walter isaacson 撞击 chapter 35

Art Levinson, who was on Apple’s board, was chairing the board meeting of his own company,
Genentech, when his cell phone rang and Jobs’s name appeared on the screen. As soon as there was a
break, Levinson called him back and heard the news of the tumor. He had a background in cancer
biology, and his firm made cancer treatment drugs, so he became an advisor. So did Andy Grove of Intel,
who had fought and beaten prostate cancer. Jobs called him that Sunday, and he drove right over to
Jobs’s house and stayed for two hours.
To the horror of his friends and wife, Jobs decided not to have surgery to remove the tumor, which was
the only accepted medical approach. “I really didn’t want them to open up my body, so I tried to see if a
few other things would work,” he told me years later with a hint of regret. Specifically, he kept to a strict
vegan diet, with large quantities of fresh carrot and fruit juices. To that regimen he added acupuncture, a
variety of herbal remedies, and occasionally a few other treatments he found on the Internet or by
consulting people around the country, including a psychic. For a while he was under the sway of a doctor
who operated a natural healing clinic in southern California that stressed the use of organic herbs, juice
fasts, frequent bowel cleansings, hydrotherapy, and the expression of all negative feelings.
“The big thing was that he really was not ready to open his body,” Powell recalled. “It’s hard to push
someone to do that.” She did try, however. “The body exists to serve the spirit,” she argued. His friends
repeatedly urged him to have surgery and chemotherapy. “Steve talked to me when he was trying to cure
himself by eating horseshit and horseshit roots, and I told him he was crazy,” Grove recalled. Levinson
said that he “pleaded every day” with Jobs and found it “enormously frustrating that I just couldn’t connect
with him.” The fights almost ruined their friendship. “That’s not how cancer works,” Levinson insisted
when Jobs discussed his diet treatments. “You cannot solve this without surgery and blasting it with toxic
chemicals.” Even the diet doctor Dean Ornish, a pioneer in alternative and nutritional methods of treating
diseases, took a long walk with Jobs and insisted that sometimes traditional methods were the right
option. “You really need surgery,” Ornish told him.
Jobs’s obstinacy lasted for nine months after his October 2003 diagnosis. Part of it was the product of
the dark side of his reality distortion field. “I think Steve has such a strong desire for the world to be a
certain way that he wills it to be that way,” Levinson speculated. “Sometimes it doesn’t work. Reality is
unforgiving.” The flip side of his wondrous ability to focus was his fearsome willingness to filter out things
he did not wish to deal with. This led to many of his great breakthroughs, but it could also backfire. “He
has that ability to ignore stuff he doesn’t want to confront,” Powell explained. “It’s just the way he’s wired.”
Whether it involved personal topics relating to his family and marriage, or professional issues relating to
engineering or business challenges, or health and cancer issues, Jobs sometimes simply didn’t engage.
In the past he had been rewarded for what his wife called his “magical thinking”—his assumption that
he could will things to be as he wanted. But cancer does not work that way. Powell enlisted everyone
close to him, including his sister Mona Simpson, to try to bring him around. In July 2004 a CAT scan
showed that the tumor had grown and possibly spread. It forced him to face reality.
Jobs underwent surgery on Saturday, July 31, 2004, at Stanford University Medical Center. He did not
have a full “Whipple procedure,” which removes a large part of the stomach and intestine as well as the
pancreas. The doctors considered it, but decided instead on a less radical approach, a modified Whipple
that removed only part of the pancreas.
Jobs sent employees an email the next day, using his PowerBook hooked up to an AirPort Express in
his hospital room, announcing his surgery. He assured them that the type of pancreatic cancer he had
“represents about 1% of the total cases of pancreatic cancer diagnosed each year, and can be cured by
surgical removal if diagnosed in time (mine was).” He said he would not require chemotherapy or
radiation treatment, and he planned to return to work in September. “While I’m out, I’ve asked Tim Cook
to be responsible for Apple’s day to day operations, so we shouldn’t miss a beat. I’m sure I’ll be calling
some of you way too much in August, and I look forward to seeing you in September.”
One side effect of the operation would become a problem for Jobs because of his obsessive diets and
the weird routines of purging and fasting that he had practiced since he was a teenager. Because the
pancreas provides the enzymes that allow the stomach to digest food and absorb nutrients, removing part
of the organ makes it hard to get enough protein. Patients are advised to make sure that they eat frequent
meals and maintain a nutritious diet, with a wide variety of meat and fish proteins as well as full-fat milk
products. Jobs had never done this, and he never would.
He stayed in the hospital for two weeks and then struggled to regain his strength. “I remember coming
back and sitting in that rocking chair,” he told me, pointing to one in his living room. “I didn’t have the
energy to walk. It took me a week before I could walk around the block. I pushed myself to walk to the
gardens a few blocks away, then further, and within six months I had my energy almost back.”
Unfortunately the cancer had spread. During the operation the doctors found three liver metastases.
Had they operated nine months earlier, they might have caught it before it spread, though they would
never know for sure. Jobs began chemotherapy treatments, which further complicated his eating
challenges.