Darrell Hughes fights to make a donation from incarceration.

Denise Jenkins needs a new kidney. Diagnosed with lupus in early 1994, the 43-year-old mother of two has been on dialysis for nearly two years. By April 1998, the disease—which causes a person’s immune system to produce antibodies against the body’s own cells—attacked her kidneys, effectively destroying them. So now, she takes the H-12 bus from her Naylor Gardens home to Washington Hospital Center three mornings a week to sit for three hours while a dialysis machine cleans her blood.

On a wintry Thursday after one of those dialysis sessions, Jenkins sits down with me in her living room, which boasts a spotless ensemble of plastic-covered black furniture atop a white carpet that’s protected by more plastic. A blocky child’s bed made up with a green print quilt rests in a recess, and an arrangement of black and red artificial flowers sits in a black vase on the coffee table. It is 3 p.m., close to the time Jenkins usually walks the three blocks to pick up her youngest son from elementary school.

Jenkins doesn’t want to be late, so she’s left her dark-green coat and keys hanging just by the door, ready to go. She has a few minutes to talk, though, and she takes her time, speaking in firm, measured tones. Only up close can you notice the scars on her neck and arms—where she has had three grafts to facilitate her dialysis—or the tube sneaking out from the neck of her blouse.

Jenkins doesn’t spend a lot of time complaining about being sick. She found out about her illness just four months after her husband died, and kept the news from her then-18-year-old son for as long as she could. But that doesn’t mean Jenkins wouldn’t like the treatment she really needs. “If I had a working kidney,” she says, “I would be like normal.”

That’s not so easy to come by. Jenkins has been on the national waiting list for a new kidney (United Network Organ Sharing Registry) since December 1998. It’ll most likely take four or five years for her name to come up, according to Josephine Flores, a transplant coordinator at the Washington Hospital Center. But actually, one specific kidney has been available for nearly as long as she’s needed one.

When Jenkins’ son Darrell Hughes, now 24, heard that her disease had progressed to the point that she needed a kidney, in May 1998, he immediately volunteered. “He was going to worry me to death if I didn’t give in,” says Jenkins. “I kept telling him no, but he was telling me he wasn’t listening to that. I told him, ‘Don’t feel like that’s something you have to do.’ I know I’m his mother, but it’s not an obligation; that’s your own choice. I’ll love him no matter what….I was saying, ‘Well, we need to sit down and talk about this.’”

It turned out that sitting down for that conversation wasn’t too easy. Darrell Hughes’ kidney—like the rest of him—was in jail, on a 36-year sentence for murder.

For 20 months, mother and son’s efforts to get the organ out from behind bars have been stymied. One of 117 D.C. inmates housed at the Corrections Corporation of America’s (CCA) Central Arizona Detention Center in Florence, Ariz., Hughes finds himself caught between the health needs of his mother, the security needs of a maximum-security prison, and the budget constraints of a city that houses its prisoners in far-flung private facilities. And although Hughes has made some progress, Jenkins’ new kidney remains firmly behind bars.

The only way Hughes has been able to see his mother since 1993 has been through the glass panel of a prison visiting room. When he was imprisoned locally, at Lorton, Jenkins visited him every Sunday. After he was shipped in 1997 to CCA’s Youngstown, Ohio, prison, Jenkins and her sister once rented a car to drive out to see him. Because Jenkins had to return for dialysis the next day, it was a long, hard trip.

And since leaving Ohio in June 1998, Hughes hasn’t seen his mother at all. Florence is a 90-minute drive from Phoenix. For Jenkins, the cost of a two-and-a-half-day bus trip—or, alternately, plane ticket and car rental—is prohibitive, even without the logistical nightmare of figuring out how she could undergo dialysis away from home.

These days, mother and son’s only contact is through his daily collect calls. “If I ain’t there, he will call around everywhere,” says Jenkins. “I say, ‘Boy, stop hunting me down!’ He tells me, ‘I ain’t even listening to that.’ He’s just kind of scared, and if he don’t hear from me he starts panicking. He thinks I’m in the hospital—he thinks I might be sick again.”

Growing up, Hughes was a good kid, according to his mother. “A lot of my neighbors noticed how he never talked back to me,” says Jenkins. “He never really cut up, because he knew he would have to answer to me.” But in school, says Jenkins, teachers never noticed the boy’s difficulty with reading and, because he wouldn’t do his work, declared him a problem child. And as he grew up, the troubles spread to home. “We were always close, but you know teenagers—they want to do their own little thing. He didn’t want to sit in the house with me.”

At 18, Hughes was restarting the 10th grade, still struggling to learn to read. “All I was interested in was females, and money to look good for the females,” Hughes said. “I wanted to follow the crowd.” He did, to disastrous consequences. In October 1993, Hughes was arrested for first-degree murder. Convicted in 1995, he was sentenced to 36 years in prison, with parole possible only after 30 years. Since then, he has bounced from D.C. Jail to Lorton to Youngstown to a Tennessee facility and then off to Arizona.

Like many inmates, Hughes says he’s a changed man. In prison, he says, he taught himself to read. “I guess I just had more time,” he says. He read The Autobiography of Malcolm X. “I started reading about Islam, and my attitude really changed,” he says. Soon he was praying six times a day. “It’s really five, but the sixth time is an extra prayer….My attitude changed—the way I look at people. I don’t do no cussing no more. A lot of people say I changed.”

