Randy Pausch教授的《最后一课》

兰迪·波许的病情自述

Late in the summer of 2006, I started having some unusual symptoms, culminating with jaudice. Scans revealed it was pancreatic cancer. At this time, my wife Jai and I had a 4 year old, a 2 year old, and a three month old baby.

2006年夏末，我出现了一些异常症状，后来发展为黄疸。扫描发现是胰腺癌。那时，我的三个孩子分别是 4 岁、2 岁和3个月大。

Pancreatic cancer is the most deadly of cancers, with only a 4% 5-year survival rate. The only hope is to be one of the 20% of patients (which I was) where surgery is possible. I had a Whipple surgery on Sept 19th, 2006; Dr. Herbert Zeh removed the (4.5cm) tumor, my gallbladder, 1/3rd of my pancreas, 1/3rd of my stomach, and several feet of my small intestine. I was in the hospital 11 days. Even with a successful Whipple surgery, only 15% of pancreatic cancer patients make it to 5 years, and there is no concensus about which chemotherapy and/or radiation after surgery helps. I found the Virginia Mason protocol, where early trials were claiming to get 45% of people to 5 years. However, it was an extremely toxic combination of chemotherapy and daily radiation: a nation-wide trial was shut down because several patients died from the treatment. There were two centers still offering the treatment: Virginia Mason in Seattle, and MD Anderson in Houston, and I was able to quality for the treatment in Houston. This happened in a whirlwind: the treatment needed to start within 6-8 weeks of the surgery. And Jai & I needed to figure out how to have somebody stay with me full time, and also take care of our 3 kids.

胰腺癌是最致命的癌症，5年生存率仅 4% 。唯一有希望的是那些 20%可手术治疗的患者（我是其中之一）。2006年 9月19日，我接受了胰十二指肠切除术（Whipple），赫伯特·泽医生切除了我的肿瘤（4.5cm）、胆囊、1/3的胰腺、1/3的胃和几英尺的小肠。我在医院住了11 天。即使Whipple手术成功，也只有 15%的胰腺癌患者可以存活 5年，而且对于术后的放化疗方案，医界也无共识。我找到维吉尼亚梅森方案，初期临床试验表明它可以把5年生存率提高到 45%。但是，这是毒性很大的化疗和每日放疗的组合，因为有几名患者死于该治疗，所以全国性的临床试验被终止了。只有二个医学中心仍提供该疗法：西雅图的维吉尼亚梅森医疗中心，以及休斯敦的德州大学安德生癌症中心。而我有资格在休斯敦接受治疗。治疗需在手术后 6-8周内开始。我的妻子洁和我，需要想办法既能照顾我们的3个小孩，又要有人全时陪护我。

I spent November and December at MD Anderson receiving IV Cisplatin once a week, interferon injections three times a week, continuous infusion 5-FU, and daily radiation. Fortunately, Jai's brother and sister-in-law took in our three kids (on top of their 8 and 12 year old), in Norfolk Virginia, while Jai stayed with me in Houston. Every weekend, Jai flew to Norfolk to be with our kids, and my sister Ruby or one of my friends (thank God for Jessica Hodgins, Scott Sherman, and Jack Sheriff) would come stay with me. I was also blessed with my colleague Chris Hoffmann, a CS professor at Purdue who had been through this exact ordeal two years prior: his encouragment and practical tips were invaluable in getting through the treatment. The less I say about Houston the better, but by the end I was barely able to walk, and my weight (starting at 182) dropped to 138.

我在安德生癌症中心度过了11月和 12月，静脉注射顺铂每周一次，干扰素注射每周三次，5-氟尿嘧啶持续滴注，还有每日放疗。幸运的是，当洁和我一起在休斯敦时，她在弗吉尼亚州诺福克的兄嫂为我们照看三个小孩（再加上他们自己两个8岁和12岁的孩子）。每个周末，洁飞到诺福克跟我们的孩子在一起，而我姐姐或我的朋友（非常感谢杰西卡·霍金斯、斯科特·谢尔曼和杰克·谢若夫）会来和我呆在一起。我的同事克里斯·霍夫曼（一位两年前经历过同样磨难的普渡大学计算机学教授），给予了我无价的鼓励和熬过治疗的窍门。关于休斯敦，我还是少说一点，最后我几乎不能走路，我的体重（原来 182磅）掉到 138磅。

The next four months of chemo (continuous infusion 5-FU) was back in Pittsburgh, through May 2007. Now, I'm 168 pounds and look normal. (To answer everybody's first question, no, my hair never fell out). One additional treatment is a vaccine done at Johns Hopkins: I don't expect it will change my odds much, but it can't hurt. I still have digestive inconveniences from the Whipple surgery: I have to eat 5 small meals a day and take pills with each meal, and I have some abdominal cramping from time to time. A small price to pay for walking around.

接下来是四个月的化疗（5-氟尿嘧啶持续滴注），回到匹兹堡做，直到 2007 年 5月。现在，我体重168磅，看起来正常。（回答每个人的第一个问题，没有，我从未脱发）。另外还有在约翰霍普金斯大学做的疫苗治疗：我不期望它扭转乾坤，但总是有益无害。我仍然有手术后的消化问题：我必须一天吃 5小顿饭，每顿饭都要吃药，有时肚子还会抽筋。这是为了活着，而付出的一个小小代价。

In August of 2007, we learned that the cancer had returned, having metastasized to my liver and spleen, which is a death sentence. At that time, the doctors gave me an estimate of having 3-6 months of healthy living left. On Oct 1st, we learned that the first round of palliative chemotherapy was working, and that I would likely be 'more like the 6 than like the 3 in that estimate.'

2007年8月，我们获悉，癌症已复发，而且转移到肝和脾，这意味着必死无疑。那时，医生估计我有 3-6个月的健康生存期。10月1日，我们获悉第一轮姑息性化疗有效，我的剩余寿命可能是6个月，而不是3个月。

My wife Jai has been an incredible source of stability and courage through all this. We both agree that 'you can't control the cards you're dealt, just how you play the hand.'

在整个过程中，我的妻子洁一直以超乎寻常的能力，帮助我保持情绪稳定和鼓起勇气。我们都同意，'你不能控制发给你的牌，只能控制如何打牌。'

Randy Pausch, October 2007

兰迪·波许，2007年 10月