One Such Narrative

 I once made a phage display library. The CEO of the company had a narrative he wanted to push. We find a peptide that binds to a protein and we can deliver drugs to specific targets. Making the library was in the realm of complicated. It required a background in many laboratory techniques but most people should be capable of learning how it is done. The narrative on the other hand required a Cargo Cult Scientist. 

After my cohorts and I had been sacked the Cargo Cult Scientists set themselves to work. They published a paper. They patented the library and the idea behind it. They sent the library to a professor in a far away land who reported back that everything was going well. Nothing specific was ever reported but the company renewed the professors contract and sent out a press release stating that all was going according to plan.

Then the company failed. The CEO had been fired. The President of the company had been sent forth to sell the narrative. I last saw him on a stage presenting our research. He knew they fired the technicians. The whole idea failed to produce results but the narrative still had legs. The Presidents voice faltered as he told the tale. No one believed the technology was going to work. What magical pixy dust was being sprinkled on the phage display library in that far off land by the esteemed college professor? 

The President seemed to disappear. I hoped he hadn't done anything rash. He was a good person. His involvement with the Cargo Cults of Biotech had put him in a tight spot. What was his future?

Fast forward. The Chief Scientific Officer under the CEO and President had moved on to a new Cargo Cult selling a similar narrative. This company specialized in drug deliver systems. The former President now needed a job and was hired to push the narrative of the new company. He was hired in 2016. The company filed for bankruptcy in 2018. They were purchased for less than my old Seattle house sold for recently. 

In the word "Biotechnology" is technology. It is not science to produce or discover molecules that bind to other molecules. There are technologies such as phage display that one can use to find such molecules. Technology is real. Phage Display can find you a peptide that binds to a protein. Then what?

That is the point where most technologists lose their jobs. THEY are supposed to now make the technology fit the narrative. The narrative is the purview of the PhD. The narrative is what the C-level executives are selling. 

A New Alzheimers Drug

 The FDA approved a drug for the treatment of Alzheimers on June 6, 2021. 

Today FDA approved Aduhelm (aducanumab) to treat patients with Alzheimer’s disease using the Accelerated Approval pathway, under which the FDA approves a drug for a serious or life-threatening illness that may provide meaningful therapeutic benefit over existing treatments when the drug is shown to have an effect on a surrogate endpoint that is reasonably likely to predict a clinical benefit to patients and there remains some uncertainty about the drug’s clinical benefit.

In all of my experience with biotechnology, I have never worked at a company or research laboratory that did not have an amyloid beta project underway. Aduhelm is an antibody that binds to amyloid beta. In my core belief in the cynefin method of thinking (simple, complicated, complex), this approach has always been simple. Alzheimers, the human brain and aging are complex. Amyloid beta as a drug target is simple using complicated research and complicated methods of developing an antibody. Clinical trials are also complicated. BUT... to merely hire scientists to develop an antibody against Amyloid Beta is simple. Telling doctors and clinical trial specialists to hammer that square peg through a round hole is simple. 

But it didn't work. At least that was the conclusion in: 

https://www.health.harvard.edu/blog/a-new-alzheimers-drug-has-been-approved-but-should-you-take-it-202106082483

Once again, we really should look into science that isn't science. What prompted the powers that be to approve the drug? The need to fill the gap was too great. They needed to offer something even though that something doesn't work. 

What happens next? The answer is well known in the pharmaceutical industry. If the patient gets better... claim responsibility. If they get worse... they came too late. If they stay the same... up the dose. 

Elizabeth Holmes Enters the Cargo Cult Hall of Fame

Elizabeth Homes was on trial for fraud. She intentionally lied to people to enrich herself and maintain her multi-billion dollar biotech empire. But remember, biotechnology has a substantial cargo cult science branch of science and technology. What Ms. Holmes did was not unusual. Her crime against the good name of science is the same as most biotech/pharma companies. Fake it til you make it.

Biotechnology is good. It is real. I once argued with a distant family member over the existence of DNA. His church had put on a seminar by someone who argued that DNA is a man made construct. How then did I use it to do my work? How could I order a piece of DNA and end up with a protein that I could purify and use to do specific things?

Science is about the truth. Cargo Cult Science is about BS. A bullshit artist prefers the truth when they can use it but the narrative is of utmost importance.

