Who Qualifies as an “Expert” And How Can We Decide Who Is Trustworthy?
This article is part of the magazine, "The Future of Science In America: The Election Issue," co-published by LeapsMag, the Aspen Institute Science & Society Program, and GOOD.
Expertise is a slippery concept. Who has it, who claims it, and who attributes or yields it to whom is a culturally specific, sociological process. During the COVID-19 pandemic, we have witnessed a remarkable emergence of legitimate and not-so-legitimate scientists publicly claiming or being attributed to have academic expertise in precisely my field: infectious disease epidemiology. From any vantage point, it is clear that charlatans abound out there, garnering TV coverage and hundreds of thousands of Twitter followers based on loud opinions despite flimsy credentials. What is more interesting as an insider is the gradient of expertise beyond these obvious fakers.
A person's expertise is not a fixed attribute; it is a hierarchical trait defined relative to others. Despite my protestations, I am the go-to expert on every aspect of the pandemic to my family. To a reporter, I might do my best to answer a question about the immune response to SARS-CoV-2, noting that I'm not an immunologist. Among other academic scientists, my expertise is more well-defined as a subfield of epidemiology, and within that as a particular area within infectious disease epidemiology. There's a fractal quality to it; as you zoom in on a particular subject, a differentiation of expertise emerges among scientists who, from farther out, appear to be interchangeable.
We all have our scientific domain and are less knowledgeable outside it, of course, and we are often asked to comment on a broad range of topics. But many scientists without a track record in the field have become favorites among university administrators, senior faculty in unrelated fields, policymakers, and science journalists, using institutional prestige or social connections to promote themselves. This phenomenon leads to a distorted representation of science—and of academic scientists—in the public realm.
Trustworthy experts will direct you to others in their field who know more about particular topics, and will tend to be honest about what is and what isn't "in their lane."
Predictably, white male voices have been disproportionately amplified, and men are certainly over-represented in the category of those who use their connections to inappropriately claim expertise. Generally speaking, we are missing women, racial minorities, and global perspectives. This is not only important because it misrepresents who scientists are and reinforces outdated stereotypes that place white men in the Global North at the top of a credibility hierarchy. It also matters because it can promote bad science, and it passes over scientists who can lend nuance to the scientific discourse and give global perspectives on this quintessentially global crisis.
Also at work, in my opinion, are two biases within academia: the conflation of institutional prestige with individual expertise, and the bizarre hierarchy among scientists that attributes greater credibility to those in quantitative fields like physics. Regardless of mathematical expertise or institutional affiliation, lack of experience working with epidemiological data can lead to over-confidence in the deceptively simple mathematical models that we use to understand epidemics, as well as the inappropriate use of uncertain data to inform them. Prominent and vocal scientists from different quantitative fields have misapplied the methods of infectious disease epidemiology during the COVID-19 pandemic so far, creating enormous confusion among policymakers and the public. Early forecasts that predicted the epidemic would be over by now, for example, led to a sense that epidemiological models were all unreliable.
Meanwhile, legitimate scientific uncertainties and differences of opinion, as well as fundamentally different epidemic dynamics arising in diverse global contexts and in different demographic groups, appear in the press as an indistinguishable part of this general chaos. This leads many people to question whether the field has anything worthwhile to contribute, and muddies the facts about COVID-19 policies for reducing transmission that most experts agree on, like wearing masks and avoiding large indoor gatherings.
So how do we distinguish an expert from a charlatan? I believe a willingness to say "I don't know" and to openly describe uncertainties, nuances, and limitations of science are all good signs. Thoughtful engagement with questions and new ideas is also an indication of expertise, as opposed to arrogant bluster or a bullish insistence on a particular policy strategy regardless of context (which is almost always an attempt to hide a lack of depth of understanding). Trustworthy experts will direct you to others in their field who know more about particular topics, and will tend to be honest about what is and what isn't "in their lane." For example, some expertise is quite specific to a given subfield: epidemiologists who study non-infectious conditions or nutrition, for example, use different methods from those of infectious disease experts, because they generally don't need to account for the exponential growth that is inherent to a contagion process.
Academic scientists have a specific, technical contribution to make in containing the COVID-19 pandemic and in communicating research findings as they emerge. But the liminal space between scientists and the public is subject to the same undercurrents of sexism, racism, and opportunism that society and the academy have always suffered from. Although none of the proxies for expertise described above are fool-proof, they are at least indicative of integrity and humility—two traits the world is in dire need of at this moment in history.
