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,
We all need a little wholesome content every now and then. Much of the world, especially right now, can seem very dark and depressing.
It's important to recognize that not all of the world is as scary as it may seem. So we wanted to see what wholesome facts people had to share with us.
In fact, the world "wholesome" literally means "promoting health or well-being of mind or spirit."
Take a minute to enjoy this list of wholesome facts that will just make your heart melt.
Redditor 2ndRockBottom asked:
"What is the most wholesome fact you know?"
You might want to grab some tissues.
A lottery winner and a lucky waitress.
"In 1984, a regular customer at a pizzeria asked his waitress for help choosing his lottery numbers. He won, came back, and tipped her $3 million."
"For eight years, Robert Cunningham was a regular at Sal's Pizzeria in Yonkers, NY. One night, he asked waitress Phyllis Penzo to split the numbers on his card. On April Fool's Day, she was woken up by a phone call from Cunningham telling her he'd won $6 million and she was entitled to half of it and made good on his promise."
"There's a movie about that, right? Early 90's?"
Yep! It's called It Could Happen To You from 1994.
"There was a man from a small rural settlement in Australia (I think) who won $20,000 from a scratch card."
"A news crew reported on it and the chap demonstrated how it works by buying another ticket. When he scratched the ticket, he had won another $50,000."
"Not $50,000. He won $250,000."
"Not just that, I think he had just survived being declared legally dead, right?"
That's right. The man was declared dead and was then in a 15-day coma.
Cows are actually so cute.
"Cows have best friends."
"My parents had cows for many years. They always knew which cows were friends to each other. It was so cute."
"Cows love music."
"They'll drop what they're doing and run over to listen, and studies have shown lower stress levels and higher milk production."
"(Not doubting you) but I'm my experience, cows are just curious creatures. I remember throwing a football with my dad outside and the cows would always gather around to watch. Same would happen if I were playing in the yard. Any activity that wasn't 'normal' brought all the milkshakes to the yard"
"Cows ARE curious creatures. We had them come investigate our campfire one night."
"THAT'S a startling sight. You're drinking and smoking around a campfire with your friends, and suddenly you're in the middle of a circle of 30 cows."
"It was wild."
Happy little trees.
"Bob Ross's voice was intentionally soothing and quiet."
"He was a Airforce Master Sergeant, 'I was the guy who makes you scrub the latrine, the guy who makes you make your bed, the guy who screams at you for being late to work. The job requires you to be a mean, tough person. And I was fed up with it. I promised myself that if I ever got away from it, it wasn't going to be that way anymore.'"
"My wife and I have been watching Bob Ross' The Joy of Painting on YouTube. If you haven't checked it out, it is really relaxing and sometimes we fall asleep to it on the tv while lying in bed."
"We sometimes like to pick paintings and do a Bob Ross Night. We get out our supplies, some alcohol and some snacks, and we just watch Bob teach us. Some of the paintings do come out well."
More libraries than McDonald's.
"That there are more public libraries in the US than there are McDonald's. I grew up poor and the library was a refuge for me, my library card was the only thing I carried in my first wallet."
"I started taking my kids to libraries like my dad did with me and my brothers when we were kids."
"I f*cking love libraries man."
"Libraries are great! I spent the last 14 years living in a city with an underfunded library system, where I could never find what I was looking for. I moved to a different city that believes in funding public services, and I've been taking full advantage of my local library now."
Animals in mourning.
"Horses mourn the death of other creatures, not just horses. When my daughter was younger we took her to riding lessons. One of the horses stepped on one of the barn cats and killed it. It was buried inside the horse pen and ALL of them, including the younger one that was usually a pita and super playful, were standing around the burial area with their heads down. They were like this for 2 days I was told and this was common for how they deal with the dead."
"Elephants also mourn the dead hence the term 'Elephant graveyard' where relatives pay homage to those that have fallen. It seems the concept of life and death isn't an exclusive human thing."
"Crows mourn the deaths of other crows in a similar manner. They stand in a circle around the deceased and sometimes raise their wings up. Very surreal thing to see. They also remember faces and hold grudges, so be kind to your local crows."
Pets really are healing.
