[ebook4everything.com]Steve Jobs - Isaacson_ Walter

health leave, in 2011.

Some at Apple didn’t believe the quotes attributed to York were accurate, since he had not officially raised objections at the time. But Bill Campbell knew that the reports rang true; York had complained to him in early 2009. “Jerry had a little more white wine than he should have late at night, and he would call at two or three in the morning and say, ‘What the fuck, I’m not buying that shit about his health, we’ve got to make sure.’ And then I’d call him the next morning and he’d say, ‘Oh fine, no problem.’ So on some of those evenings, I’m sure he got raggy and talked to reporters.”

Memphis

The head of Jobs’s oncology team was Stanford University’s George Fisher, a leading researcher on gastrointestinal and colorectal cancers. He had been warning Jobs for months that he might have to consider a liver transplant, but that was the type of information that Jobs resisted processing. Powell was glad that Fisher kept raising the possibility, because she knew it would take repeated proddings to get her husband to consider the idea.

He finally became convinced in January 2009, just after he claimed his “hormonal imbalance” could be treated easily. But there was a problem. He was put on the wait list for a liver transplant in California, but it became clear he would never get one there in time. The number of available

donors with his blood type was small. Also, the metrics used by the United Network for Organ Sharing, which establishes policies in the United States, favored those suffering from cirrhosis and hepatitis over cancer patients.

There is no legal way for a patient, even one as wealthy as Jobs, to jump the queue, and he didn’t. Recipients are chosen based on their MELD score (Model for End-Stage Liver Disease), which uses lab tests of hormone levels to determine how urgently a transplant is needed, and on the length of time they have been waiting. Every donation is closely audited, data are available on public websites (optn.transplant.hrsa.gov/), and you can monitor your status on the wait list at any time.

Powell became the troller of the organ-donation websites, checking in every night to see how many were on the wait lists, what their MELD scores were, and how long they had been on. “You can do the math, which I did, and it would have been way past June before he got a liver in California, and the doctors felt that his liver would give out in about April,” she recalled. So she started asking questions and discovered that it was permissible to be on the list in two different states at the same time, which is something that about 3% of potential recipients do. Such multiple listing is not discouraged by policy, even though critics say it favors the rich, but it is difficult. There were two major requirements: The potential recipient had to be able to get to the chosen hospital within eight hours, which Jobs could do thanks to his plane, and the doctors from that hospital had to evaluate the patient in person before adding

him or her to the list.

George Riley, the San Francisco lawyer who often served as Apple’s outside counsel, was a caring Tennessee gentleman, and he had become close to Jobs. His parents had both been doctors at Methodist University Hospital in Memphis, he was born there, and he was a friend of James Eason, who ran the transplant institute there. Eason’s unit was one of the best and busiest in the nation; in 2008 he and his team did 121 liver transplants. He had no problem allowing people from elsewhere to multiple-list in Memphis. “It’s not gaming the system,” he said. “It’s people choosing where they want their health care. Some people would leave Tennessee to go to California or somewhere else to seek treatment. Now we have people coming from California to Tennessee.” Riley arranged for Eason to fly to Palo Alto and conduct the required evaluation there.

By late February 2009 Jobs had secured a place on the Tennessee list (as well as the one in California), and the nervous waiting began. He was declining rapidly by the first week in March, and the waiting time was projected to be twenty-one days. “It was dreadful,” Powell recalled. “It didn’t look like we would make it in time.” Every day became more excruciating. He moved up to third on the list by midMarch, then second, and finally first. But then days went by. The awful reality was that upcoming events like St. Patrick’s Day and March Madness (Memphis was in the 2009 tournament and was a regional site) offered a greater likelihood of getting a donor because the drinking causes a

spike in car accidents.

Indeed, on the weekend of March 21, 2009, a young man in his midtwenties was killed in a car crash, and his organs were made available. Jobs and his wife flew to Memphis, where they landed just before 4 a.m. and were met by Eason. A car was waiting on the tarmac, and everything was staged so that the admitting paperwork was done as they rushed to the hospital.

