Denis Pombriant is a retired, board certified, medical technologist.
Understanding Elizabeth Holmes’ guilt is as easy or as difficult as knowing what a femtoliter (fL) is. It’s an impossibly small volume, 10–15 liters, for comparison a milliliter is 10–3 or one one-thousandth of a liter. A femtoliter is fivefold smaller. In medical testing it is the unit that describes the volume of a red blood cell. In humans the normal range for a red blood cell’s size is between 80 and 100 fL.
Red cells need to be that small because they must squeeze through narrow capillaries to bring oxygen to all the tissues of the body. They can be larger or smaller than that range, but those sizes often indicate pathology. That’s the reason we do medical laboratory testing — if you find the outliers, you find disease. Most of medicine and medical testing amounts to ruling things out.
In medical testing everything you can think of analyzing for has important parameters that are the knife’s edge between health and disease. Some tests measure a quantity or volume, others measure activity such as for a particular enzyme. Some testing happens in vitro, the autoanalyzer equivalent of a test tube, while other tests require a trained technician to view something under a microscope. You can learn a lot looking at a blood smear, urine sediment or even plain spit that way.
Knowing all of this is what makes up modern medical practice and it takes years of training. People with medical degrees, Ph. D’s, even engineering degrees have, over many years come together to build this body of knowledge; they have patents and copyrights and most importantly bibliographies.
Bibliographies are very important because new knowledge rarely comes from a lone wolf researcher burning the midnight oil. Knowledge builds on knowledge evidenced by a trail of academic papers that have been peer reviewed, questioned and found valid by the medical and scientific community. A researcher might use another’s published findings to further some understanding of basic science. All of this is a life’s work at the most rigorous level.
In contrast, Elizabeth Holmes dropped out of school at 19, the age when people who give their lives to the study and practice of medicine take introductory chemistry in college. Holmes’…