Friday, 7 October 2011

Help the Next Steve Jobs

Steve Jobs made machines. They’re machines you can type on, or talk on, or listen to music on. He didn’t just tinker with gadgets. He changed what they did. He made machines do what machines had never done before.

But there was one machine he couldn’t fix: his body.

Jobs died yesterday at 56 because of a glitch in his programming. The glitch was cancer. A lot of smart people are trying to fix this glitch in future releases of the human body. But that’s going to take a while. In the meantime, there’s something you can do to help people such as Jobs. You can supply replacement parts for the machines that keep them alive. You can sign up as an organ donor.

Two years ago, Jobs got a liver transplant to prolong his life. Apparently his cancer, which began in his pancreas, had damaged his liver. To get the liver, Jobs went to Tennessee, because the waiting list in Northern California was too long. There weren’t enough livers to go around. Lots of other people in Northern California needed livers but couldn’t get them, because they didn’t have the kind of money or savvy Jobs did. They couldn’t afford to fly around the country, go through extensive evaluations at multiple transplant centers, and guarantee their availability within an hour for the next liver that became available.

Go to the data page of the Organ Procurement and Transplantation Network and look at the numbers. More than 100,000 people are on waiting lists for organs. Sixteen thousand are waiting for livers. Ninety thousand are waiting for kidneys. Three thousand are waiting for hearts. In the past decade and a half, more than 100,000 people—on average, more than 6,000 per year—were removed from the lists not because they got organs, but because they died. Another 30,000 were removed because they became too ill. Right now, more than 3,000 people are waiting for livers in California. Most of them have been waiting more than two years.

Earlier this year, when Jobs took a leave from Apple because of deteriorating health, I asked whether he should have received his transplant in the first place. As bioethicist Arthur Caplan has noted, almost none of the 1,500 people who received liver transplants in the U.S. when Jobs did, in the first quarter of 2009, had cancer. That’s because there’s no evidence that transplants stop metastatic cancer. The much more likely scenario is that the cancer continues to spread and soon kills the patient, destroying a liver that could have kept someone else alive for many years. Among liver recipients, cancer patients have the worst survival rate. While more than 70 percent of liver recipients in Jobs’ age bracket are still alive and functioning five years later, Jobs lasted only half that long.

Spending that liver on Jobs seems unfair, given the scarcity of organs. But why should we accept scarcity? Jobs didn’t. He used his influence to prod California to enact a new law that requires applicants for a driver's license to be asked whether they'd like to be organ donors. He recognized that the wait for organs doesn’t have to be a zero-sum game. If more organs become available, people like Jobs can get transplants, possibly prolonging their lives, without sentencing others on the waiting list to death.

In the hours since the world learned of Jobs’ death, I’ve seen lots of people posting tributes to him online. They say he was one of a kind. They say he did things nobody else could do. But medically, he was one of thousands. And the thing he needed most was something any of us can do. He needed an organ donor. There are 100,000 people behind him—people who didn’t have his wealth or connections—still waiting.

If you want to honor Jobs and his donor, don’t just recycle your computer. Recycle your body. Register as an organ donor, and spread the word. You can help the next Steve Jobs reboot the machine that matters most.
William Saletan @'Salon'