The transplant was a success, but not reassuring. When the doctors took out his liver, they found spots on the peritoneum, the thin membrane that surrounds internal organs. In addition, there were tumors throughout the liver, which meant it was likely that the cancer had migrated elsewhere as well. It had apparently mutated and grown quickly. They took samples and did more genetic mapping.

A few days later they needed to perform another procedure. Jobs insisted against all advice they not pump out his stomach, and when they sedated him, he aspirated some of the contents into his lungs and developed pneumonia. At that point they thought he might die. As he described it later:

I almost died because in this routine procedure they blew it. Laurene was there and they flew my children in, because they did not think I would make it through the night. Reed was looking at colleges with one of Laurene’s brothers. We had a private plane pick him up near Dartmouth and tell them what was going on. A plane also picked up the girls. They

thought it might be the last chance they had to see me conscious. But I made it.

Powell took charge of overseeing the treatment, staying in the hospital room all day and watching each of the monitors vigilantly. “Laurene was a beautiful tiger protecting him,” recalled Jony Ive, who came as soon as Jobs could receive visitors. Her mother and three brothers came down at various times to keep her company. Jobs’s sister Mona Simpson also hovered protectively. She and George Riley were the only people Jobs would allow to fill in for Powell at his bedside. “Laurene’s family helped us take care of the kids—her mom and brothers were great,” Jobs later said. “I was very fragile and not cooperative. But an experience like that binds you together in a deep way.”

Powell came every day at 7 a.m. and gathered the relevant data, which she put on a spreadsheet. “It was very complicated because there were a lot of different things going on,” she recalled. When James Eason and his team of doctors arrived at 9 a.m., she would have a meeting with them to coordinate all aspects of Jobs’s treatment. At 9 p.m., before she left, she would prepare a report on how each of the vital signs and other measurements were trending, along with a set of questions she wanted answered the next day. “It allowed me to engage my brain and stay focused,” she recalled.

Eason did what no one at Stanford had fully done: take charge of all aspects of the medical care. Since he ran the facility, he could coordinate the transplant recovery, cancer

tests, pain treatments, nutrition, rehabilitation, and nursing. He would even stop at the convenience store to get the energy drinks Jobs liked.

Two of the nurses were from tiny towns in Mississippi, and they became Jobs’s favorites. They were solid family women and not intimidated by him. Eason arranged for them to be assigned only to Jobs. “To manage Steve, you have to be persistent,” recalled Tim Cook. “Eason managed Steve and forced him to do things that no one else could, things that were good for him that may not have been pleasant.”

Despite all the coddling, Jobs at times almost went crazy. He chafed at not being in control, and he sometimes hallucinated or became angry. Even when he was barely conscious, his strong personality came through. At one point the pulmonologist tried to put a mask over his face when he was deeply sedated. Jobs ripped it off and mumbled that he hated the design and refused to wear it. Though barely able to speak, he ordered them to bring five different options for the mask and he would pick a design he liked. The doctors looked at Powell, puzzled. She was finally able to distract him so they could put on the mask. He also hated the oxygen monitor they put on his finger. He told them it was ugly and too complex. He suggested ways it could be designed more simply. “He was very attuned to every nuance of the environment and objects around him, and that drained him,” Powell recalled.

One day, when he was still floating in and out of consciousness, Powell’s close friend Kathryn Smith came

to visit. Her relationship with Jobs had not always been the best, but Powell insisted that she come by the bedside. He motioned her over, signaled for a pad and pen, and wrote, “I want my iPhone.” Smith took it off the dresser and brought it to him. Taking her hand, he showed her the “swipe to open” function and made her play with the menus.

Jobs’s relationship with Lisa Brennan-Jobs, his daughter with Chrisann, had frayed. She had graduated from Harvard, moved to New York City, and rarely communicated with her father. But she flew down to Memphis twice, and he appreciated it. “It meant a lot to me that she would do that,” he recalled. Unfortunately he didn’t tell her at the time. Many of the people around Jobs found Lisa could be as demanding as her father, but Powell welcomed her and tried to get her involved. It was a relationship she wanted to restore.

