Bad Blood by John Carreyrou: A Piercing Look at the Myth and Bust of Theranos and Elizabeth Holmes

For five years, during the entirety of my master’s degree and beyond, I worked as a TA. I was a French literature and film studies student at the Department of French at my university. A native Spanish speaker, I was a fluent French speaker by then and taught the introductory French course for first-year students, French 100.  The class was taught in English at the beginning and gradually moved into an almost French class at the end as students learnt the basic language for communicating in the classroom.

Gradually, I started to get assigned more advanced courses, with intermediate French students. Over those five years, I never not felt nervous when stepping in front of the class and to this day, I have dreams of looking at the clock and realizing the class is starting in ten minutes and I haven’t prepared for it. No matter how many hours I prepared, how I went over every single question the students could ask, how I reviewed lists and lists of vocabulary, I was always terrified. My fear was that I would be found out to be an impostor. I was not a native French speaker, so how could I pretend I could teach people to speak French? For most of those years, I hadn’t even been to France, though I had lived in Quebec for a year and a half and moved around solid francophone circles. Still, the fear was too much.

When I graduated, I realized I could not be in front of a classroom, not because I didn’t enjoy it, but because calming the fear through hours and hours of preparation was exhausting, and in the end, debilitating. When I found a position as a bilingual researcher at a local firm I felt better, but the fear was still very present every time I had to do big, long, technical interviews as part of our projects. Eight years later, I still get nervous I will be found out: and now I feel nervous not only about my language skills but my research and analysis skills. The impostor syndrome is strong.

This is what I kept thinking about when reading Bad Blood: Secrets and Lies in a Silicon Valley Startup by John Carreyrou. It tells the story of Elizabeth Holmes, the founder and CEO of Theranos, a blood-testing`87 company based at the heart of Silicon Valley in San Jose, California, and how her obsessive drive to change the world led her down a path of dangerous lies, deception, and ultimately, fraud.

I first heard about this story through a great podcast recommendation somebody made online. I quickly listened to The Dropout, a six-part podcast about the rise and fall of Theranos, but felt after I finished it that I still didn’t understand how Elizabeth Holmes had built a company, valued at its peak at $9 billion USD, based on faulty science and technology that didn’t work.

That’s where Carreyrou’s book comes in. The reporter, a veteran of investigative journalism at the Wall Street Journal, was the first to break the story with a series of articles he published starting in October 2015 and which he later, thankfully, turned into a book. Indeed, this is a story so impossible to believe that the best way to understand it is through the long-form only a book can offer. In Bad Blood, Carreyrou carefully lays out every aspect of Holmes’ trajectory, from the days she was a 19-year-old dropout from Stanford University in California, to the moment she became the disgraced CEO of Theranos after the publication of his initial investigative article. The story is gripping on many levels.

It is a story about Silicon Valley and how it has become synonymous with the myth of the renegade genius, the dropouts who went on to become the founders of the tech giants who have changed so much of how we live our lives today: Bill Gates, Mark Zuckerberg, and of course, Steve Jobs. Elizabeth Holmes, as many young people did at the peak of his and Apple’s creative power, deeply admired Steve Jobs and she sought to emulate him in ways both overt and subtle, down to the way she dressed and ran her company.

It is the story of a bright, even brilliant young woman who after completing only a couple of semesters at university,  came up with an idea and then sat down for five days straight to write a patent for an arm band, a medical device, that would diagnose and offer treatment to patients at the same time. Soon after she dropped out to fund a company that would make this device a reality. Later, after she founded Theranos, the idea would change into building a blood-testing device that would use only a couple of drops of blood to run hundreds of the most common blood tests needed by doctors to diagnose and treat patients.

It is also a story about the very specific American culture of ingenuity and entrepreneurship, a place where a dream, no matter how impossible it seems, can become true if you believe in it and work on it long and hard enough. Elizabeth Holmes played this role perfectly, selling her idea to investor after investor, and putting together a board of directors that was a who’s who of former politicians and powerful businessmen.

It is a story about work, what we do for work, how far we are willing to go for our work, and of work culture in Silicon Valley, where companies build compounds fully equipped with gyms, napping areas, and multiple restaurants to encourage their employees to never leave work.

What I most appreciated in Carreyrou’s book, however, was the methodical approach with which he explained how Elizabeth Holmes went from an idealistic entrepreneur to a ruthless CEO who fired anybody who deigned contradict her ideas, usually with facts about the faulty and deeply troubling lab results her device, the Edison, was actually producing. Elizabeth Holmes was so fixated with the idea of changing the world that she went to extreme lengths to cover up the fact that the technology her company created simply did not work. Was it delusion, hubris?

It’s hard to understand Holmes’ motivation, though as her company started to be successful, millions pouring in after each round of investment, she quietly enjoyed many of the luxuries that money gave her. Later, when she became a celebrity after being featured on the cover of Fortune magazine, she seemed to enjoy her status as the female darling of the tech world, appearing in multiple TV interviews and even more magazine covers. Only once, from all the stories related by Carreyrou’s sources, did she externally betray some of the fear she may be hiding behind her façade.  It was a few days before the launch of the Theranos blood-testing technology at Walgreens – a $140 million contract – when Alan Beam, Theranos’ laboratory director came to see Holmes to ask her to delay, the technology simply wasn’t ready. She was visibly shaking but she still reassured him they would be able to launch and be OK. Reading this I wondered what kind of anxiety-filled dreams did Elizabeth Holmes had during this time, did she even have them? Did she experience guilt or regret? This is not clear, because if she did, she never admitted it, not to any of the employees, junior and senior, who confronted her with questions and facts, nor to Carreyrou, who repeatedly asked her for an interview before he published his first article on the Journal; she never responded.

This book is also an example of the power of investigative journalism, and how more than ever we need it as a tool for accountability when all the other systems and institutions fail. Elizabeth Holmes started out really wanting to change the world, to get there she grossly overstated the capabilities of her technology and bought — as did all the investors, young graduates applying to her company, the newspapers and magazines, and those hungry to see a woman rise up as the next star of Silicon Valley – too much into her own mythology. She was all image and no substance, all dream and bravado but very little science, facts, and sense of morality to back it up.

Read Bad Blood: Secrets and Lies in a Silicon Valley Startup by John Carreyrou.
And listen to The Dropout.

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