Steve Jobs Had a Liver Transplant Two Months Ago 436
evw writes "The Wall Street Journal reports that Steve Jobs had a liver transplant two months ago (subscription required, alternative coverage is available based on the WSJ's report). He is on track to return to work at the end of June. 'William Hawkins, a doctor specializing in pancreatic and gastrointestinal surgery at Washington University in St. Louis, Mo., said that the type of slow-growing pancreatic tumor Mr. Jobs had will commonly metastasize in another organ during a patient's lifetime, and that the organ is usually the liver. ... Having the procedure done in Tennessee makes sense because its list of patients waiting for transplants is shorter than in many other states.' There are no residency requirements for transplants."
Re:How much (Score:2, Interesting)
How much did it cost? (Score:2, Interesting)
I know nobody has exact numbers but wish Mr. Jobs well. I wonder how much it cost though. Is the cost of such a procedure high to the extent that it would force an average family into bankruptcy? If bankruptcy is indeed a realistic possibility then I support some sort of government involvement in health care.
Why a liver transplant? (Score:4, Interesting)
Re:Proof / Evidence (Score:1, Interesting)
Stock and options traders start these rumors to make money on their short stock or long put positions. The upside for AAPL is pretty much bought out so there's just the down side to strike it rich.
I, for one, am monitoring Jobs' health and reading everything I can about Jobs' health. When the time comes, I'm loading up on out of the money puts and PRESTO - I'm rich. Then, I'll be able to afford that Mac Book Pro I've always wanted!
can Americans tell me.. (Score:3, Interesting)
..what happens there if you aren't insured for this treatment / not very rich? Are you just left to die?
Questionable standards for reporting by WSJ (Score:5, Interesting)
Immediately after the article was posted on their site, I wrote the writers and editors the following email:
Date: Sat, Jun 20, 2009 at 01:23
Subject: Questionable standards for reporting by Wall Street Journal journalists Kane, Lublin, and Meckler
To: Yukari Iwatani Kane , "Joann S. Lublin" , Laura Meckler
Cc: "Robert J. Thomson" , New York Times News Department
Dear Journalists of The Wall Street Journal,
The two articles referred to below, published June 20, 2009 on the website of The Wall Street Journal, state controversially without attribution that Apple Inc. CEO Steve Jobs received a liver transplant in Tennessee approximately two months ago:
Reported June 20, 2009 by Yukari Iwatani Kane and Joann S. Lublin, "Jobs Had Liver Transplant",
http://online.wsj.com/article/SB124546193182433491.html [wsj.com]
Reported June 20, 2009 by Laura Meckler, "Jobs's Transplant Highlights Differing Wait Times",
http://online.wsj.com/article/SB124546226305633529.html [wsj.com]
As journalists you are expected to seek reliable sources and to accompany reports of controversial facts with attribution. However, as Yukari Iwatani Kane and Joann S. Lublin state in the first article, "The specifics of Mr. Jobs's surgery couldn't be established." They further state explicit lack of verification of Job's putative surgery by spokespeople for each of the three hospitals in Tennessee designated as liver-transplant centers.
As of ten minutes ago I could find only the following two other online articles reporting on this topic. As their sources these articles cite only The Wall Street Journal, and at that as a secondary source:
Reported June 19, 2009 by MG Siegler, "Not Only Was Steve Jobs Sick. He Had A Liver Transplant",
http://www.techcrunch.com/2009/06/19/not-only-was-steve-jobs-sick-he-had-a-liver-transplant/ [techcrunch.com]
Reported June 19, 2009 by Peter Kavka, "Report: Steve Jobs Is Recovering From Liver Transplant, Still Coming Back to Apple",
http://mediamemo.allthingsd.com/20090619/report-steve-jobs-is-recovering-from-liver-transplant-still-coming-back-to-apple/ [allthingsd.com]
Do you have primary sources of this information? Have you checked and cross checked this information? If you have evidence, have you validated its authenticity? Do you have corroboration?
