Donna's last days

Eight-year-old Damyuss Woods stopped playing with his friends in the cul-de-sac off Bankhead Highway as I drove up to his house. When he saw me, he ran toward my car.

“Mama fell three times yesterday!” he shouted.

Donna had called me a couple of hours earlier; I was at the Sarasota, Fla., airport, about to board a plane headed home. Could I bring some groceries? Pork chops, Chef Boyardee, peanut butter. Donna never asked me for anything. Something was wrong.

On my way home from the Atlanta airport a couple hours later, I picked up the groceries and drove to her house off Donald Lee Hollowell Parkway, west of the city.

Usually we sat on the sofa in her living room when we visited. But that day last August, she lay in her double bed. Worn brown carpet covered the floors; pink posters and get-well cards covered the walls. Donna, 45, looked more like a teenager with the flu than a widowed mother of six who had been battling breast cancer for 11 years.

She was thin as a straight pin, and her cheekbones were as sharp as the edges of her bedroom door. She wore a pink gown and the little black cap she favored when she didn’t feel like fooling with a wig. I always thought she looked she should be pulling cupcakes from the oven when she wore that cap.

That day, she just looked sick and fragile. And scared.

“I can’t use my legs. I tried to get up, but I couldn’t,” she said. “Chopper’s been having to take me to the bathroom.”

Chopper, or Dayzhon, is 15, a sophomore in high school at B.E.S.T. Academy, a public boys’ school nearby. Three of Donna’s four boys are students there. Besides Chopper, there’s Darius, the oldest and captain of the Eagles football team. Dazmine, who just turned 12, is in sixth grade. Damyuss is a third-grader.

Donna also has two daughters: Kendra, 25, who goes to dental hygienist school in Miami, and 23-year-old Ashley, who has a son of her own and works two jobs to help pay the family’s bills.

Donna’s husband, mother and father were all dead. She had no siblings. All Donna had in the world was her children, and all they had was her. They were her sole caregivers — and her biggest concern.

Now she was dying.

2

‘Poverty is a carcinogen’

That day was when I figured out God had something in mind for me other than full-time work. I had been interviewing for jobs, having just completed my master’s degree in science, health and environmental journalism at Columbia University. My thesis was on the burden of cancer on the poor. It was inspired by Donna.

I met Donna Lynn Woods in 2012 at Winship Cancer Institute, a cancer research and treatment center at Emory University in Atlanta, where I was communications director. Donna was there for treatment of metastatic breast cancer. She’d been told to say her goodbyes in 2009, but here she was years later, still fighting for her life.

The first time I saw her, she was sitting on an exam table, waiting to see the doctor. She raised her shirt to show me where her left breast had been, like a child showing off a bandage on a scraped knee. She showed me her left arm, swollen and heavy from lymphedema.

To get to Winship for her treatments, Donna had to take two buses and a train each way from her house. When she returned home, drained and nauseated, only the children were there to take care of her.

I became aware of the extra burden impoverished cancer patients bear in the late ’80s when I was working at a hospice in rural Georgia. Even if they had Medicaid, like Donna, or family and neighbors who could help, their support systems never were as reliable as those in “the casserole culture.”

Patients living in poverty generally are friends with people who are stretched equally thin. They do not own reliable transportation. They may work several jobs. They may not even own a Pyrex dish to tote chili or stew to a friend with cancer.

At Winship, I saw it again. I could easily spot the rural and inner-city poor, if not for the overalls, worn shoes and even more worn faces, but for looks of utter puzzlement as they tried to navigate a big-city medical center.

Winship physicians are first-rate, but the issues the poor with cancer face go beyond individual, caring physicians. There are language barriers, racial and ethnic barriers, transportation barriers. There are issues with childcare and personal care.

Getting to know Donna — and seeing a real-life person, not a saint but a decent, kind person who’d been dealt some serious blows — led me to learn more about disparities on cancer outcomes, and they are many.

Black women with breast cancer in the United States are, on average, 40 percent more likely to die from the disease than white women, according to a recent study by the Sinai Urban Health Institute. In some cities, the gap is even greater. On the surface it may appear the gap is about race, but income is the culprit.

“What we offer is first-class and coach fare, and coach doesn’t get you to the same place that first-class does,” says Dr. Otis Brawley, chief medical officer for the American Cancer Society and an expert on racial and economic gaps in cancer treatment.

The chance of getting cancer is increased by as much as 80 percent for people with three or more social risk factors, such as being a minority, being poor and being single, according to another study.

