Part 1A portrait of Dr. Dick Boyd's life and an intimate view of his final days
Editor’s note: This is the first story in a two-part series. Click here to view part 2.
Click here to view the accompanying photo gallery
Click here to view the accompanying Video, taken from the Memorial Service.
Friday, Sept. 2
It’s Friday, Sept. 2, and Hospice nurse Sina Brown pulls onto the gravel driveway leading to the side door of the Boyd house on West End Avenue. She walks to the back of her SUV and digs through plastic tubs of medical supplies. She fishes out a needle, vials, a blood pressure cuff, thermometer and paperwork and then clutches the supplies against her robot-print scrubs.
It is her first visit with Dr. Richard "Dick" Boyd, who is dying of kidney cancer. He had become a patient of Hospice and Pal-liative Care of Iredell County only four days before.
Sina knocks on the door and is greeted by Betty Stimson Boyd, Dick's wife of 51 years, who shows her into the paneled den. A breeze blows through the open windows, stirring the too-warm air.
Wrapped in a blanket, Dick is sitting in his blue recliner. A brass bell is nearby on a small stool so he can ring for help. Dick is 75 years old. Glasses perch on his nose. His hair is white, and age has added lines to his face. The lines disappear when he smiles, which is often.
He is well-known to generations of Statesville residents. A retired physician and local philanthropist, he delivered more than 8,000 babies in his long career as an obstetrician.
When the R & L approached Hospice about following a patient through the dying process, Dr. Boyd didn’t hesitate, wanting to chronicle the final weeks of his life and his death as his last public service.
He wanted others to know about the work that Hospice does and how its staff helps the terminally ill die with dignity at home.
"I'm sicker than that"
Sina pulls up a chair and sits down next to her new patient. The purpose of this first visit is to evaluate Dick’s health and to provide support for the family.
"I don't know how people go through this process without a lot of help," Dick says.
The nurse prepares to draw two vials of blood. She pulls out a tiny needle — the kind often used with small children. She talks about the good old days of medicine, mentioning a grandchild of hers that Dick delivered and the impact he had on her family.
He curls his toes as his blood flows into the vial. "No one is a better nurse than my wife," Dick says. "She catches on fine.
"My son has very little understanding of medicine. For a long time, he thought that I had a bad cold. I told him, 'Son, you know I'm sicker than that.' "
"He didn't want to face it," says Sina, who has worked for Hospice for three years and has been a nurse for 28 years. She's become an expert of sorts at diagnosing denial. "This is his daddy, Dr. Boyd."
Dick was diagnosed with small vessel vasculitis seven years ago. The disease stretches the blood vessels until they narrow or even close, cutting off the blood supply to the organs. The cause is unknown; the disease can be fatal.
"It's a fairly high occurrence in people with vasculitis to develop kidney cancer," Dick says in his clinical voice. "The urologist thought it was a benign cyst. He watched it, and all of a sudden it became apparent that it was growing fast and it was no longer benign."
Dick's kidney was removed last August. But the cancer had spread, sending its roots throughout his lower body. He is taking morphine for the pain, Phenergan for nausea and lorazepam for anxiety.
Dick's oldest son, Richard Jr., lives nearby and is often over to help his parents. He helps his father stand and shower and gets him to his wheelchair or recliner. Dick complains that Richard doesn't let him try to walk very much.
"I keep trying to fight, to stay tough, to use my muscles and use my legs," he says.
As Sina looks over her checklist, she tells Dick that Hospice’s mission is to help him make the best of the time he has left. "What are we trying to do? Save your energy," she explains. "Save your energy so you can feel better."
During each visit, Sina assesses Dick’s condition and the needs of his family. She asks Dick about his last bowel movement, about the color and output of his urine, and about his diet. That morning, he had a poached egg and some preserves on toast. The night before, Betty said, he had a little bit of a Frosty and a tablespoon of beef stew.
"I can’t eat much," Dick says. "It comes back up. I used to be an eat-everything-on-the-plate person."
Betty's goal is to keep her husband warm and comfortable and the house quiet. She has trouble handling his 240-pound body, so she calls Richard to help lift him.
"He provides the brawn, and she provides the brains," Dick says with a smile.
