Joe and Wynema Goins, June, 2003
Joe Goins is a 66-year-old retired machinist and longtime Baptist deacon.
A humble man who is frugal with himself and giving to others, Joe has
lived wisely, and well. He married his high school sweetheart, Wynema
("Nemie" to Joe). Joe tells me they have never been with another,
and declares, "Do you know how lucky I am?" He smoked only briefly
during the Army, and gave up the nasty habit, which did not agree with
him. Joe and Wynema have three sons, one daughter, eight grandchildren,
and four great-grandchildren. The machinist with a high school degree
always put food on the table and made sure Wynema could stay home and
raise the children.
They live on 40 acres of rolling hills in the country outside of Frankfort,
the capital of Kentucky which never became a big town. Frankfort's
countryside is some of the lushest, most picturesque land you'll ever
see. The grass does get so green it looks blue. In August, the summer
air is warm but fresh; in winters, which are relatively brief, the snow
can pile up to the window ledges of homes.
The tidy Goins home has a finished-out basement complete with kitchen and
bath which once served as his father-in-law's living quarters. He
kept about two of the acres surrounding his home neatly mowed. He also
worked a large flower and vegetable garden on the east side of the house.
His 16 year-old Arabian and quarter horse mix, Star, is free to wander
about in the remaining acreage.
The Lord and family surround Joe and Wynema. A sculpture of praying hands
is in the living room; Joe readily finds a well-worn Bible when a question
of Scripture comes up. In retirement, Joe continued what he had done for
his church for years -- he taught Sunday school, led an adult Bible class,
and ministered to the sick in their homes.
Across the road is the house of one of their sons, Troy, and his family.
Their teenage grandson Troy, Jr. rides up on a four-wheeler to see if
his grandfather needs any help. To the west is Wynema's land, which
she inherited from her parents. Off to the north is the little pond where
Joe and his sons and grandchildren like to fish. In town is Joe's
91 year-old mother, still living in her own home, but dependent on Joe
to maintain her yard and house, get her groceries and run her to the doctor's,
among other things. A temperate man who might have a couple of glasses
of wine in a year and practiced moderation in all things, Joe thought
he'd live as long as his mother, or longer, in a life some might call
simple and others, simply idyllic.
Joe and Star in August, 2003
So Joe thought until the Fall of 2002, when he began to feel unusually
tired and run-down. In early January of 2003, Joe awoke one morning with
terrible chest pains. That afternoon Joe met with his family physician,
who guessed Joe had had a minor heart attack. After several tests, a heart-related
problem was ruled out. He was admitted to Central Baptist Hospital in
Lexington, Kentucky on January 14. After more tests, including a CT scan
and a chest film, the doctors at Central Baptist noted a mass on Joe's
right lung. On January 16, Joe underwent a needle biopsy. Pathological
tests upon the biopsied tissue resulted in the shocking diagnosis of malignant
pleural mesothelioma. Like many afflicted with this cancer, Joe still
has difficulty pronouncing the word.
Joe was referred to a local lung specialist. After looking at Joe's
medical record, the pulmonologist admitted to Joe that this was only the
second case of mesothelioma he had ever seen and he did not feel qualified
to treat him. This doctor wisely referred Joe to Dr. David Sugarbaker
of Brigham and Women's Hospital in Boston, Massachusetts. Dr. Sugarbaker
is one of the most prominent surgeons in the world specializing in the
treatment of pleural mesothelioma.
Joe and Wynema traveled to Boston via "Mercy Med+Flight", the
country's only charitable air ambulance, and met with Dr. Sugarbaker
on February 4, 2003. The surgeon told Joe the latter would have to come
back after undergoing tests to determine his suitability for surgery.
Joe begged Dr. Sugarbaker not to make him travel back to Kentucky before
surgery, to try to "work him in." Joe believes it was divine
intervention or simply God's plan that another patient canceled surgery
scheduled for February 6, and after getting the call the night before,
within hours Joe found himself being wheeled into the operating room.
On February 6, Dr. Sugarbaker performed a right upper lung lobe wedge resection
with removal of ribs two through five. The tumor had invaded the third
and fourth rib, extending into the most superficial third rib cortex.
Immunohistochemical staining performed on the removed tissue confirmed
the diagnosis of malignant mesothelioma. According to Joe, the tumor Dr.
Sugarbaker took out of his chest was the size of a grapefruit. Joe was
discharged from the hospital on February 16, but remained in Boston for
another 10 days so that his status could be closely monitored by Dr. Sugarbaker's team.
Joe's Surgical Scars
Hardly recovered from the intense pain of the surgery, Joe next endured
14 cycles of chemotherapy under the care of a Lexington, Kentucky oncologist.
