The Last Lecture: Chapter 12 Summary & Analysis

In the summer of 2006, Randy’s medical odyssey begins, and doctors eventually discover that he has pancreatic cancer. A Google search lets him know how bad this was at the time—half of people die within six months of a diagnosis, and 96% die within five years. Randy approaches his treatment like he does most things: as a data-seeking scientist. He asks questions, records conversations, does research, brings colleagues for second opinions—anything to give him more information. He tells doctors that he would do any surgery or treatment that might either increase his odds of recovery or prolong his life. When he first meets his surgeon Dr. Herb Zeh, Randy tells him his goal is to be alive and on Dr. Zeh’s brochure in ten years.

Randy is told he can benefit from a “Whipple operation,” a dangerous, complicated surgery that kills a little under 5% of those who undergo it. Randy has the surgery, recovers, and undergoes two months of powerful chemotherapy at MD Anderson Cancer Center in Houston, dropping from 182 to 138 pounds in the process. When he goes home to Pittsburgh, Randy’s scans show no cancer, and he slowly regains his strength. Eventually, Jai and Randy fly to Houston for a check-in appointment, treating the trip almost like a romantic getaway—they go to a water park the day before his appointment, and Randy rides the speed slide, “grinning all the way down.”

On August 15th, 2007, Jai and Randy arrive at MD Anderson to go over the results of his latest scans with Randy’s oncologist, Dr. Robert Wolff. They chat with a nurse, then are left to wait for the doctor. Randy notices that the nurse has left herself logged in on the computer, with his medical records pulled up. When Randy reads the results, he’s horrified, and tells Jai his “goose is cooked.” Randy pulls up his CT scans and counts his tumors aloud, up to ten. Jai is horrified, as is Randy, and Jai falls into Randy’s arms and they cry together. Randy, even in this state, thinks like a scientist, believing the lack of tissues in the office to be a “glaring operational flaw.”

When Dr. Wolff shows up, Randy tells him that Jai and Randy already know the news. Jai is hysterical, and Dr. Wolff sits next to her. He calmly explains that they are no longer trying to save Randy’s life, but rather to extend the time he has left. Jai is furious, feeling as if the doctors are giving up, but Dr. Wolff explains that they can ease symptoms, maybe buy Randy few months. Randy asks questions and feels stunned, but, at the same time, he’s extremely impressed with Dr. Wolff’s delivery of the news to Jai—he’s “carefully rehearsed,” yet also makes everything sound “heartfelt and spontaneous.” Randy notes that Dr. Wolff always shifts questions into a more positive light—when Randy asks “how long before I die?” Dr. Wolff responds that he has “three to six months of good health.”

This reminds Randy of his time working at Disney. If you ask any Disney employee what time the theme park closes, they’re supposed to respond, “The park is open until 8 p.m.” Back in the doctor’s office, Randy says he feels, in a way, relieved, because the wait to find out his prognosis is over—now Jai and Randy can plan the rest of Randy’s life, and make plans for after his death.

When leaving the office, Randy remembers what he’d said to Jai the day before at the water park, after riding the speed slide. He’d told her that, even if the results are bad, he just wants Jai to know that he is happy to be alive, right then, with her. And, no matter what, Randy tells Jai he isn’t going to die when they get the news, or the next day, or the day after that. Randy says he wants Jai to know just how much he’s enjoying being with her. And right then Randy knows—living like he’s enjoying every day, like in the water park, is exactly how he must live the rest of his life.