Thread by @Rick_Pescatore

Every week in the ER I meet people whose symptoms are real but invisible to every tool we have.

There’s a name for why medicine keeps missing them…and it’s not what you think:

Eroom’s Law is the observation that drug discovery gets slower and more expensive every decade, despite better tools, better data, and better computing.

Some PhDs and MBAs think it’s an economic problem.

But it’s not.

It’s a measurement problem.

We’ve been building drugs on top of disease models that don’t match the people living the disease.

Nausea that derails mornings.
Pain that arrives like weather.
Flares tied to stress, meals, hormones, sleep—but never captured in a chart.

Normal labs. Normal imaging. Normal everything…except the person’s life.

When you sit at the bedside long enough, you see the same pattern:

Medicine doesn’t dismiss these patients because it doesn’t care.

It dismisses them because it can’t measure what they’re describing.

Medicine was never built to detect the biology beneath their symptoms—the biology within their biography.

I once treated a woman who checks the “temperature of her face” every morning because it predicts whether she can keep food down.
Another feels a tight band under her ribs hours before every flare.

For decades, medicine treated details like these as curiosities.
They aren’t.

They’re physiological signals:

unrecorded, uninvestigated, and unknown.

A teenager who vomited until he burst capillaries in his eyes was told it might be anxiety.
He knew the timing, the triggers, the sequence of every episode.
He was the most accurate narrator in the room.
But the system had nowhere to store his truth.

This is where Eroom’s Law actually lives.
Not in budgets or timelines, but in the widening gap between human experience and the models we use to define and cure disease.

Drug discovery keeps getting harder because we start with the wrong assumptions.
If you misdefine the phenotype, you misdefine the biology.
And if you misdefine the biology, no amount of downstream brilliance can rescue the program.

Across medicine, the same story repeats.
People living with chronic nausea, fatigue, dizziness, pain, crashes, flares, food reactions, sensory overwhelm, hormonal swings—
all reporting patterns that are consistent, predictable, and physiological.

The problem isn’t mystery.
The problem is that our system never built a way to capture any of it.

I’m an emergency physician who has practiced across multiple health systems, cultures, and continents.
And no matter where you work, one rule never changes: pattern recognition is the core of care.

Your ability to save a life depends on catching the real signal in the noise.
And one truth becomes impossible to ignore:

The body tells the truth…if you know how to listen.

The failure in modern medicine isn’t a lack of data.
It’s a lack of the right data—
the lived, structured physiology patients report every day.
The patterns that predict flares, recoveries, and crashes long before any lab value moves.

You can’t fix Eroom’s Law with bigger datasets or sleeker algorithms.
You fix it by grounding discovery in the real human phenotype.
By collapsing the search space before the first molecule is modeled.

That’s why we built a system that starts with the human pattern itself—
the day-to-day physiology people have been forced to track in their heads—
and turned it into the foundation for how we understand, model, and ultimately treat these conditions.

Because when you begin with the real phenotype—the actual biology expressed in lived experience—everything downstream changes.

Mechanisms become visible.
Targets make sense.
Discovery accelerates.

And patients stop waiting decades for answers that should have come years ago.

If Eroom’s Law is the story of medicine drifting away from the people it was meant to serve, then the next chapter is simple:
Listen harder.
Measure what matters.

Start with the humans who’ve been screaming the truth all along.