Elizabeth did not create a blood testing device that provided accurate results. If you had a concentration of glucose in your blood of X you could not expect Theranos technology to ever know what X is. Theranos boasted that their blood testing device could perform 273 tests. No longer would a patient have to go into a hospital and pay the exorbitant cost of their tests. Using a device the size of a toaster one could get a pin prick, have the blood sucked into the Theranos "Nanotainer", insert the "Nanotainer" into the device and within an hour have the results sent to their doctor. The only problem was that the results were not accurate. The tests did not work

Now... to Elizabeth Holmes, this did not pose a big problem. She most likely assumed that scientists could be hired to sort out those pesky details. Her mission was go raise capital to hire the scientists and provide them with what they needed. What they all needed however was the scientific method. It's not for sale in the Sigma catalog. 

Any and all of the biotechnology companies that I worked for could have simply been a branch of Theranos. We all had the same problem. We began with an outcome that we would prefer. We then hired lower level "scientists" and forced them to provide evidence that the narrative is the truth. 

Perhaps Elizabeth Holmes did not know how science and technology works. Perhaps she believed that one begins with a narrative based on preference. Once the narrative began to fail she was too far into a lifestyle that was wildly exciting. Sitting on stage with Bill Clinton, face on the cover of Forbes, name on list of 30 (billionaires) under 30... must of have been intoxicating. She was in a place where she wanted to be. Science/technology would be her savior. She believed in science. She had faith. She did not understand that science is not about faith. 

Her story is a cautionary tale of how science can devolve into Cargo Cult Science. It costs people money, careers and freedom. As Elizabeth settles into her jail cell, many more will begin their careers in the life sciences. They too will begin pushing narratives that are not true. The world of life science, biotechnology and medical science is wrought with fraud. We do not have a sure fire way of weeding out the CCS folk from the good. It is only through the study of such cases as the Theranos fraud that we can advance our understanding of what is science and what is not. 

We have a long way to go. The scientific method remains in the same quandary as it did during Richard Feynman's day. 

"Most people believe so many wonderful things that I decided to investigate why they did." "So we really ought to look into theories that don't work, and science that isn't science."   -Richard Feynman. 

Rogan and Gupta

Recently there was an exchange between Joe Rogan and Sanjay Gupta on Joe's show. It involves the controversial subject of Covid 19 treatments. Let us explore the use of language in this story and how it applies to the Cargo Cult belief system. 

Stromectol is an anti-parasite human medication. DuraMectin is an anti-parasite horse medication. Both have, as the active ingredient, Ivermectin. Each drug has a name. They each have distinct ingredients. They are produced in separate locations by separate companies. They both use Ivermectin as the active ingredient. 

Was it accurate that Joe Rogan took a horse medication versus a human medication? Did CNN lie?

As you know, The Cargo Cult Scientist is interested in the truth and how we get at it. What we know in this case is that Joe took an Ivermectin drug prescribed by his doctor. We know that CNN people said that Joe took a horse medication. If (and we don't know this) Joe took Stromectol, we could ask CNN a different question. Is Stromectol a horse medication. If they say yes, then the onus is upon them to prove that point. The argument they will make will be that Ivermectin is the active ingredient used to treat horses for parasites. We would then be arguing whether or not an active ingredient is the same as a drug. 

Why does it matter? We human beings have different ways of dealing with the truth. If it suits our narrative we eagerly accept the truth and use it to make people think positively about our narrative. If it does not suit our narrative we downplay the truth. We find ways to discredit the truth. If we are clever we can fool people into focusing on the positive nature of our narrative while ignoring the negative impact the truth has upon our narrative.

This is a major factor in the Cargo Cult thought process.  If the positive aspects of the narrative outweighs the negative aspects of the truth, people will accept the narrative. 

"I think that there's a lot of people more concerned about being precisely, factually, and semantically correct than about being morally right." -Alexandria Ocasio Cortez

There is a reason why the scientific method has provided the world with so much. Human selfishness gets some people more than their fair share. It can also lead to a lifetime of unhappiness. Science only seeks to know the truth. Facts are used as tools to learn, not to manipulate the understanding of others. Being concerned about what is "morally right" is the purview of scoundrels. 

Joe Rogan put Sanjay Gupta on the spot. He didn't ask Gupta if CNN had lied. He told Gupta that CNN lied and he asked if that bothered him. Gupta finally had to admit, "They shouldn't have said that." In other words, a news agency should not intentionally lie. True.