At Carnegie Mellon University recently, a professor of computer science and a world expert on virtual reality gave his last lecture. The rules of the talk would be to ask a faculty member to give a presentation as if it were the final class of his or her life. The objective was contemplation of the most important last words the learned teacher would give to his students. What message would be the ongoing living legacy of the scholar to others that would last beyond the years?

For most speakers it is an interesting intellectual exercise. For Dr. Randy Pausch, it's real. This scientist, creator, lecturer, role model, mentor, husband and dad is dying from metastatic pancreatic cancer. Pausch, a father of three, gave his "last lecture" a month before his 46th birthday. Since then his heroic presentation ( has spread via the medium he has personally advanced in the science of computers. I encourage all to learn from it. It has made me wonder what would be the last lecture I would give to the parents who bring their children to me as their pediatrician.

Part of the challenge of such a task is that doctors don't spend a lot of time with patients these days. The world of insurance reimbursement is heavily weighted toward doing things, not feeling or sharing things. So the last message in medicine has to fit into the scheduled 10-minute office visit.

Of course, it would be impossible to include everything. The message would vary for different parents and children of different ages with their different medical and emotional needs. Perhaps there could be some fudging like, "this is important so I will tell you, but it is not really my last message." In that group would be to eat right with more omega 3, iron for children and pregnant and nursing mothers. That goes along with increased day-to-day activity and regular exercise. I would tell teenagers to love their mothers and fathers and "If mama ain't happy; nobody's happy."

Then there would be the speech about "Garbage in, garbage out" in relationship to brains, children and TV, movies, computer time and video games. It is still bewildering to me the number of parents who are totally oblivious of the harm audio-visual trash does to a child's growing absorbing brain.

After that, it would be a paragraph thrown in on getting the right vaccines for your children, wearing seat belts, slowing down your driving and putting away distracting things like cell phones. And for heaven's sake, don't drink and drive.

I would emphasize not smoking. Don't start, and stop if you already have.

All of this would be just the introduction of the last thoughts. Then the hard work starts. What to say. But more to the point, how to say it so others understand. It wouldn't even be original. I would say:

Know yourself. Know you are loved and have intrinsic worth. Fear is the ultimate enemy of good. Promote security for yourself and for your children by creating a peaceful environment. Identify their needs and distresses, provide comfort and teach a skill of success. Name your emotions and those of your children and loved ones in order to be better schooled and practiced at responding appropriately to their fears and also your own.

That's it.

Pausch doesn't have that choice. Instead he left a message of encouragement for those he is leaving behind. For the rest of us, we should think what we want to say in 10 minutes; then act like we are going to live forever.

Joseph Cramer, M.D., is a fellow of the American Academy of Pediatrics, practicing pediatrician for more than 25 years and an adjunct professor of pediatrics at the University of Utah. He can be reached at