The Inventor. Or everything that’s wrong with America. Part I

The Inventor, the documentary about Theranos founder, Elizabeth Holmes, debuted on HBO this week. Check it out if you have a subscription.

There’s also a podcast on the same subject, The Dropout, and a book, Bad Blood, by John Carreyrou, reporter for the WSJ.

A little background: Elizabeth Holmes came from a well connected family and went to Stanford for all of three semesters before she dropped out to start Theranos. Theranos promised to be able to diagnose illness with a little finger stick instead of a vial or two of blood. The nanotainer of blood would be fed into a black box called Edison and analysts would receive data from Edison that they would interpret and send back to the patient or the patient’s doctor.

Now, this actually sounds like a great idea. And someday, I think we’ll get there. Someday.

The problem is that Holmes was all of 19 when she started the company and if there’s one thing we in the pharma R&D industry learned from bitter experience is that biology is WILDLY different from a Intel Chip. It’s a YUGE difference. I can’t even tell you how big a difference it is. You think you have a problem making some calculation about Boeing airplanes that would keep them from suddenly plunging towards the ground but it’s nothing compared to systems biology or trying to figure out how to make a kinase inhibitor specific enough without triggering up and downstream ripple effects.

I guess that what I’m trying to say is that Silicon Valley vastly underestimates the challenges of a startup where biology is involved. It’s used to “trial and success” because everything it is doing is based on some man made object or code. The physics are pretty well understood. There’s nothing made there that can’t be unmade. You can predict or reason your way around every product. New stuff can be interesting but in the end, nothing is hard except for coming up with a good idea.

Biology is just not like that. Not even the assays are like that. And cells can be fickle and do whatever the hell they want for no apparent reason at all.

It’s not that Theranos wasn’t a good idea. It’s that a 19 year old with very little experience, or even many lab courses, was trusted with billions of dollars in start up money before she understood what “trial and error” means. Learning on the job is fine, as long as you understand that the learning will take a decade or two to really get the hang of it. It means reading a lot of papers, not just the business proposals and marketing glossies.

Sure, a really gifted person might have pulled this off. But when it came right down to it, Holmes was merely bright and had no idea what she was getting into.

There was one thing unusual about her. She didn’t blink. I’ll leave that nugget to the psych majors out there.

Some people will excuse her behavior and say that she was simply naive, got over her head and the lies spiraled out of control. But I don’t think that’s the whole story. Part II of this post will deal with her backers. What they say reveals a lot about how they see the world, success and inheritance. They’re wrong about most of it but, unfortunately, we’re forced to live with their rules.

There’s the rub.