The book is a collection of several essays from Tumortown, a land where he went to live after his diagnosis of esophageal cancer. He proposes a handbook for communication between denizens of the healthy world and those of Tumortown. For the healthy, it would have suggestions on topics to avoid, and advice on how to be neither too rosy nor too blunt. As an example of rosiness he imagines hearing of someone's grandmother who "was diagnosed with terminal melanoma of the G-Spot. But she hung in there and last year she climbed Mt. Everest."
The book is often sad, mostly because of his characteristic relentless honesty in laying out the facts, but there's never enough time to dwell on the morbid content. He never lingers on anything sympathy-inducing before he sets off ridiculing some stupidity, like Fundamentalists on YouTube betting whether he'll experience a deathbed conversion.
To this he says, "If I convert it's because it's better that a believer dies than that an atheist does."
He goes on to deride intercessory prayer, even those made by friends for his benefit: "A different secular problem also occurs to me: What if I pulled through and the pious faction contendtedly claimed that their prayers had been answered? That would somehow be irritating."
There is no grand insight in this book. Just his wit and humanity. He did what he was best at until he couldn't.
I'll end this with my favorite part of the book, an etiquette suggestion for those from Tumortown: advice on how not to behave. His example is Randy Pausch, the star of the viral video "The Last Lecture." This video was seen by millions and has as many devotees who attest to its profound, life-affirming qualities.
It should bear its own health warning: so sugary that you may need an insulin shot to withstand it. Pausch used to work for Disney and it shows .... Of course, you don't have to read Pausch's book, but many students and colleagues did have to attend the lecture, at which Pausch did push-ups, showed home videos, mugged for the camera, and generally joshed his head off. It ought to be an offense to be excruciating and unfunny in circumstances where your audience is almost morally obliged to enthuse.