by C McGivern
On the morning of the operation Pat arrived at the hospital at six. He was already up and fretting about his younger children, “Pat, you’ve got to make sure they’re all OK about what’s going on here today. They ought to know how I’m doing.” He was already heavily sedated but nothing quietened him until she promised to keep them informed. As he was wheeled away he laughed brightly, “See you in the movies!” On January 12 at 7:45 am Dr William Longmire began the long operation at the start of another traumatic day.
As soon as the procedure began, the surgeon knew he was operating on a dying man. The tumor was large and he suspected the cancer cells had already spread to other organs and lymph nodes. He removed the whole stomach, including the tumor and gall-bladder, to give him a fighting chance. In The Shootist Books was told by his doctor that no operation would save him, “I’d have to gut you like a fish.” The reality was worse, Duke’s oesophagus, blood vessels, arteries and nerves were severed and later, after the cancerous tissue had been removed, reconnected. All the regional lymph nodes were taken for analysis after an operation lasting over nine hours.
When the family were told half way into the operation that a tumor had been found Pat had a sudden blinding vision of him complaining about the pain in his stomach since October. It was now January, and she asked the doctor how fast cancer spread, “From half an inch to an inch a month, but you don’t worry about the rain when the water’s up to here,” the doctor answered pointing to his throat. Even back in October it had been too late, it may even have been too late when he had his heart surgery earlier that year.
Long before he was out of theatre the Press had engulfed the hospital for the start of the death watch. Duke had gone down at 7:45 in the morning, by late afternoon when there was still no news they were onto the story, no gall bladder operation lasted that long. They packed the lobby and the whole unit was in chaos. Reporters claimed to be patients’ relatives as they tried to get closer to Duke’s room, some donned doctors coats, some got right up to the theatre doors, and one even tried to take photographs of him as he was being operated on
After ten hours he was transferred to intensive care. The doctor told the family, “If he’d not had his heart surgery he would not have withstood the ordeal, but I’m relatively pleased with how he’s doing now. We’re going to allow him to come round soon. You might even get to see him later tonight.”
A statement was immediately released that a low grade tumor had been removed, that there was no evidence that the disease had spread. Duke had no hand in or knowledge of, this statement. In fact the tumor wasn’t low-grade, it was a rare and extremely dangerous variety. Surgeons had been unable to detect any sign of tumor outside the stomach but believed there were likely to be microscopic cancerous cells present in the area, the prognosis was poor; he was weak from earlier surgery, he had only one lung, he was older and less fit than in 1964, and the cancer present this time was particularly virulent. For the next few days the Press continued to receive the news that Duke was doing well. The world held its breath and waited and the real life tension was as taut as anything he had ever created on screen.
Death, just like his life, was coming in the glare of the public eye and the knowledge left him little leeway for the dignity that was so important to him. A life lived in a goldfish bowl meant he had no door to close behind him now. His fight was public property, there was no confidentiality and no holds barred, and the news that he was regaining consciousness flew down the wires as soon as he opened drowsy eyes in the recovery room. Reporters had been told he was there for a gall bladder operation and yet the first word out of Duke’s mouth was, “Cancer?” No one with him had the heart to confirm his fears. When he repeated the question, hoping to hear a denial, Pat just smiled her encouragement. He closed his eyes and drifted back to sleep.
The following day the doctor confirmed that he did have cancer again. He explained everything in detail, telling him his stomach had been removed and about the possibility of metastasis. He was told he would have to follow a special diet for the rest of his life because his body would no longer be able to produce the acids necessary to break down foods. “Did you get it all?” The doctor could only tell him they would have to wait for the results of the pathology. If his lymph nodes showed it had spread, he would need radiotherapy and chemotherapy.
On that first day he managed to sit up in ICU, still attached to drips and monitors, and he began telling jokes to anyone who would listen. Alice Day, his private nurse, was surprised by the speed of his recovery and she began to think he’d pulled it off again. He was doing well when the news everyone had been dreading arrived, microscopic cancer cells had been found in the lymph nodes taken from the gastric area. He had been up and walking by January 17th and when he was told the worst he showed no reaction at all, he wasn’t listening, he didn’t want to know. He wanted to believe he was on the mend and didn’t begin to take in the enormity of what the doctor was telling him, that in fact the real nightmare was only just beginning. His incredible endurance held firm and he simply ignored the news that he was fighting a losing battle, “The final pathological report of the tissue removed at the operation has disclosed evidence of microscopic metastasis in the gastric lymph nodes that were removed with the stomach. Such microscopic involvement was not detected at the time of the operation or upon the initial gross pathological examination. There is a probability that it has spread.” Everyone but Duke understood there was to be no repeat of 1964.
