Inside Steve's Brain - Leander Kahney [95]
Luckily, Jobs said, his cancer was a very rare form of the disease called a neuroendocrine or islet-cell tumor, which occurs in about one percent of all cases of pancreatic cancer diagnosed each year. It can be cured by surgery if diagnosed in time, and his was.
Jobs said he’d already undergone the operation and that he didn’t need any follow-up radiation or chemotherapy treatments. He’d be taking the month of August off to recuperate and planned to be back at work in September. The memo ended on an odd but perky note: “PS: I’m sending this from my hospital bed using my 17-inch PowerBook and an Airport Express.” Typical of Jobs: even a sick note is an opportunity to plug Apple’s products. (Perhaps not coincidentally, the note was shared with the press and was widely reprinted in newspapers and magazines, as well as on websites.)
Jobs was extremely lucky. Pancreatic cancer is usually a quick and efficient killer. The more common form, adenocarcinoma, is incurable. Even so, Jobs initially resisted getting the surgery. According to Fortune magazine, he opted instead to treat the disease by adopting a special vegetarian diet for nine months. But when this failed to cure the cancer, he underwent a pancre aticoduodenectomy (otherwise known as the Whipple procedure) in late July 2004, which successfully removed the tumor.
Named after the American surgeon Dr. Allen Oldfather Whipple, who perfected the surgery in the thirties, the procedure is a complex operation that reconfigures a large part of the patient’s digestive system. The head of the pancreas is removed, along with the common bile duct and the gallbladder. A large part of the stomach and the duodenum are also taken out, and the system is stitched back together in a new configuration. What remains of the pancreas supplies the new system with digestive juices and insulin. Most patients who have undergone the Whipple procedure suffer from digestive problems, ranging from mild aversion to certain foods to more serious conditions like diabetes. Initially most patients lose 5 to 10 percent of their body weight, though their weight stabilizes a year or two after the procedure. Some have persistent problems with weight loss and lack of energy, though doctors are not always sure why. For many patients, their quality of life and life expectancy are equivalent to that of healthy people.
For two years, Jobs appeared to be on the mend. But in August 2006, he took to the stage to deliver a keynote speech at Apple’s Worldwide Developers Conference, the annual gathering of Apple’s software developers. I happened to attend the conference, and I was struck by Jobs’s thin, almost gaunt appearance. He also seemed unusually tired. His delivery was lethargic, and he delegated large portions of his presentation to other Apple executives. Unlike his previous speeches, this keynote was listless and lackluster—and he’d clearly lost a lot of weight.
Jobs’s sickly appearance at the conference prompted the first in several waves of speculation about his health. Obviously, many people wondered if his cancer had returned. All over the Internet, forums and websites lit up with discussions of whether Jobs’s cancer really was in remission. An Apple spokesperson tried to dampen rumors. “Steve’s health is robust,” said Katie Cotton, Apple’s VP of worldwide corporate communications.
Speculation about Jobs’s health reached fever pitch two years later, after his keynote speech at Apple’s 2008 WWDC in June. Appearing alarmingly emaciated, Jobs again delegated most of the presentation to lieutenants. When the subject of his health dominated media reports of the speech, Apple again tried to dampen rumors, saying he was suffering from a “common bug” and was taking a course of antibiotics.
But the statement only fueled rumors. Common bugs don’t generally lead to such dramatic weight loss. Apple’s wildly implausible denial only gave credence to the idea that something was really wrong.
In a subsequent