"Interacting with pets causes brain to make oxytocin."
"Where there was a lethal bus accident outside my workplace that had killed 8 passengers including coworkers, our workplace brought in some puppies for people to enjoy to make them feel better."
Mr. Rogers fun fact.
"Every one of the sweaters Mr. Rogers wore on his show were hand knitted by his mom."
"Bonus Neighborhood fact, Mr. Rogers began to include a segment of the show where he fed his fish because a child wrote him, concerned about whether or not they were still alive and well."
"Mr. Rogers kept to a fairly rigid diet and exercise program, in order to consistently weigh 143 pounds. 143 was important to him, because the word 'I' contains 1 letter, the word 'love' contains 4 letters, and the word 'you' contains 3 letters."
"So, 143 = 'I love you.'"
"After he passed away, the Governor of Pennsylvania declared May 23 - the 143rd day of the year - to be '143 Day,' in honor of Mr. Rogers. Citizens are encouraged to show kindness to neighbors on May 23. (And every other day)."
"He responded to every single letter he received, and kept every letter and drawing in a special filing cabinet. He considered every letter and drawing to be sacred."
"He named his puppet King Friday the 13th because he didn't like the negative stigma associated with Friday the 13th, and wanted children to associate Friday the 13th with a friendly puppet rather than a day of bad luck or evil."
"One night, Mr. Rogers was invited to a fancy dinner for PBS employees and executives. He was given a limousine ride to the restaurant. When they arrived, Mr. Rogers asked the chauffer when they would see each other again. The chauffeur explained that he would wait 2-3 hours outside, in the car, then drive him home."
"This didn't sit right with Mr. Rogers. So, he insisted on having the chauffeur join him for dinner."
"On the way home, Mr. Rogers sat in the front seat with the chauffeur, getting to know him better. As the chauffeur told Mr. Rogers what a fan his children were of the show, Mr. Rogers asked the chauffeur if he could meet them. The chauffeur took Mr. Rogers to his own home, where Mr. Rogers met everyone, hung out for a couple hours, and even played piano for them."
"The chauffeur said it was one of the best days of his life."
Some of these really hit hard. If you needed a few happy tears today, we hope this did it for you. There's a lot of difficult news in the world right now and it's important to remember that there are good, wholesome things happening all at the same time.
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Laws exist to maintain order. However, they do not prevent crimes from actually happening, and before any punishments are made, the damage is already done.
Curious to hear about some of the more creepy indiscretions people get away with, Redditor Flytechofficial asked:
"What is perfectly legal, but creepy as hell?"
These things that happen in public restrooms can be considered criminal.
Respecting Splash Zones
"Using the urinal next to me when there were plenty of other choices."
Nightmare For The Pee-Shy
"hanging out in a public bathroom timing how long people pee."
"I swear to God. I did a lot of work in hospitals for a while, big f'king hospitals with tons of bathrooms all over the place. For some God damned reason, regardless of what time or bathroom I selected to take a sh*t in not 30 seconds after I sat down a janitor would knock on the door to clean the bathroom. It's not as if it was one janitor, just some random janitor would inevitably need to clean whatever bathroom I was in as soon as I got comfy. It's like I was being stalked by the janitors."
"So now I'm trying to take a sh*t knowing full well there's somebody out there actively timing how long it takes."
"I was drunk in a casino and went to use the washroom. The floors in there were a polished marble or something. Sitting on the toilet, pants down, my stall neighbour made eye contact with me on the reflective floor tile."
The following examples involving minors have no legal repercussions.
Kids For Show
"Child Beauty pageants."
"Technically, you can stand on the sidewalk and stare into someone's house through a window. It's not illegal as long as you stay off of their property, but it's really freaking creepy."
Keeping Tabs On Someone's Age
"A national newspaper having a countdown for when a child actress becomes 'legal' for sex."
"Answers to questions that will surely come. ....Yes. The Sun (UK). Emma Watson."
The Young Subjects
"When I was a child, we had a creepy horrible neighbor that would harass my family constantly. One of the things he did was stand at the corner of his yard and videotape me playing in a pool with my friends (we were around 8). My parents called the police but were told that it's legal if he's on his property."