If so, please elaborate in your articles.
We need a cancer expert here, since... (Score:2, Interesting)
Surely suppressing the immune system for stopping transplant rejection = massive increase in cancer aggressiveness!
If this is true, then either steve's doctors are crazy, or the WSJ are telling porkies!
Re:Questionable standards for reporting by WSJ (Score:2, Interesting)
MOD PARENT UP!! this is very insightful and i appreciate your objectivity here. as of late main stream media has been _very_ lax in handling the information they receive. there is a huge lack of fact checking in a desperate attempt to compete with the internet and "news" sites. the profession of journalism needs to realise that by shirking thier responsibility to be accurate so they can break the news they are in effect breaking the prefession. if i find something on the internet i am smart enough to know it is of dubious certainty, when i go to a professional news outlet (Reuters, AP, BBC, NPR, CNN, hell even FOX news) i should be able to expect honest well verified journalism. lets not even get into yellow journalism, in the US the news is so slanted its a joke.
Re:We need a cancer expert here, since... (Score:3, Interesting)
I hope Jobs is gonna be OK. Hepatitis C is one of the major causes of liver cancer.
Just a reminder to all Apple users: don't forget to use protection when you go to the bathhouses.
Re:2 Months is very fast (Score:5, Interesting)
Living in Canada (where are you located), I disagree. The system does not provide best care and there should be a legal way to get extra care above what they normally provide if you pay the money.
Think about this: if a public hospital allows a person to stay only for a few days after a surgery, why shouldn't a person with means be able to leave that place and go to a private hospital that does not depend on the public resources and stay there for any amount of time that it takes this person to recover fully or until he even simply feels like it as long as he pays? In Ontario this is generally illegal, however what would be the difference between that and simply hiring a bunch of nurses/doctors to take care of you personally in your house even (except that doing it would be so expensive that only the richest people, someone exactly like Jobs could afford it?)
How is it even legal to prevent a professional to provide his/her services for the best payment if he wants that extra money? I am a software developer working on contracts, generally speaking I always search for the best deal I can get. Why should a doctor be denied opportunity to get the most money his abilities would allow him?
So the only argument against a fully private system would be this: if the government subsidizes education of some doctors, then it could demand that those, who were subsidized give back at least some of their time to the public system (say 30% minimum of their time would go to public system) Of-course there is a larger problem with government subsidizing any education system - it drives the education costs up, because universities know that government is there to provide loans, so whatever the costs of education are, anyone can just get this 'mortgage' to pay for it, so there is no incentive to make education any cheaper.
If the government stayed away from subsidizing education, the prices for it would go down and more people would be able to afford it in the first place. More doctors would graduate and that would drive their prices down so even a private health system could be affordable.
You can probably guess I one of those evil socialist types
- and I am not, as you can probably guess, I believe on economy my position is logical and yours is not. You would have a system that would be regulated, taxed and subsidized and would eventually collapse under its own bureaucratic cost.
Re:2 Months is very fast (Score:2, Interesting)
I don't know what kind of shape your dad was in before his transplant, but that's got to be a factor in recovery time. Aside from these specific health issues, Steve is probably in good physical condition.
Be glad your dad got one. I hope he's continuing to do well.
My dad died in '92 in a surgery designed to reroute blood flow around his ruined liver. We were told there was no way he was getting a transplant as a long-time alcoholic.
A few year later, in 1995, Mickey Mantle got a new liver. He too was an alcoholic, characterized as "recovering," and also had hepatitis C, but was a famous and beloved public figure. "Although the average wait time on the list to receive a liver in 1995 was three to four months, Mantle received his in a day."* Everyone involved claimed there was no favoritism, and still does. I don't believe it.
(The liver did Mantle no long-term good; he died of cancer two months later.)
So don't anyone think the rules apply to everyone equally. They don't. Money and fame talk.