He’d insisted on complete privacy, “Dying’s my own business. I don’t want any fuss.” There wasn’t the slightest chance, and as soon as the news was out the phone never stopped ringing. Friends pleaded to see him and a steady stream of visitors arrived at the hospital. When he was too sick to see them they asked that he was told they’d been asking about him and praying for him. Flowers by the ton were delivered from well-wishers and a nurse read all the cards to him. Pat was left to deal with sack loads of letters. The hospital was under siege. The staff were soon at breaking point but no one seemed to mind the havoc their most celebrated patient was causing.
He never asked Pat to stay but the nurses all agreed that he was more comfortable and easier to deal with once she arrived in the morning to take control. He was generally content when she sat in the room with him and, although he didn’t particularly want to talk, he enjoyed watching TV with her, “I learn more about my condition from the news than I do from the doctors.” He became addicted to game shows, actively participating in them, shouting the answers out at the top of his voice and getting angry when contestants couldn’t hear. He had never had much time to watch TV before, now he found he enjoyed many of the programs.
He persuaded reluctant doctors to allow him to go for short walks around the hospital, no words of warning from them could hold him back, and he began dragging his intravenous trolley behind him as he marched doggedly along the corridors escorted by one of his sons, Pat or his devoted nurse and his life’s habit of endless, restless pacing was resumed. Once he felt stronger he even refused to allow anyone to accompany him to the bathroom. With drips, drains and tubes sticking out in all directions he locked Nurse Day outside. It was a big triumph in his book, a sign that he was on the mend, a reclamation of a little precious dignity.
The IV trolley was dragged around the hospital with him and anything that was attached firmly enough was pulled along in his wake. By January 28th nothing could hold him back and on that day he even managed to walk along the corridor without support. His daily improvement excited him and stunned the medical profession. He felt better, slept less, sat up more, pulled the IV on longer and longer walks and eventually he even began to eat again! The doctors had created a small pouch from his intestine to replace the stomach they had removed, and he knew that even though digestion was going to be difficult he had to make an effort. He felt hungry and tried a thickened apricot drink; it was not long before he was tackling solids. He seemed to have no trouble, and felt triumphant when he
managed to keep it down. His evident recovery was steady and remarkable.
An infection in the incision forced him to stay in hospital longer than he wanted but on February 10 he was allowed to go home. He was smuggled out of the back entrance into his waiting motor home. Pat travelled with him and tried to ease his discomfort on the drive back to Newport. Later, when she asked him when his radiation therapy was due to start he said he knew nothing about any further treatment. He had only taken in what he had wanted to hear and he exploded with fury, saying the surgeon told him the tumor had all been removed, and that he was going to be fine, “I’m so sick and tired of treatment and hospitals.”
For the first time in many years he was unable to attend the Arizona bull sale. He wrote to his friends saying he would be there next year and promised that he felt fine. Radiation treatment was due to start six weeks after his surgery, the scars had to be fully healed first. He resented having to suffer further treatment, and the knowledge that he was still in trouble worried him. After the first euphoric days of being allowed home he became withdrawn and didn’t want to talk to anyone. The phone rang constantly. Reporters camped outside. Friends who had been told of his improvement began swamping him with invitations. Pat and Michael shielded him from most of this and refused admittance to everyone.
Nurse Alice had gone home with him and was staying at Bayshore Drive to look after her favorite patient. She had never done anything like it before, she told him, “I’m not doing this for you, I’m doing it for Dr Longmuir.” Duke of course was well aware of his position in Alice’s heart, and he did not believe her words, trusting instead the eyes which told him how much she cared about him, despite his often difficult behavior. During the last weeks she had become another dedicated and loyal friend, “No one could spend any time with him and not fall in love with him.” Even the threat of death had done nothing to dent the charisma.
His heart and mind focused on moving forward and his interest in new projects increased. He was determined to make another movie! The thought drove him; but first, radiation.
When he returned to the hospital the radiation target was marked out in purple pen. It covered the central part of his abdomen from the naval to the sternum, and then spread out to include his left side up to the armpit. Every Monday to Friday he drove himself to the hospital where he waited his turn to receive 170 rads. Whilst each treatment was painless, the cumulative effect wasn’t. He developed a bright red, burnt patch over the whole target area. He became nauseous and what little appetite he had was lost. He refused to eat or drink and his weight plunged rapidly until he was thinner than he had been in his second year at high school. His mood deteriorated at an equivalent rate. He was a terrible patient and it was a good job that Alice did love him, that she, like Pat, had become his devoted slave, for no one was safe from his anger. He had always been volatile to say the least, but his boiling temper had always been balanced by an equivalent willingness to seek forgiveness. All his life he had despised anything or anyone that he considered petty, now that life was slipping away, he became petty himself. And even that angered him.
His dying infuriated him. The smallest discomfort could trigger a show of wild aggression and no one was safe. Luckily Pat stayed with him and understood that his rage damaged him more than it did anyone else. He was having difficulty getting through each day and she wasn’t surprised that he felt angry. In 1964 Pilar said his brush with cancer left him a changed man, in 1979 it robbed him of everything he had once been. He had lost control of his life and he was no longer warm, gentle, generous or kind… he was as mad as hell! The Press carried daily stories about his fierce will to live, in truth he could hardly hold his head up, but they were right about one thing, he was fierce.