And, he says, he began to think of ways he could help his mother. “I try not to be a burden on her, try not to bug her too much. She’s sick. She got to take care of my little brother….The plug in her arm keeps getting infected—they just put one in her neck. I guess I can’t be a real help to her.”

As it turns out, getting a kidney out of jail—even from a guy who says he wants to help his mother—isn’t that much easier than getting an actual prisoner out of jail. “As soon as I heard it, I started writing them request slips,” says Hughes, who was then in Ohio. “They took my blood pressure and said they was going to get back to me.”

Immediately, though, he says he ran into problems. “They was saying they didn’t want to release my medical records,” says Hughes. And as he tried to figure out the logistics, prison developments overtook him. After two May 1998 stabbings at the medium-security Youngstown facility, CCA decided to transfer maximum-security D.C. inmates like Hughes. “By the time I knew they wouldn’t release my records, they was telling me to pack my stuff up, so I couldn’t fight it.”

According to Eric Lotke of the D.C. Prisoners Legal Services Project, the pattern is a familiar one. “We believe that CCA sometimes delays expensive medical procedures until the prisoner is no longer in CCA’s custody,” he says. But even as Hughes bounced from Ohio to Tennessee and then packed up again, he remained at CCA facilities. And according to D.C. Department of Corrections spokesperson Darryl J. Madden, D.C. inmates in Arizona may soon move again.

Hughes first arrived in Florence that October—five futile months after beginning his campaign to donate his kidney. “He came to me in the first couple months,” says Warden Michael Samberg. “He made the request here, and it seemed like an important thing at the time….I turned it over to Gene Greeley [the former administrator of health services for the prison]. He had to look into it to verify all the information.”

But Greeley left his position soon afterward. Health care at the prison was turned over to First Medical Corrections Inc., a private corporation specializing in prison medical care. And Hughes’ case was understandably not on the top of the agenda. Nevertheless, last March, 10 months after volunteering his kidney, Hughes signed a release absolving CCA from all responsibility in case anything should go wrong in the tests necessary for him to donate an organ. A week later, he received the papers outlining the required exams: a general checkup, a blood-pressure test to determine whether he was healthy enough to give up a kidney, urinalysis to see how well his kidney worked, and a blood analysis to test whether his kidney would be compatible with his mother’s body.

What would have taken the average citizen six to eight weeks took Hughes nearly four more months. “They kept losing samples,” he says. “Or, like, the urine sample never got to the lab on time, the blood sample didn’t get put in the freezer.” Hughes claims he gave four blood samples and four urine samples before one of each arrived safely at its respective testing site in late June. He passed all with flying colors. In July, he was told that he was indeed a match for his mother.

All that remained was for a kidney expert—a nephrologist—to verify that Hughes indeed had a kidney to spare. But again, the process ran aground. “The D.C. facility said the CT-scan should be done in Arizona, and Arizona said it should be done here,” says Flores from her office at the Washington Hospital Center, where the transplant was to be done. Flores says D.C. officials wanted it done in Arizona, because “if he doesn’t have two kidneys, then what’s the point?”

“There was a lot of correspondence that went back and forth,” says Samberg. “It’s a kind of a long-distance coordination, of them telling us what has to be done and we get it done.”

Beyond the logistics of who would do the scan, though, there was the small matter of money. D.C. pays for its inmates’ medical care and picks up the costly check for transporting them off-site when their health requires it. But shelling out for a prisoner’s kidney donation is something else. Jenkins’ health insurance would cover the tests and Hughes’ operation, but not the costs of moving him.

Just taking Hughes to see a nearby nephrologist required armed guards, a special security vehicle, and a secured site at the hospital where the CT-scan could take place. “We can’t be put in the position of using public funds to facilitate a private or medical transaction,” says corrections spokesperson Madden. Almost eight months after Hughes first learned which tests he needed to undergo, CCA finally agreed to foot the bill for taking him to the scan in Arizona.

Hughes was taken to a local hospital early in the morning of Jan. 31 for the test. Last week, he was OK’d for the transplant.

Hughes and Jenkins have both tried to keep their hopes in check. “They say to look on the bright side first,” Hughes says, “but I always think about the bad things that could happen, so that if I get disappointed I won’t get so sad.”

And there are still plenty of opportunities for sadness. If sending Hughes down the road to an Arizona hospital was tough, getting him transported to D.C. for the transplant operation may be even harder. The move requires a special airplane, complete with security guards. The cost, to be covered by D.C., is in the neighborhood of $2,500, says D.C. Department of Corrections Medicaid Director Dr. Eliza Taylor. Another option is the bus, she says, which would cost around $1,800 and take six to 10 days each way.

What would be done with him once he gets here is yet another question mark. “I don’t believe Washington Hospital Center has a secure unit [to carry out the operation],” Madden says. “He would have to have it done in another facility.”

This facility has yet to be located. There is no procedure set up for prisoners to donate their kidneys. Until now, none was needed—Hughes, if he makes it to the operating room, will be the first D.C. inmate to donate an organ. “I can recall two others who offered to donate. There may have been others, but none of them qualified,” says Taylor.

No one knows whether Hughes would remain in D.C. or return to Arizona after the operation. “Chances are, he would be shipped somewhere,” says Taylor.

But as far as Hughes sees it, he’ll feel close to home no matter where they ship him. “In a way, I’m glad I got locked up, because me and my mother have gotten so close. I really got to know her,” he says. “She’s been coming to see me. She’s been writing to me, sends me cards. She’s my best friend, the only friend that I have…in here and out there. It’s hard to understand, but it’s true.” CP