Elizabeth Holmes Isn’t Fooling Anyone
The convicted fraudster and founder of the defunct medical start-up Theranos, is waiting to begin an 11-year sentence in federal prison. She received this punishment for misleading investors about her lab-in-a-box technology, which she claimed could run hundreds of tests on a few drops of blood. In reality, when Theranos’s Edison device wasn’t exploding, it was delivering unreliable results to frightened patients. Holmes’s fall from grace—she was once the youngest self-made woman billionaire—has been described over and over again. But there’s still a little more blood left in this stone.
On Sunday, The New York Times ran a profile of Holmes—which included the first interview she’s given since 2016. The author, Amy Chozick, suggests that she was charmed by Holmes, the devoted family woman. Chozick writes that Holmes is “gentle and charismatic,” and “didn’t seem like a hero or a villain. She seemed, like most people, somewhere in between.” This flattering or at least ambivalent tone was not well received. The Axios editor Sam Baker picked the article apart on Twitter. The emergency-medicine physician Jeremy Faust called it “credulous drivel.” Journalists and doctors alike argued that the Times had erred by helping Holmes rehabilitate her image.
When mistakes happen in the health-care system, doctors try to trace their origin to broken processes. Errors are addressed at the system—not individual—level: If a patient receives an incorrect dose of a medicine, for instance, the blame doesn’t necessarily fall on the nurse who administered it or the physician who prescribed it. The entire drug-delivery process, from pharmacy to bedside, is carefully inspected for unsafe practices. The media—and their content-delivery process—have been going through a similar postmortem over the Theranos debacle. Before John Carreyrou broke the bad news about the company at The Wall Street Journal, reporters were happy to write flattering profiles of Holmes with only the most rudimentary caveats. Even the Journal praised her before it damned her. But the Times’ latest visit to Holmesville suggests that this unsafe practice is still in place.
[Read: Theranos and COVID-19 testing are mirror-image cautionary tales]
As a pathologist—a doctor who specializes in laboratory testing—I’ve been following the Theranos story since the beginning. Holmes’s rise and fall is the most glamorous scandal to hit my field in some time: Most are more body-parts-in-the-back-of-a-pickup than celebrity-stuffed financial crimes. Just last week, I was giving a grand-rounds talk about Theranos. Loopholes in laboratory regulation and widespread ignorance of how blood testing works had caused medical professionals and the public to fall for diagnostic scams, I told the academics in attendance. Toward the end of the lecture, I posed a question: Have the media learned their lesson after enabling Holmes’s charade?
Much has changed about science reporting in the years since Holmes’s disgrace. I’ve watched the media’s discussion of novel health technologies grow more nuanced and leery. Major news outlets now go out of their way to emphasize the precariousness of early study findings. I’ve been getting more calls from journalists who seek a skeptical perspective on some new lab test or scientific finding. But there are cracks in the media’s armor. The weakest component is the headline: You can still declare all manner of decisive breakthroughs, as long as you append “scientists find” to the title. Another persistent problem is that medical controversies are reported out study by study. Back-and-forth articles about contested areas offer ready-made drama but little clarity. (Masks help prevent COVID; wait, they don’t work at all; never mind, now they do again.) When doctors evaluate the latest research, we recognize that some methods are more reliable than others. Wisdom comes from learning which results to ignore, and scientific consensus changes slowly.
But journalists’ most stubborn instinct—the one they share with Holmes—is to lean into a good story. It’s the human side of science that attracts readers. Every technical advance must be contextualized with a tale of suffering or triumph. Holmes knew this as well as anyone. She hardly dwelled on how her devices worked—she couldn’t, because they didn’t. Instead, she repeatedly told the world about her fear of needles and of losing loved ones to diseases that might have been caught earlier by a convenient blood test. Of course reporters were taken in. The next entrepreneur to come along and tell a tale like that may also get a sympathetic hearing in the press.
Holmes understood that almost everyone—journalists, investors, patients, doctors—can be swayed by a pat narrative. She’s still trying to get ahead by telling stories. In offering herself up to the Times as a reformed idealist and a wonderful mother, Holmes adds to a story that was started by her partner, Billy Evans. As part of Holmes’s sentencing proceedings last fall, Evans wrote a multipage letter to the judge pleading for mercy, which was accompanied by numerous photos of Holmes posing with animals and children. “She is gullible, overly trusting, and simply naive,” Evans wrote about one of the great corporate hucksters of our era.
Journalists are still telling stories about her too, for better or for worse. Holmes is not naive, nor are most readers of The New York Times. While last weekend’s “a hero or a villain” coverage may be said to have betrayed the patients who were harmed by her inaccurate blood tests, and the memory of a Theranos employee who died by suicide, it is also just another entry in the expanded universe of Holmes-themed entertainment. There are books and podcasts and feature-length documentaries. A TV miniseries about Holmes has a score of 89 percent on Rotten Tomatoes. (“Addictively engrossing!” “Consistently entertaining!”) Surely some of those who now bemoan the Times’ friendly treatment have consumed this material for less-than-academic reasons.
The prosaic details of a convicted cheat’s domestic life aren’t really news, but they are interesting—because the character of Elizabeth Holmes is interesting. So, too, are her continued efforts to spin a narrative of who she is. But with such well-trodden ground, the irony is built right in. You know that Holmes is a scammer. I know it. On some level, The New York Times seems to know it too; the article runs through her crimes and even quotes a friend of Holmes’s who says she isn’t to be trusted. This isn’t character rehabilitation; it’s content. We’re all waiting to see what Liz gets up to next. Have the media learned their lesson? The real test will arrive when the next scientific scammer comes along, and the one after that—when their narrative is still intact, and their fraud hasn’t yet been revealed. At that point, the system for preventing errors will have to do its work.