His treatment cycle consisted of a Cisplatinum and Gemzar "cocktail"
one week, Gemzar alone the next week, and the third week off. After the
Cisplatinum-Gemzar cocktail, Joe would spend nearly the entire following
week in bed, barely able to walk to the restroom. The treatment of just
Gemzar left him nauseous and weak for the next 24 to 36 hours. His hearing
has been affected adversely (and, apparently, permanently) by the chemotherapy.
Joe makes himself eat, trying to recover from the weight loss caused by
his cancer and chemotherapy. It is a testament to this effort and prior
good living that he looks surprisingly good for a man who has had mesothelioma
for close to a year and undergone radical surgery and lengthy, nauseating
chemotherapy. Still, he tires easily and becomes "shaky" when
He can no longer mow his yard. His vegetable garden lies neglected. His
horse Star is starting to act up and get a little wild. A good but spirited
horse, Star "needs to be rode, and rode hard", Joe says with
a hint of a malicious grin, but there is no way he could ride now. Troy,
Jr. is afraid to ride Star, and Troy, Sr. doesn't have the time. Just
walking Star from the house down the grassy slope to his fenced-in acres
now involves some risk to Joe; he is simply not strong enough or agile
enough to handle the little "tricks" Star plays from time to
time. He cannot drive, and Wynema now has taken over the care of Joe's
mother. Joe has had to give up teaching Sunday school and leading adult
Bible study. Although he could still visit the sick (with Wynema driving
him), Joe does not feel he is "spiritually right" to tend to
others yet. He keeps his own dark thoughts at bay mainly through a fierce
discipline to prayer and Bible study.
As Wynema seemingly always has been, she remains there for Joe, strong,
steadfast, prayerful, and at times unexpectedly and uproariously funny.
Knowing Joe was dreading the ordeal of testimony, she handed me a slip
of paper in confidence the day before his deposition, which in turn I
passed to Joe just before his cross-examination. The note, apparently
photocopied from another source, reads:
Today's mighty oak is yesterday's nut that held its ground.
Joe chuckled and passed the saying back to me before the defense attorneys
began pitilessly trying to trip him up. The slip of paper is now pinned
to my office wall, a daily reminder of Joe Goins, a testament to how great
a man can become if he will simply -- and as the saying implies, crazily
-- hold his ground. Joe Goins has been a pillar of strength for his family
and his community by sticking to his principles, day after day. Whether
Joe is one of the rare few to outlast mesothelioma or not lies in God's
hands, but that outcome cannot dim his life's work. Count me among
the many touched by Joe pulling for him to hold his ground, once again.
*** POSTED SEPTEMBER 15, 2003 ***
An Update -- 1/13/04
Throughout the spring and summer Joe worked hard to regain the strength
and energy he was once took for granted. A setback came in late November
when the results of a follow up CT scan revealed a new mass located in
the same vicinity of the original tumor. The tumor, though not large,
was biopsied on November 22, 2003. The pathological testing of the tissue
specimen confirmed the return of mesothelioma. An appointment with Dr.
Sugarbaker was immediately scheduled.
On December 9, Joe met with Dr. Sugarbaker. The examination and consultation
with Dr. Sugarbaker resulted in the decision not to re-attempt surgical
intervention but to use chemotherapy to shrink the tumor. The chemotherapy
will be administered in Lexington.
Joe began radiation treatments on Tuesday, January 6. Arrangements were
made with so that he could receive his radiation treatments in Frankfort.
He is scheduled to receive radiation five days a weeks and will continue
until he has completed a cycle of thirty treatments or six weeks. On Friday
January 16, Joe and Wynema will travel to Lexington to meet with his oncologist
and schedule his chemotherapy. Joe still recalling the adverse reactions
he had with the cocktail of Cisplatin and Gemzar, has been assured that
this go-a-round will not be as severe.
Joe feels good about the treatments. Dr. Sugarbaker is coordinating all
of his treatment and communicating with both doctors in Frankfort and
Lexington. Although the radiation makes him extremely tired, Joe advises
that he "feels pretty darn good" as long as he takes a nap right
when he gets home from his daily radiation treatment.. Wynema does her
part by preparing nutritious and delicious meals that Joe always eats.
He claims that he has been able to maintain his weight because he will
eat even when he is not hungry.
Once Joe has completed all of the radiation and chemotherapy prescribed
by Dr. Sugarbaker, he will return to Boston for further analysis. If radiation
and chemotherapy successfully shrinks the tumor, Dr. Sugarbaker will not
operate. However, if the treatments were unsuccessful, surgical intervention
will likely be necessary.
Mr. Joseph Goins passed away on November 24, 2004