The Obstinacy of the Real

We live in an age of denial. On all fronts of public life, the last few decades have seen a retreat from a shared world of publicly identifiable facts. These facts, first and foremost, have been the facts of science whose whole mission is to provide claims to truth that can be verified.

It began with the faux “debate” over climate change, moved on to vaccines, and now is part of the more mundane world of what happens on any given day in politics. In the process we’ve become lost in a house mirrors where prominent actors on the public stage feel free to make, and stand by, claims that bear no resemblance to real world we must all share.

In this light the astonishing and spectacular rise and fall of the technology company Theranos has a lot to teach us. The principle lesson of this story is that reality always wins.

The story of Theranos has been expertly captured in a recent HBO documentary, The Inventor: Out for Blood in Silicon Valley. If you have not already encountered Theranos, and its enigmatic leader Elizabeth Holmes (pictured above), the two hours of HBO’s effort is worth your time.

The broad outlines of the arc are as straightforward as they are surprising. Holmes, a young Silicon Valley entrepreneur, aims to disrupt the world of medical testing. Instead of expensive blood tests involving long needles plunged into your arm to draw vials of blood, Holmes dreamed of quick finger sticks that pull just a drop of blood into tiny “nanotainers.”  The miniaturized blood samples would then be analyzed on-site with her company’s revolutionary lab-in-a-box machine dubbed the Edison. With the Edison, people could get fast, inexpensive, and painless lab tests. The name of the company was meant to initiate a world where there would be no space between therapy and diagnosis—Theranos.

Holmes’ star rose like a rocket as the company attracted both huge investments and praise from public figures like George Schultz, Henry Kissinger, and Joe Biden. At its peak, Theranos was valued at $9 billion, and Holmes was featured on almost every major news outlet. She was, we were told, the new embodiment of Steve Jobs, out to disrupt an industry (medical testing) which was greedy, bloated, inefficient, and hated by everyone.

There was, however, one small key problem with the story: The Edison didn’t work. Even with $9 billion and an army of smart, hardworking scientists/engineers, the lab-in-a-box concept—all using just a drop of blood—was impossible to build.

One of the most important parts of the HBO documentary comes via interviews with the people tasked with the science. Holmes kept upping the number of tests the Edison was supposed to carry out, but the engineers struggled to get even basic tests automated within the microwave oven sized machine. Pipettes broke. Centrifuges spun off their housings. Too much heat was generated within the machine. To the scientists and engineers, it was clear they were running up against the limits of what was physically possible.

But Holmes and Theranos’ upper management could not, and would not, hear it. Any dissent meant the dissenter was clearly not “on board” with the company’s vision. Perhaps, it would be suggested to the scientist who raised a science issue, that they just weren’t meant for a company on the frontiers like Theranos.

Truth matters

In the end, the truth came out. Theranos, built on a house of cards, saw its valuation drop from billions to nothing at all. Now Holmes and her partner are awaiting trial for various versions of fraud.

As you can imagine, a great deal has written about Theranos as an object lesson for Silicon Valley’s “fake it until you make it” ethos. Much ink has also been spilled on how Holmes’ story underscores how far one can now get in public life by simply lying with determination. Where once there was the possibility of shame, now there is only the dreaded loss of Twitter followers.

While all this is interesting, the lesson I want to focus on is the sad, or perhaps hopeful, fact that facts will always triumph.

Science has always been a method of entering in a conversation with the world. It’s a commitment to following a set of rules for interaction with reality. You figure out how to pose a question and then let the answers—the data—take you in their own direction. In the end, the thing that makes science so valuable is the investigator’s determination to play by the rules so that nature can speak for itself. Sometimes the answers are clear. Sometimes they are more vague and require honesty about how far they’re taking you. But always and forever, science is about the commitment to the process.

There is no short cut around reality. No amount of hope or righteousness or fast talking can undo the world’s own ways of behaving or the ways of science for making that behavior apparent. In the end, be it the rising temperatures and tides of climate change or the spread of long forgotten diseases because we’ve abandoned vaccinations, reality has the last word.

This is real lesson of Theranos. Elizabeth Holmes had lost herself in Silicon Valley’s belief that it’s all about the will to achieve. Believe hard enough, work hard enough, and you will triumph.  But the laws of thermodynamics were immune to her will. Just as they, and all the other principles of nature, are for all of us.


Jennifer Lawrence will play Holmes in Bad Blood, an upcoming feature film about the rise and fall of Theranos, and Hulu is planning a series about the story with Kate McKinnon in the lead role.

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Frank is a professor of astrophysics at the University of Rochester.