How tech billionaires are disrupting biomedical science

Twenty-second of October. Rain on the glass all afternoon, and I have been reading about money entering laboratories the way meltwater enters a valley - from above, in a rush, carving new channels as it comes.

The question posed is whether philanthropy changes how science is done. Of course it does. But the interesting question is not whether; it is where along the gradient the change registers. Follow the transect: at the summit sits the donor, whose fortune came from a system that rewards speed, scale, and the elimination of friction. Descend one altitude and you find the institute director, who now writes proposals calibrated to a patron’s enthusiasms rather than a peer review panel’s scepticism. Descend again: the postdoctoral researcher, whose project lives or dies by whether it flatters the funder’s theory of the disease. At the base of the mountain, the patient, who receives whatever the gradient delivered.

Here is what troubles me. The instrument I trust most is the one that can be checked by a stranger. Peer review is imperfect - I have seen it reject what time vindicated - but it is a measurement anyone can repeat. A patron’s conviction is not repeatable. It is a single reading, taken once, at one altitude, and then generalised to the whole mountain.

And yet I will not be a hypocrite. My own expeditions were financed by a fortune not mine, and I answered to it. The difference, if there is one, lies in whether the funder permits the result to contradict the premise. Fund the question, not the answer.

The practitioners know this already - the lab technicians, the nurses in the trial wards, the people who handle the samples at three in the morning. Ask them what changed. They will tell you before the journals do.

Twenty-second of October.

A question arrived today in the pages of a journal I read: whether the money of prosperous men is changing how the science of the body is done. I turned it over as I would turn a stone in my hand, looking for the fracture line.

Here is what I notice first, before any theory: the money does not enter the laboratory as money. It enters as a schedule. A grant from a public body is a slow river - it moves by committee, by season, by the deliberation of many men who must agree. A grant from a single wealthy patron is a canal cut straight to the site. Same water. Different channel. And the shape of the channel determines where the sediment settles.

Consider the wing. A bird’s wing flexes along its whole length, distributing load through many small articulations, each doing a little work. A rigid glider wing carries the same load through fewer points, and those points must be stronger, and if one fails the whole surface tears. A laboratory funded by one hand has the load distribution of the glider. It flies higher, faster, and it has fewer places to fail - but each of those places bears more.

I do not say this is corruption. I say it is a change in the geometry of force. The question is not whether private money is good or bad. The question is whether the structure that receives it can bend without breaking.

Three things I have not solved. Whether a canal that moves fast also moves straight - that is, whether speed in funding narrows the questions asked. Whether the many-articulated wing is slow only because it is cautious, or because caution is itself a kind of knowledge. And whether the body of science, like the body of a man, heals better from many small wounds than from one large one.

I have not yet determined whether the patron’s hand and the committee’s hand produce different truths, or only different timetables for the same truth. The question stays open.

22 October 2026.

The gentlemen from the software trade have discovered medicine, and I am told we should all be grateful, and I believe I am. A man who has made nine hundred million dollars teaching people to click a button has now decided that the human liver is a solvable problem, and he has brought to it the two habits that made him rich: moving fast, and being certain.

I have no quarrel with the money. Money is a fine thing to have in a laboratory, and better there than in a yacht. What interests me is the method. The old way of finding out whether a drug works was to give it to some people and not to others and then wait, sometimes for years, in a state of ignorance that the researchers found almost unbearable. The new way, as I understand it, is to decide first that the drug works - this is called having a vision - and then to arrange the evidence around the vision like flowers around a monument.

They speak of “disrupting” the science, which is a word that means the stagecoach has been overturned and everybody is very excited about the speed.

I have always wondered why the man who is most certain he is right is so seldom the man who has checked. In my day the quack sold his bottle from a wagon and was gone by morning. Now he sells it from a platform, and the wagon is worth forty billion dollars, and the bottle is the same bottle.

The river taught me one thing, and it was this: the water does not care what you believe about it. You may call the bar deep or shallow, and it will take your boat either way. The body is a river of that kind. It has drowned better men than these, and it has never once read a press release.