Jack Cawthon unabashedly brags about the secret sauce that is a hallmark of his renowned barbeque restaurant in Nashville, Tennesse, Jack's Bar-B-Que, where tourists and locals line up for Texas brisket and Tennessee pork shoulder.
The iconic sauce remains a family secret and a vital part of the landmark restaurant located on the honkytonk strip on lower Broadway in downtown Nashville. These days, however, the Barbeque King is a fan of a whole different kind of secret sauce.
"My secret sauce now is being motivated and compliant, and doing a daily exercise that allows me to swallow food, especially my delicious ribs," he says.
In what he agrees is a cruel irony, Jack lost his ability to swallow in 2004, when he was diagnosed with tonsillar cancer. He underwent surgery and several rounds of chemotherapy and radiation therapy. Because scarring and strictures developed in his esophagus, "swallowing became a real challenge," Jack says.
Jack's only way to stay alive was to endure a feeding tube for a year. "I couldn't swallow or taste or smell food during that time," he says. "That year was pretty ugly. I wanted to live, so I could die of something else, because that was terrible."
He had to undergo frequent esophageal dilation procedures at a Nashville hospital to keep his esophagus open. He could only swallow small amounts of food, and he didn't look forward to frequent hospital visits for the dilation procedures that required anesthesia.
"I was curious, hoping for an alternative, so I Googled around," Jack explains. "I just knew there had to be a better way."
To his surprise, up popped Mayo Clinic's Arizona campus, where he saw a video of a patient doing self-dilation. "It can be done at home," Jack says. Standing next to the patient in the video was "a tall, distinguished man with a bow tie and a great bedside manner," he adds. That man was David Fleischer, M.D., a physician in Mayo’s Department of Gastroenterology and Hepatology.
Jack wasted no time contacting Mayo Clinic, and in February 2016, he was in a Mayo exam room, pondering his possible options. To his surprise, "in walked the man from the video," Jack says. As he gazed at Jack's chart, Dr. Fleischer, who had earned his medical degree at Vanderbilt University in Nashville, asked Jack if he possibly was "the" Barbeque King on Broadway in Nashville. The answer was yes. He told Jack, "I love that place!"
"Dr. Fleischer told me he couldn't believe I was here, but he was glad that I was, and he was sorry that I couldn't enjoy my own barbeque, as so many others do. It seems unfair," Jack says.
Jack qualified for self-dilation and underwent training on how to do it. The program at Arizona's campus has trained more than 50 patients on how to perform self-dilation. The program is staffed by Dr Fleischer, other esophageal specialists, and nurses Robert Spratley and Lori Goette.
Now, every morning, Jack is dutiful about sipping water and then carefully guiding a long, flexible tube down his throat and into his esophagus to open the pathway for solid food. What at first seemed to be an intimidating procedure is now a simple routine that takes Jack only 15 seconds.
"Mayo could not have been nicer to train me, step-by-step, and to transfer my files to Vanderbilt University in Nashville, where I continue my care," Jack says.
Dr. Fleischer had told Jack that he needed to be "motivated and compliant" to qualify for self-dilation. "I told him, 'Bingo, that’s me!'" Jack says. "That is what works, and that is the real secret sauce. I was determined to get my throat open and to sit down and enjoy my barbeque with my friends and family."
Now 70, Jack is still active in the business. Over the New Year’s holiday in 2017, Dr. Fleischer and members of his family were invited to have lunch with Jack, his son Jay and his family — at Jack's Bar-B-Que.
"It has to be an answer to our prayers for two men to find one another in such a way," Jack says, referring to Dr. Fleischer. "I am now able to encourage others to take that step that I did. It just may change your life, as it did mine."
Now 13 years in remission, Jack is enjoying and thankful for every day.
Watch this video of the self-dilation procedure, where Dr. Fleischer, right, and Robert Spratley, left, are observing the patients: