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The Oncologist, Vol. 12, No. 11, 1374-1375, November 2007
© 2007 AlphaMed Press

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Reflections

Excerpts from Dr. Randy Pausch's Last Lecture: "Really Achieving Your Childhood Dreams"


   INTRODUCTION
Top
 Introduction
Excerpts from Dr. Pausch's...
 Acknowledgments
 References
 
If you had one last lecture to give before you died, what would it be? Dr. Randy Pausch (Fig. 1), a computer science professor at Carnegie Mellon University (Pittsburgh, PA), gave his last lecture on September 18, 2007. During that final lecture, he talked about his childhood dreams and how he achieved them, and then how he went on to enable others to achieve their childhood dreams. He recounted outstanding moments from his life, the outstanding people he had encountered, and the lessons learned along the way. Dr. Pausch dedicated his last lecture to his three young children, aged 5, 3, and 1, but the lessons to be learned from this lecture are universal.


Figure 1
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  		Figure 1. Dr. Randy Pausch with his three children, Dylan, Logan, and Chloe.

 
Dr. Randy Pausch is 47 years old and he has terminal cancer, with a life expectancy of a few months. First diagnosed with pancreatic cancer in the summer of 2006 [1], he underwent Whipple surgery in September 2006, followed by chemotherapy with cisplatin, interferon, and 5-fluorouracil combined with daily radiation (the Virginia Mason protocol). By August of 2007, the cancer had metastasized to his liver and spleen, and he was given a survival prognosis of 3–6 months. At the end of August 2007, he began palliative chemotherapy with gemcitabine and erlotinib [1]. A computed tomography (CT) scan on October 1, 2007 and positron emission tomography CT scan on October 13, 2007 both showed tumor response in the spleen and response or stable disease in the liver tumors [2]. At the time of this writing, Dr. Pausch was considering other treatments, including other chemotherapies and a cancer vaccine, and reported having a very good quality of life.


   EXCERPTS FROM DR. PAUSCH'S LAST LECTURE
Top
 Introduction
 Excerpts from Dr. Pausch's...
Acknowledgments
 References
 
Dr. Pausch began his last lecture by cutting to the chase:

So, you know, in case there's anybody who wandered in and doesn't know the back story, my dad always taught me that when there's an elephant in the room, introduce them. If you look at my CAT scans, there are approximately 10 tumors in my liver, and the doctors told me 3–6 months of good health left. That was a month ago, so you can do the math. I have some of the best doctors in the world. ... So that is what it is. We can't change it, and we just have to decide how we're going to respond to that. We cannot change the cards we are dealt, just how we play the hand. If I don't seem as depressed or morose as I should be, sorry to disappoint you. And I assure you I am not in denial. It's not like I'm not aware of what's going on. My family, my three kids, my wife, we just decamped. We bought a lovely house in Virginia, and we're doing that because that's a better place for the family to be, down the road. And the other thing is I am in phenomenally good health right now. I mean it's the greatest thing of cognitive dissonance you will ever see is the fact that I am in really good shape. In fact, I am in better shape than most of you. [At this point in the lecture, he gets on the ground and executes some one-handed pushups.] So anybody who wants to cry or pity me can come down and do a few of those, and then you may pity me.

Dr. Pausch goes on to recount his childhood dreams—being in zero gravity, playing in the National Football League, being an author in the World Book Encyclopedia, being Captain Kirk, working for Disney—and what it takes to achieve them:
... remember, the brick walls are there for a reason. The brick walls are not there to keep us out. The brick walls are there to give us a chance to show how badly we want something. Because the brick walls are there to stop the people who don't want it badly enough. ... [H]ave something to bring to the table, ... because that will make you more welcome.

And he discloses some valuable lessons learned along the way:
I did not make it to the National Football League, but I probably got more from that dream and not accomplishing it than I got from any of the ones that I did accomplish. ... when you see yourself doing something badly and nobody's bothering to tell you anymore, that's a very bad place to be. Your critics are your ones telling you they still love you and care. ... And the other thing about football is we send our kids out to play football or soccer or swimming or whatever it is, and it's the first example of what I'm going to call a head fake, or indirect learning. We actually don't want our kids to learn football. ... we send our kids out to learn much more important things. Teamwork, sportsmanship, perseverance, et cetera, et cetera.