Sina has 21 patients. Hospice and Palliative Care of Iredell County is serving about 90 patients.
Betty is grateful for the help and emotional support that Hospice brings. "They have the knowledge and compassion," Betty says. "If I have a problem, I can call and I know they will come — no matter what time of day."
Dick has made all the arrangements for his death. It’s hard to predict when the end will come.
Lessons from a horse
"In every generation, there is an alpha person," said Ty Boyd, Dick's brother. "Dick was the alpha Boyd boy." Born Jan. 23, 1930, Dick was the middle child of Armistead Jerman and Adabelle Barringer Boyd. His older brother, Bill, died in an Air Force plane crash, and Dick "became the senior of the Boyd boys," Ty said.
"It was his second nature. He was wise before his time."
Dick discovered a talent for healing when he was in grade school. His father bought a horse named Major for $175. One af-ternoon, with Bill riding, the horse shimmied out into the road. A car came by and struck Major, tearing a hole in the horse’s muscle.
A veterinarian said Major needed to be put down, but Dick begged his father not to do it.
"I said 'You're not going to shoot my horse,' " Dick said. "I doctored that horse for over a year. He finally got well. He ended up with just a thin scar, but he didn’t limp at all.
"I thought, if I can do that with a horse, I can do it with humans," he said. "I learned a lot about medicine from that horse, and I decided I wanted to be a doctor."
Dick didn’t spend much time in Statesville. He lived in Warrenton with his grandmother during World War II and finished high school in Chattanooga, Tenn.
During one of Dick’s visits to Statesville, Ty arranged a blind date for him with Betty Stimson, one of Ty's classmates. "He asked me if I would date his brother Dick for a frat party," Betty said. "In church, I had seen the back of his head, but I had never met him."
More than 55 years later, Dick remembers that first date well.
"It was love at first sight," he said. “"She wore this kind of perfume and a dress that just drove me crazy. One thing led to an-other, and we kept dating. We have been dating each other ever since."
Ty said a love blossomed from that first date.
"They just understand each other," Ty said. "He has been a pretty good model as a parent, a father, a spouse and a brother."
Thursday, Sept. 8
Dick has good and bad days. Today, he says, "I'm really feeling terrible."
He sits in his recliner again, wrapped in his blanket and sweater. He looks paler, frailer. Betty leaves to run some errands, and neighbor Gene Makarevich comes over to help while she is out.
Dick has vomited on his shirt, and Gene helps him change. Once clean, he wraps himself in the sweater he inherited from his father in 1969. It has holes in the elbows, but it comforts Dick.
"I thought I was going to sleep like a log," he says. "I called the nurse, and she gave me medicine. It didn’t work."
The tiredness is creeping up on him.
Gene cleans up a little in the kitchen while Dick sleeps. He said he wants to help out because the Boyds helped him when his wife died three years ago.
"They are very good neighbors and great people," Gene says.
Dick received his bachelor's degree from Davidson College in 1952 and went on to the School of Medicine at the University of North Carolina. First-year students didn’t perform any physical diagnosis. But Dick got a preview of his life as a physician as a camp counselor that summer.
The camp’s owner thought medical students knew everything there was to know about medicine, and Dick was the only one on staff that year.
The owner wanted Dick to perform a physical examination on each camper. He tried to talk the man out of it, saying he didn’t have any equipment, but the owner managed to find some tongue depressors, an otoscope, a flashlight and a stethoscope.
“With some fear and trepidation, I performed my first physical examination on the girl campers,” Dick said. “I had been around girls very little. The first camper was a girl from Louisiana. I had never been around a girl that was shaped quite like that before.“
The nurse stood at the door, letting the campers in for Dick to examine. Dick looked in the first girl’s ears and down her throat, but when he went to listen to her heart, something went wrong.
“It was like I was struck deaf,” Dick said. “I listened closer to her heart to figure out what was the trouble. I followed the stethoscope and realized I didn’t have it in my ears.
“I was so shook up that I had to give her a passing grade. The rest were a snap.“
Dick and Betty got married in 1954 during Dick’s third year in medical school. Betty worked as a medical technician to support them. They lived in a tiny apartment that consisted of a kitchen, a small bedroom and a living area. They didn’t have a bathroom. They had to walk down the street to the bus station to shower.
