Being the richest man in the cemetery doesn't matter to me. Going to bed at night saying we've done something wonderful, that's what matters to me.
This was a response by Ramzi Amri,
I hesitated a long time before addressing this topic, but now that someone asked me to, I'll just do it. To avoid any risks of bias, let me start by stating that all the details on Jobs' specific case are based on secondary sources, albeit from reliable sources in the media. I write this on a personal title, I do not pretend to know anything about the case on a personal level and I never participated in the care of Mr. Jobs. I base all my cancer figures on sources from bio-medical research known to me.
I respect the privacy of, and in no way wish to offend, anyone mourning his passing. I have the profoundest respect for Mr. Jobs and his legacy but I feel that in the spirit of his progressive view of the world, learning from his case is an appropriate way to look back on the facts concerning his life and legacy.
I have done 1.5 years of research on the type of tumor that affected Steve Jobs as a medical student in Amsterdam and have some strong opinions on his case, not only as an admirer of his work, but also as a cancer researcher who has the impression that his disease course has been far from optimal.
Let me cut to the chase: Mr. Jobs allegedly chose to undergo all sorts of alternative treatment options before opting for conventional medicine.
This was, of course, a freedom he had all the rights to take, but given the circumstances it seems sound to assume that Mr. Jobs' choice for alternative medicine could have led to an unnecessarily early death.
First, let me clarify a few things about his disease:
Neuroendocrine tumors are far less deadly than "ordinary" pancreatic cancer.
The big confusion in the media is that Jobs had pancreatic cancer. Though his tumor might have originated in his pancreas, we're not speaking of the dreaded pancreaticadenocarcinoma that has such a horrible prognosis and makes up for 95% of pancreatic tumors.
Jobs is cited to have said himself that he had an islet-cell tumor, which is a colloquially used, less accurate name for the other 5% of pancreatic tumors, so-called neuroendocrine tumors.
Neuroendocrine tumors are relatively mild forms of cancer.
(Gastroenteropancreatic) Neuroendocrine Tumors (GEP-NET's) are a range of tumors that mostly keep their original function, producing endocrine hormones.
In my series of patients, for many subtypes, the survival rate was as high as 100% over a decade.
Neuroendocrine tumors caught in time can be treated just by surgically removing the tumor.
This is a relatively low-risk treatment that -- especially compared to chemo and radiation -- has negligible disadvantages. In many cases, a simple enucleation (just cutting out the tumor with a safe margin around it) is enough and leaves no residual side-effects.
Now, about this specific case:
Jobs had many favorable factors that indicate an early surgical treatment could have been curative.
Mr. Jobs said himself that they caught the tumor early. Early in GEP-NETs means in many cases that surgically removing the primary tumor without additional removal of organs is a curative with a low chance or recurrence.
The tumor was located at a relatively clement site, the pancreas.
The tumor was allegedly an insulinoma, one of the best treatable subtypes of GEP-NETs.
The tumor was probably well-differentiated. Mr. Jobs spoke of a hormonal imbalance, this points to a tumor that keeps its endocrine function, which is an general indicator of good differentiation. Well differentiated tumors are less prone to metastasize and grow rapidly.
... but not treating the most innocent cancer can still cause it to go seriously bad.
I'm currently reviewing hundreds of colon cancer cases, and about 25% of them start with a patient that comes with a history of polyps. Polyps are small benign little growths in the lining of the intestine. They are absolutely harmless at first, yet slowly but surely, over years, they lose more and more of the above mentioned "differentiation" and some eventually turn to a malign colon cancer.
In fact, it is supposed that all colon cancers start as a polyp.
These 25% had polyps removed, but were unlucky enough that between two colonoscopies, some other polyp found the time to grow into a real cancer. That's also why screening -- and going there on time -- is so important.
This illustrates also why leaving even the most innocent malign tumor to grow is just a foolish thing to do -- a ticking time bomb.
Jobs was a hippie back in the day, and a conventional medicine skeptic now. His reaction to the disease gave the disease time to spread.
Many mainstream media, including CNN, stated that Mr. Jobs might have spent as long as two years without proper (conventional) treatment.
While Mr. Jobs was trying all sorts of alternative medicine that I won't even bother to go through, as their failure is now sadly irrefutably proven, his tumor grew, and grew, and grew...
and then it somehow grew beyond control.
