Country music legend Johnny Cash died at age 71 due to complications from diabetes on September
12, 2003.
There was nothing easy about Cash's life — and his last year proved to be one of his most
challenging.
Here's what the final 12 months of Johnny Cash's life were like.
Johnny Cash spent most of the 1990s dealing with health issues.
While he was originally misdiagnosed with Shy-Drager syndrome, his doctors later diagnosed
him with autonomic neuropathy in 2000, a complication of diabetes.
According to Johnny Cash: The Biography by Michael Streissguth, his neuropathy often
resulted in bouts of pneumonia that forced him to spend a lot of time in the hospital.
In 2002, after he finished recording for his wife June Carter Cash's album Wildwood Flower,
he fell ill again.
By this time, he was finding it difficult to walk and had trouble with his eyesight
too.
He was taken to the hospital for what seemed to be an allergic reaction.
Legendary country star Merle Haggard, who was a close friend, told Rolling Stone,
"We knew he'd been sick, and we'd thought he was going to die so many times over the
last couple years — if you want to get really serious, he'd been near death for decades.
Johnny Cash lived in constant, serious pain."
Although Johnny Cash was in severe pain in the last year of his life and struggled to
get things done, he remained stoic and kept his pain to himself, preferring to distract
himself with work.
As Haggard explained to Rolling Stone,
"On a scale of one to ten, it was somewhere around an eight for the last eight years of
his life."
Haggard added that Cash didn't take care of himself and didn't eat well for a while, which
made his bones brittle.
Cash ended up breaking his jaw during dental surgery and never quite recovered from it.
"He lived as an example of a man in pain, going from one stage of bad health to another,
but he held his head up the whole way."
All Cash wished to do was work on his next album, even as his health issues grew increasingly
worse.
Music producer Rick Rubin said that Cash somehow could still record and keep his spirits high.
"One of his qualities was that he would never really talk about [...] pain or if he wasn't
doing well, so we never really knew other than when it got so bad that he would say,
'I can't sing anymore now.
I have to lay down for a little while.'"
In his final months, Johnny Cash was committed to music and didn't wish to stop producing
albums and singing live.
He was very active in the industry and worked tirelessly on his last album, American IV:
The Man Comes Around.
In fact, Cash recorded about 60 songs in his last four months.
The recording process was not easy, as Cash struggled with complications from neuropathy.
Though he never complained about how his illnesses were ravaging his body, Vanity Fair reported
that he worried how it was affecting his signature baritone voice, which now quavered.
Still, Cash told NME that he was determined to keep making music no matter what.
"Sometimes I came to the studio and I couldn't sing.
I came in with no voice when I could have stayed at home and pouted in my room and cried
in my beer or my milk, but I didn't let that happen.
[...] We put more blood, sweat, and tears and love into this one than anything we've
ever done.
It reaches out even farther and in more directions than the others did."
Widely regarded as one of his most heart-wrenching covers, Cash's version of the Nine Inch Nails
song "Hurt" was released in 2003.
According to Dave Urbanski's book The Man Comes Around: The Spiritual Journey of Johnny
Cash, filmmaker Mark Romanek told the author, quote, "I begged Rick Rubin to let me shoot
something to that track."
Romanek flew to Nashville and was inspired by the Cash museum.
"It had been closed for a long time.
The place was in such a state of dereliction.
That's when I got the idea that maybe we could be extremely candid about the state of Johnny's
health — as candid as Johnny has always been in his songs."
The video was a massive hit, striking a chord with viewers.
However, what many don't know is that Cash's family was initially unsure about the video,
asking Romanek to edit it to make it less maudlin.
One of Cash's daughters, Rosanne, said,
"I didn't want to watch it because we were already in that space of years of intense
anxiety about my dad's health and this fear that he was going to die at any moment."
In 2002, Johnny Cash released an updated version of an earlier track, "Give My Love to Rose."
The song was originally produced in 1957 for Sun Records, and Cash chose to revisit it
many times in his career.
In an interview with Rolling Stone, Cash's daughter Rosanne said,
"My father when he would call my mother from the road he would say, 'Give my love to Rosanne.'
So I think that's probably where it came from.
I never asked him outright."
In 2003, the song earned Cash a Grammy win for Best Male Country Vocal Performance.
It was the last he would win during his lifetime, but he went on to win two more posthumously,
bringing his total number of Grammy wins to 13 — so far.
Throughout all of Cash's health issues, his beloved wife June Carter Cash provided support.
So it was a tremendous shock when she unexpectedly passed away on May 15, 2003, following complications
from heart valve replacement surgery.
Roseanne Cash told Vanity Fair,
"It was so shocking to think — you know, all of our anxiety had been focused on Dad
for 10 years, and the whole time she was slipping away."
Rick Rubin told Vanity Fair,
"I spoke to Johnny maybe a half-hour or an hour after she passed away.
And he sounded, by far, the worst I'd ever heard him.
He sounded terrible.
