Monologues for Molecules
A not-so-casual reminder that your molecule isn’t a molecule—it’s a movie pitch.
Dear reader:
Permit me the paranoid pleasure of sharing a secret—one whispered only in boardrooms behind frosted glass, at cocktail parties where dopamine agonists meet Doppler-affected agents:
The pharmaceutical industry is nothing more nor less than Hollywood wrapped snugly in a sterile white coat.
They've traded glittering sequins for sterile nitrile gloves; replaced three-act structures with pharmacokinetics; plot twists recast as mechanism-of-action. Narratives no longer whisper through Variety, but ripple anxiously through PubMed's cold digital arteries. Billboards on Sunset Boulevard give way to journal covers, yet the talent agents remain, discreetly rebranded as KOLs1, wearing wire-rimmed glasses and smiling knowingly at their residual checks—because, yes, the overlap between actors and KOLs is nontrivial, embarrassingly substantial, almost Pynchonesque in its shadowy omnipresence.
Both Hollywood and Pharma genuflect, in anxious obedience, before the same shadowy cartel, a clandestine deity known only as Narrative—bloodstream coursing with currency, hunger spreading neoplastically, unstoppably. Its smoke-filled temples hum with whispered pitch decks and the arcana of prestige; director's chairs stitched from a thousand stock options creak ominously beneath apparatchiks gripping MBAs like pearl-handled revolvers, cocked and trembling at the temple of Artifice itself.
Every molecule, a movie. Every trial, a screening. Every launch, opening weekend.
And the audience—half-distracted, restless, doom-scrolling endlessly—is you.
Both Pharma and Film traffic exclusively in one-offs, bespoke artifacts painstakingly hand-crafted through countless hours of desperate devotional labor, millions of dollars burned in effigy, lives shaped and twisted in service of an unseen god. Each project a singular gamble: one molecule, one movie—one trembling shot at immortality, or oblivion.
And with each wager, sacrifices must be offered: a screenplay, a molecule, a grad student's irrevocable twenties. Performances staged for shadowy watchers. Not metaphorical—but literal; financial; budgetary. The $2.8B lost on Exubera2, the decade-long tombstone marking Batgirl’s3 grave. Blockbuster success requires real burnt celluloid. The projector lamp flickers quietly.
And yet, perversely, crews were cast and credits rolled long before the cameras—or microscopes—ever flickered into life.
Into this arcane circus swaggered venture capitalists from Sand Hill Road, their eyes alight with messianic, digital fervor. These neo-Californian zealots mistook drug discovery for debugging code, human cells for silicon wafers, and pharmacodynamics for Moore's law. Whispering dark chants of “Minimum Viable Molecule” and "rapid pivots," they imagined mitochondria spinning obediently on AWS servers, proteins compiling cleanly in tidy sprints. Yet biology stubbornly, perversely refused to debug itself—INDs orphaned, clinical wreckage left strewn across portfolios in piles of promising disappointments. Flagship’s slow-motion implosions, OrbiMed’s covert retreats.
Bodies are not code. Cells do not pivot.
Meanwhile, across town—cut scene—indie biotech learned to shoot on shoestring budgets, Criterion austerity bleeding through each carefully staged narrative beat—no lavish costumes, no platoons of VPs. But even Criterion releases rarely become blockbusters; the biotech indices crater, leaving narratives unfinished and half-executed.
Belief, unmoored from discipline, metastasizes into delusion. And the studio system, collapsing under its own bloat, resurrects itself hauntingly in sterile white coats.
We choreograph frantically, stage-manage desperately, plot feverishly. Blockbusters are born in whispered pitches—Hollywood muttering "Jaws in Space!" while biotech reverently chants "PD-L1 inhibition for NSCLC!" VCs nod solemnly, playing studio executives; Scientific Advisory Boards smoke quietly, murmuring their casting notes. A term sheet, your greenlight. An IND submission, a nervous table read.
Then begins real dramaturgy:
Phase I—Does it kill?
Phase II—Does anyone feel anything?
Phase III—Do audiences applaud, or silently flee at intermission?4
And then a marketing assault: Nature covers, late-night TV rounds, prime-time commercials filled with CGI mitochondria, doctor-focused swag, CME dinners in hotel ballrooms. The molecule itself becomes secondary—narrative is the drug, brand the merch, belief the product.
They don't want art—they want sellouts.
The studio becomes a myth factory. Roivant becomes Miramax draped in biotech finery, each Vant a single-picture production house—casting, filming, cutting, wrapping. BridgeBio is the Producers Guild, orchestrating screenplays as molecules. Pfizer becomes Disney, monopolizing inflammation as Marvel does superheroes, with a solitary blockbuster funding a decade of flops.
They don’t want mere molecules; they seek franchises, dreams reincarnated endlessly in fresh shapes.
Now, we see not tragedy, but farce—too many scripts unwritten, too many directors vying, too few visionaries remaining. Sequels greenlit for movies nobody watched, molecules developed without mechanism, trials run blindly, hopelessly. Pharma as Hollywood: bloated, decadent, exhausted.
Yet, amidst the bloated wreckage, some auteurs endure—noir directors hiding behind fume hoods, method-acting PIs, CEOs glimpsing transcendence in Kaplan-Meier curves. They await their one shot.
And when that moment arrives—when molecules finally bind, when symptoms subside, when audiences, bewildered and grateful, rise to applaud—the lights flicker brighter, reality bends slightly, and we glimpse something almost magical.
Capital-M Magic.
The pharmaceutical industry, dear reader, remains cinema cloaked in sterile linens.
Both industries peddle one-off dreams. Both sell advance tickets to Tomorrow. Both industries tremble beneath spotlight scrutiny and cutting-room precision, whisper failures away into development hell, and constantly chase the ghostly shadow of unmet narrative.
And at their finest?
They alter lives, frame by frame, dose by dose, scene by scene.
Somewhere, in a fluorescent-lit clinic in Topeka or Tacoma, a patient swallows a pill and pauses—a flicker, uncertain.
Something, impossibly, changes.
That's the performance.
Key Opinion Leaders.
Exubera, Pfizer’s failed inhalable insulin, cost $2.8B and was discontinued in 2007 after abysmal sales. The metaphor writes itself.
Batgirl (2022), a nearly-finished $90M Warner Bros. film, was canceled for a tax write-off and never released. It lives on as a ghost.
You might also wedge in post-marketing surveillance as the Rotten Tomatoes of Pharma—where Phase IV is when the audience starts vomiting or tweeting or both.