By now you've probably seen several reports about how Steve Jobs, 55, has taken a medical leave of absence to focus on his health. According to the New York Times, an anonymous source at Apple stated that Jobs had been looking "increasingly emaciated," and that he was on a "down cycle" leading up to his medical leave announcement.

It's well-known that Jobs had pancreatic cancer, a rare form called islet cell neuroendocrine tumor with an incident rate of 2 per 1 million people. He was originally diagnosed in 2003 and successfully treated with a variation on the "Whipple" procedure, called a pancreatoduodenectomy, on July 31, 2004. This procedure includes the removal of part of the stomach and small intestine, portions of the duodenum, the head of the pancreas, the gallbladder, the common bile duct and regional lymph nodes.

According to a Fortune magazine profile of Jobs, for nine months leading up to his surgery he tried alternative therapies, with reports that he had initially refused traditional Western medicine. He finally acquiesced to pressures from those close to him after a scan revealed growth in his tumor, and went through with the Whipple procedure. Without having to receive chemotherapy or radiation, he ended up recovering, back at Apple shortly after his surgery.

WWDC 2006, 2007, 2008

Over the next few years, Jobs became noticeably thinner. It's not uncommon for those who have undergone a Whipple procedure to lose body mass. However, according to The Center for Pancreatic and Biliary Diseases at the University of Southern California, Department of Surgery, it's usually only around 5% to 10% of the body's regular weight, and "stabilizes very rapidly". Based on his appearance, this hasn't seemed to have been the case with Jobs.

When he announced the iPhone 3G on June 9, 2008, about four years after his original cancer surgery, his weight sparked rumors in both the media and the Apple community that his cancer had returned. Apple PR was quick to respond, with the Wall Street Journal reporting that he was suffering from a "common bug."

In January 2009, he took another medical leave of absence. Just like now, the media was buzzing. To quell speculation, Jobs wrote an open letter to the Apple community on Jan. 5, right before MacWorld 2009 San Francisco, explaining that his weight loss was due to a hormone imbalance that had been "robbing" his body of essential proteins, and that he had already begun treatment.

Guest author Ryan Vetter is a Project Manager at liquidpubs. He has published articles on MacNN, and is the author of an upcoming book "People, Technology, and Change". His interests revolve around education, publishing, and technology.

One week later, he wrote an email to Apple employees explaining that his health issues were "more complex" than he had originally thought, and that he would be taking a six month medical leave of absence. During his absence, Tim Cook, Apple's COO became operations manager while Jobs remained CEO and was still involved in all major strategic decisions for the company.

The same month in which he was to return from his absence, The Wall Street Journal reported that Jobs had received a liver transplant in Tennessee and was recovering. As Fortune would later report, he flew to Switzerland prior to his transplant to undergo an "unusual radiological treatment" at the University of Basel. According to Fortune, he chose the University of Basel because it had developed a unique form of hormone-delivered radiotherapy to treat neuroendocrine cancer. This treatment isn't currently available in the U.S.

When Jobs appeared on stage at an Apple Special Event in September looking frail and speaking in a soft-pitched voice, he told the world that he had indeed received a liver transplant. It?s still unclear whether the transplant was due to a recurrence of cancer spreading to his liver, or because of some other reason. However, it may have been due to a recurrence of his cancer, since a liver transplant is a treatment option for people whose neuroendocrine tumors have metastasized to the liver itself. This would also explain his trip to Switzerland.

Now that he's on another medical leave of absence, there's speculation that he has either had a recurrence of cancer or that he's having difficulty with the immunosuppressants he takes, better known as anti-rejection drugs. Without these drugs, the body would quickly mark and attack any transplanted organs because they contain foreign DNA.

Since we're not at a the point where we can grow new organs from patients' own stem cells, Jobs has to deal with the side effects of anti-rejection drugs. Those are increased risks of disease and infection, in addition to an increased risk of tumors recurring. Apple is characteristically tight-lipped about Jobs' medical issues, and has not stated exactly what kinds of medical problems he?s experiencing.

There has been much debate about whether shareholders have the right to know more details about the CEO's condition, including information about a succession plan.

Here's why I'm not terribly interested in succession plans.

Let's assume for the moment that Jobs will not be returning to Apple.

 

Apple Without Jobs

 

There?re two camps when it comes to the topic of Apple sans Jobs. One camp is optimistic. Apple is comprised of great people from top-to-bottom, and because the company has so much depth, it would continue to be successful well into the future - particularly because it's believed that it has a set of products and services in the pipeline that will carry it for the next two-to-five years.

The other camp is not so optimistic. They believe Apple will never be the same company without Jobs. The thinking goes something like this: Apple equals Steve Jobs. Without Jobs, there is no Apple. As many great people as they may have, without a leader to steer the ship, there will be no vision, no navigator.

