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Most of the world knew her only as the mother of rap star Kanye West. But to those who knew her personally, Donda West was a respected literature professor who raised her only child as a divorced parent. As her nephew Stephan Scoggins told 250 mourners at a Nov. 16 memorial service at Chicago State University, where she taught for 24 years and chaired the English department, West was "nothing less than spectacular."

In her response to aging, however, West was a fairly ordinary woman. At 58, she had grown soft around the middle—and with Kanye, 30, planning an upcoming wedding to fashion designer Alexis Phifer, 31, West had incentive to look good. As early as June, and with access to the nation's top doctors, thanks to her son's generous offer to pay for her procedures, she began consulting with plastic surgeons about tweaking her body. After receiving a referral from a close friend, she settled on a high-profile choice: Dr. Jan Adams, a telegenic surgeon in Brentwood, Calif., who had authored two books on cosmetic surgery for women of color, hosted his own TV show (Plastic Surgery: Before & After) on the Discovery Health Channel and been an expert guest on Oprah.

And yet on Nov. 10, a day after Adams performed a tummy tuck and breast reduction on West, she was dead, leaving her son "a complete mess," says a friend—and leading to serious questions about whether Adams should have been operating on West in the first place. Since April, his medical license has been under review by the state board, owing to two DUI arrests. He has also been sued in Los Angeles and Orange counties for medical malpractice 11 times in the last nine years. These cases include allegations that range from negligence to sexual battery of a patient. He also has close to $400,000 in judgments against him. "That's a pattern that's concerning," says Dr. David A. Kulber, director of the Plastic Surgery Center for Cedars-Sinai Medical Group. His lawsuit count "is definitely above average." Finally, Adams is not board-certified in plastic surgery. Certification is not required to practice, but its absence "should be a red flag," Kulber says, because it can indicate "a problem in your training or education, something that's a serious deficiency." (See box on page 150.)

In a Nov. 18 interview at a restaurant in Newport Beach, Calif., Adams, 53, who practices at the Brentwood Surgery Center, an L.A. outpatient clinic housed in a strip mall, told PEOPLE he has not hired or even spoken to a lawyer about the West case. (The coroner's report likely won't be released until late December; West's family has yet to indicate that they will sue Adams.) He says he has, however, spoken to members of West's family since she died, and that "out of respect" for her, he does not want to speculate on the cause of her death.

What Adams did address were other concerns about his record raised in recent weeks. Though he has taken criticism from other surgeons for being a TV doctor, Adams counters, "A lot of guys wanted my job" on the Discovery Health Channel and adds that no one challenged his ability to do it well. "For five years I've been explaining this stuff on TV, and not one doctor has said to me, 'That wasn't accurate.'" And although he says that two years ago he started the process to get board-certified—which involves additional training in plastic surgery and a rigorous series of exams—only to be waylaid by an illness, he's okay not having the credential, explaining, "We've made the boards a tie to a certain level of competence, which I don't really think is true." He can also point to satisfied patients. One, a prominent L.A. socialite, says that Adams "took good care of me, and I'm pleased with my results. My nose is realistic as are my breasts."

As for the myriad lawsuits against him, Adams dismisses them largely as "nuisance suits," including the one that had him in an L.A. court on Nov. 16, the very day West was being memorialized in Chicago. He arrived three hours late to a follow-up hearing in the case of Lori Ufondu, who won a $100,000 default judgment against Adams after she claimed he left a surgical sponge in her body—and at one point, his cell phone rang in the courtroom, revealing a ringtone that plays Marvin Gaye's "Let's Get it On."

"He needs to be held accountable for what he's done. I'm deformed for life," says Ufondu, 38, a marketing manager. Adams insists, "I've never used a sponge," and claims that it was a mistake to default in Ufondu's case and in those of the other women (there are at least three) at whose malpractice trials he failed to appear. "The idiocy is mine," he says. These cases "don't represent bad plastic surgery, they represent a bad decision in terms of choice of patient."