He said that he'd experienced so much pain in his life and that nothing came anywhere
near to how he was feeling at that moment."
Everyone feared for Johnny after June's passing, as they worried he wouldn't be able to go
on without her.
It was a fear that he himself shared.
Rubin told Vanity Fair that Cash threw himself into his work.
"It actually got more intense after June died.
Because before, we always worked kind of casually, either whenever we had a song or whenever
he felt like recording.
Now he said to me, 'I want to work every day, and I need you to have something for me to
do every day.
Because if I don't have something to focus on, I'm gonna die.'"
According to Rolling Stone, Cash got back to work just three days after June passed
away.
Rick Rubin told the magazine,
"He said, 'I don't want to do any of the things some people do when they lose their partner
— I don't want to go out and spend a lot of money.
I don't want to meet girls.
I don't want to do anything of this world.
I want to make music and do the best work I can.
That's what she would want me to do, and that's what I want to do.'"
There were days when his health wouldn't allow him to work.
However, Cash would find ways to get back to recording as soon as he felt better.
He even started recording with Rubin in his home when he simply didn't have enough strength
to head out.
Rubin told Rolling Stone,
"The last session that I did [...] was in one of the bedrooms."
To get through the days and cope with his inner demons, Johnny Cash started relying
on his kids.
He often suffered through bouts of insomnia after June's death and found himself asking
for help, as the grief was overwhelming.
His daughter Kathy Cash revealed in Johnny Cash: The Biography that to help him sleep,
she would tell him stories until he finally drifted off.
And his daughter Cindy Cash said,
"He would not let me leave.
I was only going to stay for a couple of weeks, and I ended up not leaving at all.
Every day he would say, 'You're not leaving, right?'
He was like a little boy again."
Two months before he died, Johnny Cash held his last live performance.
On July 5, 2003, at the Carter Family Fold in Hiltons, Virginia, Cash and his band performed
for a scant half hour.
Though Cash was frail to the point where he needed assistance getting to the stage, he
still summoned up the energy to perform some of his most beloved hits, including "Ring
of Fire," "I Walk the Line," and "Folsom Prison Blues."
According to FarOut magazine, Johnny Cash paid a moving tribute to his late wife on
stage.
"The spirit of June Carter overshadows me tonight.
With the love she had for me and the love I have for her, we connect somewhere between
here and heaven.
She came down for a short visit tonight, I guess, from heaven, to visit with me tonight
and give me courage and inspiration, like she always has."
The Man in Black made history at MTV's Video Music Awards with six nominations in August
2003.
He won an award for his take on "Hurt" but couldn't make it to the ceremony.
As per Entertainment Weekly, the singer was in the hospital where he'd been taken to treat
pancreatitis.
It took him two full weeks to recover and get back home.
When he returned, he issued a statement that read in part,
"I'm excited about my video 'Hurt' winning the MTV cinematography award.
The making of the video was a great experience for me."
Cash was edged out for the Best Pop Video award by Justin Timberlake for "Cry Me a River."
In his acceptance speech, Timberlake said,
"This is a travesty!
I demand a recount!
My grandfather raised me on Johnny Cash, I'm from Tennessee and I think he deserves this
more than any of us here tonight."
Cash's manager, Lou Robin, told E! Online that Cash appreciated the sentiment.
"He got a big kick out of what Justin said.
He was very appreciative."
Right up to the end, Cash was always himself: honest, forthright, and unapologetic.
In his final interview, with MTV's Kurt Loder, Cash encouraged people to be themselves and
listen to their own conscience, regardless of what anyone else says.
"You can't let people delegate to you what you should do.
When it's coming from way in here, you know?"
He said he'd been criticized over the years for tackling tough topics, but he had no plans
to change.
"I wouldn't let anybody influence me into thinking I was doing the wrong thing by singing
about death, hell, and drugs.
Cause I've always done that, and I always will."
Still, he was also realistic about his health, saying, quote, "I expect my life to end pretty
soon."
But he faced his end unafraid.
"I have great faith, I have unshakeable faith, I've never been angry with God, I've never
turned my back on God."
After decades of struggle with drugs, health woes, and authority, the icon Johnny Cash
died on September 12, 2003, after suffering from respiratory failure due to complications
from diabetes.
Cash's passing came just four months after his wife June Carter Cash's death, and unleashed
a worldwide outpouring of grief and affection for the Man in Black.
U2's lead singer Bono told BBC,
"I considered myself a friend, he considered me a fan — he indulged me."
Mick Jagger from the Rolling Stones also paid his respects, saying,
"His influence spread over many generations of different people.
I loved him as a singer and a writer."
Fans prayed for Johnny Cash and his wife, hoping that the two were finally together
as they mourned their loss.
His daughter, Rosanne Cash, summed things up at his funeral with a heartfelt eulogy,
saying
"I can almost live in a world without Johnny Cash because he will always be with us.
I cannot begin to imagine a world without daddy."