I tend to side more with these folks than I do with the optimistic ones. I don't think Apple will fall face-first if Jobs is unable to return, but eventually, it'll lose some ground and focus. Jobs is a special kind of person. He's one of the few that can lead a company through all the competitive detritus in the world, and make it sing.

Thanks to Jobs, Apple is one of the most innovative companies. He's the perfect blend of a consumer and a businessman all wrapped into one, creative, visionary body. He strives for ultimate perfection and accepts nothing less. With his famous reality distortion field, he?s able to push people to new heights, and shake up entire industries. He's a Da Vinci and a tyrant all in one.

From all the little decisions to all the big ones, Jobs has his hand in a lot of it. You can see his name on an array of Apple?s patents for instance. He was even known to pick the music for iPod commercials. Since his return in 1997, Apple has become very dependent on his leadership and vision, and the culture that he infused into the company. As a result, he?s the source of Apple?s greatest strength. But he?s also the source of its greatest weakness, and that?s simply because he's irreplaceable.

Photo credits: top photo by BENM.AT Live Coverage; WWDC 2006, Collin Allen; WWDC 2007, acaben; WWDC 2008, Tom Coates; Newsweek, Business Week and Time magazine covers via Ballistik Coffee Boy; UnixWorld via mrbill.

 

A History of Apple Without Jobs

 

During Jobs' absence, Apple ended up nearly bankrupt. According to Jobs, when he first got back to Apple, it was within 90 days of bankruptcy. The stock had tanked; its product line was a mess. There was no real business strategy.

While anything can happen in the future, we do have some prior knowledge of what Apple was like without Jobs at the helm. Let's look back to 1983. Jobs et al. were hard at work on the all-in-one Macintosh computer. With sales of its previous computers, like the Apple II, having transformed it from being a basement business into a multi-million dollar company in just a few years, it needed to not only look like a big company, but act like it too.

In order to achieve this, Jobs, among others at Apple, decided that they should bring in someone from the corporate world to run things. At this point, Jobs and company were self-aware enough about how hippy-ish Apple's culture was and that it needed some kind of father to come in and watch over it.

Jobs and the company chose John Sculley, the CEO of PepsiCo. Sculley exemplified the cold, withdrawn, hard-nosed CEO they were looking for. In a now famous line, Jobs called up Sculley and said, "Do you want to sell sugar water for the rest of your life or do you want to come with me and change the world?" While they developed a close relationship in the beginning, Sculley was immediately taken aback by how out-of-control both Jobs and Apple as a company was upon his arrival. For instance, as Sculley stated in his memoir Odyssey, at one of his first meetings with Jobs and other Apple executives, there were people interrupting and insulting each other, acting rude. "Many of them traded insults as often as kids used to trade baseball cards," he wrote.

Fast forward two years. At this point, Sculley managed to rally the board against Jobs, which resulted in him being removed from power. Feeling dejected, Jobs left Apple in September, 1985. Shortly before Jobs?s departure, Sculley had also executed a massive layoff, axing 1,200 jobs from Apple?s payroll. Apple wouldn't be same again until 1997, when Jobs officially came back to Apple.

During Jobs' absence, Apple ended up nearly bankrupt. According to Jobs, when he first got back to Apple, it was within 90 days of bankruptcy. The stock had tanked; its product line was a mess. There was no real business strategy. Sculley was responsible for a lot of the trouble Apple was in. As Jobs said in an interview in Rolling Stone in 1994:

 

"[Microsoft was] able to copy the Mac because the Mac was frozen in time. The Mac didn't change much for the last 10 years. It changed maybe 10 percent. It was a sitting duck. It's amazing that it took Microsoft 10 years to copy something that was a sitting duck. Apple, unfortunately, doesn't deserve too much sympathy. They invested hundreds and hundreds of millions of dollars into R&D, but very little came out. They produced almost no new innovation since the original Mac itself."

 

Billions of dollars were spent under Sculley's rule, with hardly any product output. For instance, Apple tried to create a new, cutting-edge operating system in the late 1980s code-named "Pink". Because of problems with memory leaks, processing power and more, they weren't able to output a product. This was part of the beginning of Apple's troubles. With other expensive R&D initiatives that didn't result in any consumer products, the bills added up, and quickly.

In 1993, the same year the first Newton MessagePad was launched, Sculley?s pet project that ended up costing the company hundreds of millions of dollars, Apple was beginning to seriously question Sculley's ability to run the company. It didn't help that its six-year lawsuit against Microsoft over the ownership of a graphical user interface operating system had just been dismissed. Around this time, Sculley admitted to his secretary that he was tired and was thinking about leaving Apple. In June of that year, the board removed Sculley from power, and placed Michael Spindler as CEO.

Shortly after, Sculley left Apple.

By the end of 1996, Apple was in disarray, unable to recover from its past mistakes, and was on its third CEO of the decade. Its stock was trading at $5.22.

