“A healthy person has a thousand wishes, but a sick person only has one.” Robert Berger said this in 1968. In April 2023, eight months ago, I announced the theme for the 2024 Gathering of Titans, an entrepreneurial event held at MIT that I’ve led several times. This event has been going on for 20 years. In April, I stood in front of the room and announced that the theme for 2024 is ‘Transcendence: Going Beyond Your Known Limits.’ Before making the announcement, I said something interesting to the guy on my left. I said, “I hope God gives me something to overcome.” I distinctly remember asking God for something big, and He delivered.

I always have a word of the year, and this year’s word was ‘pronoia.’ The opposite of pronoia is paranoia. Paranoia is the belief that the world is conspiring behind my back to bring me down and cause harm. Pronoia, on the other hand, is the belief that the world is conspiring behind my back to bring me blessings. That’s how I felt on August 18, 2023, when I received the news.

Thank you for the setup, Ran. It was actually beautiful, though the worst part was hearing so many friends say, “You have to tell the kids.” Five years ago, I was up here telling the story of my family when my dad announced to me and my eight siblings, at the age of 11, that he had incurable cancer. This time, I had to gather my wife, Melissa, and our kids—who are now 9, 11, 13, and 16—around the kitchen table and share the news. My 13-year-old said, “Dad, we’re studying that one in school. That’s the worst one.” It was incredibly hard.

I made the mistake of Googling pancreatic cancer. The first thing I found said it’s one of the ten deadliest cancers, with no cure. To make matters worse, mine was inoperable, as it was surrounding veins and arteries and was attached to the liver. After receiving the diagnosis, I emailed the Gathering of Titans group and said, “I got my project. Here it is. What’s yours?”

The last diagnosis from the radiologist, five weeks ago, was inoperable stage four cancer, which was ironic. One night, five or six weeks ago, my wife said, “Wow, I just watched Randy Pausch’s Last Lecture.” I asked why that was relevant, and she replied, “He had the same cancer diagnosis as you.” Randy was a guy who was on Oprah, sold millions of copies of his book, and died six months later. I told her, “Honey, I want to give my last lecture when I’m 107 years old, not now. I’m not ready for that.”

According to one of my doctors, 15% of pancreatic cancer cases are misdiagnosed, and the patient actually has zero cancer at all. I asked, “Why is that relevant?” The doctor said, “Of those misdiagnosed, only 7.5% survive five years.” I asked, “Why do only 7.5% survive five years?” The answer was, “They die for two reasons: one, from the chemotherapy, or two, from the cancer.” I then asked, “So they’re dying from the chemotherapy, even though they don’t have cancer?” The answer was yes. It was pretty scary.

Another doctor said to me, “Two and two, Rick, two and two.” I asked, “What the hell is two and two?” The doctor explained, “You have a 2% chance to live for two years.”

Watch the full speech here: https://youtu.be/g4cQGEv3IrA