Jobs waited so long before seeking normal treatment that he had to undergo a Whipple procedure, losing his pancreas and whole duodenum in 2004. This was the first alarming sign that his disease had progressed beyond a compact primary to at least a tumor so large his Pancreas and duodenum could not be saved.
Jobs seemingly waited long enough for the disease revealed to have spread extensively to his liver. The only reason he'd have a transplant after a GEP-NET would be that the tumor invaded all major parts of the liver, which takes a considerable amount of time. Years, in most neuroendocrine tumors. It could be that this happened before his diagnosis, but the risk grows exponentially with time.
We then saw the tumor slowly draining the life out him. It was a horrible thing to see him lose weight and slowly turn into a skin and bones form of himself.
Yet it seems that even during this recurrent phase, Mr. Jobs opted to dedicate his time to Apple as the disease progressed, instead of opting for chemotherapy or any other conventional treatment.
As for the "why?" question:
Every patient has another view of his or her disease and the priorities for the treatment, or how much suffering and risk they're ready to endure as a trade-off for a higher chance of getting cured.
For most people, the trust in their doctor's intention to treat them is near-absolute. We encourage patients to inform themselves on the subject and stimulate personal choices, but the extent to which people can go through all the technicalities and the enormous pile of medical evidence is limited not only by the level of understanding of this specialist knowledge, but also simply by the sheer time it takes to inform oneself about this.
Now, Mr. Jobs always was a free thinker, a strong believer in spirituality, a vegetarian and a known skeptic of conventional medicine. He chose to reject conventional medicine altogether for a while. He's not alone in that. We come across many people like this and we all know someone in our midst that uses homeopathy or has this known fear of anything "chemical" (to those I always say that everything is chemical, if you think dihydrogen oxide sounds scary you should stop drinking water). Individual freedom of thought and choice is a cornerstone of our modern society and the medical world makes no exception.
It's always an ethical puzzle if a patient chooses alternative treatment that we know from fact will not work. Yet, as long as the person is mentally sane, we cannot force them to choose a working treatment, even if it means their death. Sadly, even for one of the greatest personalities of the last 100 years, there will be no exception, and badly treated cancer is just as deadly for him as for anyone else...
Thanks to Ramzi Amri,
Raise your hands--who had an emo phase in the 2000s? I know I did, as did a lot of people around me. All of us heard “It's just a phase" from our parents at some point, but when you're a kid, life as we know it seems so permanent.
Of course, most of the time, it was “just a phase". And looking back, those phases are regrettable, to say the least. Here are some prime examples of that.
What was your biggest/most regrettable "It's not a phase, mom. It's my life." that, in fact, turned out to be just a phase and not your life?
The enthusiasm of a young person can lead to some unexpected changes that parents are just not ready for.
I was VERY into The Transformers when I was a wee lad in the 1980s. One day, I decided to change my name to the name of my favorite Autobot. My name was lame, and I wanted an awesome Transformer name. And I was VERY insistent that my parents only call me by my new name. Calling me by my 'old' name would cause a big fat tantrum on my part.
So for the better part of a week, my poor parents had to call me Wheeljack.
Very 2008.Ariana Grande Shrug GIFGiphy
My cat-ear phase. I wore cat ears every single day. Everywhere. I had like 20 pairs of them. Now everyone thinks I'm a furry.
I find that very cute and wouldn't have thought you'd be furry. Even if you'd had cat mittens. I think my suspicions would have started if you moved a bit like a cat, displayed catlike grooming habits or got a cat mask.
Not gonna lie, that car sounds cool.
I went to a car show once as a teen, and the only newer car there was some chick's PT cruiser. It was hot glittery pink, and at the time I was obsessed. I insisted that one day I would have a hot pink car, with pink seats, pink dash, pink carpets, etc. I was pretty heavily goth at the time, so my parents just rolled their eyes.
These phases can often lead to some very strange fashion choices.
When I was a teenager (early 00s), I was waiting for my mother to pick me up and was wearing one of those sh!tty sports wristwatches. It was itching me so I took it off for a second, but then she arrived and because I was struggling to get it back on my wrist, I looped it around the equally sh!tty chain I had around my neck in a rush to get out the door.
My mom asked me about it in the car, and I told her this was my new style and I planned to wear it like that every day. She rolled her eyes.
I wore that watch on a chain around my neck every single day for 3 years or so. There are even professional family photos where I'm wearing it because I refused to take it off.
One day, the chain broke and I lost the watch. I was in high school at that point anyway and it was a major lady repellent, so... phase over.
