As I learn more about the death of Steve Jobs from a form of pancreatic cancer and the attempts he made to treat it, I think about how we all go about making decisions. Most of us, including this author, tend to fight or flee what we perceive as dangerous, threatening, or making us more vulnerable—however unfounded that perception might be. We create definitions of ourselves, place ourselves in limiting boxes of thoughts and beliefs, and then react by fighting or fleeing anything that questions those belief systems. One of my favorite quotations is by André Gide: “Follow those who seek the truth; avoid those who have found it.”
As much as I love that quote, the reality is that people who fight or flee their own insecurities by claiming they know the truth may in fact have some information that could be valuable to us. Let’s look at this more closely in the case of Steve Jobs, as I feel all of us can learn from it, especially when it comes to medical care—both preventive and therapeutic.
In Jobs’s authorized biography, we learn about his reactions to learning he had pancreatic cancer. Jobs had spent time studying Buddhism in India, and he felt it served him in his work. “The main thing I’ve learned,” he said, “is intuition—that the people in India are not just pure rational thinkers, that the great spiritual ones also have an intuition.” In a report recently broadcast on “60 Minutes,” CBS News says that Jobs refused surgery after his diagnosis and for nine months after, favoring instead dietary treatments and other alternative methods. Interviewed on the 60 Minutes program, his biographer, Walter Isaacson, said that when he asked Jobs why he had resisted it, Jobs said “I didn’t want my body to be opened…I didn’t want to be violated in that way.” His early resistance to surgery was apparently incomprehensible to his wife and close friends, who continually urged him to do it.
But there seemed to be more to his resistance than just fear of surgery. “I think that he kind of felt that if you ignore something,” Isaacson told CBS, “if you don’t want something to exist, you can have magical thinking. And it had worked for him in the past.”
Another element of Jobs’ decision-making process was, according to Isaacson, his trust of his own instinct. But what of this instinct? To me, it appears that Jobs feared more putting his life in the hands of doctors who implicitly claim to “have found the truth” than he feared pancreatic cancer itself. Maybe he also feared the possibility that his intuition may not have been as reliable as he liked to think. Through Buddhism, Jobs was a seeker of truth. When, despite his belief in the intangible power of the human mind, he got pancreatic cancer, I can only imagine he dug his heels in deeper. He probably fought and fled the rational, practical, empirical world of science and medicine—and the self-proclaimed holders of truth.
As intelligent as Jobs believed himself to be, at that time when it came to making his decision, he did what most of us do when making decisions—he relied on his ever-present primitive automatic brain. Instead of stepping back and reflecting, he unknowingly fled the “danger” of considering what his doctors recommended.
Being a doctor who would not have judged Jobs’s beliefs (and might share many of them myself), I still think Jobs could have received better counsel. To be sure, his doctors either to his face or behind his back, considered him a lunatic and rejected alternative approaches, relying on “tried and true” conventional medicine. If someone had only sat down with Jobs and explained it like this, I believe he would have elected early surgery, which could very well have cured his early-stage, slow-growing form of pancreatic cancer:
“Steve,” a wise counselor might have said, “you have a growth in your body. It got there somehow. Neither you nor I know how it got there. You may speculate that it was from toxins in your system or the environment, or the result of your stress and hard work. But the bottom line is that we don’t know what caused this abnormal growth, and whatever has caused this has allowed cells to grow to a point where they will not stop unless something drastic is done.
“I will be with you from start to finish,” the wise counselor would have continued. “I will help you develop visualizations and meditations to make the process non-threatening. Once you remove what does not belong in your body, let’s implement some of your beliefs. Listening to these doctors now does not invalidate your beliefs. If the other doctors recommend further treatment down the road, like chemotherapy, we will address that later and, with my help, you will determine if it is right for you.
“I know that other doctors are skeptical of your beliefs, but I’m not. Try not to let your fear of giving into the ‘finders of truth’ cloud your judgment of what is the best treatment for you. Steve, if your mother told you to wear a raincoat everyday because it might rain someday, what would happen if you never wore one simply to avoid being told what to do? Right—you would eventually get soaked. You decide when you are going to wear that raincoat, Steve.
Jobs’s wise counselor might have concluded: “Steve, don’t decide against surgery just because you know that the surgeons don’t believe in what you do and may even be hostile to it. Make the decision that is right for you. Let them remove from your body what does not belong and what has become too big for your body to remove on its own. Make that mindful decision and then move on from there with further mindful approaches. Don’t let your fear guide you, because it will NEVER lead you to what is right for you. “
My words would be the same to any patient.
We all have our own beliefs. Those who have “found the truth” often dismiss the seekers as magical thinkers. But seekers must not use their hostility toward the “finders” as an excuse to fight and flee any of their suggestions. As we seek our personal truth, it likely will intersect with aspects of others’ truths, even those of the “know-it-alls”. Don’t discount ideas simply because they seem at odds with your cherished belief system.
If you are skeptical of the medical establishment, doctors, or conventional medicine, join the club. There is much ammunition for your doubts. However, the same can be said about alternative therapies. The truth is, there are incredible therapies available to you within both, and the wise approach is to consider all ideas, and determine the best approach, or combination of approaches, for you.
I wish Steve Jobs had realized that.
Charles Glassman, MD, FACP