On his own terms, S.F. coach Nate Lewis
lives out his last days in peace at Zen Hospice
San Francisco Chronicle, Sunday, September 15, 2002

by C.W. Nevius, Chronicle Staff Writer

This is a story about life, death and the time between...

It's not a story of how someone fought an incurable disease to the very end, refusing to ever give up. Lewis did something more difficult: He shut down the anger and desperation and moved on with living and controlling his life. He refused chemotherapy after trying it once, and chose to spend his last months at Zen Hospice Project in San Francisco.

"The Guest House is a residential hospice and a collaboration between Zen Hospice Project and Hospice by the Bay. The Guest House has been the final home for hundreds of wonderful people who have lived out their dying with us. Every one of them has had their own story, their own journey, and their own experience. But somehow this story about Nate seems to capture a common experience of finding the Guest House a safe place to engage in the tasks of dying: letting go, opening up, loving, forgiving, being forgiven, and saying goodbye. The staff and volunteers of Zen Hospice Project and Hospice by the Bay are grateful for the gift of serving to create a space in which this work can happen."

In the small hours of a chilly April night in San Francisco last year, Nate Lewis reached for the phone. He was wide awake.

In fact, he hadn't slept in nine straight nights, ever since he'd been told he had some kind of complicated bone marrow disease. He knew it was bad, as he'd listened to the prognosis, but at the time he was so stunned he wondered if he had heard it all correctly.

His physician, Dr. James Burke, an oncologist at UCSF Medical Center, had given him a home phone number and told him to call any time.

This was the time.

"There's no tape recorder running, and I am not trying to get anything," Lewis told him. "I just need some cold, hard facts."

Dr. Burke had them. Lewis had multiple myeloma. Probably about a year at best. No magic bullets. No miracle cures. He could try chemotherapy to extend his life expectancy to a year and a half. At the time, Lewis was 56 years old.

"I will never forget the conversation I had with him before I knew the diagnosis was final," Dr. Burke said. "I knew what he had before I saw the biopsy result -- a young man with a terrible disease. My father had the same disease at the same age."

This is a story about life, death and the time between that lacks only a happy ending: Nate Lewis died on Aug. 29.

It's not the story of how someone fought an incurable disease to the very end, refusing to ever give up. Lewis did something more difficult: He shut down the anger and desperation and moved on with living and controlling his life. He refused chemotherapy after trying it once, and chose to spend his last months at Zen Hospice Project in San Francisco.

There he learned that while there is no escaping the finality of death, it can be a rare opportunity to explore and examine life. A major reason that Lewis declined chemotherapy was that he wanted the clarity to put his life in order and learn to accept the inevitable.

"In some ways," said Dr. Burke, "the time between when you know you are dying and your death can be the most interesting time of your life."

The irony is that doctors suggested to Lewis that chemo might prolong his life as much an nine months. Actually, without the side effects, he ended up with very much the same life span. Lewis gives the credit to the spirituality of the Zen Hospice (although he did not practice Zen Buddhism) and the sense of closure he was able to find. This is not as common as you might think.

Stages of Death

"You know, in medical school they tell you that people have these stages in dying and in the final stages everyone accepts it," Dr. Burke said. "That is not true. I can tell you that at least 50 percent of the time, they never accept the fact that they are dying. They fight the disease and fight the process to the end."

In certain parts of San Francisco, the name Nate Lewis will open some doors.

If you know the right gyms and the right nights, you can see some scary-good basketball in the summer in the city. The Pro-Am league is an underground cult.

You never know who might walk out on the floor. NBA All-Pro Jason Kidd used to play, and one summer night former Stanford All-American and current NBA guard Brevin Knight went head to head with East Bay legend Raymond "Circus" King. The games are loud, frantic and amazing.

Lewis, who coached basketball at San Francisco's Mission High, Galileo Academy and McAteer, spent his summers coaching Pro-Am. In all, he coached youth basketball for 37 years. They all played for Lewis, from the pros to the famed Snake Jones.

"You know the Pro-Am games?" Lewis said back in May. "Well, I'm Nate Lewis. I won more of those than anybody."

At the time he met The Chronicle, Lewis was living at the Zen Hospice, a lovely old Victorian house. He was clear-eyed and alert. And when he wadded up a Kleenex, he could still bank it into the wastebasket from six feet out. He was optimistic, cheerful and witty. But he wasn't pretending that a miracle cure was in the offing.

There were nights, he admitted, when he left his upstairs room and made his way quietly down the stairs to the backyard garden. He'd sit there, puffing a stick of medically approved marijuana, and look up at the sky, vast and distant and dotted with stars. A few weeks before the diagnosis, he was playing pickup basketball.

"You do more thinking at three o'clock in the morning than you can imagine, " Lewis said. "Some of the things that worried me -- 'Why is this? Why is that?' -- they don't worry me now. I give what I have left and I don't worry about whatever is left. I am hoping that some people may see something in my life that they admire. And they might think, 'It worked for Nate, it might work for me.' "

Trying Chemotherapy

It wasn't as if nothing could be done. Dr. Burke said he "talked him into" a round of chemotherapy.

