Why Steve Jobs’ Magic Doesn’t Work In Medicine

Posted on January 24, 2012. Filed under: google, internet, linux |

As Steve Jobs biographer Walter Isaacson made the PR rounds everywhere from 60 Minutes to the Daily Show, the terribleness of Jobs’ too-early death has come into focus: that Jobs evaded conventional medicine when his tumor first appeared, may have died as a result, and regretted it.
“I think that he kind of felt that if you ignore something, if you don’t want something to exist, you can have magical thinking,” Isaacson told 60 Minutes. “We talked about this a lot. He wanted to talk about it, how he regretted it….I think he felt he should have been operated on sooner.”
It’s not just that Jobs’ refusal of treatment is “crazy,” as former Intel chief Andy Grove put it to Isaacson. This tragedy sprung from the very thing that made him so great: his unwillingness to believe that technology needed to be clumsy, ugly, or difficult. In consumer products, this led to the MacIntosh and the iPhone. In animation, it created the Pixar canon. But biology and medicine are messy, and demanding a magic solution doesn’t always produce one.
There’s more here than just the simple lesson that people with cancer should listen to their doctors about getting their tumor cut out, or that you can’t cure cancer with diet or acupuncture, as Jobs apparently hoped he could. The kind of innovation Steve Jobs practiced, probably the type of innovation we mythologize and lionize most since personal computers started changing the fabric of society three decades ago, does not and has not translated to medicine in the same way.
To some extent, everything that Bill Gates, Steve Jobs, and the folks at Googlehave done to change our world springs from a single innovation: the creation of the microprocessor in the early 1970s. Every computer technology has sprung from this fundamental innovation. If we really want to talk about the biggest heroes of the digital age, we should always be starting with Robert Noyce, the Intel co-founder, or Jack Kilby, the physicist who won the Nobel Prize for his transistor work.
But we don’t. Neither of those men ever bonded with the larger public the way Jobs did. And that’s because Jobs (like Gates, and Sergey Brin and Larry Page, really), was solving a different kind of problem: how to make a powerful new technology useable to people. And Jobs, with an artist’s vision, went a step further: he made it perfect. Like Ferdinand Porsche building cars, he made the mundane beautiful, building technological gadgets in which people could see themselves.
Certainly, hospitals could use the Jobs touch. In a stunning eulogy, Jobs’ sister Mona Simpson recounted how an intubated Jobs asked for a sketchpad in the ICU. “He designed new fluid monitors and x-ray equipment,” she said. “He redrew that not-quite-special-enough hospital unit. And every time his wife walked into the room, I watched his smile remake itself on his face.”
Hospitals could use someone to stitch all the gadgets together, and make it all perfect, but there simply may be too much going on for this to happen. Meanwhile, the innovations that matter most in medicine are more of the Noyce and Kilby variety. The gutsy decision by Andreas Gruentzig, a German cardiologist, to use a catheter to open clogged arteries; the resulting procedure has saved millions of lives. The creation of the first statin drug for lowering cholesterol by Akira Endo, a Japanese scientist, which made no fortune for him but has also saved millions and made billions for Pfizer and AstraZeneca. Millions of people don’t wind up in the hospital because of the vaccines made by researchers like Merck‘s Maurice Hilleman, who developed most of our childhood inoculations.
The hospital where Jobs was has had every bit as much technological innovation over the past thirty years as the computer industry. But much more of that innovation has been technical, and hard to understand, and only physicians and surgeons can grasp it. And we don’t reward it as much as a society: unlike in tech, little of the money in medicine goes to the actual innovator. There are 50% more billionaires from tech than from health care, and they are far richer. This has to stunt medical innovation – although it is still progressing at an amazing pace, which gave Jobs extra chances at life. Isaacson reports Jobs had his genome sequenced, in the hopes of finding the targeted cancer drugs that would kill his specific tumor.
I’ve idolized Jobs since I was a teenager. My first email account was on a NeXT, and I think he more than deserves his place in the firmament of business stars. But I’m haunted by a story I heard once about a biotech industry lobbyist who went to see a congressman and was told, “You guys don’t do innovation. The iPad. That’s innovative.” As a society, it seems to me, we say that a lot. We value the magic box built out of many more basic innovations much more than what came before – and as a result, we overlook the work that is actually foundational. And I worry that were this less true, medicine could have done even more for Steve Jobs.

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