That's a Lot of Pills

The last John Wayne is dying.

Intrahepatic cholangiocarcinoma, metastasized to various and sundry other organs and tissues. Primary liver cancer. Inoperative and widespread, a painful and indignant way for a cowboy to die, it reaffirms my own sense of outrage toward this disease. The body is now fighting itself, with him as the loser.

We all lose, with him dies a little bit of us all.

He’s emaciated and small, wasting away, and I am angry and helpless in life again. His son immediately took him to one of the finest cancer diagnostic and treatment centers around, where he’s been in and out of for the last two weeks. Soon it will be time to bring him home and let him go to the ranch one more time.

For now though, instead of jeans, boots and hat, he wears blue warm ups hanging limply from the hulk of a man who I long to hear roar with drunken laughter again, ever ready to lend a smile or a helping hand. Now his boots are replaced by moccasins, his head is uncovered, valunerable, and he's subordinate to the minions of doctors and administrators who attend him like so many techno-mechanics trying to repair an old totaled out pick up truck.

There's still some dirt road cowboy left in this man though.

Yesterday I waited with him at the reception desk where he was handed a pager, like the one we get whenever we eat over at the Pirates Landing, one that lights up with a UFO like circle of LED lights when they’re ready to see you. He hadn’t gotten the news yet, but I think for sure he suspected.

While we stood there waiting for the receptionist to input his information he spied a huge clear plastic bag sitting on a chair, stuffed with maybe thirty five or forty different amber plastic pill bottles, belonging to a cancer treatment patient. His eyes grew big as saucers, he swallowed and croaked in a sort of half whisper;

“Gawdamn that’s a lot of pills”. And then he chuckled.

He’s quiet now, digesting the knowledge that he’s looking at the last chapter of his life. He doesn’t speak much, the fire is gone as he tries to understand what’s happening, and how to handle it with dignity and style.

In the consultation room, the doctor reads his chart and states somewhat triumphantly that the cowboy "liked to drink beer". I detect just a hint of rancor in his voice, because cirrhosis is a big factor in liver cancer. As if making fun of the doctors attitude, he smirks and answers “I like to drink A LOT of beer”, to which the doctor queries; “It says here that some nights you drink as many as twelve beers?", again he replies in a voice strong and confident, eyes crinkling with laughter around the edges; “I like to drink as many beers as I can!”

Just for that brief moment, his spirit returned and I could again see the man in his dirty jeans, dusty boots and sweat stained cowboy hat, arms crossed, bellowing that infectious laugh, spitting in the face of his own death.