Rock’s original legends are aging into their 70s and 80s, but you rarely hear about the severity of their health issues, since an ongoing touring career involves maintaining the appearance of physical vitality, if not eternal youth. Count Dick Dale as the exception: The "king of the surf guitar" may just do for real talk about senior maladies what he did for reverb and amps in the early 1960s, being perhaps the one seminal musician of his generation who’s eager to rock you like a hurricane and talk about extreme renal failure.

Dale’s health concerns have become an unlikely viral sensation following the wide dissemination of a July 29 interview for the Pittsburgh City Paper that had the guitar hero declaring: "I can’t stop touring because I will die. Physically and literally, I will die." The 78-year-old’s road regimen has less to do with the love of satisfying oldies hounds and Quentin Tarantino fans (1962’s "Misirlou" having found a second life as the theme to 1994’s Pulp Fiction) than with paying medical bills involving diabetes, post-cancer treatment and other debilitating conditions. Suddenly, he’s the poster child for a generation that’s not too sick to work, but too sick to retire.

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His is not a case of lacking health care -- he’s double insured -- but of insurers refusing to pay for the replenishment of supplies he says is necessary to keep his stoma infection-free. That’s why Dale says he has to tour, to make up for thousands of dollars of uncovered medical expenses every month. "My only income is what comes in when I’m on the road," he says (with "Misirlou" bringing in performance rights payments but no writing royalties).

There’s a secondary motive, too. Each gig remains a show of prowess, but he also enjoys putting the power-picking mystique momentarily aside for rapport with the fellow "sickies" in his audience.

"If I had the money coming in, I’d stay home with Lana" -- his beloved wife, manager, and booking agent, who suffers from MS herself -- "and build a ship in a bottle," he tells Billboard. "But I’ve also got to realize I’ve been kept alive for a reason. People are not only coming to a concert, they’re coming to a way of life… where we’re willing to share what our lives are all about and how we make fun of [health issues]. It’s not ‘Oh, I’m suffering down here and you’re having a good time up there.’ I can tell ‘em how much goddam pain I’m going through ‘up there.’ I let them know: I’ve got the same crap you’ve got."

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He can mean that fairly literally. Some of his most luridly funny or engrossing stories involve the limitations of urinary bags in high-pressure show-biz situations. Speaking to Billboard from the car between tour stops, he tells of having a bag break as he was coming out of a Bob Evans earlier in the day (where, being a healthy eater, he was stopping to get his vegetables). That was no big problem, compared to his situation at the Viva Las Vegas festival a couple of years ago, when he experienced a wardrobe malfunction while taking pictures with Little Richard’s band shortly before he was to go on-stage. "My fecal matter went down my legs, up my pants, my beautiful cowboy shirt -- everything. We didn’t have a backup pair of pants, because it was a one-off. Lana took everything off and washed my jeans, my stockings, my shoes, my shirt, every part of me. Then we wrung them out wet, and I did the concert with wet pants and shirts. After that, I sat at the merch table, and signed for five and a half hours, me still in my wet clothes. You can only laugh at the whole damn thing."

Choosing where to insert a tube in your body has complications for musicians. "The bag used to be on my right side, then the doctors took it out of there because there was so much scar tissue and put it on the left side of me." Problem: he’s one of rock’s legendary lefties, playing an upside-down righties’ guitar. "I told them, ‘Don’t put it there because my guitar lays against it. It’ll break it.’ But they did." At least having the tube in his side beats the couple of years he spent catheterizing himself, "shoving a tube up my dick, for Christ’s sake. You want to do that every single day, to pee? Talk about pain. I finally tore it out and said, ‘I’ll just keep on keeping Depends in business.’ Then they stuck it in [his side] for good. I stood on stage and played, and people didn’t know I was filling up the bag while I was playing to them."

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His five-decade-old back problem, meanwhile, dictates his crew has to lift him onto the drum riser so Dale can indulge in his nightly Gene Krupa-style drum-off with his percussionist. This might all count as TMI if Dale didn’t still have the chops to make audiences stop thinking about his health problems and worry about whether their own ears are bleeding.

"Even with my illnesses and diseases," he claims, "I’m faster with my hands than I’ve ever been"… which includes not just guitar and drums but martial arts. He studied under Elvis Presley’s trainer in the ‘60s. "I learned what pain was when I fought in tournaments. I learned to disguise the pain when I’d go through concrete cinderblock with my fist. I learned how to focus. At 78, you look at me bouncing on that stage, and go ‘How does he do it?’ -- without the use of pain pills and drugs. On stage, I’m a working machine."

