Steve Jobs: The sickest patient on the waiting list
After three days of ducking the press — and telling the Wall Street Journal that Steve Jobs was not listed as a patient there — Methodist University Hospital in Memphis finally admitted Tuesday that Jobs did in fact receive a new liver at their transplant facility.
It the process, the faith-based hospital revealed more than we knew about just how sick Apple's (AAPL) CEOÂ had been.
With Jobs' permission, Methodist's chief transplant surgeon, Dr. James Eason, issued a four paragraph statement designed to counter the impression — apparently widespread — that Jobs had jumped to the top of the transplant waiting list on the strength of his wealth and celebrity.
Judging from our comment stream, most readers believe Jobs' new liver should have gone to someone who had been waiting longer, needed it more or had a better chance of survival.
Eason flatly denies that. His statement reads, in part:
"Mr. Jobs underwent a complete transplant evaluation and was listed for transplantation for an approved indication in accordance with the Transplant Institute policies and United Network for Organ Sharing (UNOS) policies.
"He received a liver transplant because he was the patient with the highest MELD score (Model for End-Stage Liver Disease) of his blood type and, therefore, the sickest patient on the waiting list at the time a donor organ became available. Mr. Jobs is now recovering well and has an excellent prognosis."
This is revealing.
MELD is the numerical measure used by transplant centers to assess the severity of chronic liver disease. It was developed to predict the odds that a patient will die within three months based on a scoring system that ranges from less than 10 (4% mortality) to 40 or more (100% mortality).
The MELD algorithm takes values from the patient's blood and urine tests and spits out an answer. In a hospital's computer, it looks like this:
Where
- INR, or international normalized ratio for prothrombin time, is a measure of how fast the patient's blood clots
- Bilirubin levels tell doctors how well the patient's liver is functioning
- Creatinine levels provide a measure of the patient's kidney function
- Dialysis treatments, which do the work of the kidneys, affect creatinine readings
We don't know whether Steve Jobs was getting dialysis twice a week, but if his MELD score was higher than every other liver transplant candidate with his blood type in Tennessee — which has a relatively short waiting list but still averages 48 days — he was very sick indeed.
Jobs had a cancerous tumor removed from his pancreas in 2004 and went on a medical leave January to deal with continuing health issues that he initially described as an easily treated hormone imbalance.
Although he was spotted on Apple's Cupertino, Calif., campus Monday, his spokespeople continue to say only that Jobs looks forward to returning to Apple at the end of June.
See also:
In the current organ allocation system, based on MELD, you can't "jump the system". Your blood tests go into the computer, a score is calculated, and the system offers the liver to the highest score. No person or center can manipulate this, period.
Africa. To be frank, Steve Jobs and people like him are to thank for technological revolutions and competitiveness in the commercial revolutions of this world. There is absolutely no reason why he should not be preferred over and above some doddering idiot who has contributed little but weather complaints to the world. Good on him, and bugger the totterers sitting at home waiting to clock out because all they did was sit on their butt the most of their life. And are still sitting on it, but now have a more immediate means of complaining about life, through the internet. Thank you too, and all around, Stever Jobbs, good on your new liver. Live well, and enjoy it, no doubt you deserve it. And thank you to all the contributions the technology you have given to this world have given to Africa, and to charities in general.
I admire the man for who he is, what he's done for the world & wish nothing but good for him. Suffering with liver disease myself I'm curious to know what Mr. Jobs MELD score was at time of transplant.
My Bad! I apologize!
The author did not suggest that Steve "jumped the list". His point is that Steve was the sickest patient on the list for the MUH Transplant Center the day the donor organ was available.
David
ex ped: No problem. Thanks for the clarification.
Elmer,
What this reveals is that you can't count:
Do the math:
150 day medical leave minus
48 day waiting period leaves
102 days prepping for and recovering from the liver transplant process.
Now, Apple said that he had the transplant "about two months" before his return. So that means he had about 42 days "unaccounted for" before the transplant, so he could actually have been on the list for 90 days before he got the transplant.
Once again you twist things your own way and make all things Apple doom and gloom.
David
ex ped: Not sure what you think I was twisting or for what purpose, David, but for the record, Apple has said nothing about when he had a transplant — or even that he had one.
"Steve used to park in handicapped parking spaces and ignore to law."
Me too. I hated those handicapped folks, acting like they are better than everyone else.
I think it is high time folks started standing up for norms rights. I tell you, if a guy in a wheelchair looks at me funny, like "I'm better than you.", I'm gonna kick him down the stairs.
If you wish to donate your organs, the most important thing to do is to inform your family of your wishes.
This is because in the event of a death, the family makes the final decision even if an individual has been listed on a state registry.
Often grieving families are in shock, and need time to think about this decision if they have not discussed it earlier. While many families ultimately decide to donate organs, this decision sometimes comes too late for the organs to be useful.