Was West a less-than-ideal patient? Death in elective cosmetic surgery is rare—just 1 in 58,810 procedures performed at certified, office-based surgery centers over a two-year period, according to the American Society of Plastic Surgeons. (Though First Wives' Club author Olivia Goldsmith is widely remembered as a plastic surgery casualty, she actually died from the anesthesia administered before her facial tuck at a New York hospital.) But those risks rise for patients over the age of 40, or those who have pre-existing health problems like heart disease or high blood pressure, which is why many plastic surgeons ask their patients to receive medical clearance from an internist before agreeing to perform a procedure.

West consulted several doctors before committing to Adams. One of them, Dr. Andre Aboolian, a board-certified plastic surgeon she met in June on referral of friends, says, "I saw her eight times. She was in good shape as far as I could see, but she is almost 60 years old, so you need a compete battery of tests, including cardiac clearance." He says she made an appointment with an internist but didn't keep it. Then, in August, after scheduling surgery with a different doctor in Chicago, she "chickened out," says a friend. Soon after, West decided to go with Adams, whom she met several times over four months, Adams says, changing her mind about having the surgery at least three times. "She was a smart woman who did her due diligence," he says. "She talked to three patients of mine who had the same surgeries." But Adams says he does not require an exam by an internist. "We do blood work, and if any of the blood work comes back abnormal, we order other tests," he explains. "I tell people all the time they aren't suited for surgery."

Adams, however, felt West was qualified, and at 8 a.m. on Nov. 9, Adams says, she was on his operating table. According to Adams, West spent five hours in surgery, then three more at his clinic in recovery. To coax her out of anesthesia, loved ones "played Kanye's music," says a family friend.

When West was finally released in the late afternoon, "she was happy, anxious, attentive, tired, hurt and asking for more pain medication," Adams says. Instead of heading to a post-op recovery suite, offered by several hotels in the area that keep nurses on-call for plastic surgery outpatients, West returned to her Playa del Rey, Calif., home, where West's nephew Scoggins, who is a nurse, and her cousin took care of her. Recalls West's L.A. pal, who offered to cook for her post-surgery: "She said, 'It'll be like a party.' Everything was a party with Donda."

The following evening, after a call to 911, West was rushed by ambulance to Centinela Freeman Regional Medical Center, where she died. Since getting the news, Kanye "is not doing well—at all," says a friend. "She was everything to him. He's taking it bad."

Reclusive in the days following West's death—he canceled a Nov. 15 taping of the Victoria's Secret fashion show—Kanye performed in Paris on Nov. 17. But when he attempted to dedicate the song, "Hey, Mama" to Donda, "he just cracked," says one concertgoer, and left the stage for nearly 15 minutes. "He said the word 'Mother' and just couldn't go any further," Le Parisien journalist Meddy Magloire said. "A backup singer, the deejay and a guitar player came over to console him. It looked like he might collapse." He has since canceled a Nov. 19 Amsterdam show.

Back in Los Angeles, Adams says he is holding up fine, although he doesn't plan to perform any more surgeries until the West situation gets "cleared up. Right now, patients don't have a level of comfort coming to my office when there's 30 reporters outside." As for his television career, Adams's Discovery Health series had been canceled last year after five seasons—though the decision was unrelated to any of his legal woes, says producer Mary Glynn, adding, "I've never known Dr. Adams to be anything but professional and to get fantastic results."

West's friends and family, too, are trying to focus on the positive. They are talking about her legacy in education and the work she did when she retired from teaching, running the Kanye West Foundation, which helps keep high school students from dropping out. In the days leading up to her scheduled Nov. 20 funeral in Oklahoma City, where her parents still live, West's life and work were remembered not only at her Chicago State memorial but at a Nov. 17 charity awards ceremony in Los Angeles. At neither event did loved ones dwell on how West had died. "Sometimes people are more preoccupied with what happened after the fact," says Scoggins, "instead of what happened before the fact, which is the very thing we're celebrating."

  • Contributors:
  • Howard Breuer/Los Angeles,
  • Maureen Harrington/Los Angeles,
  • Amy Elisa Keith/Los Angeles,
  • Tiffany McGee/New York,
  • Lesley Messer/New York,
  • Michelle Tan/New York,
  • Haiwen Lu/Chicago.