(* - from http://www.miracosta.edu/home/lmoon/allocate.html [miracosta.edu], which frankly doesn't look like the best citation in the world, but I do remember it from news reports at the time. Wikipedia agrees about the alcoholism and hepatitis.)
Re:2 Months is very fast (Score:4, Interesting)
This Churchill quote seems appropriate right now: The inherent vice of capitalism is the unequal sharing of blessings; the inherent virtue of socialism is the equal sharing of miseries.
How about this one from Geza Hofi: "In capitalism, people exploit people. In socialism, it's the other way around."
And no need to guess about going abroad: Hungarian politicians haven't seen a Hungarian hospital from the inside since WW2.
Canadian system (Score:1, Interesting)
Think about this: if a public hospital allows a person to stay only for a few days after a surgery, why shouldn't a person with means be able to leave that place and go to a private hospital that does not depend on the public resources and stay there for any amount of time that it takes this person to recover fully or until he even simply feels like it as long as he pays?
This is allowed in Canada (I live in Ontario).
The main rule about health care in Canada is this: you cannot "double-dip". You either receive payments from the government (which in Canada's single-payer system are the provincial governments), or you receive payments from private parties, you cannot mix and match. Once you choose to join the provincial payment system you have to do all your billing that way. Each province handles the billing and payments, and there are generally agreements between the provinces, so you can use your Ontario health card in BC for payments, and the two provinces will work out payments between themselves.
All doctor offices are basically private businesses, and there are private clinics that do X-rays, MRIs, CT scan, etc. (in addition to public institutions who offer these services). So we have private businesses in the Canadian system, it's just we (generally speaking) have only one payer (the provincial government), so prices are set (after being negotiated).
The fact that there's only a single payer cuts overhead costs a lot since there's basically no billing paperwork, so a doctor (and hospitals, clinics, etc.) doesn't need a back-end staff to handle it.
Now, it's perfectly legal for you to have supplemental insurance if you want, but there are only certain places that have chosen to opt out of the public single-payer system. So if you have the means to pay for surgery at a "better" private hospital you can. If you want to have your surgery at public hospital, and then be transferred to a private one, you can as well.
Most people don't know these things because the public system is generally "good enough" (even if wait times can be a bit long) so they don't go looking at these details, and also because 95% of the population don't have the money to do these things so it's a moot point.
How is it even legal to prevent a professional to provide his/her services for the best payment if he wants that extra money?
When I joined by current employer my contract stated that I couldn't work for someone else (without first getting permission at least). If you receive payments from the government, you agree not to get payments from anywhere else. If you don't like it, don't sign up with them.
Now the system isn't perfect, but one thing I think should be avoided at all costs is something like the US system. If Canada is going to change, we should look at France or Germany or perhaps Switzerland. The US system is one giant cluster fuck.
Of-course there is a larger problem with government subsidizing any education system - it drives the education costs up, because universities know that government is there to provide loans, so whatever the costs of education are, anyone can just get this 'mortgage' to pay for it, so there is no incentive to make education any cheaper.
And that's why the "international tuition" fee for a high-end education like McGill or University of Toronto is $30,000 per year, but Harvard's or Standford's normal fee is something like $50,000? There are many reports of Americans coming to Canada to receive an "Ivey league" education because even the full price in Canada is cheaper than the price in the US.
Re:2 Months is very fast (Score:2, Interesting)
Re:Lets see what you have common in there. (Score:3, Interesting)
Re:We need a cancer expert here, since... (Score:3, Interesting)
Re:2 Months is very fast (Score:5, Interesting)
But when such a society treats the most despised better than they treat the most valued, what does that say about how they understand value? There are millions of disenfranchised working poor who cannot get medical treatment that prisoners in jail get simply by being incarcerated. If you can advance the constitutional rights of criminals, why is it that such arguments are not made for those who are financially imprisoned?
There is no conundrum here, you just aren't following things through to their logical conclusion.
