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Archive for October 21st, 2011

Steve Jobs’ medical reality distortion field

As I pointed out in my previous post about Steve Jobs, I’m a bit of an Apple fan boy. A housemate of mine got the very first Mac way back in 1984, and ever since I bought my first computer that was mine and mine alone back in 1991 (a Mac LC), I’ve used nothing but Macintosh computers, except when compelled to use Windows machines by work—and even then under protest. Indeed, as I searched for jobs at various times in my life, I asked myself whether I could accept a job at an institution that didn’t permit me to have a Mac in my office, such as the V.A. Fortunately, I never had to make that choice. All of this explains why I paid a lot of attention to Steve Jobs and also why his death saddened me and, relevant to this blog, the clinical history of the cancer that killed him fascinates me.

It’s often been said that there was a sort of “reality distortion field” around Steve Jobs. It was a part joking, part derogatory, part admiring term applied to Jobs’ talent for persuasion in which, through a combination of personal charisma, bravado, hyperbole, marketing, and persistence, Jobs was able to persuade almost anyone, even developers and engineers, of almost anything. In particular, it referred to his ability to convince so many people that each new Apple product was the greatest thing ever, even when that product had obvious flaws. Unfortunately, as more news comes out about how Steve Jobs initially dealt with his diagnosis of a neuroendocrine tumor of the pancreas (specifically, an insulinoma) back in 2003 and 2004, it’s become apparent that Jobs had his own medical reality distortion field, at least in the beginning right after his diagnosis of a rare form of pancreatic cancer, that allowed him to come to think that he might be able to reverse his cancer with diet plus various “alternative” modalities.

In the immediate aftermath of Steve Jobs’ death, I summarized the facts about Jobs’ case that were known at the time. In particular, I took issue with the claims of a skeptic that “alternative medicine killed Steve Jobs.” At the time, I pointed out that, although it was very clear that Steve Jobs did himself no favors by delaying his initial surgery for nine months after his initial diagnosis, we do not have sufficient information to know what his clinical situation was and therefore how much, if at all, he decreased his odds of survival by not undergoing surgery expeditiously. To recap: Did Steve Jobs harm himself by trying diet and alternative medicine first? Quite possibly. Did alternative medicine kill him? As I’ve argued before, that’s impossible to say, and any skeptic who dogmatically makes such an argument has taken what we known beyond what can be supported. Regular readers know that when I see a story that looks as though “alternative medicine” directly contributed to the death of someone, I usually pull no punches, but in this case I had a hard time being so definitive because the unknowns are too many, with all due respect to Ramzi Amri, a Research Associate at Harvard Medical School who in my opinion also went too far. I did, however, point out that I’m always open to changing my opinion if new evidence comes in. Jobs was always incredibly secretive about his medical condition, so much so that it didn’t even come out in the press until after it had happened that he had undergone a liver transplant in 2008 for metastatic insulinoma in his liver, just as his cancer diagnosis in 2003 remained secret for 9 months, not being revealed until he sent an e-mail to Apple employees announcing that he had undergone surgery.

It turns out that, with the imminent release of a major biography of Steve Jobs, more information is finally trickling out about his medical history. For instance, Jobs’ biographer Walter Isaacson is going to appear on 60 Minutes this Sunday, and apparently he is going to say this:
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Posted in: Cancer, Nutrition, Science and the Media

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Alternative Vaccination Schedules

Evidently the 7 billionth human is going to be born on October 31. Happy birthday and welcome to the Earth.  If you were unfortunate enough to be born into a developing country or a affluent California family, you may not receive your vaccinations, and may join one the 57 million who die each year of vaccine preventable diseases (VPD).

I totally misread the table.  It’s about 4,320,000 who die of VPD. Well, I said I was no damn good at stats.

And if you are doubly unlucky, you may be exposed to illness from an unvaccinated friend, family or health care worker before you can get your vaccines, and join the ranks of the ‘only’s.’  The ‘only’s’ are those who die of vaccine preventable diseases and are mentioned in anti-vaccine literature in a sentence like ‘VPD X is a mild illness in most children and only kills Y% of cases ’.  As I have said before the anti-vaxers do not care for whom the bell tolls.

I am no good at statistics.  I signed up for, and dropped, statistics at least 4 times in college.  Once they got past the bell shaped curve, it was one incomprehensible huh?  Part of the problem with statistical concepts such as risks, both relative and absolute, is that it is often impossible to get a feel from what they represent. For me it is like metric measurements.  I know what a 8 mile hike represents, but not an 8 kilometer hike.  Same with centigrade and liters.  I have been unable to internalize what metric means in my daily life. (more…)

Posted in: Vaccines

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