A machine with a few quirks or hiccups. Dale works without a setlist, but says the ever-changing show has less to do with a quest for improve than a forgetfulness he attributes to diabetes (he refuses to undergo dialysis). "Every night is different. I tell the people ‘If you hear me going into another song after I start one song, that’s because I forgot how to end it.’ And they all start laughing. But it’s true! I don’t follow a list in anything I do, but I’ll do everything from Johnny Cash to Deep Purple’s 'Smoke on the Water.' But every night we do close with 'Amazing Grace" -- a version of which he recently recorded at Sun Studios and plans to release digitally -- "followed by ‘Miserlou.’"

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Dale remains as boastful about his musical legacy as he is self-deprecating about life as a physically beleaguered showman. He’ll regale you with stories about riding in Elvis’ Bearcat, or how Frank Sinatra offered to manage him in his youth. "He wanted to take 90 percent. My dad said, ‘I’ll put a bullet in his head first.’ But we remained friends, because I knew the Rat Pack when I performed in Vegas and Tahoe. I ended up buying his pool table…"

The Sinatra connection also came in handy when Dale was cataloging different kinds of equipment in his head one fateful month. The Chairman had recommended a particular Shure microphone that Dale wanted to use to expand the sound of his voice on record, because he lacked natural vibrato. Then the guitarist was looking at a Hammond organ and saw a reverb button that led to a tank bolted inside the instrument. "I took it to Leo (Fender) and said, ‘Leo, this is what we’ve got to build.’" That informed what they came up with for guitar amplifiers and transformers, "and I plugged in my Shure microphone that Sinatra told me about" -- not for his voice, now, which was always a secondary consideration, but his signature instrument. Voila: the sonics that came to be associated with the surf guitar, even though Dale didn’t start experimenting with reverb until his best known album, 1962’s Surfers’ Choice, had already been released.

He’ll happily take credit for making rock and roll as loud as it’s become, too, with all those amp developments, which he says was necessary to overcome the muffling when 4,000 surfers would crowd into a Huntington Beach ballroom to hear him in the early ‘60s. "That’s why they call me the father of heavy metal: I’m creating all of that power. I was playing with 60-gage strings on my guitar, too; where people were playing 6, 7, 8, 9, 10-gage strings, mine started off with 16, 18, 20, and then 39, 49, and 60-gage." In other words, you could practically hang the Golden Gate Bridge with the broken strings from one of Dale’s guitars, which come very near to counting as percussion instruments.

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The dichotomy between those power chords and the feeling of powerlessness that can come with failing health is one Dale isn’t afraid to openly explore. "I’ve lived the world with a bag strapped to my leg, just for the urine, and I discuss this with the people at my concerts," he says, "because many of them are experiencing the same things in their lives. So instead of letting that destroy them, and laying down and going ‘Woe is me, I’m gonna die,’ I tell ‘em, ‘Look, we’re all gonna die, but it’s how you die.’ Then we make them laugh and yell at it."

After the Pittsburgh story went viral, Dale says Lana got more than 10,000 emails, some from fans in countries as far away as England and even Greenland. "We can’t get over there because you’ve got to have the right kind of hospital around, and supplies. So some of them are saying ‘I’m bringing a bunch of people in and I’m paying for their tickets, because I want them to see you’ -- in other words, before you leave the earth."

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Dale isn’t fearful about leaving the earth: Lana is a "sensitive," which he says is far more powerful than a medium, and together they claim to have been in contact with spirits from the other side, including Dale’s late mother and father, who are still bickering in the great beyond. Dale and his wife want to offer aging fans hope about life after death -- but also, in the emails Lana exchanges with fans who suffer from similar maladies, practical advice about how to buy the proper medical equipment and avoid stoma infections.

"Last year they said to me, ‘We think you’ve got cancer coming back down there.’ Well, we all have cancer all over our bodies -- from the foods we’re eating. I said, ‘I’m not going into the hospital. Feed this puppy full of electrolytes, because I’ve got to do a concert at the Whisky a Go Go.’" He says he subsequently got a clean bill of health on the cancer, even if his other problems might seem like death from a million severe paper cuts. He doesn’t foresee the need to tour to pay bills ever giving way to bottled ship-building. "When I die, it’s not going to be in a rocking chair with a big beer belly, that’s for sure. Like I always say: I’ll die in one big explosion of body parts, on stage."

A version of this story appeared in the Aug. 22 edition of Billboard.