My wife often tells me that there are different kinds of smart. No one would ever doubt that Apple CEO Steve Jobs, who died Oct. 5, was one of the most ingenious inventors in American history.
But if his intuitive creativity was beyond question, why did this computer wizard make decisions that were anything but smart concerning his own medical care? The neuroendocrine carcinoma of the pancreas that ultimately killed him was discovered in its early stages when, according to several oncologists, it may have been curable. Yet, according to Walter Isaacson’s biography of Jobs and a “60 Minutes” interview, he “refused cancer treatment that might have saved his life, finding the notion of surgery intrusive.
Instead, according to Isaacson, Jobs opted for a combination of diet, spiritualists and macrobiotics — “roots and vegetables” — and waited nine months to begin treatment in earnest. By then, Isaacson said, the cancer had spread from Jobs’ pancreas to the surrounding tissue. Jobs explained, “I didn’t want my body to be opened. ... I didn’t want to be violated in that way.” Isaacson concludes with the question: “How could such a smart man do such a stupid thing?”
Indeed, how could he? When more modern medical care can be given to prolong life, why do so many otherwise reasonable people eschew common sense and irrationally choose to be scammed by all things wacko, including homeopathy, naturopathy, chiropractic, acupuncture, reflexology, Psi and anything that flies in the face of reality.
Sometimes the gravitation to these things is understandable. On the other hand, sometimes it just makes me mad. For example, a multiple sclerosis patient I had not seen for over 10 years arrived in my office in a wheelchair. When she was healthy and ambulatory, she declined my recommendation to take proven therapy to slow her disease. Now she was asking for the same medicine, but it was too late. I feebly tried to console her, saying at least she didn’t spend thousands of dollars in the interim on medicine. Then she informed me of the more than $100,000 she spent on just such quackery, including bee stings, acupuncture, chiropractic and who knows what else. Medical therapy could not guarantee a good outcome in her, but it has been proved to make a difference, unlike anything she had done herself.
The science behind all these “alternative” treatments is dubious at best, full of biases and never adequately tested with blinded, placebo-controlled trials — the very rigorous standard required of medical treatments, especially those with cancer. The irony of it all is that when we can now do more for patients than ever before, many people want to believe in magical thinking.
Sometimes even the greatest creative minds need to be persuaded that some of their greatest achievements are built on foundations of prior knowledge, based on scientific method leading to right-thinking. Indeed, none of Jobs’ achievements would have been possible without the very scientific process that he ultimately rejected at the end of his own life.
Dr. Matthews W. Gwynn is director of the Stroke Center at Northside Hospital.
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