Not everyone can be Eminem.slim shady eminem GIFGiphy
Baggy pants, being a rapper someday and being a professional skater.
When I was about 14 and Eminem was starting to blow up I bought myself a keyboard with a synthesizer. It cost like $200 which was all the money I had saved up. It finally came (this was way before amazon prime and such) and I tried rapping.
My sister told me "you're effing horrible" and I gave up right then and there.
This should be a sin.
I used to button the top buttons of polo shirts.
I must say, this is probably the worst one I've read.
Looking back at our regrettable choices, all we can do is cringe.
An optimistic look at bad tattoos.check me out season 3 GIF by PortlandiaGiphy
Being a tattooer. Regrettable because of those poor people who have my awful doodles on their bodies.
Take heart! My favorite tattoo is the one I drunkenly got my buddy to do in his living room one year during March Madness! It's dumb and frankly mediocre? But such a good story and has such good associations I smile every time I see it.
My friend and I decided we were going to open a bar in Jamaica with exotic snakes in glass cages in the walls at each booth. We convinced ourselves it would be amazing for at least two years in college. It was going to be called Fredro's.
My entire family made fun of me for it. Once we got out of college, we realized it was not feasible and joined the office grind. We're also two white guys with no ties to Jamaica.
Talk about cringey.
I wore a top hat with an anime pin on it for around a year. Met one of my current best friends while wearing it, idk how he could bear to speak to me after that.
My weirdest phase was probably when I insisted on wearing knee-high rainbow socks to school every day. But honestly, I don't regret it. I rocked those socks, and I wish I still have a pair.
To all the people out there cringing over their past selves, remember that you were just a kid, and to be easy on yourselves. After all, we've all been there
It should not take much for a consumer to be satisfied with the products they purchase.
Yet, too often, manufacturers who oversell their products fail to deliver what is promised and are inevitably left with angry customers who want their money back.
Whether the merchandise was defective or ridiculously overpriced, strangers online shared some of their worst purchases when Redditor BooksMcGee asked:
"What is the worst product you ever paid money for?"
Short Life Span
"This NERF gun that's supposed to shoot tennis balls for your dog. I bought it cause I thought you could load 3 at a time and shoot them far, but it's just one and it's super loud and the gun broke after like 4 shots (reading reviews later, this was a common issue)."
"There were these toys called squiggles when I was a kid and the commercials made it seem like the toy was alive. It looked like you would get this crazy little fuzzy worms as pets that would follow you around an so sick tricks and listen to your every command. It was really just a piece of fluffy string tied to another piece of string with googly eyes on it. People may say that it was supposed to be a magic trick but they should also explain that to a 5 year old who really wanted a pet."
"Not their fault, but I paid $70 for a Yugioh card hours before it was limited to one copy. Probably dropped to $20 by the end of the day."
These purchases were bad for your bum.
"A bicycle that literally fell apart before I made it out of the parking lot."
Not Worth Sitting On
"Joybird brand couch. Was so terrible, we returned it. Still hard to believe, we returned a freaking couch."
Going Nowhere Fast
"A 2000 VW Beetle (used)."
"Biggest piece of sh*t that literally had to have just about everything replaced before 100k miles and would still break down every time you left the driveway to the point where the tow-truck driver knew us on a first-name basis."
"An Oldsmobile Achieva from one of those buy here pay here places. I should have known better, but I was young and thought I was getting a good deal. I had the thing for about 5 months, I drove it for maybe 3 weeks. The rest of the time it was either in the shop, or in my driveway waiting until pay day so I could afford to fix whatever broke on it this week. Eventually told the dealer just take it, I'm not paying for it any more. He said nope, and I will make sure your credit is ruined. I said well you sold me a lemon, do you really want to go this route? He came and took it. Never reported anything to credit. I heard he got sued by several other people who sold sh**ty cars too and eventually went out of business."
"Always amazes me when I see them driving around still, I can only assume there's enthusiasts who just love repairing horribly designed cars."
These Redditors were not convinced what they ingested was edible.
"A box of plain Cheerios. Thought they were honey nut, poured a bowl, was very disappointed."
"If I wanted to taste cardboard, I'd just eat the box."
"A burnt frozen pizza at the air and space museum cafe in DC. I Don't wish that experience on anyone. There are some amazing restaurants in DC, don't settle."
The following electronics just gave off a bad charge.