Those of us who work in the organ donation and transplantation field would encourage you to actively ignore posts from donottransplant.com, David Undis or Lifesharers. They have too much time on their hands and too little knowledge. Lifesharers is an "organ donor club" claiming to offer preferential access to organs for their members, something that will never happen. Both Lifesharers and donottransplant.com promote fear as a motivation to register as an organ donor. If they were really interested in increasing donation, they would encourage Americans to go to http://www.donatelife.net to find out how they can join their state registry. More than 82 million Americans have registered, not because they are afraid, but because they want to help people.
If he was anywhere near as sick as the hospital asserts, he is still in trouble, as systemic poisioning from liver failure affect the whole body. I wish him better health and long life and thank him for giving the world such useful products.
How Apple manipulates news of him is another matter. The announcement of his surgery came the day after the expiration of June options on Apple stock, which would have rocked uopward in value if the news had been announced earlier, causing a drop in the price of Apple stock. Fortunately I was only paper trading the puts…
Jobs played the system fair and square like everybody else who values their life. Who out there wouldn't do the same thing under the same circumstances? You're lying to yourself if you think you're any different.
It appears from the comments that Elmer-DeWitt's piece on Steve Jobs — and his "reality distortion field" — was taken out of context. There is no schadenfreude or ill will upon Steve Jobs in the piece. Jobs is buying time, obviously: He has a child under 10, as well as a company in which he is star-in-chief. No matter how you spin it, his medical condition is a ghastly ordeal and fate. My take on Elmer-Dewitt's piece is that there seems to be one set of rules and regulations for most public companies and another set for Steve Jobs and his Apple, be it the manipulation of stock options, or the sleight of hand around veritable disclosure of Jobs' health status. To wit, the prima donna flip-flopping disclosures, the outbursts, and the outright contempt for the public by a public company and its unimpeachable Numero Uno: there seems to be an 'imbalance.'
Steve used to park in handicapped parking spaces and ignore to law.
Do you think he jumped the line.
Your guess is good as mine.
Only those directly involved will know but judging from his personality in the past we can surmise what might have happened.
There's one question that nobody seems to be asking about Steve Jobs and his liver transplant: was Steve Jobs a registered organ donor?
It's not fair to give an organ to a non-donor as long as there is a donor who needs it. But about 50% of the organs transplanted in the United States go to people who haven't agreed to donate their own organs when they die. It's no wonder there's such a large organ shortage. If organs were allocated first to organ donors, more people would agree to donate and fewer people would die waiting for transplants.
Anyone who would like to donate their organs to other organ donors can join LifeSharers at http://www.lifesharers.org or by calling 1-888-ORGAN88. Membership is free. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition.
The media keeps saying that investors need to know about Steve Jobs. I'm an investor. I would think that most investors know that he has been ill. It's probably easy enough to tell with his weight loss. Most investors know he had pancreatic cancer. I'm just not exactly sure what they want Apple to disclose about Steve Jobs. Exactly how sick he is? How he feels on a day-to-day basis.
To me, it seems like these so-called investors want to know the exact time he is going to die and I don't think anyone can give that sort of answer. Any investor can sell their shares anytime they'd like if they believe Apple is lying to them. Maybe these investors shouldn't even bother investing in Apple. It's really amazing how they feel they have the right to dig into the business of a sick man.
So now he has a transplant and it's known and still the complaints keep rolling in. If he had said he was waiting for a transplant, investors would start bailing and then when he got the transplant, investors would start buying again? Now that he has the transplant and doctors say he is doing well, investors are still upset. I just don't understand why Steve Jobs should be under such scrutiny. The company is doing well and that should be more than enough. These investors seem to be playing Apple on Steve's longevity or something. It just seems rather silly to me since there are no guarantees on a human lifespan.
I personally don't think it's the investors who need a day-by-day update on Steve, but a bunch of meddlesome people who have lots of spare time on their hands and no real life of their own.
This is so overblown. My cousin is now 60. In the past 15 years he has had two liver transplants. He isn't famous. He was just that sick. Thankfully, there were two people in this world who were thinking of others at the time of their death and gave him life. What is wrong with everyone these days? Can't you just be happy a guy is doing better now through the miracles of modern medicine and perhaps think, "hey, maybe I can donate my own organs when I die and save another life."
So many evil spirited people here.
You know who you are. You were the ones who WERE happy when Jobs was obviously sick. You were the ones who were hoping Jobs will die. Don't tell me you didn't.
Now, he got a transplant because he was dying, and you came here and complain.
Surprisingly, this is not a reflection about Steve Jobs. It is about you. It shows how you lived your life. How you were unhappy about everything, and how you will continue to hate everything.
Last time I was sick and needed to go the ER, I called my friend who's the a MD head of department at the hospital. he was home, he called the hospital. When I got there, I was 1st in line….Do you really think that connections, stature and money have nothing to do with it?
Maybe Steve's score was similar or equal to another patient but all things being equal (or almost equal) who do you think will go 1st?
I am sure the logarithm was helped…We'll never know.
