Joe Dicus

In October 2003, Steve Jobs was diagnosed with a neuroendocrine tumour of the pancreas. This is important context, because a neuroendocrine pancreatic tumour is not ordinary pancreatic cancer. Ordinary pancreatic cancer, adenocarcinoma, is among the most aggressive and lethal malignancies in medicine. Survival is typically measured in months. But a neuroendocrine tumour grows more slowly. It is localised. In 2003, caught at the stage Jobs' was caught, surgery offered a genuinely strong chance of a cure. His doctors told him to have surgery. He did not have surgery. Instead, for nine months, Jobs pursued a programme that included a vegan diet, fruit juices, acupuncture, herbal remedies sourced from the internet, a psychic, and a doctor who ran a clinic specialising in bowel cleansing and juice fasting. He had spent his adult life oscillating between extreme fruitarian diets and prolonged fasting. He had named his company after a fruit while on one of these diets. He had deep, sincere, lifelong convictions about the relationship between food and the body: convictions rooted in his Zen Buddhist practice and his early immersion in 1970s California wellness culture. Those convictions told him that the body, properly cleansed and nourished, would heal itself. That animal products were corrupting. That fruit and pure food were the path to a kind of internal purity that medicine could not offer. He waited nine months. By the time he had surgery, in July 2004, the tumour had spread to surrounding tissue. Walter Isaacson, his authorised biographer, who had dozens of hours of interviews with Jobs in his final years, records that Jobs talked about this decision frequently. With what Isaacson describes as a hint of regret. Jobs himself, in one of their conversations, said: "I really didn't want them to open up my body, so I tried to see if a few other things would work." He spent the rest of his life managing the spread. A liver transplant in 2009, which he obtained by registering in Tennessee, a state with shorter waiting lists, then flying to Memphis when a match became available. More dietary restrictions throughout, including after the transplant, when the standard of care for pancreatic surgery patients calls for frequent meals and a variety of proteins from meat, fish, and dairy: which Jobs refused. By Christmas 2010 he was 115 pounds. He died in October 2011 at 56. He was one of the most intelligent people of his generation. He was a lifelong adherent of a food philosophy that grew directly from the same California wellness culture that grew from the same Adventist and Kellogg-descended tradition that decided, in the 19th century, that plant food was purity and animal food was corruption. That philosophy told him, when it mattered most, that he should wait. He waited. The cost of that wait is unknowable in precise terms. His oncologists, when asked, said cautiously that they couldn't be certain the delay was fatal. Neuroendocrine tumours are variable. Some slow. Some fast. But the surgery that might have cured him was available in October 2003. He chose juice fasts instead. And then he spent eight years chasing the spread. The fruitarian diet that named Apple couldn't save the man who built it.