In the biotech world, you can’t see everything

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In the biotech world, you can’t see everything

EXECUTIVE SUMMARY Earlier this week, I attended a screening of You Can See Everything, the buzzy new documentary about the disgraced former biotech CEO Elizabeth Holmes. I went in not really knowing what to expect. I’d avoided spoilers (and won’t be giving anything away here, either!). I was wondering what new information this film could reveal, given how familiar many of us are with the Theranos story thanks to years of media coverage, the best-selling book Bad Blood, and the Hulu series The Dropout, starring Amanda Seyfried.

执行摘要：本周早些时候，我参加了纪录片《你能看到一切》（You Can See Everything）的放映会，这是一部关于名誉扫地的生物技术公司前首席执行官伊丽莎白·霍姆斯（Elizabeth Holmes）的热门新片。我进去时并不知道会看到什么。我避开了剧透（这里也不会透露任何内容！）。考虑到我们许多人通过多年的媒体报道、畅销书《坏血》（Bad Blood）以及阿曼达·塞弗里德（Amanda Seyfried）主演的 Hulu 剧集《辍学生》（The Dropout）对 Theranos 的故事已经非常熟悉，我很好奇这部电影还能揭示什么新信息。

Like many others who have seen the film, I came away feeling unsettled. But not just about Holmes’s fraud and the somewhat disturbing interactions between the subjects. The film reignited a concern I’ve had about covering science for most of my career: Despite our best efforts, we never can actually see everything.

和许多看过这部电影的人一样，我看完后感到不安。这种不安不仅源于霍姆斯的欺诈行为，也源于片中人物之间令人困扰的互动。这部电影重新点燃了我职业生涯中大部分时间里对科学报道的担忧：尽管我们尽了最大努力，但我们永远无法真正看到一切。

In case you’re rusty on the details, Elizabeth Holmes dropped out of Stanford University in 2003 to run Theranos, a diagnostics company she founded, when she was just 19. She went on to claim that her company had invented a way to run over 100 diagnostic tests on just a few drops of blood. Holmes raised hundreds of millions of dollars for Theranos, which was valued at $9 billion in 2014. Forbes named her the youngest self-made female billionaire—she was worth $4.5 billion when she was just 30 years old.

如果你对细节有些生疏，伊丽莎白·霍姆斯在 2003 年年仅 19 岁时从斯坦福大学退学，创办了诊断公司 Theranos。她随后声称，她的公司发明了一种只需几滴血就能进行 100 多项诊断测试的方法。霍姆斯为 Theranos 筹集了数亿美元，该公司在 2014 年估值达到 90 亿美元。《福布斯》将她评为最年轻的白手起家女性亿万富翁——她在 30 岁时身价已达 45 亿美元。

Things started to unravel in 2015, when an investigation by the Wall Street Journal raised concerns by former Theranos employees that the tests didn’t work. Some also said that the company’s device had not been tested properly, and that blood samples had been analyzed on machines from other companies instead. MIT Technology Review named it one of the biggest technology failures of 2015. Forbes had revised Holmes’s worth to $0 by 2016.

事情在 2015 年开始败露，当时《华尔街日报》的一项调查引发了前 Theranos 员工的担忧，他们指出这些测试根本无效。一些人还表示，该公司的设备从未经过适当测试，血液样本实际上是在其他公司的机器上分析的。《麻省理工科技评论》将其评为 2015 年最大的技术失败之一。到 2016 年，《福布斯》已将霍姆斯的净资产修正为 0 美元。

That year, a damning government report said that the company’s lab was struggling with basic procedures and gave patients results even when they knew they could be wrong. In 2018, Theranos, Holmes, and former company president Ramesh Balwani were charged with “massive fraud.” In 2022, she was sentenced to a little over 11 years in prison for defrauding investors. She began serving her sentence in May 2023.

那一年，一份严厉的政府报告指出，该公司的实验室在基本程序上存在严重问题，甚至在明知结果可能错误的情况下仍向患者提供报告。2018 年，Theranos、霍姆斯以及公司前总裁拉梅什·巴尔瓦尼（Ramesh Balwani）被控“大规模欺诈”。2022 年，她因欺诈投资者被判处 11 年多监禁。她于 2023 年 5 月开始服刑。

It was around a month before this that filmmakers Nathan Fielder, Lance Oppenheim, and their colleagues began documenting Holmes and her partner, Billy Evans, at home with their two young children. I’m not giving anything away when I say it’s an extremely intimate portrayal—at least of how the two adults interact with Fielder, who is also a central character in the film. As you might know if you’ve seen the trailer, there are plenty of super close-ups. I felt as if I spent most of the film staring straight into the faces of those people. And almost the whole way through, they all seemed to be trying to figure each other out.

就在此约一个月前，电影制作人内森·菲尔德（Nathan Fielder）、兰斯·奥本海姆（Lance Oppenheim）及其同事开始记录霍姆斯和她的伴侣比利·埃文斯（Billy Evans）与两个年幼孩子在家中的生活。我可以说，这是一部极其私密的纪录片——至少在展现这两位成年人与同时作为片中核心人物的菲尔德之间的互动时是如此。如果你看过预告片，可能知道片中有大量的超近距离特写。我感觉自己大部分时间都在直视这些人的脸。而在整个过程中，他们似乎都在试图揣摩对方。

Holmes is known for her dishonesty, but she invited cameras into her home in an apparent bid to reframe the narrative and position herself as an honest person with an unusual mind. Will anyone believe her? I couldn’t help feeling some empathy for Holmes, a mother we see preparing to leave her two kids for a lengthy prison sentence. And even though I have long known the facts, Holmes is clearly an effective manipulator. You can see her plant the seeds of doubt in Fielder’s mind. At times, I felt she was convincing me, sitting in my cinema seat. Maybe she really didn’t mean to lie?