The fact of the matter is that we value the working poor less than those who are imprisoned for their crimes.
The attitude seems to be that if you're imprisoned you have no choice in the matter. You cannot care for yourself. You cannot get your own healtchare. And someone has to take care of you. We feel obligated to those we've robbed of their ability to take care of themselves.
But if you're out of prison, and just plain poor, it's your own damn fault. You need to get a better job or invent something cool so you earn enough money to pay for your own healthcare. And if you can't manage that? Well, that's nobody's fault but your own...
The imprisoned might very well be valuable members of society as soon as we let them. The poor, obviously, aren't valuable members of society because they wouldn't be poor if they were.
What is this, E Entertainment? (Score:2, Interesting)
Re:2 Months is very fast (Score:4, Interesting)
Question: Why aren't you campaigning to get rid of the "socialized" fire service, "socialized" highways, and "socialized" police services you already have. Surely according to your line of thinking they will never work.
It's working well in Michigan...
Fire Service ... layoffs/closures ... disrepair/natural reclamation ... layoffs ... layoffs/closures ... sporadic shutdowns
Highways/Roads
Police
Education
Government
Well, at least they recognize that something is wrong, they just can't seem to figure out what it is.
Process of getting a liver transplant (Score:5, Interesting)
First, you need to have good medical care and good insurance. If your doctor has been carefully monitoring your liver with CT scans every six months because he realizes you're at risk (perhaps because you have Hep B), you will have a good chance at early detection of liver cancer. If you have no such proactive care, good luck!
Next, your doctor has to present you the option, you have to recognize its urgency, and you have to ask for the transplant, aggressively. If your doctor says, "This is not yet urgent", or "We can wait and monitor this", or if you say, "Can we just wait and see?", it might be too late by the time you recognize the danger (much like climate change and peak oil). That's because...
It takes 6 months to process a liver transplant application, then months to years to actually receive the transplant.
The application process has two parts: medical evaluation and financial means. The medical evaluation is a comprehensive evaluation to determine that you're a good candidate for transplant, that the cancer has not spread beyond the liver, and that you're psychologically fit for the transplant. The financial means evaluation... well, if you don't have the financial means, you do NOT get listed on the transplant list. Period. The only way to get a liver transplant without financial means is if you're an emergency case with sudden liver failure. Oh, you also need to have a designated caregiver who commits to taking time off work to take care if you, if/when necessary.
Once the application process starts, it can take 5 months to actually get on the transplant list. If the winter holidays occur fall in this time period, make that 6 months. If they accidentally list you on the non-cancer waiting list (with lower priority than the cancer waiting list), it might be another month (total 7 months) by the time somebody catches this mistake and it gets corrected. Most likely it will be YOU who catches the mistake, because nobody else is paying attention. If YOU fail to catch this error, the patient may be on the wrong (lower priority) waiting list indefinitely.
Once you're listed, it could take weeks to years to get the transplant. For non-cancer patients, the priority is determined strictly by a function of three blood test results: bilirubin, creatinine, and INR. As these levels go up, you develop ascites (fluid in abdomen), encephalopathy (cloudy mind), and then it gets worse. The problem is, you typically lose weight as you get sicker, and as you lose weight, the creatinine level goes DOWN, so your priority gets lower, initially! If you're lucky enough to be in Oregon or Florida, with no motorcycle helmet laws, you might get your transplant in a few months. If you're in Southern California or New York, you might be waiting a year or longer, progress to extreme illness and hospitalization, and be on the verge of death before getting the transplant. These are the patients who take 6 months to recover from the transplant. Often it takes days to weeks for the transplanted liver to start functioning. These patient have been IV fed for so long that the digestive tract is initially dysfunctional. They have to start with limited plain-cracker diets. Because their gut microbes have been ravaged, their gastric emissions are horrendous foul smelling.
