With apologies to punk composer Jello Biafra, hype today is more than alive and well – its popularity is surging. From politcs to economics to health care, what “just might possibly be true” is crowding out the dusty, dull details of reality. So let’s examine why audacious hype appears so preferable to cautious hope –and the nasty implications for national health and health care. We’ll end with the cautionary example of Theranos – another “revolutionary” company that “will change how everything is done.”
Why Prefer Hype?
Yes, humans like to fantasize. But the brain often gives preferential attention to salience – the needle in the haystack we need to find so we won’t get pierced. Just as people can get used to the smell of slaughterhouses and sleep peacefully through the screaming cries of “subways,” we really notice something that looks novel.
Now, marry brain preferences for the the New to the Net – where billions of voices fight to be heard and what seems to only count is what can be counted – and hype wins the contests for attention. Soon, many media sites regard hype as not just preferable, but necessary. For example, which headline is more noticeable – “American Rice Production Declines by 0.2% in 2014” or “Post Office Taken Over by Aliens?” And so the “rankings” go – which is why the bizarre more rapidly becomes viral than the mundane. If you don’t believe that, look to politics.
Rarely has boring been so unpopular. Could a candidate like Dwight Eisenhower truly win a presidential election in our time? Probably not without spin doctors performing quantum backflips in hyperspace.
Politics – what Jay Leno calls “show business for ugly people” – has now become a favored playground for purveyors of escalating hype. Acting ability – as in the capacity to “put across oneself” in debates – is now far more important to many than experience, track record, or competence. To take recent examples: 1. A giant wall across the U.S. – Canadian border will stop terrorists “from reaching our shores.” (Scott Walker) 2. Eleven million people in the United States can be easily and rapidly deported at minimal direct costs, and costs to humanity and the economy (and just who will be picking strawberries and lettuce?) 3. Taxes can be cut across the board – especially for those millions – and the ensuing leap in business investment will so juice the economy that the Federal Budget deficit will rapidly disappear. (Forget history on this one – the verdict is distinctly negative – whatever happened to people doing simple arithmetic? You collect less money and immediately have more to spend?) 4. Global climate change is not happening and we don’t need to do anything about it (as with low-lying Florida’s Governor Scott – who has made it clear state employees cannot even talk about such matters.) Disregard what’s happening to Arctic ice sheets or Pacific temperatures – have these folks looked outside recently, or just walked along a beach?
Given the extrusion of reality from national political discourse, it’s no surprise that health care hype ascends new heights.
Health Care Hype and Theranos
Magic is in the air. So says Silicon Valley, which has a parade of magicians punching out business plans created on custom start-up software. No wonder companies valued at more than a billion dollars – especially ones with virtually no revenue or history – are known as “unicorns.”
One prominent, very large and hungry unicorn is Theranos. The basis for the company seems compelling – with all the cheap new sensors and computer hardware/software out there, can’t we take the tiniest drop of blood from you and run all the lab tests devised since creation for practically no money?
In keeping with the hype economy of Silicon Valley, for whom the Pet Rock was just an underperforming slight of hand, Theranos has positioned itself as the “destabilizer” of the lab testing business. Lots of people want it to succeed. Lab tests are extraordinarily expensive, hard to obtain, run by a relatively small cartel of companies, and often inaccurate.
But as the Wall Street Journal is proposing, Theranos may be another of those Silicon Valley companies which promise everything but only plan to deliver at the very last moment – after the capital for expansion and development has been collected and sieved. Some ex-employees declare Theranos’ tests are not accurate – and the company ends us using the same old labs and techniques for most of what they do.
That’s a big problem. In a world where what is counted counts, and what is not counted disregarded, physicians and other health workers often believe lab tests before they believe their eyes. Today what matters are the numbers – for “the numbers are real,” as if symptoms and medical signs are not. And few physicians – let alone the public – understand the statistical bases for these studies, or how they can be misleading or inaccurately performed.
So where numbers are king, false numbers prove deadly. Theranos or someone else should pull it off – the technological ideas behind quick and efficient assays are compelling – but in health care, hype is particularly dangerous.
For bodies don’t care much about lab tests. They rebuild and regenerate themselves according to their own rules, and retain their secrets. So when test numbers are false, the rest of the daisy chain of inference is rapidly and often fatally corrupted.
Hype’s popularity has many pitfalls – for all of us. But did you hear that President Putin, Forbes “most powerful man in the world,” is actually a thoughtful, far seeing extraterrestrial who just wants to save humanity?
Just remember – you heard it here first.