Dr. Pausch's legacy is built on what he calls the "head fake" or indirect learning.
So Alice is a project that we worked on for a long, long time. It's a novel way to teach computer programming. Kids make movies and games. The head fake, again, we're back to the head fakes. The best way to teach somebody something is to have them think they're learning something else. ... the head fake here is that they're learning to program but they just think they're making movies and video games. This thing has already been downloaded well over a million times. ... And it's not the good stuff yet. The good stuff is coming in the next version. I, like Moses, get to see the promised land, but I won't get to set foot in it. And that's OK, because I can see it. And the vision is clear. Millions of kids having fun while learning something hard. That's pretty cool. I can deal with that as a legacy.

He hasn't forgotten the instrumental people along the way and, among many others, credits his parents with helping him achieve his dreams and keeping him grounded.
When I was here studying to get my Ph.D. and I was taking something called the theory qualifier, which I can definitively say is the second worst thing in my life after chemotherapy. And I was complaining to my mother about how hard this test was and how awful it was, and she just leaned over and she patted me on the arm and she said, "we know how you feel honey, and remember when your father was your age he was fighting the Germans." After I got my Ph.D., my mother took great relish in introducing me as, "this is my son, he's a doctor but not the kind that helps people."

But he has never forgotten that it is all about having fun.
[Carnegie Mellon University] President Cohen, when I told him I was going to do this talk, said, "please tell them about having fun, because that's what I remember you for." And I said, "I can do that, but it's kind of like a fish talking about the importance of water." I mean I don't know how to not have fun. I'm dying and I'm having fun. And I'm going to keep having fun every day I have left. Because there's no other way to play it.

So my next piece of advice is, you just have to decide if you're a Tigger or an Eeyore. I think I'm clear where I stand on the great Tigger/Eeyore debate. Never lose the childlike wonder. It's just too important. It's what drives us.

Dr. Pausch concluded his lecture with words of wisdom from his lessons learned, summarized as follows:
  • Loyalty is a two-way street.
  • Never give up.
  • You get people to help you by telling the truth. Being earnest. I'll take an earnest person over a hip person every day, because hip is short term. Earnest is long term.
  • Apologize when you screw up and focus on other people, not on yourself.
  • Get a feedback loop and listen to it. ... Anybody can get chewed out. It's the rare person who says, oh my god, you were right. ... When people give you feedback, cherish it and use it.
  • Show gratitude.
  • Don't complain. Just work harder.
  • Be good at something, it makes you valuable.
  • Work hard.
  • Find the best in everybody. ... No one is all evil. Everybody has a good side; just keep waiting, it will come out.
  • And be prepared. Luck is truly where preparation meets opportunity.

The final "head fake" of Dr. Pausch's last lecture was that none of this was meant for the audience, but for his children. And that may be his true legacy.

To read the complete transcript of Randy Pausch's last lecture or to view the lecture online, visit http://www.randypausch.com.


   ACKNOWLEDGMENTS
Top
 Introduction
 Excerpts from Dr. Pausch's...
 Acknowledgments
References
 
The Editors thank Dr. Randy Pausch for permission to reprint material from his final lecture, Carnegie Mellon University for access to the video and transcript of the lecture, and Susan Dufault for editorial assistance in assembling the material.


   REFERENCES
Top
 Introduction
 Excerpts from Dr. Pausch's...
 Acknowledgments
 References
 

  1. Pausch R, Summary of the Adventure. Available at http://www.cs.cmu.edu/~pausch/shortsummary.html. Accessed October 26, 2007.
  2. Pausch R, Randy Pausch's Cancer Update Page. Available at http://www.cs.cmu.edu/~pausch/news/index.html. Accessed October 26, 2007.




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