Divine determination

In fall 2022, South Bend, Indiana, mom Arabia Brumfield wanted her three girls, Nariah, Aria and Divine, to spend time with their paternal grandmother in Jacksonville. Arabia was in school studying to become a massage therapist and cosmetologist and was starting a new job, wanting to give it her all to help support her daughters.

Divine and her closest sister Nariah had gotten into a sisterly “scuffle” on Halloween night in 2022, Divine dressed as a scarecrow and Nariah dressed as Snow White. Two-year-old Divine fell off the bed. Their grandmother found that Divine had a “knot” on her stomach and grew concerned so she took her to urgent care and then to Wolfson Children’s Emergency Center.

Divine’s Wolfson Children’s emergency medicine physician ordered a bloodwork panel and an imaging scan. The shocking results showed Divine had multiple tumors on both kidneys, resulting in a diagnosis of a rare but aggressive condition called bilateral Wilms tumor.

“Her left kidney was engulfed with tumors,” said Arabia. “And there were two tumors on her right kidney, as well.”

Scott Bradfield, MD, chief of hematology/oncology for Wolfson Children’s Hospital and pediatric hematologist/oncologist with Nemours Children’s Health, Jacksonville, said while a Wilms tumor is rare and often one-sided, the condition can present in early diagnosis as bilateral, which means it impacts both kidneys.

“In the case of bilateral Wilms tumors, we try to take out parts of both kidneys to save as much of the child’s kidneys as possible to postpone or avoid dialysis,” said Dr. Bradfield. “The protocol upon imaging confirmation is to start chemotherapy immediately to try to shrink the tumors and plan for surgical removal of the kidney or kidneys as needed.”

A family’s two-year journey begins

Divine started an aggressive chemotherapy treatment regimen on Nov. 2, 2022, spending weeks at Wolfson Children’s Hospital and then its new Eckstein Family Infusion Therapy Suite at Nemours Children’s Health, Jacksonville.

The surgery to remove 1½ of her kidneys was complex and well planned in hopes that Divine wouldn’t need dialysis in addition to her chemotherapy treatment. Andrew Stec, MD, chief of pediatric urology for Wolfson Children’s Hospital and Nemours Children’s Health, Jacksonville, and a pediatric general surgeon collaborated to perform the procedure.

Arabia remembered, “The surgery took place on Valentine’s Day of 2023. I was so scared. But her Wolfson Children’s operating room nurse Cheryl Gaball was assigned to me so she could update me at every stage. Her updates let me know Divine was alive, when the big part of her surgery was done, and that she was doing well.”

Finally, after the surgery and chemotherapy regimen, Divine completed her treatment. She rang the bell, a tradition that signifies the “end of treatment,” although not being “cancer-free.”

Sadly, only days later, imaging scans showed Divine’s cancer had spread to her lungs.

“Divine had to start a new chemotherapy regimen at that point,” said Arabia.

“Her current course based on her scans is a chemotherapy regimen that aims to spare her remaining kidney function,” said Dr. Bradfield.

Somehow, through all of this treatment, Divine (nicknamed “Diva D” for her charm and sassy personality), now 4, has a near-constant smile, with adorable dimples the entire treatment team at Nemours and Wolfson Children’s recognizes when she’s at the clinic or hospital.

“Divine has been so personable and interactive with our teams since early in her treatment,” said Dr. Bradfield. “She is a happy, optimistic little girl who absorbs all the love her mother, family members and our team bestow upon her, giving hugs to everyone! She gives a boost to our team, including me. Every day we get to see her, it reminds us of why we work so hard to treat kids like Divine.”

“Divine is a celebrity here at Wolfson Children’s and Nemours Children’s,” said Arabia. “When they see those dimples, they know, ‘That must be Divine.’ She is a sweet, loving, sassy girl who is adored by her family, including her sisters, and we are so grateful for the care she has received!”

Arabia said while Divine’s future is uncertain, she is hopeful. “She has been doing so well throughout her treatment, which has been tough, and she is always sweet, sassy and full of energy. She is such a joy in our lives.”

Emergencies can happen when you're far from home. In Northeast Florida, Wolfson Children's Emergency Centers are staffed around the clock by pediatric emergency medicine specialists to provide expert care when you need it most.

Our hematology/oncology teams are here to help families fighting cancer through diagnosis, treatment and recovery. To learn more, visit wolfsonchildrens.com/cancer.