These perfectly harmless examples can give you goosebumps.
"Hanging your doll collection from the trees in your yard using string made from human hair."
"I believe the act of cannibalism itself is legal so long as you didn't murder anyone to do it. If your homie gives you his arm to gnaw on, it's fair game."
"Facing the wrong way in an elevator."
I recently treated myself by going to a movie theater after what seemed like a long hiatus for much of the year.
Streaming blockbuster movies from home, while convenient, has never made as much of an impact when compared to the moviegoing experience.
But after my recent trip to our local AMC, I'm beginning to think watching entertainment from the comfort of my quiet home is a much better option.
I forgot that a good majority of audience members are disrespectful and pretty much ignore all the rules—including no texting or talking during the movie.
The normal volume conversations and the number of lit screens from people's smartphone's in my peripheral vision throughout the movie were huge distractions.
Maybe as I'm getting older, my patience has worn thin, or I happened to have a particularly unpleasant experience. But seriously, how can anyone enjoy going to the movies when people are constantly updating their status inside a darkened auditorium?
It should illegal. Rant over.
Shaking hands... what's up with that?
Could this social custom be going out of style given that we're all in the middle of a global pandemic and have become hyperaware of all the germs around us?
And not just that, but just how nasty people are? Why would you want to shake hands with them?
People shared their opinions after Redditor alebenchhe asked the online community,
"What social customs do we need to retire?"
"Making couples feel obligated to have giant, fancy, weddings."
If someone wants that, then more power to them.
But there are indeed people out there who spend thousands upon thousands of dollars to have weddings to please their families... only to divorce later.
"If I take a day..."
"Rest being seen as lazy. If I take a day off of work simply to sleep in and rest at home instead of having to have some sort of big plans or destination it shouldn't be seen as anything less."
"Having to purchase..."
"Having to purchase gifts for extended family that you cannot afford because it is Christmas or another holiday."
Yeah, let's stop that. Not all of us are made of money!
"Though it looks like this custom is fading away during the pandemic...but how about we stop glorifying us "being model employees by showing up to work even while sick?"
I was at a retailer for 14 years, and I don't have enough fingers and toes to count how many times I used to see managers and supervisors dragging themselves to work while sick to please their superiors. In January 2020, I ended up getting the flu from a co-worker that decided it would impress the store manager if she still showed up while sick with the flu.
That culture went away REAL quick when we started getting COVID cases in the store I was at...and I too ended up getting a mild case of COVID. I've called out any time in the past when I felt sick...and I will continue to do so as I normally did."
"I don't create..."
"Worshipping celebrities. I don't get it and it seems to just create tons of problems."
The celebrity worshipping culture, at least in the United States, is insane, and sets people up with rather unrealistic expectations.
"This goes along..."
"That because someone is"family", you should force yourself to spend time with them and be "nice and respectful", no matter what kind of person they are or how they treat you.
This goes along with the enabling acceptance of "that's just how they are" rather than condemning poor behavior choices."
Yes, let's normalize cutting out toxic people from our lives. We'll thank ourselves later.
"Expensive funerals. The funeral industry is insane."
"Discussing salary with co-workers should no longer be taboo."
That's how they get you––it's in your employer's best interest to keep you in the dark, and it's wrong. Many people out there are not aware of their rights in the workplace.
"Giving greeting cards..."
"Giving greeting cards for every single event imaginable. Why pay $5 to give someone a piece of paper that will get thrown out the next day? I'd rather you give me $5 and skip the card."
It's a wild world we live in and social customs can and do change. Life now won't look the same twenty years from now for instance––perhaps for the better? Who knows?
Oh, and sorry, but can we go back to the topic of shaking hands? Let's not do that. Just wanted to be extra clear.
Have some opinions of your own? Feel free to tell us more in the comments below!
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I have a paralyzing fear of death. If I could I would live forever. Have you ever seen the movie "Death Becomes Her?" I would give every penny for that potion. And I wouldn't be all crazy like them.
Live well forever and be happy? It's possible. Even though life is nuts and scary, you're still here. What if there is nothing after the final breath? I don't want to just not exist, while everybody else just gets to keep on dancing.