"Asus Transformer Pad TF700"
"This was one of those early 'high end' Android tablets that was grossly underpowered, and it showed. Thing was slow as sh!t in no time flat. Rookie mistake investing into shiny new tech while they were still working all the bugs out. Think I paid somewhere in the neighborhood of $350-400 for it..."
"macbook pro 2018 13" touchbar. 2 years old and dead (battery). they're asking $300-$400 to change the battery. malfunctioning keyboard with double presses and missing presses. that's a lot of money for bad design."
"Past winter my old room heater broke down and I had to buy a new one. Went to a store nearby and somehow got convinced to buy a very costly heating device.. It's also my fault, since there were some sligthly cheaper options around, but nope. I wanted the expensive one thinking it will make my small room a volcano with little to no effort/cost (that's also what the seller told me). Long story short the device wasn't doing ANYTHING. No significant temperature changes, too much space, a weird noise, and was doubling my previous device in utility cost. I still gloom over those 80 euros.."
Some of my disappointing purchases was clothing, but only because I purchased them online. Unless they are a brand I'm familiar with, I'm usually fine with buying new jeans off of their websites.
But when it comes to graphic tees only available on specialty shops, an M-size shirt is not necessarily the same size as those found in other reputable stores.
I bought a medium sized T-shirt from a boutique store online because I loved the look of the design. But when it arrived, the supposed medium fit me like an XL.
At least I gained a fierce cleaning rag from this impulsive purchase.
We all know the job interview butterflies.
We sit outside the office or wait for the phone call and our foot taps at rapid speed. We run through some rehearsed answers, but worry that they'll ask a slew of things we never even considered. We try not to sweat too much.
Often, it turns out alright. We may not get the job, but we're respectable, give solid answers, and learn a lot about the place we're trying to get hired.
Other times, however, all of our far-fetched worries seem to come to life.
Curious to hear just how bad an interview can go, Redditor UIGrimsen asked:
"What was your worst job interview?"
Plenty of people had some truly bizarre stories to share. Part of these train wrecks were bad luck, and part were the insane antics of the people giving the interview.
But for us, they're simply hilarious.
"I applied for a job in a Planetarium, the interview was conducted in a big dome."
"Problem was, another part of the Planetarium staff was doing fire alarm tests during the interview. The dome amplified the sound so much, it was deafening. The interview staff acted like nothing was going on. We had to shout so we could hear each other."
"My mom raises chickens … and during COVID one of them got sick (not COVID). She had it inside to feed water hourly to try to nurse it back to life. My mom has to run an errand so I'm in charge of this chicken for the afternoon."
"I was on a phone screening with a candidate for a position in my office and this chicken starts having a seizure and dies on the middle of this phone call. I look over and it's laying almost like it was crucified."
"The candidate heard the commotion and asked if everything was ok … Which I relied 'yeah, the chicken just died.' "
"She withdrew her application the next morning."
"1.) I walked in as the HR lady farted"
"2.) it was a small office with no windows"
"3.) I asked her questions about their employee retention rate that she couldn't answer"
"4.) the fart stayed the duration of the interview"
"5.) I hope the fart got the job, because I didn't want it"
A Very Instructive Moment
"Applied to work at a vet clinic. Veterinarian did the interview while spaying a cat, apparently one of the cleanest and quickest surgeries they do. I fainted."
"Was not offered the job (after I woke up)."
Others shared moments when their excitement was deflated instantly. They encountered such closed-minded interviewers that there was almost no need for discussion.
That Bus Perk
"As an interviewee It was when I applied to a job as a Junior programmer and in 5 minutes the guys goes 'look, I'll be honest, there is no job, you can get an internship, no pay, we offer the bus pass' "
Plains, Trains, and Automobiles Later...
"I took vacation days to interview, bought my own plane ticket, and paid for my own hotel. First thing the interviewer said was, 'I have no intention of hiring you. This is just a courtesy because I knew your brother.' I had 8 more hours left in my interview day. It was painful."
"They ended up offering me the position many weeks down the road because they couldn't fill the position. I politely declined and got a very passive aggressively worded survey to fill out explaining why I passed."
There's a Right Answer??
"Wanted to work at H&M, got interviewed by the worst person ever."
"One question was and I am legit not lying, 'What is your favorite color and why?' "
"I answered 'baby blue because it's calming and not too harsh to the eyes.' My interviewer then said Oooh, sorry! Red is what we were looking for. And then proceeded to show me the exit."
Last, some shared the times they arrived for the interview excited and enthusiastic, but quickly learned how out of their league the position was.
