It was September 2017. Josh Paul was getting acclimated to his new role as Assistant Principal at Lanier Middle School in Brazosport ISD when he noticed a hardened area in his tongue. He scheduled an appointment to get it checked out. After a few visits with his dentist, primary care physician and oncologist, a biopsy was performed just before Thanksgiving. Not too long after the holiday week, the doctors called… Squamous Cell Carcinoma, stage four. He didn’t smoke and lived a relatively healthy lifestyle. This was serious stuff, and a complete shock to Josh Paul, his family, friends, and colleagues. Recently engaged, with a new house, and the job he’d been dreaming of; Josh Paul was just getting started. What would this diagnosis mean for the future? In true Josh Paul form, he was determined to beat it, and get back to living well, as soon as possible.
On December 15, 2017, Josh Paul went to St. Luke’s Hospital for a grueling 15-hour surgery. Surgeons removed the tumor from his tongue and more than 100 lymph nodes from his neck, for testing. With a skin graft harvested from his wrist, they developed a flapper to replace the missing section of his tongue. Surgeons then took a skin graft from his groin to replace what was now missing from his wrist. A trach was put in, along with a feeding tube, to help Josh Paul breathe and eat as his mouth healed. When he woke up, in the Post-Surgery ICU wing, Josh Paul high-fived his nurses and shook their hands in gratitude.
It would be a long road to recovery. Josh Paul needed speech therapy to help him retrain his mouth, tongue and lips to speak, smile, and swallow; along with many other muscle movements we easily take for granted.
He also began six hard months of chemotherapy and radiation, before ringing the bell in the summer of 2018. With so many rooting for Josh Paul, that was a major moment for him, and everyone that knew him!
He had his first six-month scan and was so excited to learn that nothing had changed, and no new cancer cells were visible. This meant he could get back to school with his students and colleagues in the fall! Josh Paul was truly looking forward to it!
At the beginning of 2019, it was time for another six-month scan. Unfortunately, doctors found that the cancer had spread to the lower lobe of his left lung. He would need surgery to remove it. His sister, Kristin, said, “I remember taking Josh Paul to his pre-op appointment. He kept asking the surgeon about being able to run again, after surgery. He couldn’t wait to get back to his training at Memorial Park and wanted to make sure it was a possibility for the future!”
Josh Paul also wanted to attend the student field trip he was a part of planning, before leaving school again for surgery. So, he scheduled his lung surgery for the day after the event.
Days before his 38th birthday, in late February, he went into surgery to remove part of his left lung. Surgery went well. Shortly thereafter, a far more aggressive chemotherapy and radiation treatment plan began. It was extremely hard on Josh Paul’s body and mind. But he pushed through, focused on healing.
In the late summer of 2019, it was time for another six-month scan. Doctors had bad news for Josh Paul. The cancer had spread to four additional organs, including his stomach and heart. There were more tumors in his throat/neck as well. His oncologist shared that Josh Paul needed to get his affairs in order, as he only had a few months – maybe weeks – left to live. The news was devastating.
Josh Paul had always wanted to take his family on a special trip to Boston. While his heart was very weak and doctors suggested against it, Josh Paul was bound and determined to do it anyway. In late September, he booked that special trip to Boston. He got to take his family on a plane, out to do some whale-watching, and to a baseball game at Fenway Park. It was an unforgettable weekend for them all!
In early October, Josh Paul stopped his treatment and planned to spend the rest of his days in as much comfort as possible. One night, he woke up abruptly, having trouble swallowing and speaking. Hospice care was still pending, so he was later taken to the emergency room at St. Luke’s Hospital. It was later revealed that a tumor had grown larger in his neck and was now pressing against his esophagus.
Triage nurses, in the ER, took his vitals and saw that his heartbeat was dangerously slow. They made some calls and rushed him back to a room where cardiologists, OR surgeons, and nurses began to prep Josh Paul for what they thought might be an emergency open-heart surgery. What they didn’t know was that he had a DNR in place, and that cancerous tumors had all but consumed his heart. It was a scary time for his wife and sister who were there with him. Josh Paul – in the thick of all the chaos – was surprisingly calm. Kristin said, “It was like angels were shielding him from the worry of that particular moment. Erika and I knew he had a DNR in place, and we thought we were about to lose him. But he seemed so still, and without fear. The doctors all left the room. There was one nurse remaining. He closed the door, looked at both of us, and asked if he could pray for us. We all shook our heads YES! What an angel, in such a scary moment. We needed him – and that prayer – more than he will ever know!”
Josh Paul was admitted to the hospital, and cardiology tests were run. All the while, he still couldn’t speak, or swallow, and getting any food down was impossible. He was too weak for any doctor to agree to operate on him, to install a feeding tube. After days of waiting, his oncologist suggested his family get him back home, in hospice care, and make him as comfortable as possible.
Josh Paul spent the next week or so, at home, being loved on by friends, family, and colleagues. His family helped him taste all his favorite beverages. He wrote notes with all his special visitors. He listened to The Beatles with his sister, Kristin. He even played guitar with his little brother, Jeremy!
On the morning October 18, 2019, Josh Paul passed away.
He was buried a week later at Forest Park Lawndale cemetery in Houston, Texas. In the largest chapel, every pew was filled, with scores of people standing in the back, and waiting outside to pay their respects. The outpouring of love spoke volumes to the kind of man Josh Paul was, to so many. The social media pictures, messages, and comments flooded in about how Josh Paul saved, inspired, motivated, and loved everyone he met. It was incredible!
His gift of making everyone feel seen, heard, valued, and worthy is why The Josh Paul Foundation was created. While Josh Paul is no longer with us, his legacy lives on today, through his family, friends, colleagues and in our efforts of supporting youth in continuing education, even in the face of adversity.
