It all began with one, age-old question: What would you say if you knew you were going to die and had a chance to sum up everything that was most important to you?
That question had been posed to the annual speaker of a lecture series at Carnegie Mellon University, where Pausch was a computer science professor. For Pausch, though, the question wasn't hypothetical.
Pausch, a father of three small children with his wife Jai, had been diagnosed with pancreatic cancer -- and given six months to live.
Friends and colleagues flew in from all around the country to attend his last lecture. And -- almost as an afterthought -- the lecture was videotaped and put on the Internet for the few people who couldn't get there that day.
That was all it took.
Somehow amid the vast clamor of the Web and the bling-bling of million-dollar budgets, savvy marketing campaigns and millions of strange and bizarre videos, the voice of one earnest professor standing at a podium and talking about his childhood dreams cut through the noise.
The lecture was so uplifting, so funny, so inspirational that it went viral. So far, 10 million people have downloaded it.
And thousands have written in to say that his lecture changed their lives.
Click here to see ABC News' full coverage of Randy Pausch.
If you had only six months to live, what would you do? How would you live your life? And how can all of us take heart from Pausch's inspiring message to live each day to its fullest?
Pausch's answers to these questions, both in the lecture and in three separate interviews over a series of months with Diane Sawyer, are moving, funny, thought-provoking and extraordinary.
According to PanCAN, an advocacy organization for the pancreatic cancer community, approximately 37,170 Americans will be diagnosed with pancreatic cancer in 2008 and 33,370 will die from it.
It is the fourth leading cause of cancer death in the United States, and unlike other cancers, during the last 30 years the medical community has seen very little advancement in prolonging the lives of pancreatic cancer patients.
But instead of focusing on his death, Pausch spoke about his childhood dreams. "You may not agree with the list but I was there. ... Being in zero gravity, playing in the National Football League, authoring an article in the World Book Encyclopedia -- I guess you can tell the nerds early. ... I wanted to be one of the guys who won the big stuffed animals in the amusement park."
He went on to attain almost all of those dreams, but they didn't all come easy.
In the lecture, he speaks of overcoming the obstacles that may seem insurmountable.
Although he graduated magna cum laude from Brown University, he nearly didn't get in to Brown in the first place -- he was wait listed. It was a brick wall that some might have walked away from. But Pausch has a novel way of looking at obstacles:
"The brick walls are there for a reason," he said during his lecture. "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."
He kept calling the college until it let him in.