“Poverty is a carcinogen,” says Harold Freeman, founding director of the National Cancer Institute Center to Reduce Health Disparities.

3

‘I can’t leave them boys’

Donna’s children are well versed on their roles in the family. Kendra and Ashley help keep the family financially afloat. Darius is good for all mechanical issues, and Chopper cooks. Dazmine and Damyuss clean house. All of them know Donna’s medication schedule and when to bring ginger ale and peppermint candies.

But that August day Donna called me at the airport, she needed more than sweets. She was failing, and the boys knew it.

Late that night, as she and Chopper slept together in her bed, Dazmine woke up and crawled into the bed with them. Then Damyuss joined them. When Darius came home, he saw them huddled together and climbed into the bed, too.

I thought I understood poor. I grew up poor in Athens, the daughter of a single mother of five. Getting to know Donna and her family, I came to realize there’s a big difference between being poor and living in poverty. When you are poor, you’ve got a shot at making it out. Millions of poor Americans become success stories.

When you live in poverty, your best shot is just to stay alive.

But seeing the love in Donna’s family, I discovered there is no difference at all in how much a mother, rich or poor, loves her children, and how much they love her.

When morning came, an ambulance whisked Donna to Emory University Hospital Midtown. Chopper and Ashley followed in the 2003 Toyota Camry Donna had financed in April with tax refund checks from Kendra and Ashley. She still had a $250 payment every two weeks, but the Camry got her to Emory Hospital and back for treatments — or the kids to the hospital and back when she was admitted.

I got to Donna’s hospital room late that afternoon.

“It’s gone to my spine,” she said. “It’s putting pressure on my nerves. That’s why I can’t walk.”

I noticed pale streaks down her cheeks from where she’d been crying.

“They want me to do radiation.”

She paused.

“I can’t leave them boys yet. They’re too young. I don’t want them to think I’ve given up.”

An icy, rolling wind whipped across my heart. Donna was in this alone, I thought, really alone. And what could I do? She was asking me for advice? I was just a journalist. I began to feel guilty each time I left her.

A few days later, Emory held a press conference for Dr. Kent Brantley, the physician who had contracted Ebola. Brantley was cured, and he was thanking all his nurses for their incredible care.

When I arrived at Donna’s room at noon that same day, Donna had not had pain meds in 12 hours. Her diaper had not been changed in 16 hours.

A nurse and nurse tech walked in, and I queried them about her care.

They’d get her pain meds, they said, but it wasn’t their job to change her diaper.

“Then whose job is it?”

“The family’s,” one of them replied. “We’re not supposed to change diapers. We change pads.”

“And what if the family is a bunch of teenagers?”

They looked at each other and shrugged.

Later that evening, after I’d left the hospital, Donna left me a voicemail.

“Come get me out of here. No more radiation.”

On Tuesday, she was transported to Hospice Atlanta, in Buckhead. It seemed strange to visit her in such a welcoming environment. Her first night there, I opened the door to a terrace. We heard a choir of crickets and smiled. I suggested we read scripture. The Bible opened to the 15th chapter of the book of Matthew.

“That was good,” she said. “Read it again.”

“You and me,” she said. “We’re on this wagon together. You gotta stay with me now. There’s nobody else.”

Like most people, I don’t like hospitals, and that includes hospices. I don’t like stinking, smug death. I don’t love being around sick people, and I had discovered, I really wasn’t wild about being around poor ones, either. I was working through those things, but I was taken aback by the realization that there really was no one else for Donna. I was going to be it on this journey.

I knew I had crossed a journalistic line in trying to help her through the last few weeks of her life, but I didn’t care.

“Yeah, Donna,” I said. “We’re on this wagon together.”

The next morning, I got another call.

“Get me outta here,” she said. “They’re trying to kill me.”

Donna claimed demons had visited her during the night. She was convinced it was because nurses had switched her pain medicine from morphine to methadone.

The nurses said the cancer had spread to her brain, but Donna didn’t believe them.

Each time they gave Donna a pill, she’d pretend to take it. When they left, she’d spit it out.

She begged me to stay. I told her I couldn’t.

That night after I got home, I researched online the differences between methadone and morphine. Methadone is considerably cheaper. The skeptic in me wondered: Is that why they switched her meds?

I packed a bag and went back to the hospice.

“Hey, Donna,” I told her. “We’ll get you home. Not tonight, but as soon as we can.”

I brushed my teeth and then hers. I changed into my pink nightgown and settled down on the cot by the window in what felt like the shadow of death. The crickets were quiet.