In my hopes I see a Heaven with ice cream and vodka. So I'm going to hold onto that until eternal life is an option. Let's hear from the gallery...
Redditor u/St3fan34 wanted to discuss life after life, by asking:
What do you think really happens after death?
I feel like if there is nothing after life, it just invalidates life. But maybe I'm just dramatic. I hope there is peace. Thoughts?
Leftoversblack and white two funerals GIFGiphy
"Your family fights for your belongings."
"When we die, the whole world as seen by us, dies together with us."
"Yes it does. As does the entire universe. Only when we are alive can we experience the passage of time. The instant we die the entire universe will experience heat death and cease to be. It my take a million eons but since we can no longer experience time it will be relatively instantaneous."
"It's one of the great wonders of life: What will it be like to go to sleep and never wake up? And if you think long enough about that, something will happen to you. You will find out, among other things, that it will pose the next question to you: What was it like to wake up after never having gone to sleep? That was when you were born. You see, you can't have an experience of nothing. Nature abhors a vacuum. ~Alan Watts"
"When I was much younger, I had a dream where I died. Not a typical dream, not a romanticized dream. It was a dream where I was an archer in a medieval battle. About 5 minutes into the battle, chaos was all around me, and I watched an opposing archer aim and loose an arrow straight into my left eye."
"I remember the sensation of impact, ringing in my ears, and falling to the ground. I remember the warmth of the blood on my face. The feeling of life leaving my body, and the sense of worry evaporating into warmth and peace as the world left behind me."
"I remember waking up shortly after thinking that the feeling and reality of that experience was so vivid and so detailed that it must have been an experience from a previous incarnation hundreds of years ago. From that moment on, I've never feared the actual process of death. I feel like I've experienced it many times before."
EraseComputer Reaction GIFGiphy
"I think one of your best friends delete's your browsing history."
If you love me... rule number one... HIDE THE EVIDENCE!!! Let that be heard far and wide. And dreams, always so intertwined aren't they?
Before & AfterHappy Baby GIFGiphy
"Exactly the same as before you were born."
"We clean the bed and assign it to another patient."
"The REAL reason why nurses are so dark. 90 year old man in hospice got hit by a car on his way to get fitted for his funeral tuxedo, and didn't have a DNR. Kept him alive for four hours, and now it's time to document everything that was done to save his life because there will inevitably be a lawsuit from a family member who has had four years to say goodbye but somehow didn't get to."
I don't know what they mean or how to utilize them. I'm a Buddhist (but a gamer first and foremost) so it's cool you guys made those connections This totally makes up for r/movies continuously banning me."
"I've answered this one before but here it is again. Either two things happen after you die: you either go somewhere or it's oblivion. If it is oblivion, then we're just going back to the same place before we were born and there's nothing wrong with that. We were there for billions or trillions of years, possibly infinity."
"You lose that concept of time since your brain doesn't work anymore so you don't even know it's over. It's not nothing because nothing would be something and that means that you are aware, which you can not be if you're dead. If we do go somewhere, then that's something no one understands because no one has ever come back to tell us."
"Those stories of people coming back after they "died" and "saw stuff" weren't really dead. Their hearts stopped but their brains were still working. If the Universe continues to recycle itself infinitely, then there's a chance we will be reborn or continuously reborn but have no memory of our previous selves."
"When I was a kid I drowned while on holiday with my family, a giant fat man jumped in the pool on top of me and no one noticed till I was on the bottom of the pool. I remember the feeling of my lungs being on fire, then shivering then as everything was going dark a strange sense of peace and I was ok with it, No panic or terror then it went black."
"I was resuscitated at the side of the pool a few minutes later. I remember nothing from the black to being "alive" again. I was around 7 when it happened and since then I've been strangely at peace with the fact that one day I will die and slip into the dark void of nothingness. Hope that helps."
Popcorn?500 days of summer cinema GIFGiphy
"You wake up in a chair in a cinema and learn that the other are past lives of you and you're about to watch your next life very soon on the big screen."
The truth is none of us know the truth. We live everyday with the afterlife being a gamble. And that seems like it's going to have to be enough.
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