[Editor's Note: To read other articles in this special magazine issue, visit the beautifully designed e-reader version.]
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[Editor's Note: This video is the second of a five-part series titled "The Future Is Now: The Revolutionary Power of Stem Cell Research." Produced in partnership with the Regenerative Medicine Foundation, and filmed at the annual 2019 World Stem Cell Summit, this series illustrates how stem cell research will profoundly impact life on earth.]
Kira Peikoff was the editor-in-chief of Leaps.org from 2017 to 2021. As a journalist, her work has appeared in The New York Times, Newsweek, Nautilus, Popular Mechanics, The New York Academy of Sciences, and other outlets. She is also the author of four suspense novels that explore controversial issues arising from scientific innovation: Living Proof, No Time to Die, Die Again Tomorrow, and Mother Knows Best. Peikoff holds a B.A. in Journalism from New York University and an M.S. in Bioethics from Columbia University. She lives in New Jersey with her husband and two young sons. Follow her on Twitter @KiraPeikoff.
Elizabeth Holmes Through the Director’s Lens
"The Inventor," a chronicle of Theranos's storied downfall, premiered recently on HBO. Leapsmag reached out to director Alex Gibney, whom The New York Times has called "one of America's most successful and prolific documentary filmmakers," for his perspective on Elizabeth Holmes and the world she inhabited.
Do you think Elizabeth Holmes was a charismatic sociopath from the start — or is she someone who had good intentions, over-promised, and began the lies to keep her business afloat, a "fake it till you make it" entrepreneur like Thomas Edison?
I'm not qualified to say if EH was or is a sociopath. I don't think she started Theranos as a scam whose only purpose was to make money. If she had done so, she surely would have taken more money for herself along the way. I do think that she had good intentions and that she, as you say, "began the lies to keep her business afloat." ([Reporter John] Carreyrou's book points out that those lies began early.) I think that the Edison comparison is instructive for a lot of reasons.
First, Edison was the original "fake-it-till-you-make-it" entrepreneur. That puts this kind of behavior in the mainstream of American business. By saying that, I am NOT endorsing the ethic, just the opposite. As one Enron executive mused about the mendacity there, "Was it fraud or was it bad marketing?" That gives you a sense of how baked-in the "fake it" sensibility is.
"Having a thirst for fame and a noble cause enabled her to think it was OK to lie in service of those goals."
I think EH shares one other thing with Edison, which is a huge ego coupled with a talent for storytelling as long as she is the heroic, larger-than-life main character. It's interesting that EH calls her initial device "Edison." Edison was the world's most famous "inventor," both because of the devices that came out of his shop and and for his ability for "self-invention." As Randall Stross notes in "The Wizard of Menlo Park," he was the first celebrity businessman. In addition to her "good intentions," EH was certainly motivated by fame and glory and many of her lies were in service to those goals.
Having a thirst for fame and a noble cause enabled her to think it was OK to lie in service of those goals. That doesn't excuse the lies. But those noble goals may have allowed EH to excuse them for herself or, more perniciously, to make believe that they weren't lies at all. This is where we get into scary psychological territory.
But rather than thinking of it as freakish, I think it's more productive to think of it as an exaggeration of the way we all lie to others and to ourselves. That's the point of including the Dan Ariely experiment with the dice. In that experiment, most of the subjects cheated more when they thought they were doing it for a good cause. Even more disturbing, that "good cause" allowed them to lie much more effectively because they had come to believe they weren't doing anything wrong. As it turns out, economics isn't a rational practice; it's the practice of rationalizing.
Where EH and Edison differ is that Edison had a firm grip on reality. He knew he could find a way to make the incandescent lightbulb work. There is no evidence that EH was close to making her "Edison" work. But rather than face reality (and possibly adjust her goals) she pretended that her dream was real. That kind of "over-promising" or "bold vision" is one thing when you are making a prototype in the lab. It's a far more serious matter when you are using a deeply flawed system on real patients. EH can tell herself that she had to do that (Walgreens was ready to walk away if she hadn't "gone live") or else Theranos would have run out of money.
But look at the calculation she made: she thought it was worth putting lives at risk in order to make her dream come true. Now we're getting into the realm of the sociopath. But my experience leads me to believe that -- as in the case of the Milgram experiment -- most people don't do terrible things right away, they come to crimes gradually as they become more comfortable with bigger and bigger rationalizations. At Theranos, the more valuable the company became, the bigger grew the lies.
