God save you from ever having to endure the ordeal that Alexander Govan lived as a 10-year-old.
It began with cops pulling him out of his mother's arms and taking him to a foster home. Then came exploratory surgery on his neck and a cancer diagnosis. Life became a blur of hospital visits, chemotherapy, radiation treatments, and gut-wrenching nausea. Occasionally, when he wasn't too sick to walk, Alex's foster family--a group of Jehovah's Witnesses--dressed him up in church clothes and took him out on proselytizing excursions. Hairless, thin as a stick, with the tumor on his neck bulging out over the collar of his dress shirt, he went from house to house knocking on doors for a faith he barely knew.
Through it all, Alex had one wish, say children's advocates who befriended him at the time: to go home to his mother. But the court refused to allow it. The only time his mother was permitted near him was when he went to the hospital for treatments. After a year had passed, though, it became clear that the treatments weren't working: The cancer would not be cured, and Alex would not survive. The foster-care judge relented, and Alex returned home. Two weeks later--in May1996--he died.
Now, the blame game has begun.
Fingers are being pointed, and the biggest finger has landed on Alex's mother. Federal prosecutors say 29-year-old D.C. native Endura Govan helped bring about her son's death by refusing to allow doctors to remove a growth from his neck when there was still time to save him. They're charging her with felony child abuse and manslaughter.
Jerome Miller, the city's federal foster care overseer, thinks the case against Govan is "bizarre." Told of the charges pending against Govan, Miller practically explodes over the phone, "Don't they have anything better to do down there? There's no reason for them to grind up a good woman like that."
To understand Miller's anger, you've got to understand the relationship that Alex shared with his mother. By all accounts it was exceptional. "That child simply loved his mother," says Rozita Wilson, who has known Endura since the two were in junior high school together. "Endura and Alexander were just an item. He adored and worshiped that woman."
It had been that way from the beginning. When Alex was born, Endura was 19 years old and unmarried. She lived with her parents in their family home on Rhode Island Avenue NE. Over the next few years, she worked hard at establishing a career for herself in real estate while at the same time keeping her mind on what she calls the "24-7 job of parenting."
It helped that Alex was an exceptional child. At the age of 4 he announced that he wanted to start a business. So Govan bought him a portable button-making machine and helped him sell customized buttons and badges to friends and neighbors. By the time he was 5 he had expanded this business to include a line of T-shirts. Within two years, he was a distributor for a line of personalized children's books. By that time he had chosen a name for his business: B.A.D. Kids Inc., which stood for Bold, Ambitious, and Determined.
He was all of that. "He had a sense of purpose early on," Govan says. "Somebody asked him once what he wanted to be when he grew up, and he said, 'What I am now--a businessman.'"
The growth on Alex's neck first appeared in the spring of 1993. It didn't look like a mole or a birthmark. "It was like a puffiness on his skin," says Govan. It was about half the size of an almond, on the right side of his neck, just above his clavicle.
At the time, Alex was fighting strep throat--an annual battle--and since Endura was taking him into the hospital to get his amoxycillin anyway, she asked a specialist to look at the growth. "The doctor said don't worry about it. When you have strep throat, your lymph nodes swell. We see it all the time," she recalls. So she didn't worry, and the growth seemed to go away.
The next spring, Alex had strep throat again, accompanied by that same puffiness on his neck. But this time the swelling was larger and more solid, about the size of a golf ball. When Govan took Alex to D.C. General, the doctors admitted him for CAT scans and tests. But they were unable to figure out what the swelling was. On general principles, though, their advice was to have it cut out.
And this is where Govan and the medical profession parted ways.
"I said, 'I don't mind an operation, but before you start cutting and doing very invasive procedures, could you diagnose it? Or could you tell me just a little bit more about what you think it is or what it might be? Have you ever seen anything like this before?'" recalls Govan.
Govan also asked for a tissue sample, because she feared that an operation might harm Alex's vocal cords and other vital organs. "But the doctor said, 'No, we have to take the whole growth out.' So I didn't really feel comfortable. I felt like they were rushing, and I wanted a second opinion," says Govan.
The next day, Govan called D.C. General to check on Alex and found out that they were prepping him for surgery. "I said, 'I haven't even signed a consent form. How are you going to operate? You don't even have my consent.'" So she drove to D.C. General and took Alex home. The hospital reported her to the Department of Human Services (DHS) for medical neglect.
So Govan scheduled an appointment for Alex at Children's Hospital, where a specialist spent a few minutes examining Alex. The opinion? Take him back to D.C. General and have the growth removed. Govan wasn't pleased.
Conventional medical approaches inspired very little confidence in Govan; she decided to explore other approaches. On the recommendation of a friend, Govan began looking into the world of naturopathic medicine. What she discovered was a nationwide network of holistic healers who use herbs and special diets to strengthen the body's natural resistance to disease.
According to the American Association of Naturopathic Physicians, naturopathic medicine is based on five principles: healing through natural means, avoiding harm, finding the cause of a symptom, treating the whole person, and preventing sickness.
To Govan, naturopathic medicine was a fresh antidote to her experience at D.C. General. There, the doctors had acted as though her concerns were irrelevant and annoying. Holistic medicine seemed to fill in the blanks and provide answers to the questions that conventional doctors had been blowing off.
"If you have a headache, well, you can easily find a chemical that will make it go away," explains Julie Edwards, a D.C.-based distributor of herbal medicines. "With an allopathic or naturopathic approach, making the headache go away is not enough, because it doesn't answer the question, 'Why do you have a headache in the first place?' It could be a problem with your bowels or your liver. It could be that you have too many toxins in your body. Maybe that headache is a sign that you're about to have a stroke. It just doesn't make sense to chemically suppress your body's danger signals without first trying to understand what may be causing those signals in the first place."