4

Like a Nubian princess

Four days later, Donna was released from inpatient hospice. Or maybe they kicked her out.

When I got to her house that evening, Darius was trying to figure out how to operate her oxygen tank.

“Does this mean Mama is gonna be able to walk again?” Damyuss asked. In the past, when Donna came home from the hospital it was because she was better. He didn’t understand she’d come home this time to die.

Chopper helped the delivery man unload the hospital bed while Donna beamed like a bride.

Five days later, Donna was back in the hospital, unresponsive and on life support.

“How are we going to pay for anything?” Ashley asked as she rubbed away tears with the palms of her hands. “How we even gonna pay to bury her? We’ll have to have a bake sale, or fried chicken or something. We gotta have a decent funeral for Mama.”

I told Ashley to go home and get some rest. Then I stood by Donna’s bedside and sang “Amazing Grace.” She fluttered her eyelashes. Or maybe she winced. I told her what a great mother she was and how much the children loved her.

Ashley called me early the next day.

“They said I need to get to the hospital fast. Can you come?”

We both had dirty hair, wrinkled clothes. The nurses came to check Donna’s pulse. There was none.

Ashley crouched on the floor and banged her hands against the door. Tears as big as nickels popped from her eyes and rolled down her face. She jumped into the bed with her mother.

“My baby, my baby, my baby!” she cried.

I prayed to the Blessed Mother for Donna, for Ashley and for the other five children whose lives I knew would never be the same.

Ashley had to leave, but I stayed in the room until the social worker arrived. I told her the kids needed help.

She began telling me about indigent burials.

The next day, Kendra called to say that John Grubbs, a funeral home owner in Alabama, near where Donna was born, had called and offered to handle the funeral for free.

“He said he’ll pull out all the bells and whistles. We’re gonna dress Mama like a Nubian princess!”

A few days later, the family’s Camry was repossessed for missed payments. That same day, Grubbs called Kendra and demanded $2,000 to bring Donna’s body back from Alabama for the funeral on Saturday.

Trying to help sort things out, I gave Grubbs a call.

“I never told Kendra I would do a funeral for free,” he said. “Those girls are lying.”

I told the girls I’d find the money. Then, I realized: They don’t even have groceries. Dazmine needs cleats for football. They have a $600 unpaid electric bill from the summer. Their pastor advised Kendra and Ashley not to pay the money, even if I could raise it.

On Sept. 20, about 200 mourners gathered at House of God Church on Rockbridge Road to remember Donna. Her sons wore pink shirts, and the pastor gave a rousing call to the Cross. But Donna’s body was in Eufala, Ala.

A couple of days later, I received a call from the Fulton County Indigent Burial office.

“There’s going to be a burial at the county cemetery tomorrow at 10:15,” I was told. “The girls can be there or not.”

Kendra was back in Miami. Only Ashley could go.

5

A burial for Donna

Battleship gray skies greeted us the next day. I picked up Ashley for the drive to Palmetto, in the very southern tip of Fulton County. We drove past the airport, past Union City.

Eventually, we got off I-85 toward Fairburn, then turned left onto U.S. 29 South. CSX has a hub close by, and we passed dozens of black tanker cars on the tracks. They looked like caskets. I wondered what kind of casket Donna would have. I’d been told it would be low-end. I imagined a pine box.

I thought about how Ashley and Kendra had so carefully picked out their mother’s clothes and makeup. A white suit from her closet, a pink scarf from mine. Bright pink lipstick and a wig to make her look like a princess. White, frilly underwear, everything except shoes because her feet had been so swollen.

I turned onto brindled Wilkerson Mill Road, lined with ragweed and a few ranch houses.

We came to the cemetery road. My directions said turn left, but that was a dirt road.

“They wouldn’t bury Mama down a dirt road, would they?” Ashley asked.

“Oh, no, sweetheart, of course not!”

A deep chill came over me. I saw no signs of life or afterlife. It felt like we were at the edge of the Earth. We passed some black, scowling cows, faces as insolent as teenagers when an unwelcome adult walks into a room.

Then, to our right, I noticed a large white cross in a field. And, further in the distance, a heap of red clay. I turned into the driveway and saw a tent, a hearse and some cars. I turned off the engine, and we got out of the car. Someone from the cemetery informed us it wasn’t “our turn.” Someone else was being buried first.

Tears spilled down Ashley’s face. She rubbed them away with the back of her palms as she watched the funeral under way. It looked like they opened the casket so the survivors could take a last look.