"He is exactly the patient I would have pressed as hard as I could in treatment -- young, healthy, and able to withstand the type of treatment that could have gained him an increase of a few years, at least on average," Dr. Young said. "I was really hoping he wouldn't get sick, because I knew he would never want to do chemo again, knowing his personality."

He had that right.

"If I knew then what I know now," Lewis said after the chemo, "I can't imagine anyone suggesting that. It may be eight months to a year, but it is not worth it. I realized I can't put the emergency brake on my life. I have to move on with my life."

Which, of course, meant the grim countdown until it ended.

Laughter Amid by the Tears

"It's weird," said his married daughter, Terye, at the time, "to have someone you've had around all your life, and to be told he's not going to be around any more. And even to be told the date."

Lewis politely but firmly rejected the offers of well-meaning friends and family who wanted him to swig miracle potions or get down on his knees and pray. He gathered his family, spoke to his friends and supervised the funeral arrangements months in advance.

"He asked me to write his obituary four months ago," Terye said. "I said, 'Why? Do you want to read it?' "

"Well," he said, "how many people get to read their own obituary?"

"How many people ask their daughter to write it?" she replied.

This got them laughing, which is how it usually went. Right up until her dad made an offhand comment about wishing he could be there to see her son, Devin, grow up, and the reality would hang there in the silence and everyone would get to blinking and looking at the floor again.

"You never know," Terye said. "One minute we'll be laughing, and the next minute everyone was crying."

Lewis had the time to put his affairs in order, and he didn't intend to miss anything. Among the stops was a trip to High Desert State Prison in Susanville to visit his son, Andrew. He was touched at the concern and care he was shown there.

"When I got there, I tried to show them my ID and they said, 'We know who you are, you don't have to show us anything.' " I asked, 'How long can I stay?' They said, 'The visit is yours. You tell us when it is over.' The average visit is 2 1/2 hours. I stayed 4 1/2 hours."

Accepting the Truth

When the diagnosis of an incurable disease is made, it seems incomprehensible. Surely there is something that can be done, a treatment or an operation that can fix things. There isn't.

For Lewis, the frustrating part was that his family, mostly his seven daughters, couldn't face the facts. He tried to discuss funeral arrangements and they put him off. They kept telling him he was going to be all right.

"It was total denial," Lewis said. "They'd say, 'Daddy, you're not going to die.' "

"It's an inability to deal with it," Terye said. "As long as you don't see it, you don't have to deal with it. Everybody pretty much -- well, not stayed away -- but went on as normal."

Evidently, that's how it works. The family finds it hard to accept the truth. Add the feelings of loss and regret that you should have done something more, or something different. And then there is a peace.

At the end, inexorably, he slipped to the point that even his girls couldn't pretend it wasn't true.

"Now," said Terye two months ago, "it is like, 'This really is going to happen.' "

Lewis still flashed his old sense of humor. At one point he said, "To make a long story short . . . which I haven't done." But he was annoyed and discouraged when the powerful cocktail of medications made him struggle with his memory.

Still, at least everyone was prepared. They just weren't ready. Lewis made a point to be the dad everyone remembered. Before he became so weak that it was hard to leave his room, he went fishing with the kids, and cooked his famous barbecue after 5-year-old Devin's graduation from preschool.

That was some time, everyone agrees. Nate was fussing at everyone, just as he always did, and the barbecue was spectacular, of course. But at one point he went missing. Later he admitted where he was.

"I went upstairs and got to looking at a bunch of those pictures of us," he said. "I was crying."

There was a lot of that at the end.

Father Figure

Among those Lewis met while coaching basketball was a hard-knock kid named Terry Clark. Clark was a player, a guy who might have been able to play at the big-time college level, but he slipped through the cracks.

There was a baby born to Terry and his girlfriend, some problems, and then he was standing on the corner of McAlister and Fulton in the Western Addition when a car came around the corner and a gun boomed out of the window. Suddenly Clark was down, bleeding.

He was no angel. In fact, Clark was shot twice on the mean streets. The second time he thought he had turned his life around and was on his way to work. In the hospital, one of his visitors was Nate Lewis -- every day.

"He told me, 'You're my boy,' " Clark says today. 'I don't want to see you go backward. Go forward. I want to be proud of you."

Was it that talk that turned Clark around? Probably not completely. But it was part of it. In the final months, Clark stopped by the hospice every couple of days after work, just to talk.

"He told me he loved me," Clark said. "He told me to keep my head up."

And then there was silence on the other end of the phone line. Tough Terry Clark was crying.

Nate Lewis passed away in his sleep at the hospice on Aug. 29 about 5 in the afternoon. He was surrounded by his family, of course, but also there were James "Cricket" Shepard, Clyde Simms, Eddie Joe Chavez, and Barry Young, all players from his Pro-Am teams in the '80s. The four of them carried the gurney down the stairs to the hearse.

It was a sad time, of course, but it was never without hope. Dr. Burke recalled his last visit, just a week or so before Lewis died.

"When I left he said, 'I'll see you again someday,' " Dr. Burke said. "I said, 'You are probably right.

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