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.
Powell talked to eating disorder specialists and psychiatrists, but her husband tended to shun them. He refused to take any medications, or be treated in any way, for his depression. “When you have feelings,” he said, “like sadness or anger about your cancer or your plight, to mask them is to lead an artificial life.” In fact he swung to the other extreme. He became morose, tearful, and dramatic as he lamented to all around him that he was about to die. The depression became part of the vicious cycle by making him even less likely to eat.