Dick graduated fourth in his class in 1956 — supposedly without taking notes.
“He said, ’You can’t look at your notes when you are up to your elbows in someone,’” Richard recalled. “He’s a good listener, very focused on what you are saying.”
Friday, Sept. 9
Dick is wrapped up in his blanket and his father’s sweater in the recliner. He says he has to talk to his son, Richard, who is now staying over in his childhood bedroom to help his mother.
After the talk, Richard comes to his mother in the living room. She asks what Dick had to say, and he replies, “He told me to take care of you.“ There are some things Betty had to learn when it came to caring for Dick at home. “The wheelchair runs better when it’s pulled backwards than pushed on this carpet,” she says. “We are still learning how to turn the corners.”
But one thing she knows is that Sina is a phone call away. That’s a real comfort, particularly when Dick is having a difficult night.
“We plan to stay here for the duration,” Betty said. “There’s no way we can get the wheelchair down the steps. He’s house-bound.” Dick’s strength continues to decline. He took a spill the day before.
“I had gone to breakfast and I got a call from Mom saying, ’Get back here immediately,’ ” Richard says. “Dad had fallen in the tub.
“No more baths. Yesterday scared him a little.” Dick says he simply couldn’t stand up. “I decided not to do that any more,” he adds.
Just the day before, Betty had been forced to call Sina because Dick’s pain had intensified and she was afraid to give him too much medication.
When the drugs kicked in, Betty wrapped her husband in blankets and took him out on the front porch for some fresh air. The Rev. Ben Dowling of Pressley ARP Church dropped by for a few minutes to talk and pray with the family.
Sina arrives with nurse Martha Hauser around 10 a.m. for her weekly visit.
Martha, who is training to be a Hospice nurse, begins the physical assessment, taking Dick’s temperature and blood pressure and recording her findings. The swelling in his legs has increased, so Sina heats up a towel in the microwave to wrap him in.
The swelling is a sign that Dick’s remaining kidney is shutting down. His body can’t get rid of excess fluids. Dick feels a dull aching pain in his chest and worries that his tumor has somehow changed.
“The tumor extends all the way to the heart,” he says. “I thought a part of it had broken off and clogged up my heart. I don’t know what caused it.“
His once-steady hands have begun to shake. He holds up a papery-looking hand to demonstrate for the nurses.
“It’s part of what the tumor does to your system,” Sina reminds him. “Some people do it closer to the start, and some do it closer to the end. It’s the body’s natural response to what’s going on.
“You are declining. You know that. You know you are getting weaker.”
“It’s like labor in reverse,” Betty says quietly from the couch.
Dick’s illness was never a secret.
“He’s a doctor,” says Liz Boyd Rader, his eldest child. “He knows exactly what is happening to him. He has explained it all to us many times. It’s easy to hear and easy to talk about. It’s like he’s talking about an interesting case.“
Liz says the disease didn’t seem real until Hospice entered their lives.
“I have dreaded my father dying since I was a little girl,” Liz says. “This, to me, is the big scary thing that is going to happen in my life. It was not getting married or getting in a car wreck. It was losing my father.
“Having him be so sick but being able to explain it has taken away some of the big scariness of it. He has set a good tone on this.“ When Betty is stressed, her response is to clean. So Liz often comes home to help Betty with the cleaning but finds herself talking to her father while her mother scrubs the bathroom.
“One of her big worries is that the moment of death will be a struggle,” Liz says. That’s why he has a Do Not Resuscitate order on the mantel behind a picture of his children.
“If he goes into a coma and one day he doesn’t take another breath, that will be the kinder way for her,” Liz says.
Richard copes by making sure he spends quality time with his father every day. “There is nothing that is going to stop him from dying,” Richard says. “Life is so great when it’s lived how it’s supposed to be lived. I want to get my money’s worth, because you only go through life one time.
“I feel satisfied that I’ve had good quality time with him. It’s upsetting, but it’s not the end of the world.”
’A special blessing’
Dick did his internship and residency in Atlanta at Grady Memorial Hospital, Emory University’s teaching hospital.