“Maybe they’ll open Mama’s so I can see her,” said Ashley, clutching two dozen pink roses I’d brought. “I wanna see how she looks in her pretty suit.”

A few minutes passed, and the hearse and mourners from burial number one drove away. The guy in charge told us to drive up. I didn’t see another hearse.

A beige van, like the kind you see in a school carpool line, opened. I averted my eyes as three men began to pull something out.

I took my seat in a folding chair next to Ashley, my head down in prayer and despair. Ashley sobbed.

I prepared to look up, knowing the coffin containing Donna — the patient from Winship, the mother of six, the person who became my friend — would be right in front of me. But when I raised my head, I saw there was no coffin.

Instead, there was a brown cardboard box sealed with duct tape.

I felt like throwing up and prayed Ashley would keep her eyes sealed tight.

A chaplain said a prayer and the workers rolled the box away to the yawning red earth a few feet away. Ashley was holding the roses.

“Can I put these with her?” she asked.

“No,” one of the men said. He pointed to a stretch of caution tape, indicating she couldn’t cross it.

Within minutes, the brown box containing Donna’s remains was lying in the rusty Georgia dirt.

I ran across the tape toward the grave. One of the guys stopped me.

“Can you at least put these roses with her?”

He tossed them on top of the box.

We were so stunned and shocked we could not move. Finally someone wearing a baseball cap told us our turn was up and that we needed to move on.

“How could he put my mama in a cardboard box with duct tape? How could he do that?” Ashley said after we got back in my car.

“I just wanna tell him, I just wanna tell him...” she paused as I drove slowly from the graveyard. “I just wanna tell him he’s gonna reap what he sows.”

It took several minutes to get back to the main road. I looked down and realized I was driving only 35 mph. My arms were shaking. I felt dizzy and nauseated. How could Ashley bear this? I wondered.

When we reached the main highway, about three miles away, she said, “Look, there’s a MARTA stop. I can come out here on weekends and visit Mama.”

♦♦♦

I dropped Ashley off and came home. I wanted to throw something, scream.

The phone rang. It sounded like Ashley, but I could barely hear her.

“How you doin?”

“OK. How are you?” I said.

“Whacchu doin?” the small voice said. I realized it was Damyuss.

“Oh, I am getting ready to send my best friend a birthday present.”

“You gonna have a party?”

Long pause.

“Can you come out here?”

“I was just on my way,” I said.

When I got there, Damyuss and Dazmine came running up to my car. Dazmine had football practice, so I buckled the boys up, and off we went. At the practice field, Dazmine ran off to join his team, and Damyuss trotted over to the playground. His smile was like Donna’s the day she got out of hospice. In fact, it wasn’t like Donna’s smile, it was Donna’s smile.

After a while, it was time to leave. Dazmine was getting a ride home with a friend, so it was just Damyuss and me. We drove toward Donna’s house beneath a setting sun that cast layers of gold and pink across the clear blue sky. We stopped for a milkshake, and while we sipped on our straws, I wondered what would become of Donna’s children. There was no way to know what would happen next. And I realized my journey with Donna’s family was not over yet and probably never will be.

HOW WE GOT THE STORY
I didn't know former AJC reporter Virginia Lynne Anderson when she pitched this Personal Journey, but her passion to tell Donna Woods' story convinced me to give her the assignment.  At the time Donna was dying of breast cancer, and every few days Anderson would call and update me, her voice full of emotion. We finally met the day Donna was buried, and Anderson explained how involved she had gotten with the family. That's when I suggested this story was as much about her journey as it was Donna's.  She initially resisted putting herself in the story  but eventually  came around. The result is an unblinking look at the final days in the life of a valiant cancer patient who lived a life of poverty, but who was rich in love.

Suzanne Van Atten
Personal Journeys editor
personaljourneys@ajc.com

About the reporter

Virginia Lynne Anderson  has covered courts, sports, business, politics and medicine over her 25 years in journalism. She was the lead reporter on a six-part series on a thoroughbred breeding farm that went public and, later, bankrupt.  The series  was a finalist for the Pulitzer Prize.  Anderson is a native of Athens, a University of Georgia graduate and the proud mother of two lovable daughters, both lawyers.

About the photographer

Hyosub Shin was born and raised in South Korea. Inspired by the work of National Geographic photographers, he came to the United States about 10 years ago to study photography. Past assignments include the Georgia Legislative session, Atlanta Dream's Eastern Conference title game, the Atlanta Air Show and the Atlanta Braves' National League Division Series.