霍姆斯以不诚实著称，但她邀请摄像机进入家中，显然是为了重塑叙事，将自己定位为一个拥有非凡头脑的诚实人。会有人相信她吗？我不禁对霍姆斯产生了一些同情，我们看到她作为一位母亲，正准备离开两个孩子去服长期刑。尽管我早已了解事实，但霍姆斯显然是一个有效的操纵者。你可以看到她在菲尔德心中种下怀疑的种子。有时，坐在电影院里的我甚至觉得她快要说服我了。也许她真的不是故意撒谎？

But then I remembered how other journalists felt after being taken in by her claims. “I blew it,” Fortune’s Roger Parloff reflected in 2015, a year after profiling Holmes and her company. “I’m pretty sure she lied to me,” STAT’s Matthew Herper wrote recently, having interviewed Holmes in 2015. Even the former employee turned whistleblower Tyler Shultz, who knew the product didn’t work, said that he could “have a five-minute conversation with her and walk away feeling like my work was changing the world,” he said in 2022.

但随后我记起了其他记者在被她的言论欺骗后的感受。《财富》杂志的罗杰·帕洛夫（Roger Parloff）在为霍姆斯及其公司撰写专题报道一年后的 2015 年反思道：“我搞砸了。”STAT 的马修·赫珀（Matthew Herper）在 2015 年采访过霍姆斯后，最近写道：“我很确定她对我撒了谎。”甚至连转为举报人的前员工泰勒·舒尔茨（Tyler Shultz）——他深知产品无效——在 2022 年也表示，他可以“和她交谈五分钟，然后离开时觉得自己的工作正在改变世界”。

I didn’t cover Theranos in the 2010s. If I’d interviewed Holmes, would I have fallen for it all? One of the early red flags in the Theranos case was the lack of published, peer-reviewed data. Much of the company’s work was classified as a “trade secret.” Scientists tend to publish their work in journals—a slow process that involves having the work evaluated by often anonymous experts in the field, who provide feedback, highlight questionable conclusions, and often ask for clarification. Peer review is meant to add rigor to the publication process. You should be able to trust published scientific papers. Except that sometimes you can’t.

我在 2010 年代没有报道过 Theranos。如果我当时采访过霍姆斯，我会上当吗？Theranos 案件早期的危险信号之一是缺乏已发表的同行评审数据。该公司的大部分工作都被列为“商业机密”。科学家倾向于在期刊上发表研究成果——这是一个缓慢的过程，通常需要由该领域的匿名专家对工作进行评估，他们会提供反馈、指出可疑结论并经常要求澄清。同行评审旨在增加出版过程的严谨性。你应该能够信任已发表的科学论文。但有时你却不能。

Scientists aren’t perfect. Some will exaggerate their results or inflate their importance. Some manipulate data to serve a hypothesis. Sometimes these infractions are caught during peer review, but not always. There are plenty of examples of scientific findings that could never be replicated by other labs and ended up collapsing under the weight of real evidence. Many papers ultimately end up with corrections. Some are withdrawn—10,000 research papers were retracted in 2023.

科学家并不完美。有些人会夸大结果或虚报其重要性。有些人会操纵数据来服务于假设。有时这些违规行为会在同行评审中被发现，但并非总是如此。有许多科学发现无法被其他实验室复制，最终在真实证据的重压下崩溃。许多论文最终以更正告终。有些则被撤回——2023 年有 10,000 篇研究论文被撤回。

At any rate, there’s been a shift to sharing research in other ways. Today, many scientists opt to publish their work at preprint servers like arXiv, medRxiv, and bioRxiv before they submit them to established journals. Those outlets bypass peer review. So do company press releases, social media posts, and many conference presentations. And I get a lot of my stories from conversations and interviews. I’ll admit I’ve looked at a scientific finding and thought: A scientist has just said they’ve done that. How can I be sure they really have?

无论如何，研究分享方式已经发生了转变。如今，许多科学家选择在提交给知名期刊之前，先将研究成果发布在 arXiv、medRxiv 和 bioRxiv 等预印本服务器上。这些渠道绕过了同行评审。公司新闻稿、社交媒体帖子和许多会议演讲也是如此。我有很多报道素材来自谈话和采访。我承认，我曾看着一项科学发现心想：一位科学家刚刚说他们做到了这一点。我怎么能确定他们真的做到了呢？

I like to think that I hold myself to high journalistic standards here, as does everyone at MIT Technology Review. I would never publish a story about some new scientific development without doing my own form of peer review, and asking scientists—ideally people I know and trust—what they think of a new claim. But the film is a stark reminder of how easy it can be to fall fo

我愿意相信，我在这里坚持着高标准的新闻准则，正如《麻省理工科技评论》的每一位同仁一样。在没有进行我自己的“同行评审”之前，我绝不会发表关于某项新科学进展的报道，我会询问科学家——最好是我认识并信任的人——他们对这一新主张的看法。但这部电影是一个鲜明的提醒，提醒我们陷入骗局是多么容易。