is, we have several treatment options available, and I know we can make a dent in it. This doesn’t have to be the cancer that kills you,” he said, not for the first time in his career.
Helen started to cry, involuntarily. She angrily wiped away a tear.
“Fuck cancer,” she said. “Who’s to say I don’t die from that douchebag in the other bed eating me first?”
“I—I have a theory on that too,” Doctor Peters said. “I tested this last night and it’s consistent. When I put a single blood cell of yours—a healthy one—in a suspension and run it through the machine, we get CANCER one hundred percent of the time. But when I test a cancerous cell, the predictions that come out are the others that we’ve been seeing. Helen, they’re all consistent with descriptions of cellular death. I don’t yet understand how, but I believe your cancer cells are getting their own death predictions.”
Helen looked at Tina, and then back at Doctor Peters.
“What,” she said, flatly.
The months went by as Helen’s treatment progressed. She had been allowed to stay at home, with Tina. Her hair had fallen out. She hadn’t gotten a wig.
Helen came in once a day for more tests with Doctor Peters. He’d modified the machine that he’d started to think of as “his” with a second IV. When the machine had done its analysis, the press of a button would return the entire blood sample to Helen’s bloodstream. His hope was that the cells tested in this way would reveal which treatment killed them in Helen’s body. That way they could jump to using that effective treatment right away, potentially saving months of tests.
So far, he’d had no luck: All the predictions were the same cellular deaths they’d been getting all along. But they still revealed quite a bit: a lack of predictions that mapped onto KILLED BY CHEMOTHERAPY told them that the treatments weren’t going to be immediately effective, which was the bad news. But there was also good news, because they also hadn’t had any predictions reading CIRCULATION FAILURE or STARVATION or anything else that could indicate cancer cells being killed by Helen’s own death.
“Blood cells live for about four months,” Doctor Peters told Helen and Tina. “We’ve still got time.”
Meanwhile, news had gotten out through the hospital staff, and then to the world at large, that a woman with multiple predictions was a patient. Helen had consented to one interview, done at the hospital. The interview as aired had been short, since Helen couldn’t really add much to the story beyond “cancer sucks, were you aware?” and Doctor Peters had handled the medical aspects of the explanation. After summarizing the discoveries made at Montfort, the reporter put the microphone to Helen.
“Do you have any idea why your experience is so different?” the reporter had asked.
“I don’t know why it’s just me,” Helen had said.
The camera lingered on her, so she gave it a thumbs up.
Helen’s recent surgery and chemotherapy regime had not been kind. Her last chemo cycle—the sixth—was over two weeks ago, but Helen was still in hospital, bedridden, weak, and tired. She’d had growths removed from her lymph nodes and bowels, and daily radiation targeted at the growth around her heart. Tina visited her almost every day, telling her stories about what their friends were up to when they weren’t there in the room with them. Her parents had visited five times. It was hard for everyone, and at Helen’s insistence, Tina was home today. “You still have to live your life,” she’d said. “Go, have fun. Eat something I can’t keep down. I insist.”
“Steak?” said Tina.
“No way, those belong to me,” said Helen.
Helen was alone and napping when Doctor Peters knocked on the door and wheeled his machine in. The knock was enough to wake her.
“Back for more, Nick?” Helen asked.
“Still looking for clues, yes,” said Doctor Peters, hooking her up to the machine’s IV. “Place your finger here, please, Helen.”
A few seconds later, the result was printed. As Doctor Peters read the slip of paper, his heart sank. It wasn’t CANCER, so it was a cellular-level prediction, the end-of-the-line for a single cell of Helen’s cancer. He stared at it for a long moment. “HOST DEATH,” it read.
Helen saw his reaction and asked for the paper, reading it quickly.
“Well, fuck everything about that,” said Helen, handing it back to her doctor.
Six weeks later, the “HOST DEATH” predictions had eclipsed all of Helen’s death predictions, with the exception of “CANCER.” It was going faster than they’d expected. Tina hadn’t seen Helen and Doctor Peters produce a non-CANCER or HOST DEATH prediction in days.
The cancerous cells in her body were not going to live for much longer, and everyone knew that meant Helen was not going to live for much longer either. There was no way to avoid it. Doctor Peters was still no closer to figuring out how to stop it, and given the numerous “HOST DEATH” predictions, they’d agreed to move Helen to the palliative care unit three floors up. There, the focus was no longer on curing the disease but on managing it, on making Helen as comfortable as possible for what little time she had left.
The end of the chemo and radiation treatments meant that even though Helen was dying, she felt better than she had in weeks, maybe months. Tina and Helen spent a lot of time talking, and a lot of time just sitting and not talking. They’d agreed to not start thinking that since there were only so many moments left, every moment had to be capital-s Special. That would be exhausting. This was nice.
Helen placed her finger into the machine and Doctor Peters took another reading. “You’re doing great, Helen,” he said.
“Nick,” Helen said, “if you’re waiting to cure me, now would be a good time.” Tina looked at her and smiled. A few seconds later, the machine printed out a piece of paper, and Tina read it, furrowing her brow. She held it up for Doctor Peters.
“‘DESTROYED IN LAB ACCIDENT’?” she said.
Doctor Peters quickly disassembled the machine and recovered the blood sample within. Inside that sample was a cell of Helen’s cancer that was going to die not from host death, but in the lab. This cell would survive her body—but how? The 120-day window of cell life didn’t give them much time. He put the blood sample into a sympathetic culture designed for maintaining cells. If I didn’t do that, he thought, would the cell have died from host death instead? Am I destined to knock this petri dish off a desk in a week and that’ll be that?