The two whistleblowers come across as courageous heroes, going up against the powerful and intimidating company. The contrast between their youth and lack of power and the old elite backers of Theronos is staggering, and yet justice triumphed. Were the whistleblowers hesitant or afraid to appear in the film, or were they eager to share their stories?
By the time I got to them, they were willing and eager to tell their stories, once I convinced them that I would honor their testimony. In the case of Erika and Tyler, they were nudged to participate by John Carreyrou, in whom they had enormous trust.
"It's simply crazy that no one demanded to see an objective demonstration of the magic box."
Why do you think so many elite veterans of politics and venture capitalism succumbed to Holmes' narrative in the first place, without checking into the details of its technology or financials?
The reasons are all in the film. First, Channing Robertson and many of the old men on her board were clearly charmed by her and maybe attracted to her. They may have rationalized their attraction by convincing themselves it was for a good cause! Second, as Dan Ariely tells us, we all respond to stories -- more than graphs and data -- because they stir us emotionally. EH was a great storyteller. Third, the story of her as a female inventor and entrepreneur in male-dominated Silicon Valley is a tale that they wanted to invest in.
There may have been other factors. EH was very clever about the way she put together an ensemble of credibility. How could Channing Robertson, George Shultz, Henry Kissinger and Jim Mattis all be wrong? And when Walgreens put the Wellness Centers in stores, investors like Rupert Murdoch assumed that Walgreens must have done its due diligence. But they hadn't!
It's simply crazy that no one demanded to see an objective demonstration of the magic box. But that blind faith, as it turns out, is more a part of capitalism than we have been taught.
Do you think that Roger Parloff deserves any blame for the glowing Fortune story on Theranos, since he appears in the film to blame himself? Or was he just one more victim of Theranos's fraud?
He put her on the cover of Fortune so he deserves some blame for the fraud. He still blames himself. That willingness to hold himself to account shows how seriously he takes the job of a journalist. Unlike Elizabeth, Roger has the honesty and moral integrity to admit that he made a mistake. He owned up to it and published a mea culpa. That said, Roger was also a victim because Elizabeth lied to him.
Do you think investors in Silicon Valley, with their FOMO attitudes and deep pockets, are vulnerable to making the same mistake again with a shiny new startup, or has this saga been a sober reminder to do their due diligence first?
Many of the mistakes made with Theranos were the same mistakes made with Enron. We must learn to recognize that we are, by nature, trusting souls. Knowing that should lead us to a guiding slogan: "trust but verify."
The irony of Holmes dancing to "I Can't Touch This" is almost too perfect. How did you find that footage?
It was leaked to us.
"Elizabeth Holmes is now famous for her fraud. Who better to host the re-boot of 'The Apprentice.'"
Holmes is facing up to 20 years in prison for federal fraud charges, but Vanity Fair recently reported that she is seeking redemption, taking meetings with filmmakers for a possible documentary to share her "real" story. What do you think will become of Holmes in the long run?
It's usually a mistake to handicap a trial. My guess is that she will be convicted and do some prison time. But maybe she can convince jurors -- the way she convinced journalists, her board, and her investors -- that, on account of her noble intentions, she deserves to be found not guilty. "Somewhere, over the rainbow…"
After the trial, and possibly prison, I'm sure that EH will use her supporters (like Tim Draper) to find a way to use the virtual currency of her celebrity to rebrand herself and launch something new. Fitzgerald famously said that "there are no second acts in American lives." That may be the stupidest thing he ever said.
Donald Trump failed at virtually every business he ever embarked on. But he became a celebrity for being a fake businessman and used that celebrity -- and phony expertise -- to become president of the United States. Elizabeth Holmes is now famous for her fraud. Who better to host the re-boot of "The Apprentice." And then?
"You Can't Touch This!"
Kira Peikoff was the editor-in-chief of Leaps.org from 2017 to 2021. As a journalist, her work has appeared in The New York Times, Newsweek, Nautilus, Popular Mechanics, The New York Academy of Sciences, and other outlets. She is also the author of four suspense novels that explore controversial issues arising from scientific innovation: Living Proof, No Time to Die, Die Again Tomorrow, and Mother Knows Best. Peikoff holds a B.A. in Journalism from New York University and an M.S. in Bioethics from Columbia University. She lives in New Jersey with her husband and two young sons. Follow her on Twitter @KiraPeikoff.