I read a terrific new book this weekend, Bad Blood: Secrets and Lies in a Silicon Valley Startup.
John Carreyrou of the Wall Street Journal tells the story of Theranos, a company with a brilliant idea that promised a revolution in healthcare but ended up as a billion dollar scam that delivered nothing.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]When will we accept that the claims of breastfeeding advocates were always too good to be true?[/pullquote]
It reminded me of breastfeeding.
Theranos was the brain child of Elizabeth Holmes, who dropped out of Stanford at 19 to create it, a needle-phobe who envisioned running hundreds of blood tests using a single drop of blood drawn from a finger stick.
It was an idea that was too good to be true — literally. But Holmes would not, could not admit the truth even though it became clear early on that her vision was a physical impossibility. Despite what her engineers were telling her, Holmes doubled down again and again: 200 test results from a single drop of blood became 800; the number of companies supposedly using her test successfully multiplied while in reality no one was using it; most egregiously, she faked test results and offered those results as real. Along the way, naysayers were fired and silenced with iron clad non-disclosure and non-disparagement agreements.
Theranos was the healthcare version of “vaporware”: software announced with great fanfare, promising the moon to secure massive outside investment, but ultimately delivering nothing but misery and bankruptcy. Breastfeeding is another healthcare version of vaporware, promising extraordinary savings in lives and healthcare dollars, endlessly touted to secure ever larger outside investment, but ultimately delivering more than its share of misery and medical illness.
The claims about breastfeeding have always been too good to be true. It has been promoted as the “perfect” food for newborns when we know that nothing in nature is perfect. It has been promoted as lifesaving when we know that for most of human existence all infants were breastfed and they died in droves and though contemporary countries with the highest breastfeeding rates have the highest infant mortality rates. It was promoted to solve a problem that was fundamentally misrepresented. Babies died in Africa as a result of Nestle’s greed in encouraging African women to formula feed. But the problem was never the formula; it was the contaminated water used to prepare it.
The similarities don’t end there. Elizabeth Holmes had a wonderful vision of hundreds of tests from a single drop of blood and she was determined to “fake it until you make it.” She really believed that if she could dream it, she could make it happen. She would not compromise her vision merely because reality got in the way.
For the past 40 years or so professional lactivists have had a wonderful vision of every baby being breastfed and surviving until old age because of it. They really believed that if they could dream it, they could make it happen. They refuse to compromise their vision merely because reality gets in the way. The benefits don’t materialize and the risks keep mounting, yet they’re still trying to fake it until they make it.
Elizabeth Holmes sold many otherwise hard headed people on her vision to the tune of billions of dollars in investment. They believed in the dream; they wanted it to be true; and they were taken in by her lobbying efforts. Once a few prominent investors were on board, it was easy to recruit others. If former Secretaries of State Henry Kissinger and George Schultz were investing, it must be true! Others rushed to copy them.
Professional lactivists sold many healthcare professionals on their vision to the tune of millions of dollars. Lactivist lobbying initially swayed the World Health Organization and ultimately recruited the CDC, the American Academy of Pediatrics and the American College of OB-GYNs. If those eminent organizations were supporting breastfeeding, the claimed benefits must be true. Others rush to copy them. The Baby Friendly Hospital Initiative was created and welcomed into hospitals; it promised to increase breastfeeding rates and save money at the same time!
Elizabeth Holmes ran into problems early on; the product failed to perform. In response she began to fake results; testing blood on conventional machines back in company headquarters and wirelessly transmitting the results to her machines to make it look as though they were working. She continued to ignore the evidence brought to her by her staff that the product not only didn’t work but couldn’t work.
Breastfeeding advocates ran into problems early on; some women didn’t have enough breastmilk. In response, they began to lie, claiming insufficient breastmilk was rare when it is actually common. Then the touted benefits failed to appear. In response, they began promoting mathematical models which extrapolated weak, conflicting data riddled with confounders to make it look like the claims were true. Whenever new evidence appears that contradicts early claims, and it appears often, it is simply ignored.
When Holmes deployed her devices, they began to harm people by delivering faulty results. Holmes did not back down. She and her lawyers harassed and threatened the doctors and patients who complained.
Aggressive breastfeeding efforts are harming babies, increasing injuries and deaths from dehydration, jaundice and babies smothered in their mothers’ hospital beds. Professional lactivists have not backed down, dead babies be damned. Their organizations harass and demean founders and members of the Fed Is Best Foundation, accusing them of being in the pay of formula companies without even a shred of evidence to support those claims.
To this day Elizabeth Holmes maintains that her dream of hundreds of tests performed on a single drop of blood is possible and will happen. This despite the fact that she has been sanctioned by various government organizations, has seen her net worth drop from billions to zero, and may face criminal charges for fraud. She cannot be shaken from her conviction that merely imagining something is possible makes it possible.
To this day professional breastfeeding advocates repeat the claims of lifesaving benefits of breastfeeding without any risks. This despite the fact that babies have literally died from insufficient breastmilk and the closing of well baby nurseries, despite the scientific papers showing that most of the claimed benefits don’t really exist, and despite the utter failure to appear of touted improvements in lives and money saved. They cannot be shaken from the conviction that merely insisting breastfeeding is lifesaving makes it so.
One of the saddest incidents in Bad Blood occurs when Tyler Schultz, grandson of major Theranos investor George Schultz goes to work for the company. He quickly realizes Theranos is a scam that is harming patients. He quits, tells his grandfather what he’s learned and cooperates with the Wall Street Journal investigation. It destroys his relationship with his grandfather who refuses to believe that Holmes’ claims weren’t and couldn’t be true. Tyler Schultz is excluded from his grandfather’s 95th birthday party; Elizabeth Holmes is invited.
It remains to be seen how organizations and providers scammed by the breastfeeding industry react to the rising tide of data showing that breastfeeding saves neither lives nor healthcare dollars and may actually put both at risk. Will they reject the scientific evidence and the growing clamor from mothers of babies who have been harmed or will they accept reality that the claims of breastfeeding advocates were always too good to be true? Only time will tell.