These interviews looked more like brutal interrogations from the FBI than job interviews.
All the Principals
"Fresh out of college, I was looking for my first teaching job. I applied at a small district for an elementary school position."
"I walked in, expecting the principal and a few teachers. Instead I had the superintendent of the district, some high-level admin, and every single elementary school principal in the district. Probably 15 people in all. They peppered me with questions for 45 minutes."
"I had zero experience, just my student teaching. I did not get the job."
Shove Your Masters
"Finished up a masters degree in physics. Got a phone interview and was was told it would be an introductory chat. Was confronted with a technical interview panel (over the phone) of 6 PhDs, 4 of which had graduated from the research group I had just left. We walked through my research project in about 10 minutes."
"Then the pain began... felt like I'd only learned kindergarten physics."
An Extremely Intimidating Position
"Got an interview for a job as a floor manager at a gigantic steel foundry. I have some background in metallurgy so I thought it'd fit. It paid $90k and I was qualified resume-wise. I got there, turned out it was a group interview with three other applicants, to hear the pitch."
"If something messes up, the company loses $100,000 (some shockingly high amount, I don't remember if it was exactly 100k) per hour and it's your sole responsibility to fix it. They said you'd have to be on call 24/7 to handle anything that comes up."
"I got to the solo part out of curiosity and the interviewer they put me with said something to the effect of 'I know this job sounds bad, but actually it's even worse.' I was desperate for a job because I didn't land one straight out of college, but I was glad not to hear back from them after the interview..."
Here's hoping you don't have a job interview scheduled and this just amplified your anxiety 1000%. The nice thing to remember is that these horror stories are few and far between.
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Believe it or not, Canadians don't live in igloos or freeze to death all year round. If you go to Germany, it's highly unlikely that every German you meet will be cold and uninviting. Hop over to the United Kingdom and you're not going to run into tons of people with terrible teeth and bad hygeine.
These are called stereotypes, my friends, and it's best you leave them at the door. People were more than willing to strike down some stereotypes about the countries they know and love after Redditor HelloThere577 asked the online community,
"What are some false stereotypes about your country?"
"When most folks envision Scotland, they think of kilts, whisky, bagpipes, and red hair.
All of those things exist (and are common) here.
People might also imagine verdant hillsides, rocky bluffs, and skies that randomly switch between clear and cloudy.
Once again, that's completely accurate.
However, one stereotype which has absolutely no foundation, in reality, is the assumption that Scotsmen are constantly hunting haggis. In fact, haggis-hunting only takes place in February (which is the season for deosil haggis) and May (which is the season for widdershins haggis). For the rest of the year, the haggis is more or less left alone."
"I am originally from Portugal and moved to the United States. Around 80% of the people that I have met thought Portugal was either in South America, owned by Brazil, or a part of Spain. When I first came here it made me really sad."
"If the wildlife hurts or kills you in Australia, it's generally because you are f***** stupid. You are 10000 times more likely to be injured or killed in a car accident in Australia than by anything in nature."
This is likely very true, but knowing me, I'd probably be easy pickings for one of those huntsman spiders.
"That we end every sentence with "eh" and drink maple syrup by the gallon and have moose and igloos in our backyards."
You mean... you don't?
Just kidding. Canada is lovely––visit sometime. It's a lovely place.
The United States
"That we always have a shotgun at the ready. A shotgun is a home gun where a pistol is your everyday gun. Your revolver is your dress gun, for special occasions. Then of course your assault rifle is for when you're kicking back and cracking open a cold one with the boys."
"Anything related to The Sound of Music."
Probably gets annoying afer a short while. Great movie, though. Still dreaming about a trip to Salzburg.
"A lot of Americans seem to think we're inbred because we're an island. This is dumb, because it's a very big island (10th biggest in the world), and it's not isolated, we've been invaded, invading, and trading with the mainland for thousands of years."
"That we are car thieves. Crime was widespread in Poland in the 90s but today crime (including theft) rate in Poland is low."
"We do gesticulate a lot, but we definitely don't yell like crazy."
It seems Italian Americans are the ones who could learn a thing or two about being more reserved.
"Iceland. We're not some utopian Disneyland filled with quirky superstitious people that all believe in elves."
Remember: The world is an enormous place filled with people from all walks of life, and they don't take too kindly too stereotypes. Expand your horizons by having conversations with as many people as possible. You'd be surprised how quickly your preconceived notions will vanish.
Have some stories of your own? Feel free to tell us about them in the comments below!
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