In his last days, his fear was palpable. He had faced countless losses that locked him into a perpetual cycle of frustration, loss, and grief. Barely able to press the remote control buttons or text loved ones, he could no longer communicate—the hardest indignity for him. Each labored breath begged his body to clear his airways and keep his organs functioning. There was simply no compromise. His neurons were firm in their defiance no matter the urgings of his mind.
Randy’s body had all but abandoned his spirit. The light behind his eyes told us he was still very much himself: acutely aware of his physical limitations and exasperated by his inability to express the depth of his suffering. Randy was diagnosed in March 2021 with bulbar-onset amyotrophic lateral sclerosis (ALS), a disease with a 2- to 4-year median survival time. Always one to follow the best available prognostic evidence, Randy died true to form on February 6, 2023.