He wanted to see Pilar but she didn’t want to visit him at home, unsure about the relationship that existed between her husband and his secretary. She continued to talk to him on the phone and understood that he could not be left alone now. He needed more than a nurse and was glad he had Pat. Still, when he told her he was off his food and having difficulty eating, complaining that food smelled bad to him, Pilar sent him special treats from her restaurant. He was supposed to eat small amounts six times a day, but he had trouble keeping anything down. He just didn’t want to eat and the man with the most massive appetite never felt hungry again, he never again asked for or wanted food and one of the greatest pleasures in life was lost to him.
However, his lack of appetite for food didn’t reflect a diminishing appetite for life. He was hanging on grimly, still insisting on all his mail being opened and answered and he still received requests to appear on TV shows. He rejected all but one. He had been sent an invitation to present the Best Picture Award at the 1979 Oscar ceremony. He accepted and nothing would prevent him being there that night. He had been offered one last glorious chance. There, at the most glittering Hollywood celebration of all, he could be John Wayne for his public and his profession for the last time. The ceremony took on great significance for him.
That hadn’t always been the way he felt. In 1971 when Richard Warren Lewis had written that because of his “squareness” John Wayne remained a “profit without honor in Hollywood,” Duke said, “The Oscar meant a lot to me but I really didn’t need it. When people say “A John Wayne picture got bad reviews,” it’s a redundant sentence… Hell I don’t care. People like my movies and that’s all that counts, I wasn’t hurt not to get an Oscar before True Grit.” He added later, “As a younger man I never saw the value of it. I knew that when the grip or the cameraman figured out something new... that was the only way things ever really changed in the movies. So awards for actors… they weren’t important to me. But then I figured that the Oscar ceremony was actually the only direct communication we get with the public and for that reason I finally accepted membership.”
In 1979 it became important to him in ways he could never have imagined at the beginning. He had been looking for a way to say goodbye to his world. He had to communicate with his public for the last time, and what better place to do it? He may have been considered “square” by some, but he had been secure in the affections of those unaffected by fashion for fifty years. He felt he owed a huge debt.
And thoughts of the night, planning and preparing for it, also became a valuable diversion. For many weeks he had been living in loose, baggy sports clothes, not caring what he looked like. Now he ordered a new tuxedo. He had one hanging up that he hadn’t even worn but it already swamped his thinning frame. He needed a haircut, new shoes, he had to call Dave Grayson to arrange make-up. There was a lot to organize in a hurry. The medical profession advised him to avoid the extra stress and warned him he wouldn’t be up to it. He replied with typical stubbornness, “I’m going to be there.” It was something to live for. The only thing that mattered now was being there on the night of April 9th 1979. He planned to give his finest performance, the last public show of true grit.
On the morning of the ceremony he drove to the hospital for his regular treatment and then carried on to Los Angeles for rehearsals. By the afternoon he was in great pain and had become very pale. He ate nothing all day. Dave Grayson arrived at Duke’s hotel at 6 pm but was told he was sleeping and he waited for him in the lobby. Some of Duke’s family approached and tried to prepare him for the condition he was now in, but even so, when he finally went up to the room he was staggered by the sight of a bare chested Duke who laughed, “I thought I’d shock you.” He was little more than pallid skin and bone, and the radiation burns across his stomach told Grayson what he had been going through. He laughed back as casually as he could and Duke asked, “Don’t you think I look good?”
Grayson retorted, “You look like Hell. I’m going to have to work miracles to get you out on stage.”
“It’s a miracle you’re still working at all! I’ll just have to get by on my natural beauty I guess.”
“That won’t get you far!” Grayson whispered under his breath.
“Goddamn. You
just have to have the last word don’t you!”
As Grayson opened his make-up case Duke told him, still laughing, “Damn, I look so good tonight, I don’t think I’ll bother with make-up. I don’t want to look as though I’ve already been embalmed.” In fact after he dressed and had some light powder applied Grayson was surprised and admitted, “He looked remarkably good.” As he was ready to leave the room Duke stopped and confessed, “Actually I am worried about getting through the evening.” He was presenting the very last award and already felt weak, he wasn’t sure he could survive the ordeal. Grayson knew him well enough to know that however long he was kept standing around, he would be out on stage to make his speech and to hand out that last award, nothing would stop him. He did his best to reassure him and they went together to the VIP lounge to meet up with the rest of Duke’s family. As soon as they walked into the room a line of celebrities formed, all eager for his autograph, Grayson said, “It was a stunning tribute. He remained good natured and polite to each and from that moment on he never sat down again until the evening ended.” To those people he appeared to be his normal self, moving around, chatting, signing autographs, joking with old friends, it was the start of an amazing performance. He felt hot and uncomfortable and murmured that he needed a drink. Cary Grant rushed to get one.