December 19, 2023

Cancer changed Jack Cawthon’s tune, so he found new ways to voice his gratitude

Multiple bouts with cancer and a total laryngectomy have curbed Jack Cawthon’s ability to sing, but not his spirit.

Jack Cawthon, owner of Jack’s Barbecue poses for a photo on October 11, 2023. Photos by Donn Jones/Vanderbilt University Medical Center

Every December for 15 years, Jack Cawthon picked up his guitar and sang “Holly Jolly Christmas” while he handed out bonus checks and gifts to his employees at Jack’s-Bar-B-Que.

Multiple bouts with cancer and a total laryngectomy have curbed his ability to sing, but not his spirit. Earlier this month, Cawthon strolled through two of his three restaurant locations in one of his signature hats, passing out gifts to employees and customers.

“I’ve found they don’t care that I’m not singing ‘Holly Jolly,’” Cawthon said. “They’re just glad to see me happy, well and jolly.”

Cawthon is one of Nashville’s barbecue icons: He started out as Cawthon’s Caterer, Inc. in 1976, opened his first Jack’s Bar-B-Que in 1990 at First Avenue and Broadway and moved a few blocks west to his current downtown location — with the iconic flying pigs neon sign — in 1994. He added an outpost on West Trinity Lane in 1991 and another on Charlotte Avenue in 2013.

“I’ve made a payroll for 47 years,” Cawthon said. “Haven’t missed one yet.”

Though he grew up bashful, Cawthon took a Dale Carnegie course as a young man and grew into a public speaker and community leader, buying property and organizing support in the areas around his restaurants, ushering in change in land use policies and getting involved with government leaders.

“I’m not a politician, but I support a lot of them to get things done. I did all of this while cooking barbecue and running my restaurants. Then I got involved in health care,” he said with a chuckle.

Following a bout with tonsil cancer, Cawthon was referred to James Netterville, MD, Mark C. Smith Professor of Head and Neck Surgery at Vanderbilt University Medical Center, two decades ago when a tumor developed at the base of his tongue.

“We treated the tumor with chemotherapy and radiation therapy to avoid an extensive resection of his tongue and throat,” Netterville said. “The tumor was cured, but the side effects of the treatment took a tremendous toll on one of the core joys of Jack’s life: tasting and swallowing the barbecue he’d spent his life developing.”

In 2016, Cawthon developed a second tumor on his voice box just above his vocal cords. In an effort to save his voice, Netterville told Cawthon he’d laser off the top half of his voice box and he would most likely never eat again.

“Jack responded beautifully to the laser resection and amazed everyone with his mindset and continued ability to speak and swallow,” Netterville said.

In 2021, a third tumor developed in Cawthon’s voice box region that required a total laryngectomy or voice box removal.

“Again, to our amazement, Jack approached this with the most positive attitude,” Netterville said. “Working with our team of speech therapists, and using a special implanted voice prosthesis, Jack continues to communicate beautifully, inspiring others who have followed the same path.”

Cawthon pushes a button on his neck when he wants to speak, and what comes out isn’t a manufactured voice but his signature Southern drawl.

“A lot of people say, ‘You sound like you used to,’” Cawthon said. “It’s a one-way valve: I push air into my esophagus and the vibration of the esophagus and the flap they put in with the skin graft makes the voice. Most people talk from their brains and push air to get sound. In my case, I’m making up a way to do it. I’m speaking from memory. Once you get past the fear of it, and the thought of it, it’s not that complicated.”

Words aren’t the only way to communicate, of course: Cawthon also lets his barbecue speak for him. To express gratitude for the care he’s received, Cawthon hosts Netterville and new fellows at his restaurant.

“We’re not talking about cancer or dying; we’re talking about barbecue,” Cawthon said. “It’s rewarding for them to come there, and I’m a part of that.”

Netterville, who feels blessed to connect with Cawthon beyond their medical relationship, especially enjoys the tours of “the pit,” where the barbecue brisket is cooked for 24 hours.

“Through these monthly celebrations, Jack continues to inspire all of us, and demonstrate that our efforts to make a difference in people’s lives really count,” Netterville said. “In spite of the tremendous adversity Jack has endured over the past 20 years, he and the story of his life continue to bless all of us who know him.”

Most recently, Cawthon made a contribution to support cancer discovery research in Otolaryngology to honor the dedication and vision of his care team.

“I’ve watched them do what they do for 20 years and wanted to do something for them,” he said. “What I like about Vanderbilt is that it’s a teaching and learning hospital, and I want to be part of helping them be on the cutting edge of research.”

Netterville sees Cawthon’s donation as an extension of his giving nature.

“Jack has spent his life concentrating on improving life for those around him,” he said. “His generous gift to help find cures and improve the quality of life of those with laryngeal cancer, is another example of him paying forward to make life better for patients who follow his same path in the future.”