Over There, Tod writes about Theranos with some stuff that didn’t make it into an article he wrote for Marie Claire.

I have some comments on a couple of them. First, about Holmes herself:

When speaking in public, Homes has an awkward, stilted way about her. She’s monotonous and unemotional. While others on Ted Talks vibrantly emote, Holmes just kind of dully drones on. When answering tough questions in interviews, she tightens up and looks nervous, her face a mask of forced smiles.

There’s nothing wrong with that, of course. Lot’s of people simply aren’t good on stage or interacting with people they don’t know, especially on camera. If you’re one of those people, you can sound boring, or look like you’re being disingenuous or hiding something, even if you’re not. The point simply being that when looking for a reason for how Holmes not only got away with doing what she did for as long as she did, but also for how she became a near-universal media darling, the answer “charisma” falls woefully short.

I was really taken aback when I saw my first Holmes interview. She wasn’t at all what I expected, which I guess was Melissa Mayer more or less. I’d seen pictures of her and except for the carefully staged ones, she looks… always. Pretty, in her own way, but very awkward in demeanor. Which maybe should have been an indication that she was not as polished as Mayer, but didn’t quite serve that way. Until her fall from grace, it actually made me like her more. There was a bit of phoniness about a Geek’s understanding of what a Cool Kid is, but emphasis on Geek. A kinship, of sorts.

The second is about narratives, which I think is important but have comparatively little to add:

No one who had Holmes answer their questions with that answer on national television was under any illusion that Holmes was in any way answering that question, let alone addressing a very real serious public health concern about her product. But no one cared. In every case, the person interviewing her smiles and nods, and moves on to ask her how awesome it is to be the world’s youngest female self-made-billionaire, or what it’s like to truly make the world a better place, or some other totally unserious question that fits the narrative they set out to push before they ever lined up their interview questions.

Theranos became a public health problem because it was in Theranos’s interests to push a narrative that simply and obviously was never true. But it became one too because it was in the media’s interest to do the same.

This worries me about media coverage generally. I was talking on Twitter with someone recently about globalism and how one of the criticisms may be off-base. He asked whether I actually believed what the article said, given that it’s a pro-capitalism outfit and our masters all want us to believe it. I said that I believed it, but acknowledged something important: While I believe it’s true, I believe the media would tell us its true regardless of whether it’s true. I think the media does this about a lot of things, including trade, immigration, and race and gender narratives. Even political race coverage, wherein I believe the experts who say that Trump likely won’t win, but in the event that Trump were going to win, I believe they’d be saying… pretty much what they’re saying now. Which doesn’t lead to a reflexive disbelief on my part, but a persistent skepticism I don’t always know what to do with. But narratives are exceptionally important, and deviating from high society’s favored narratives is costly, which makes it easier for everybody to go along.

The last is a bit more political:

It turns out — and I know this will come as a shock to you — that most states have laws against medically testing people without a doctor’s consent, especially by medical testing facilities using procedures not approved by the FDA. Go figure! Turns out that Arizona also once had laws like this on the books. HB2645 essentially lifted those regulations so that Theranos could begin selling its tests to Arizona citizens.

Unsurprisingly, this strikes me as a more complicated issue. Yes, the Arizona legislature dropped the ball here. And they did so in service of a bad actor. And yet… medically testing people without a doctor’s consent doesn’t strike me as an inherently bad idea. I would say something about unapproved-by-the-FDA facilities and that being a good place to hang my hat, but… well, it’s the FDA. While the FDA might keep a company like Theranos from selling faulty goods, I don’t have a whole lot of difficulty believing they’d approach a good actor the same way.

And in a statement against interest, I believe we require a doctor’s consent on too much. A commonly cited example is birth control. Eyeglasses requirements are a bug up my craw as well. Doctors are too busy, and their time both too valuable and too expensive, to be involved in everything. Which gets to the difficult, nitty-gritty aspect of regulation. My approach here isn’t “Deregulate Everything!” but that some things that sound like a transparently bad idea – such as allowing blood tests without a doctor’s consent – may not be.

So while I can easily see that this particular manifestation of such deregulation is a bad idea, it’s not super clear to me what a better model looks like.

Addendum: Make it four. He mentions former Senate Majority Leader Bill Frist as someone who lent Theranos credibility. I only bring this up because when there was talk of a Third Party thing with a split of the GOP, I brought up Frist on a few occasions. It was said mostly jokey, as someone underwhelming to a group of people who had their eyes on Mitt Romney or John Kasich. Someone kind of dusted off the shelf because “Hey, he’ll work.” Anyhow, one thought I did have that didn’t make me like the idea is how much he cashed in after he left office. The Theranos thing doesn’t surprise me. Notably, though, he sold out in ways that Democrats would approve by speaking positively about PPACA.


Category: Hospital, Statehouse

About the Author

Will Truman (trumwill) is a southern transplant in the mountain east with an IT background who bides his time taking care of their daughter while his wife brings home the bacon. You will probably be relieved to know that he does not generally refer to himself in the third-person except when he's writing short bios on his web page.

4 Responses to Three Of The Five Things On Holmes

  1. Oscar Gordon says:

    I could see letting a person get a blood test without a doctor’s order, as long as the results were sent to a licensed MD (ideally, the person’s PCP) for proper interpretation.

    • trumwill says:

      To me, if the results need explaining, then you do start involving medical professionals. Ideally there would be some trigger than would say “Make an appointment with your doctor right away” if the results are concerning. Maybe with a 1-800 number.

      Assuming a test that actually works, of course. Which here is the main problem.

  2. While I believe it’s true, I believe the media would tell us its true regardless of whether it’s true. I think the media does this about a lot of things, including trade, immigration, and race and gender narratives.

    That’s a good way to put it, and it touches on my discomfort with the media view of a lot of today’s policy disputes. I think it goes beyond the media, however. Most (all?) groups/communities/individuals have a “common sense” narrative of the way things should work and that narrative will be used in support of factual claims even when those claims aren’t true.

  3. I said this Over There, but I could see her appeal as a speaker. She’s not a great speaker, of course. But she spoke clearly, stayed on message, and that message had much good about it (if you excise the lying).

    Maybe this is because I hadn’t heard about Theranos and Holmes until I read your and Tod’s pieces. So the bar was set pretty low. That probably made it easier for me to see the appeal.

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