As Jobs got better, much of his feisty personality returned. He still had his bile ducts. “When he started to recover, he passed quickly through the phase of gratitude, and went right back into the mode of being grumpy and in charge,” Kat Smith recalled. “We were all wondering if he was going to come out of this with a kinder perspective, but he didn’t.”

He also remained a finicky eater, which was more of a problem than ever. He would eat only fruit smoothies, and he would demand that seven or eight of them be lined up so he could find an option that might satisfy him. He would touch the spoon to his mouth for a tiny taste and pronounce, “That’s no good. That one’s no good either.” Finally Eason

pushed back. “You know, this isn’t a matter of taste,” he lectured. “Stop thinking of this as food. Start thinking of it as medicine.”

Jobs’s mood buoyed when he was able to have visitors from Apple. Tim Cook came down regularly and filled him in on the progress of new products. “You could see him brighten every time the talk turned to Apple,” Cook said. “It was like the light turned on.” He loved the company deeply, and he seemed to live for the prospect of returning. Details would energize him. When Cook described a new model of the iPhone, Jobs spent the next hour discussing not only what to call it—they agreed on iPhone 3GS—but also the size and font of the “GS,” including whether the letters should be capitalized (yes) and italicized (no).

One day Riley arranged a surprise after-hours visit to Sun Studio, the redbrick shrine where Elvis, Johnny Cash, B.B. King, and many other rock-and-roll pioneers recorded. They were given a private tour and a history lecture by one of the young staffers, who sat with Jobs on the cigarettescarred bench that Jerry Lee Lewis used. Jobs was arguably the most influential person in the music industry at the time, but the kid didn’t recognize him in his emaciated state. As they were leaving, Jobs told Riley, “That kid was really smart. We should hire him for iTunes.” So Riley called Eddy Cue, who flew the boy out to California for an interview and ended up hiring him to help build the early R&B and rock-and-roll sections of iTunes. When Riley went back to see his friends at Sun Studio later, they said that it proved, as their slogan said, that your dreams can still

come true at Sun Studio.

Return

At the end of May 2009 Jobs flew back from Memphis on his jet with his wife and sister. They were met at the San Jose airfield by Tim Cook and Jony Ive, who came aboard as soon as the plane landed. “You could see in his eyes his excitement at being back,” Cook recalled. “He had fight in him and was raring to go.” Powell pulled out a bottle of sparkling apple cider and toasted her husband, and everyone embraced.

Ive was emotionally drained. He drove to Jobs’s house from the airport and told him how hard it had been to keep things going while he was away. He also complained about the stories saying that Apple’s innovation depended on Jobs and would disappear if he didn’t return. “I’m really hurt,” Ive told him. He felt “devastated,” he said, and underappreciated.

Jobs was likewise in a dark mental state after his return to Palo Alto. He was coming to grips with the thought that he might not be indispensable to the company. Apple stock had fared well while he was away, going from $82 when he announced his leave in January 2009 to $140 when he returned at the end of May. On one conference call with analysts shortly after Jobs went on leave, Cook departed from his unemotional style to give a rousing declaration of why Apple would continue to soar even with Jobs absent:

We believe that we are on the face of the earth to make great products, and that’s not changing. We are constantly focusing on innovating. We believe in the simple not the complex. We believe that we need to own and control the primary technologies behind the products that we make, and participate only in markets where we can make a significant contribution. We believe in saying no to thousands of projects, so that we can really focus on the few that are truly important and meaningful to us. We believe in deep collaboration and cross-pollination of our groups, which allow us to innovate in a way that others cannot. And frankly, we don’t settle for anything less than excellence in every group in the company, and we have the self-honesty to admit when we’re wrong and the courage to change. And I think, regardless of who is in what job, those values are so embedded in this company that Apple will do extremely well.

It sounded like something Jobs would say (and had said), but the press dubbed it “the Cook doctrine.” Jobs was rankled and deeply depressed, especially about the last line. He didn’t know whether to be proud or hurt that it might be true. There was talk that he might step aside and become chairman rather than CEO. That made him all the more motivated to get out of his bed, overcome the pain, and start taking his restorative long walks again.

A board meeting was scheduled a few days after he