The last lecture by Randy Pausch Read Free Book Online

engaged in everything. (They even didn’t seem to mind when I brought along advocates—my friend and colleague Jessica Hodgins came to appointments to offer both support and her brilliant research skills in navigating medical information.)
    I told doctors that I’d be willing to endure anything in their surgical arsenal, and I’d swallow anything in their medicine cabinet, because I had an objective: I wanted to be alive as long as possible for Jai and the kids. At my first appointment with Pittsburgh surgeon Herb Zeh, I said: “Let’s be clear. My goal is to be alive and on your brochure in ten years.”
    I turned out to be among the minority of patients who could benefit from what is called the “Whipple operation,” named for a doctor who in the 1930s conjured up this complicated procedure. Through the 1970s, the surgery itself was killing up to 25 percent of patients who underwent it. By the year 2000, the risk of dying from it was under 5 percent if done by experienced specialists. Still, I knew I was in for a brutal time, especially since the surgery needed to be followed by an extremely toxic regimen of chemotherapy and radiation.
    As part of the surgery, Dr. Zeh removed not only the tumor, but my gallbladder, a third of my pancreas, a third of my stomach, and several feet of my small intestine. Once I recovered from that, I spent two months at MD Anderson Cancer Center in Houston, receiving those powerful dosages of chemo, plus daily high-dose radiation of my abdomen. I went from 182 to 138 pounds and, by the end, could hardly walk. In January, I went home to Pittsburgh and my CT scans showed no cancer. I slowly regained my strength.
    In August, it was time for my quarterly check-in back at MD Anderson. Jai and I flew to Houston for the appointment, leaving the kids with a babysitter back home. We treated the trip like something of a romantic getaway. We even went to a giant water park the day before—I know, my idea of a romantic getaway—and I rode the speed slide, grinning all the way down.
    Then, on August 15, 2007, a Wednesday, Jai and I arrived at MD Anderson to go over the results of my latest CT scans with my oncologist, Robert Wolff. We were ushered into an examining room, where a nurse asked a few routine questions. “Any changes in your weight, Randy? Are you still taking the same medications?” Jai took note of the nurse’s happy, singsong voice as she left, how she cheerily said, “OK, the doctor will be in to see you soon,” as she closed the door behind her.
    The examining room had a computer in it, and I noticed that the nurse hadn’t logged out; my medical records were still up on the screen. I know my way around computers, of course, but this required no hacking at all. My whole chart was right there.
    “Shall we have a look-see?” I said to Jai. I felt no qualms at all about what I was about to do. After all, these were my records.
    I clicked around and found my blood-work report. There were 30 obscure blood values, but I knew the one I was looking for: CA 19-9—the tumor marker. When I found it, the number was a horrifying 208. A normal value is under 37. I studied it for just a second.
    “It’s over,” I said to Jai. “My goose is cooked.”
    “What do you mean?” she asked.
    I told her the CA 19-9 value. She had educated herself enough about cancer treatment to know that 208 indicated metastasis: a death sentence. “It’s not funny,” she said. “Stop joking around.”
    I then pulled up my CT scans on the computer and started counting. “One, two, three, four, five, six…”
    I could hear the panic in Jai’s voice. “Don’t tell me you’re counting tumors,” she said. I couldn’t help myself. I kept counting aloud. “Seven, eight, nine, ten…” I saw it all. The cancer had metastasized to my liver.
    Jai walked over to the computer, saw everything clearly with her own eyes, and fell into my arms. We cried together. And that’s when I realized there was no