After talking to Edwards and doing her own research, Govan eventually settled on Dr. Theodore L. Watkins, M.D., a licensed physician in Silver Spring who takes a holistic approach to medicine. Watkins changed Alex's diet radically--no sugar, no processed foods--and put him on a treatment regimen built around a preparation known as essiac tea.
And it seemed to work. Govan says Alex's growth shrank over the summer, and she's got CAT scans to prove it. "I was very excited, because I was told by the doctors that this was a solid tumor and the only way it would ever go away was if it were surgically removed from the body," says Govan. "You can imagine how I felt when the solid tumor that wasn't supposed to shrink was shrinking."
Meanwhile, doctors at D.C. General clung to surgery as the only viable option for Alex. In the face of Govan's continued resistance, however, the doctors agreed to try a needle biopsy, a procedure that extracts tumor cells that can be examined for signs of malignancy. But it didn't work; Alex was too afraid of the needle to hold still. It seemed like a lame excuse to Govan.
"I told them, 'Look, we're going to get this done. I'll hold him, and you stick him.' But they just said, 'Forget it, we'll schedule surgery.' Well, to me, that was the easy way out. In my opinion, they didn't really try, because they wanted surgery anyway," Govan says.
By this time, Govan had lost all faith in the doctors at D.C. General. "I kept relaying the information that the tumor was shrinking, and finally I just told them that I was going to continue to do what I was doing and that's that," she says.
DHS responded by setting a date--Sept. 18, 1994--and telling her that if she did not have the tumor surgically removed by then, it would take custody of Alex. On that date, Govan took Alex and absconded to Baltimore. There, she rented an apartment and tried to continue Alex's herbal treatments with her meager savings.
There was no way it could last. And it didn't. Life on the lam came to a crashing close in February. Govan had brought Alex back to D.C. to visit a friend, and somehow the police learned of his whereabouts and stormed the house. Alex was taken away and placed with a family that happened to be Jehovah's Witnesses. All aspects of his holistic treatment program were halted; surgery was scheduled.
When they operated, doctors found that Alex's tumor had spread throughout his lymphatic system. A biopsy revealed Hodgkin's disease, a form of cancer that attacks the lymph nodes. Doctors immediately placed Alex on a combined treatment of chemotherapy and radiation. It didn't work.
Apparently little thought was given to the psychological effect of the enforced separation of Alex from his mother at a time when he was undergoing intensive chemotherapy and radiation. "They just kept saying, 'You ran, you ran,'" Govan says. "To me, the judge seemed out for revenge more than anything else."
Michael Gatlin, former deputy to Miller at DHS, agrees with this assessment. "The irony of this whole thing is that, if she had wanted to, Endura could have taken that child right out of the hospital, been right out the door. But she didn't. I mean, after a certain point, you've got to forget what the mother did or didn't do and think about the child. This was a classic situation in which you had the abuse being created by the system that was designed to protect the child."
Finally freed of the obligation to explain themselves to Govan, Alex's doctors stopped telling her anything about the child's condition or treatment. Sometimes she got a little news from nurses who felt sorry for her, but that was it.
To this day, Govan remains convinced that chemotherapy and radiation caused Alex's cancer to spread and ultimately killed him. She has succumbed to the spell of herbal medicine.
Although alternative medicine is not exactly what you would call mainstream, it's surely not way out there on the lunatic fringe. For instance, one good place to learn more about alternative cancer treatments is the office of U.S. Rep. Jim Moran (D-Va.), who successfully used a combination of alternative and conventional treatments in fighting his daughter's cancer. His office maintains a clearinghouse of information on the alternative treatments they used.
"We've gotten a lot of requests for information," says his receptionist. "We've all learned quite a bit about alternative medicine here in the office."
Then there's the National Institutes of Health, which opened an Office of Alternative Health in 1993 and is currently financing studies of treatments such as biofeedback, Navajo spirituality, hypnosis, and acupuncture.
The problem with many naturopaths isn't that they don't have anything good to offer, it's just that the spoonful of common sense they give you too often comes seasoned with a big dose of bullshit.
For instance, Edwards is right on the money when she talks about headaches. But then she oversteps: "If the lymphatic system is stressed, the last thing the body needs is more toxic poisons in the system. The body needs cleansing so that it can heal itself," she says. "Any doctor will tell you that lymphoma is incurable from the beginning."
Not true: Lymphoma in children is eminently curable. More than 90 percent of children with Hodgkin's disease experience permanent remission through a combination of chemotherapy and radiation treatment, according to statistics from the National Cancer Institute.
"Without the chemotherapy and the radiation, they all die," says Anna T. Meadows, chief of pediatric oncology at the Children's Hospital of Philadelphia. "I have no sympathy for a lady like [Endura]. She should be prosecuted."
Faced with an aggressive surgical approach from doctors she didn't trust and a warmly presented invitation to holistically investigate and treat the tumor's underlying causes, Govan chose the latter. It looks like the wrong choice now that a child is dead, but even in retrospect it seems defensible.
Dr. Barrie Cassileth, a University of North Carolina medical professor who has spent 20 years studying alternative treatments, says that Alex isn't the first child to die after his parents chose alternative over conventional medicine. "Most of these cases involve parents who weren't very bright or wanted to follow the path of least resistance in treating their child's illness," she says.
Once Govan made her choice, she didn't waver. Instead, she put herself through considerable hardship and incurred a mountain of debt to ensure that Alex had what she considered the best possible treatment. For Miller, there's enough evidence to suggest prosecuting her is misguided.
"By no means was Alexander ever an abused child," says Miller. "There never was any question that Ms. Govan was a caring and committed mother."--Paul Belden