Jobs, sitting next to the president, kicked off the dinner by saying, “Regardless of our political persuasions, I want you to know that we’re here to do whatever you ask to help our country.” Despite that, the dinner initially became a litany of suggestions of what the president could do for the businesses there. Chambers, for example, pushed a proposal for a repatriation tax holiday that would allow major corporations to avoid tax payments on overseas profits if they brought them back to the United States for investment during a certain period. The president was annoyed, and so was Zuckerberg, who turned to Valerie Jarrett, sitting to his right, and whispered, “We should be talking about what’s important to the country. Why is he just talking about what’s good for him?”
Doerr was able to refocus the discussion by calling on everyone to suggest a list of action items. When Jobs’s turn came, he stressed the need for more trained engineers and suggested that any foreign students who earned an engineering degree in the United States should be given a visa to stay in the country. Obama said that could be done only in the context of the “Dream Act,” which would allow illegal aliens who arrived as minors and finished high school to become legal residents—something that the Republicans had blocked. Jobs found this an annoying example of how politics can lead to paralysis. “The president is very smart, but he kept explaining to us reasons why things can’t get done,” he recalled. “It infuriates me.”
Jobs went on to urge that a way be found to train more American engineers. Apple had 700,000 factory workers employed in China, he said, and that was because it needed 30,000 engineers on-site to support those workers. “You can’t find that many in America to hire,” he said. These factory engineers did not have to be PhDs or geniuses; they simply needed to have basic engineering skills for manufacturing. Tech schools, community colleges, or trade schools could train them. “If you could educate these engineers,” he said, “we could move more manufacturing plants here.” The argument made a strong impression on the president. Two or three times over the next month he told his aides, “We’ve got to find ways to train those 30,000 manufacturing engineers that Jobs told us about.”
Jobs was pleased that Obama followed up, and they talked by telephone a few times after the meeting. He offered to help create Obama’s political ads for the 2012 campaign. (He had made the same offer in 2008, but he’d become annoyed when Obama’s strategist David Axelrod wasn’t totally deferential.) “I think political advertising is terrible. I’d love to get Lee Clow out of retirement, and we can come up with great commercials for him,” Jobs told me a few weeks after the dinner. Jobs had been fighting pain all week, but the talk of politics energized him. “Every once in a while, a real ad pro gets involved, the way Hal Riney did with ‘It’s morning in America’ for Reagan’s reelection in 1984. So that’s what I’d like to do for Obama.”
Third Medical Leave, 2011
The cancer always sent signals as it reappeared. Jobs had learned that. He would lose his appetite and begin to feel pains throughout his body. His doctors would do tests, detect nothing, and reassure him that he still seemed clear. But he knew better. The cancer had its signaling pathways, and a few months after he felt the signs the doctors would discover that it was indeed no longer in remission.
Another such downturn began in early November 2010. He was in pain, stopped eating, and had to be fed intravenously by a nurse who came to the house. The doctors found no sign of more tumors, and they assumed that this was just another of his periodic cycles of fighting infections and digestive maladies. He had never been one to suffer pain stoically, so his doctors and family had become somewhat inured to his complaints.
He and his family went to Kona Village for Thanksgiving, but his eating did not improve. The dining there was in a communal room, and the other guests pretended not to notice as Jobs, looking emaciated, rocked and moaned at meals, not touching his food. It was a testament to the resort and its guests that his condition never leaked out. When he returned to Palo Alto, Jobs became increasingly emotional and morose. He thought he was going to die, he told his kids, and he would get choked up about the possibility that he would never celebrate any more of their birthdays.
By Christmas he was down to 115 pounds, which was more than fifty pounds below his normal weight. Mona Simpson came to Palo Alto for the holiday, along with her ex-husband, the television comedy writer Richard Appel, and their children. The mood picked up a bit. The families played parlor games such as Novel, in which participants try to fool each other by seeing who can write the most convincing fake opening sentence to a book, and things seemed to be looking up for a while. He was even able to go out to dinner at a restaurant with Powell a few days after Christmas. The kids went off on a ski vacation for New Year’s, with Powell and Mona Simpson taking turns staying at home with Jobs in Palo Alto.
By the beginning of 2011, however, it was clear that this was not merely one of his bad patches. His doctors detected evidence of new tumors, and the cancer-related signaling further exacerbated his loss of appetite. They were struggling to determine how much drug therapy his body, in its emaciated condition, would be able to take. Every inch of his body felt like it had been punched, he told friends, as he moaned and sometimes doubled over in pain.
It was a vicious cycle. The first signs of cancer caused pain. The morphine and other painkillers he took suppressed his appetite. His pancreas had been partly removed and his liver had been replaced, so his digestive system was faulty and had trouble absorbing protein. Losing weight made it harder to embark on aggressive drug therapies. His emaciated condition also made him more susceptible to infections, as did the immunosuppressants he sometimes took to keep his body from rejecting his liver transplant. The weight loss reduced the lipid layers around his pain receptors, causing him to suffer more. And he was prone to extreme mood swings, marked by prolonged bouts of anger and depression, which further suppressed his appetite.
Jobs’s eating problems were exacerbated over the years by his psychological attitude toward food. When he was young, he learned that he could induce euphoria and ecstasy by fasting. So even though he knew that he should eat—his doctors were begging him to consume high-quality protein—lingering in the back of his subconscious, he admitted, was his instinct for fasting and for diets like Arnold Ehret’s fruit regimen that he had embraced as a teenager. Powell kept telling him that it was crazy, even pointing out that Ehret had died at fifty-six when he stumbled and knocked his head, and she would get angry when he came to the table and just stared silently at his lap. “I wanted him to force himself to eat,” she said, “and it was incredibly tense at home.” Bryar Brown, their part-time cook, would still come in the afternoon and make an array of healthy dishes, but Jobs would touch his tongue to one or two dishes and then dismiss them all as inedible. One evening he announced, “I could probably eat a little pumpkin pie,” and the even-tempered Brown created a beautiful pie from scratch in an hour. Jobs ate only one bite, but Brown was thrilled.