Out of Jobs
With each passing year, my high intermediate French takes another step towards theory and listening to French Radio on the ride to and from work each day is not exactly Rosetta Stone. So when I heard Thursday evening on Radio Paris that Steven Jobs was “mort” the true meaning of the news did not hit me. Instead, I turned up the volume thinking to feed my I-Phone in Liberia dreams.
I thought that the new I-Phone must be pretty damn good because the story began talking about the biography of Steven Jobs. I got both excited and bitter because I have been eligible for an upgrade since August but just missed the product release by 3 days, electing instead to board the 20 hour 3-stop Delta Air trip back to Monrovia (honey moons do end). The story then turned to discussion of “cancer pancreatic”. All physicians know that pancreatic cancer is a death sentence. The organ is located deep in the abdominal cavity and by the time cancer of the bulbous organ is discovered, it has already spread. The death is particularly painful because out of control, the pancreatic enzymes responsible for digestion literally dissolve you from the inside out. The disease is so impossible to beat that disease survival is only counted up to five years. In other words, patients with pancreatic cancer make it to five years and the medical establishment considers them cured.
The discussion of Job’s cancer made me want the I-Phone 4S or 5 or whatever it is called, that much more. I mean comparing an object to a man’s ability to triumph over an impossible disease? What could this phone do? Could it project a keyboard onto a table on which users could type? Never mind voice commands, could the thing actually emote? All I wanted before was a more accurate and able GPS system that didn’t consistently place my car in the ocean or risk me crashing because of an inability to talk.
Boys in Bangga surfing the internet for the first time.
But then the radio program started charting the progression of Apple products. Starting with the green screen computer with static erasing thing-a-ma-jig under the keyboard to run your fingers so you didn’t erase the hard drive, it then talked about the box shaped Macintosh 128, which accepted hard discs with a THUNK. Then the NEXt Computer, which Jobs marketed when he was fired from Apple. Then the various I-pods, lap and hard tops and I-phones he helped develop on his glorious return. This was beginning to sound like a eulogy! When I got back home, I waited the usual five minutes for my external drive to boot up to the New York Times news front page. On the cover were tens of Apple I-Pad users with the candle application activated holding up their machines to the sky like they were at a Grateful Dead Concert. I normally would have thought, “What geeks!” but instead thought, “Steve Jobs is dead?”
The next day, every newspaper in the world filled their pages with article upon article of a man who transformed the world. The details that stuck with me was the fact that Jobs was an exacting manager who was occasionally cruel, how he recruited his first partner from a soft drink company with the line, you want to work for a company that sells sweetened beverages or one whose projects can change the world, and how he promised to step down from Apple if the time came when he could not perform his duties of CEO to the standard he promised consumers, which he did. I started thinking about the mark we all try to make in this world, the opportunity costs of our efforts and what that mark actually turns out to be. No doubt Jobs forever changed the world. He made communicating via the computer and phone easy and beautiful. More people pour over his computers and phones than ever. When I work at the hospital, I cross check all my diagnoses and treatments with clinical databases on my I-phone to avoid mistakes. When a baby comes in with tetanus, I videotape its seizures to show my students as a starting point for training them what to do.
But my Dad spends more time communicating with his Mac-Pro than my Mom. And people in public now instead of risking person-to-person interaction, act as if they are really popular by reading fake emails on their smart phones. People text each other exactly because they don’t want to talk. And what does it mean that in producing these delectable gadgets, Steve Jobs was a dick?
Jobs' death coincided with that of our IRC-Liberia housekeeper, Nelly, and incidentally that of at least ten other patients from the seven hospitals we run. As for Nelly, she came into my office last August complaining of stomach pain and a bump in her pelvic region that turned out to be a cancerous ovary. When Nelly showed me the bump, she did so suddenly, hiking up her skirt as if we were young children showing each other our belly buttons. I didn’t have time to be prudish, nor to close the door, nor did Nelly. The mass was hard and the size of my fist. Nelly groaned even when I wasn’t touching her, “Will,” she said, “It hurts so much. It hurts so much. Please help me, Will”
There was much debate about what to do with Nelly. Her cancer was probably treatable in the states but it would take a lot of money and connections to get her there. Money and connections that weren’t her own. We could import chemotherapeutic drugs, but administering chemotherapy in a country with only rudimentary nursing care and hospital facilities would kill her (faster). There was a CT scanner in Ghana, a short one and a half hour plane ride away, but what was the use of staging a cancer if you couldn’t do anything about it. And didn’t we know it was stage IV? A hard fixed mass. Weight loss of 30 pounds in a month. Nelly could no longer perform her cleaning duties. She needed to stop working which was hard for her but she told us and we knew this was true.
We went for the shotgun approach. We contacted an organization in Minnesota, which could take on Liberians requiring medical care. We asked Nelly if she wanted this and would require help acquiring a U.S. visa, which she said she did. We got her on stool softeners and pain control medicines from our organization’s drug stores, which only kind of worked though Nelly was appreciative. We asked Nelly to have a frank conversation with her family about her sickness and the need to prepare for both best and worst. I didn’t know Nelly well so at first all of this was a major pain and inconvenience for me. My primary job at IRC is not as a physician but as manager. I am a pediatrician not an oncologist/gynecologist. I kick my patients out of the office after they turn twenty-one, or break my exam table, or cringe at my office's interior design. But seeing Nelly’s interact with her children made me realize both my selfishness and her importance: Their concern and tears for their mother when they heard she had cancer even though they didn't know exactly what this was; the way they held Nelly's head in their laps when she became tired during car rides to the hospital and stroked her hair; Nelly's desire to constantly protect her children from the pain she was feeling but wanting to share this information too.
Shortly after construction of the master plan, the cancer blocked Nelly’s intestines causing her stomach to swell and for her to get really sick. Before we could get her more comfortable and come up with a plan B, her intestines burst, causing her to go into shock then to have a heart attack. Just the day before Nelly had come into my office after a blood transfusion, to tell he how well she felt. She smiled and gave me a high five and said, “Thank you Will,”
“Thanks Nelly,” I said, "call me Wilson."
"Okay, Will," she said.
Family