If you're a liver cancer patient (like Jobs) the good thing is, you'll probably get your transplant sooner than the non-cancer patients, because liver cancer transplant priority goes up strictly by time on waiting list. "Sooner" is relative to when you got listed. If you trusted your Kaiser doctor and didn't sense any urgency, you probably didn't apply for the transplant until it was almost too late (there are limits are tumor size for transplant). If you are well-informed and proactively asked for a transplant application, you might get your transplant before you start to feel any symptoms of a dysfunctional liver. This is probably wha
Re:2 Months is very fast (Score:5, Interesting)
How does that work? (Bear in mind, I work in the healthcare insurance industry, so I know of what I speak). What amazes me is that people somehow think their insurance is this magical creature that makes money and pays these excesses/is a charity covering that cost.
That money is still coming out of you, you're just put on an indirect payment plan!
Imagine a more direct method of the same: "Well, your bill is $40. Or you can pay me $40/month for the next four months."
Some would have you believe that the latter is a good deal, because it means, in theory, if you're not denied coverage, rescinded for some real or implied reason, etc, etc, that when you go to the emergency room for a couple of days and come home with a bill equal to many people's annual salary, you reap the benefits of insurance, forgetting that without the implied acceptance of such high rates, your hospital stay wouldn't have cost anywhere near as much in the first place.
I used to work for a corporate law firm in Australia. They charged up to $600/hr for legal work, more when they went into court. Companies happily paid this, because legal expenses are tax deductible. The company knows they get to write it off, so the law firms can make a mint. When was the last time you heard of a law firm going bankrupt?
Doctors are being advised to invest in MRI, LASIK. Leaving aside the interesting side effect that doctors who own or own shares in an MRI machine/practice are up to 10% more likely to refer you for an MRI, this is a fantastic investment, because of people like you and me on insurance. You can pay $1, 1.5M for an MRI machine, and see your investment paid off within a year, quite easily, and then anything beyond that is a nice skim of upwards of $500,000 a year in profit. Why? Because we, the working stiff, are paying upwards of $1,800 for an hours worth of diagnostic procedure (and again, remember, "insurance" isn't paying it. You are. Insurance is just giving you a nice payment plan).
Re:2 Months is very fast (Score:3, Interesting)
You are plain wrong.
I'm from Spain, where we have "socialzied healthcare". Private medicine of course exists and many people, usually richers ones, have some sort of insurance. I'm covered by both of them, and I choose the national 'socialized' healthcare usually becouse they have more experience and treat more "hard" cases that the private companies. Sure, if you go to your private company's hospital you will get inmediate atention. In socialized healthcare systems you only get that kind of atention if you are experiencing a serious disease/illness.
Also, I've heard from people around that it is common in my 'socialized' healthcare system to move patients to other 'socialized' hospitals if the treatment or the doctors are better or are specialized in the problem that patients face. I have the right to change my doctor to other one, also, and I did change my regular doctor to the one the other members of my family go.
So, at the end... You go to a private healthcare company if you want preferential treatment for minor diseases. When you are really bad, you go to the national one. When I read comments like yours I just think in:
Re:2 Months is very fast (Score:3, Interesting)
Re:2 Months is very fast (Score:5, Interesting)
Well, first of all, I'm neither a doctor nor an economist. So you're going to have to take most of what I say with a grain of salt.
Second, I don't know how they do it, but plenty of nations manage national healthcare without falling apart. Take a look at Canada for an example, or France. They both managed to pull it off somehow. I'd assume we can do something similar...
I'm also not certain that a shortage of doctors would be any worse than what we have now. What we have now is a very uneven system in which millions of people go without any healthcare because they cannot afford it. If we instead had a system in which millions of people went without any healthcare because there weren't enough doctors I'd say we're at about the same point, not worse-off.
Supply and demand generally seems to take care of itself... Yes, there are various shortages here and there, but you don't see the world falling apart because there's some terrible dearth of postal workers. There's plenty of people flipping burgers... Plenty of people going to school for years only to get crap jobs in IT... I'm not convinced that all our doctors would suddenly disappear just because they didn't get paid as much.