While there were some good things to come out of the company sans Jobs, like the PowerBook, it was losing relevance and desperately needed a new operating system. Windows had most of the world's market-share. At that point, Windows was more advanced than the Classic Mac OS, since it sort of multi-tasked, whereas the Classic Mac OS, full of legacy code and old technologies, didn't. The Mac had simply been frozen in time.

Since Apple failed at creating a new operating system, it decided to try and buy one.

But which one? There wasn't much choice. They courted a few companies, one being Sun Microsystems. But they soon found themselves on Jobs' doorstep. It was the little-known NeXT operating system they were after.

When Jobs had originally left Apple, not only would he go on to found Pixar, which produced Toy Story in 1995, he started a new computer company called NeXT, Inc. It was there that he created what many believed at the time to be the world's most advanced operating system: NeXTSTEP. It could multi-task, it supported multiple processors, and had excellent graphics support. It was essentially OS X, born 15 years earlier.

Apple came back into Jobs' life just at the right time. After some 10 years on the market, NeXT wasn't profitable. But it housed incredible innovation.

With Apple now at his mercy, Jobs had the opportunity to make something out of what he created at NeXT, and, most importantly, redeem himself. He seemed particularly focused on the latter. In an interview from Triumph of the Nerds, he had this to say about Sculley: "What can I say? I hired the wrong guy. He destroyed everything I spent ten years working for, starting with me, but that wasn't the saddest part. I would have gladly left Apple if Apple would have turned out like I wanted it to."

This was Jobs' chance to turn Apple around, and make it into the company he always wanted it to be. And that was a consumer company. Sculley lacked the unified vision Jobs had for Apple, teetering between a focus on business and an interest in consumers. This confused Apple's R&D initiatives and product lines. An example is the Newton.

As Jobs stated in the above-referenced Rolling Stone interview, "A perfect example is the PDA stuff, like Apple's Newton. I'm not real optimistic about it...they thought individuals were going to buy them and give them to their families...at $1,500 a pop with a cellular modem in them, I don't think too many people are going to buy three or four for their family. The people who are going to buy them in the first five years are mobile professionals." The Newton ended up being used by mobile professionals, and didn't gain much ground with consumers, just as Jobs had predicted.

Jobs had originally built the company around the idea that it was primarily to be a consumer company, betting against Xerox on the idea that personal computers were just that: personal.

He made a deal with Apple in 1997, sold NeXT and all its assets to them, and returned to run the company. He swiftly simplified and "consumerized" Apple's product line, reducing the number of products, and streamlining their marketing.

From 1997 until now, the rest is history. Apple's stock (NASDAQ:AAPL) went from a decade-low of $3.28 at the end of 1997 to a high of $348.60 as of January, 2011, with almost $60 billion in cash and marketable securities. Apple has risen to be the second most valuable publicly traded company in the world, second to Exxon (NYSE:XOM).

Shortly after Jobs returned in 1997, industry-changing products and services were spun out incredibly quickly; the Clamshell iBook, iMac and Titanium PowerBooks, Mac OS X, iTunes, the iPod, the iPhone, movie and TV show rentals, the MacBook Air, and the iPad, among others.

 

Jobs the Visionary

 

History doesn't necessarily have to repeat itself. However, since Jobs is so unique and adept at creating the most innovative consumer technology, if he is unable to return, not only will it be a major loss for Apple, but for the world. We'd be stuck with Microsoft's wares. Smartphones would likely still be dumb-phones. There'd be no iPad.

He's a change agent. We'll look back and marvel at his creations.

Jobs is one of the only individuals who has the ability to see the future with such sharp clarity, while at the same time is able to deliver that future today in a way that makes sense to consumers. As Sculley stated in Odyssey, his memoir, "What I perceived as symbols of the new technological age, Steve saw as low tech junk, remnants of antiquated technology that polluted the area's beauty. He was right. Steve was mentally living twenty-five years in the future."

In a now-famous interview in Playboy in early 1985, the interviewer asked Jobs about the purpose of personal computers in the home. Jobs replied, "The most compelling reason for most people to buy a computer for the home will be to link it into a nationwide communications network. We?re just in the beginning stages of what will be a truly remarkable breakthrough for most people--as remarkable as the telephone." And that's exactly what happened. The PC industry exploded as soon as the Internet hit critical mass.

A more recent example is from an interview Jobs did on CNBC after the announcement of the first iPhone in 2007: "I think the iPhone may really change the whole phone industry... I think this is where the world's going... This is the future... I don't see why everybody wouldn't want one of these."

I hope history doesn't repeat itself should Jobs end up not returning to Apple. And we may not even reach that point. He could get better, and be right back at the helm full-time. In fact, in a recent study , long-term survival rates for neuroendocrine pancreatic cancer can be as high as 77% post-surgery.

Here's hoping that Jobs makes a speedy recovery.

WWDC 2010 photo by BENM.AT Live Coverage.