It didn’t matter. At this point he was willing to try anything.
Two days later it was clear that cellular division was taking place. All cancer was a mutation of a cell’s regular instructions, causing the growths and lumps normally symptomatic of the disease. But Helen’s cancer cells had mutated differently: Unlike normal human red blood cells, Helen’s reproduced in culture. They cloned themselves, and would clone themselves for as long as the necessary conditions for life were present.
“These cancer cells can be sustained indefinitely,” Doctor Peters said that afternoon while briefing his colleagues. “Ladies and gentlemen, we’re looking at the first immortalized cell line descended from human DNA.” His audience had been amazed, and everyone wanted a sample to examine for themselves. At least one of those cells would be killed accidentally, but the rest—who could say? He’d already separated them into separate cultures, and, after his presentation, had received permission to move some to another nearby hospital, just to be safe. The precautions were necessary: For all intents and purposes, Helen’s cancer cells were a new form of single-cellular life.
The fact that her cells finally reproduced provided an explanation for why the machine was treating the cancer as something different from Helen—biologically, the cells were distinct, and they didn’t need Helen to survive. All they needed was the food they took from their environment, and whether that was Helen’s bloodstream or a petri dish didn’t really make a difference.
Doctor Peters met with Helen shortly after his presentation. Tina was there too, as always. He’d explained what he’d discovered about her cancer, about the cells that had developed inside her body. When he was finished, Helen was silent for a long moment.
“Hey, who’s got immortalized cells and wants a Coke?” said Helen, surprisingly upbeat. Doctor Peters looked at her, confused. Helen raised her hand.
“Me,” she said.
Three days later, Doctor Peters came to Helen and Tina with a question. Tina had been reading to her: Helen had spent a bad night, unable to sleep, and was feeling weaker than she was usually did.
“Helen, I may not be able to cure your cancer,” he said.
“Yep,” said Helen.
“But the predictions we’re getting from your cell cultures—may help us cure all cancers,” he said.
Doctor Peters had finally caught her without something to say.
“The predictions we got from your cells when they were in your body, Helen, were mainly predicated on how long you’d live. But in a culture, we don’t have that limitation, and the predictions we’re getting back are different. Tests on cell cultures we’ve cultivated have returned results like ‘LAB TEST’ or ‘EXPERIMENT,’ but one last night said ‘KILLED BY C29H32O13.’ That’s a chemotherapy drug, Helen. That’s the precise chemical formula for the etoposide phosphate, one of the drugs we’re already using in treatments. Clearly at some point in the near future that drug will be introduced to part of that culture, and it’ll be effective.”
“So you can verify drug effectiveness a little sooner?” asked Tina.
“It’s more than that. We can test treatments extremely efficiently, giving slight variants to different cultures and not having to gamble a human life in the process. We can produce new drugs by brute force alone, running experiments that would otherwise kill a human host. We could have thousands of researchers working in parallel, each cell a new experiment. And it’s not just cancer. We could infect some cultures with other diseases and use the same process to discover treatments targeting them as well. Your cells may well unlock a new age in medicine, allowing unprecedented progress to take place. But the cells are yours; they belong to you. We need your permission to develop them further.”
Helen and Tina stared at the doctor as he rushed through his speech.
“It’s a lot to take in,” said Doctor Peters.
“No, I get it,” said Helen, turning her head to look out the window. Outside, spring was turning into summer.
Helen felt Tina squeeze her hand.
She turned back to her doctor.
Twenty years later, Tina was in her living room, relaxing, reading in the Saturday morning sunlight. The magazine she’d bought had a feature on the cover. “The Miracle of Helen Lawrence’s Cells,” it said, with a science-fictiony illustration of a blood cell, all blue and orange with multiple tiny labels. It said that thanks to the great potential of Helen’s cells, strains were stored and used in labs the world over. It said that the achievements and advancements made through what scientists called the HeLa cell line included new treatments for a variety of cancers, fundamental research in gene mapping, along with many other scientific pursuits. It said that millions were alive today who had Helen’s cells to thank.
Tina smiled. It was a pretty good legacy, she had to admit.
Beside the article, there was a sidebar with more facts on the cell line. It said that the biomass of HeLa cell cultures propagated over the last twenty years would now exceed Helen’s actual weight several times over.
She looked over the magazine to her picture of Helen, resting on the mantle.
“Gross,” she told the picture.
AUTHOR’S NOTE: Don’t freak out, but there are actually immortal cell lines in real life! In the 1970s, a line was established with cells taken from a 14-year-old boy with leukemia. And in the 1950s, the very first human immortal cell line was established with real-life HeLa cells, taken from the cervical cancer of one Henrietta Lacks, a 31-year-old woman living in Maryland. The researcher who took the cells, George Gey, never informed Henrietta—who died shortly thereafter—and also kept the existence of the cells a secret from her husband and children.
This is what’s known as a “dick move.”
Her family only found this out later, after decades of groundbreaking science and medicine, when other researchers hoping to learn more about the cell line contacted them with questions about their genetics. Craziest of all, the achievements credited in this story to my fictional HeLa cells can be attributed to Henrietta’s real-life cellular culture. But after a half-century of her body being used—and profited from—without her consent, it seemed inappropriate to use Henrietta’s name in my story, and further inappropriate not to credit her immortal cells as the inspiration for Helen’s ones here.
Henrietta’s grave finally got a headstone in 2010. It reads, in part, “In loving memory of a phenomenal woman, wife, and mother who touched the lives of many.”
© 2013 by Ryan North.
Originally published in This is How You Die,
edited by Ryan North, Matthew Bennardo, and David Malki!.
Reprinted by permission of the author.