“I wanted to experience every disease known to man,” Dick wrote years ago when trying to document the stories of his life. “I couldn’t wait to get in there and get started.“
Residents at Grady were paid $10 per month, plus laundry and meals. During his residency, in 1957, Liz was born.
On his first day, Dick was tasked with treating a woman most everyone at the hospital knew. Arizona Edwards was a former trapeze artist who sold newspapers down the street. She was born on July 4, and each year she would celebrate with a patriotic dive into a nearby pool.
But that day, Arizona had suffered a heart attack mid-dive.
“Everyone knew her except me,” Dick said.
Betty said Dick came home and described his shock at pulling back the sheet to find a 95-year-old woman wearing only a red, white and blue bathing suit.
“I remember she was really skinny,” Dick said.
Dick’s residency was interrupted for two years by his service in the Navy. He served as a general medical officer in Green Cove Springs, Fla. Betty jokes that when Dick entered the Navy, she had just one child; but by the time Dick returned to his residency, she had three. Richard was born in 1959 and Martin in 1960.
While at Grady, Dick found his calling for obstetrics and gynecology.
“I loved it,” he said. “It was obviously the place I needed to be. Every day was a new day, and I had plenty of patients.“
In one day, Dick delivered 35 babies, handling patients on two delivery tables at once. “You’d run like crazy all night long,” he said.
“Delivering one baby, then you’d run to the next table and do an episiotomy and then run back to deliver the placenta.“
He later traveled to Chicago to take his board examination. He planned to study the material more when he got to Chicago but was running late.
“He read as much as he could,” Liz said. “He decided to read one more page and learn everything on that page, and then he closed the book and got some rest.“
The one illness on which the panel of examiners quizzed Dick was on that last page. “He told them everything there was to know about that one topic,” Liz said. “They didn’t ask any more questions, and he passed.
“Daddy said several times that he felt like he was living under a special blessing,” Liz said. “He loved his family. He loved his children, and he loved his job.”
Tuesday, Sept. 13
Dick’s recliner is empty.
He is too weak to make it to his favorite chair and is wrapped in blankets on the bed he shares each night with his wife.
Betty sits in a chair next to the bed, holding her husband’s hand and gently stroking his arm. A much younger version of Betty looks down from a painting above the mantel. It was from her wedding day 51 years ago, the train of her gown spilling out before her.
She says Dick told the family that he wants to die that night. The rise and fall of his chest slows to once or twice every 20 seconds. His skin is cool to the touch, his fingers tinged blue.
Liz’s husband, Frank, takes their daughter, Ellie, out of school in the afternoon, and Richard is due back soon. Dick’s young-est son, Martin, is making the six-hour drive from Northern Virginia.
“Ellie brought in some Ben & Jerry’s Chocolate, Chocolate, Chocolate and some Hershey’s and mixed it all up in a bowl,” Liz says. “It was sweet with a capital S-W-E-E-T.“
The 5-year-old makes the concoction for her grandfather. Dick manages to eat a spoonful.
Hospice social worker Cindy Hicks-Chisenahall stops by to play the piano. The notes mix with the sound of footsteps and Ellie crawling through the house looking for some attention.
All around Dick, the house is lively. But by his bed, it’s dark and still.
The soft carpet on the way to Dick’s bedroom is dented with shoe impressions from the many who have walked back and forth to his bed to say their goodbyes.
The Rev. Paul Sink, the associate minister at First Presbyterian Church in Statesville, where the Boyds worship, comes by to say a prayer with the family.
“We are just here to extend caring and let them know we love and care for them,” Sink says.
Betty hardly leaves her husband’s side. She eats the sandwich Liz brings her while she sits by him.
“Sunday night, he told Momma that he was not going to get out of bed,” Liz says. “Today, he has been even harder to under-stand. Today, there is a lot of slurring of his words.“
A hush has settled over the house by the time Martin arrives that night. “I was surprised when I got the call today,” Martin says. “It’s amazing how quickly he’s slipped.“
In the quiet of the evening, Betty signs the paperwork to authorize her husband’s cremation.
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By Carrie J. Sidener