But how's this for a solution: Free medical school.
Let anyone who passes the entrance exams go through medical school for free. Upon graduation they have to work for the state, at state-set prices/pay, for several years. Then they can go into practice for themselves.
Now you've got universal healthcare provided by the folks who're working off their tuition. And you've got plenty of doctors flooding the market because tuition is no longer a barrier to entry, only intelligence/capability. And after they've paid off their tuition they can still go into private practice and earn the big paychecks that they want - assuming they're providing something better than the universal healthcare that everyone can get for free.
Or you could do something similar with the state medical board certifications. You want to be certified to practice medicine in the state, you have to work for the state for a few years. Again you get rid of one of the barriers to entry... Again you retain the ability for doctors to make those fat paychecks you think are so important... And again you come up with free universal healthcare for the rest of us.
Re:2 Months is very fast (Score:2, Interesting)
Re:2 Months is very fast (Score:3, Interesting)
I think you should be modded up to 8 or 9...The conservative side of the healthcare debate has always been ludicrous. I supported it for about 10 years, then one day I actually thought about it. The healthcare system we have can not continue on the path it is on. Most Americans now have less choice than people in countries with socialized medicine. Don't think so? Sometime in the next year or two, your employer will move your prescription coverage to Medco..
Re:It is astounding .... (Score:3, Interesting)
Anyone who claims to have a "right" to healthcare does not actually believe in the constitution because the 13th amendment outlawed slavery. If you expect to enslave doctors and society in general for the simple reason that you got sick, then not only are you guaranteeing that the already heavily-socialized medical system will become even worse, but you also have no respect for real "human rights".
You, sir, are a moron. In developed countries, universal health care is not a right, but a public service, and we also have a separate tax category slapped on our income.
Tell me again, how is wanting to use a service I've been paying for all my carreer when I need it, "expecting slavery"?
Re:2 Months is very fast (Score:3, Interesting)
Besides that, I don't think it's a good idea to transplant a cancer patient, as the immunosupression in the first year is extremely heavy and would make every existent cancer spread, as there is no natural barrier to cancer cells anymore. The outcome is probably that his pancreatic cancer will spread even faster than before and this will reduce his life expectancy.
All this resumes in a not very ethical behavior on the doctors side, as cancer is normally a contraindication for any transplant. FYI, if you find a compatible donor, you can get a split liver transplant, so no waiting list at all. But then, money can make a lot of things happen...
Re:It is astounding .... (Score:3, Interesting)
Do you feel you have the right to have society offer you protection from others (i.e. police)? I would certainly hope so.
You're bringing rights and the constitution into this but it boils down to some things just shouldn't be for profit.
Wouldn't you think it's insane if your house was burning down and the fire dept wouldn't help you because you weren't up on your fire insurance payments?
You should have the right not only to your freedoms, but to have a society that will protect you from physical harm, and your home (as in a fire etc) or yes even your physical wellbeing regarding your health. I'm in Canada, I don't know how many times I've heard from friends in the US that they couldn't afford to go to the doctor over something. That is just insane. Yes Canada's system isn't perfect but as soon as you put a price on something you will end up with the have's and have not's. I'm willing to pay more for my taxes to not have such a situation, even though I could afford my own health care costs (currently I might add, who knows in the future).
Re:It is astounding .... (Score:3, Interesting)
]They evolved by the ones who were better able to survive wiping out the ones who were not.
Bunk. Please cite your sources, else it's just ideological prattle. It's just as easy to say that your ancestors prevailed because their language used clicks, which are better for hunting, and that they had better sex, and were better cooks. (All of which has some support in the evidence.)
Most of the world is perfectly happy to let other people carry the load for them.
The vast majority of the people in my community like to be productive, and as I travelled the world living and working like a local, discovered pretty much a universal pride in productivity, equating a variant on a work ethic with self worth.
You should probably change the company you keep.