Guitarist Dick Dale, who originated the surf rock sound, has died at age 81, Rolling Stone reports. Dale, who struggled with a range of health issues, including rectal cancer, said he toured until the end of his life in order to pay for medical expenses, calling attention to how the American health system can fail, even for those with insurance.

“I can’t stop touring because I will die. Physically and literally, I will die,” said Dale, who struggled with diabetes and kidney failure in addition to cancer, in a 2015 interview. Billboard described him as “the poster child for a generation that’s not too sick to work, but too sick to retire.”

Dale, né Richard Anthony Monsour, was born in Boston in 1937. In the 1950s, his family moved to Southern California, where he learned to surf as a teenager.

His distinctive musical style arose from multiple influences, including the Middle Eastern music he learned from his Lebanese father and the sounds of the ocean, he said. Dale and his band, the Del-Tones—along with the Beach Boys—helped launch a surf culture craze in the early 1960s,.

Dale worked with Leo Fender to develop the Stratocaster guitar and louder amplifiers, leading some to dub him the father of heavy metal. He came to the attention of a new generation when director Quentin Tarantino used his hit “Misirlou” as the opening theme song for the 1994 film Pulp Fiction.

In 1965—when he was just 28—Dale developed rectal cancer, according to The Washington Post. Although he was told he might not have long to live, he was successfully treated with surgery. He retired from the music business and moved to Hawaii but returned to the fold before long. Decades later, his cancer came back, leading to further surgery and chemotherapy. Part of his stomach and intestines were removed, and he wore a colostomy bag to collect waste.

Despite severe spinal pain and advancing age, Dale kept touring—in part to pay for his medical costs.

“I have to raise $3,000 every month to pay for the medical supplies I need to stay alive, and that’s on top of the insurance that I pay for,” he said in a 2015 interview with the Pittsburgh City Paper. Dale explained that in order to prevent infection, he wanted to change his ostomy pouch more often than his insurance would allow. “Sure, I’d love to stay home and build ships in a bottle and spend time with my wife in Hawaii, but I have to perform to save my life,” he added.

But Dale also carried on performing—and openly discussed his health problems in interviews and from the stage—in order to connect with and encourage others struggling with similar health struggles.

“You tell the people, ’Don’t be scared of dying’,” Dale said. “When your mind leaves this body, it is a beautiful thing and it is not to be feared. Don’t let that fear of dying affect the way you live.”

Click here to learn more about colorectal cancer in young people.

Click here to learn more about living with an ostomy in the spring issue of Cancer Health.