You're a PACK OF GHOULS. This man apparantly came close to dying. And the first thing you come up with is – HE SHOULD HAVE, because OBVIOUSLY he cheated!
And the next thing you'll come up with is – WHY WEREN'T WE TOLD? As if it were any of your business.
You're a bunch of sick b…-w…s.
And frankly, I don't care if they don't publish this!
Jobs is a billionaire – he could purchase the entire state of Tennessee right now if he wanted to. I'm certainly not convinced there wasn't some type of deal worked out. It's silly to think any system is so morally upright that it would not react uniquely to a transplant candidate of Jobs' status. I'd be interested to see the financial statements of all parties involved over the next few years – even if they all decided to profit from Jobs' recovery by buying call options on Apple there was still a major monetary influence.
I'm not saying I disagree; it is Darwinism at it's best. More incentive to work hard and earn a high status in society. It will be nice, though, to someday read about how this really went down.
Jason's e-mail, while maybe well-intentioned is ignorant. No, Jobs didn't get sick because he failed to eat apples (or eat healthily). He got sick because he got a form of pancreatic cancer. We don't know what causes that cancer (or most others, for that matter). But don't go blaming the victims of cancer.
The MELD score is an important indicator of who goes first but we will never know if the scores were biased based on his fame and fortune. My mother contracted Hep C from blood received during an operation in 1972 at the age 47. She was on the liver waiting list from 1990 till 75 when they took her off the list as they told here they don't like to waste livers on old people, she died at 77 of liver failure. Meanwhile back then Mickle Mantle jumped the liver list and continued to drink and died anyhow. That liver would have saved someone like my mother but it went to waste when Mickey Mantle jumped the list. FYI – Larry Hagman has also been accused of jumping the list.
To Greg of Tampa, and others of the same misguided opinion, you simply don't "jump the waiting list" and grab the next liver or organ that becomes available…tissue matches are one of the biggest factors in determining the availability of organs. The odds can sometimes be staggering to find a match, and even assuming there were others on the list for longer periods of time, they may not have been a match…which translates to organ rejection. And, with the limited supply of donated organs in the US, doctors can ill afford to waste a viable organ on someone who isn't a match. Hundreds of people die everyday for lack of a good tissue match. According to http://www.donatelife.net, another person is added to the waiting list every 12 minutes. Eighteen people die every day for lack of donated organs. Nearly 100,000 need a life-saving transplant. Only 30% of the US population knows the steps to take for donating their organs.
Hopefully when Steve Jobs gets back on his feet, he'll be a major advocate for urging people in the US to designate their bodies for organ transplants in the event of death. The US has one of the lowest per capita rates of organ donation in the world…Americans, for whatever bizarre reason, are squeamish about designating their bodies for organ donation. Europeans embrace the concept.
Maybe the next time Steve is onstage and introducing the world to new Apple products, his now famous line, "…and one more thing…" might be "…and one more thing, designate your body for organ transplants now. Save a life, make a difference…in other words, Think Different."
Perhaps his greatest role might become spokesperson for organ donation, saving thousands of lives.
I'm not an Apple fan by any stretch of the imagination, but the baseless rumors about this man's health are really over the line. We really had no info on his condition, so what would lead someone to speculate that he somehow treated the system? Thanks for providing some actual facts.
Of course he jumped the waiting list. There is a vested interest to give him a new liver because he is at the top of the food chain. Money, power, and status.
It's interesting to see this health problem comes to a man who has one of the most useful fruit in the world as his company logo.
All this health problem wouldn't have happened if only Steve Jobs eats apple daily.
You know the old saying: 'an apple a day keeps the doctor away'
Just came across this article, just like always, a day late a dollar short. I don't blame Mr, Jobs for what he did going to another hospital if he didn't like the drs. he had in Ca. My husband died in 2007 from a liver transplant where the drs. in South Carloina waited too long to list him. We found out in 2004 that he had hep c(and no he didn't drink, do drugs, he was a machinest and could have touched a machine someone bleed on with a cut on his hand, we just don't know)started going to a transplant hospital and they kept telling him he wasn't sick enought. Eventho his MELD score said he was they just overlooked that fact and kept refusing to list him till he was so sick that when they listed him in July of 2007. He got his transplant but then they ended up letting him throw up in a breathing machine which gave him sepsis and he died. I don't blame UNOS I blame the drs. for waitng too long and they never even told us we could go somewhere else. You can't get on the list unless a transplant team puts you on it. So for Mr.Jobs to be the sickest on the list some drs. had to have put him on the list. I like yourself Charlene would like to know what his Meld score was . South Carolina has a listing guideline with MELD score of <10 my husband in 2004 was a 9, by 2007 he had gotten up to a 19 and they were still refusing to list him. Mr. Jobs needs to be thankful he didn't come here. And also a liver is not like a kidney, a kidney you have to have alot of things to match, a liver its by blood type. All I wanted to say was, don't blame the UNOS system he couldn't have been on the list if drs. hadn't put him there. With that said how he got them to put him on it I haven't a clue and wouldn't even try to explain it.