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By Roger Lowenstein

• May 21, 2018

BAD BLOOD Secrets and Lies in a Silicon Valley Startup By John Carreyrou 352 pp. Alfred A. Knopf. $27.95.

In 2015, Vice President Joe Biden visited the Newark, Calif., laboratory of a hot new start-up making medical devices: Theranos. Biden saw rows of impressive-looking equipment — the company’s supposedly game-changing device for testing blood — and offered glowing praise for “the laboratory of the future.”

The lab was a fake. The devices Biden saw weren’t close to being workable; they had been staged for the visit.

Biden was not the only one conned. In Theranos’s brief, Icarus-like existence as a Silicon Valley darling, marquee investors including Robert Kraft, Betsy DeVos and Carlos Slim shelled out $900 million. The company was the subject of adoring media profiles; it attracted a who’s who of retired politicos to its board, among them George Shultz and Henry Kissinger. It wowed an associate dean at Stanford; it persuaded Safeway and Walgreens to spend millions of dollars to set up clinics to showcase Theranos’s vaunted revolutionary technology.

And its founder, Elizabeth Holmes, was feted as a biomedical version of Steve Jobs or Bill Gates, a wunderkind college dropout who would make blood testing as convenient as the iPhone.

This is the story the prizewinning Wall Street Journal reporter John Carreyrou tells virtually to perfection in “Bad Blood: Secrets and Lies in a Silicon Valley Startup,” which really amounts to two books. The first is a chilling, third-person narrative of how Holmes came up with a fantastic idea that made her, for a while, the most successful woman entrepreneur in Silicon Valley. She cast a hypnotic spell on even seasoned investors, honing an irresistible pitch about a little girl who was afraid of needles and who now wanted to improve the world by providing faster, better blood tests.

Her beguiling concept was that by a simple pinprick — drawing only a drop or two of blood — Theranos could dispense with the hypodermic needle, which she likened to a gruesome medieval torture, and perform a full range of blood tests in walk-in clinics and, ultimately, people’s homes. The premise was scientifically dubious, and Theranos’s technology was either not ready, unworkable or able to perform only a fraction of the tests promised. Many of the people who showed up at clinics actually had their blood drawn from old-fashioned needles. And most of the tests were graded not by Theranos’s proprietary technology, but by routine commercially available equipment.

Despite warnings from employees that Theranos wasn’t ready to go live on human subjects — its devices were likened to an eighth-grade science project — Holmes was unwilling to disappoint investors or her commercial partners. The result was a fiasco. Samples were stored at incorrect temperatures. Patients got faulty results and were rushed to emergency rooms. People who called Theranos to complain were ignored; employees who questioned its technology, its quality control or its ethics were fired. Ultimately, nearly a million tests conducted in California and Arizona had to be voided or corrected.

The author’s description of Holmes as a manic leader who turned coolly hostile when challenged is ripe material for a psychologist; Carreyrou wisely lets the evidence speak for itself. As presented here, Holmes harbored delusions of grandeur but couldn’t cope with the messy realities of bioengineering. Swathed in her own reality distortion field, she dressed in black turtlenecks to emulate her idol Jobs and preached that the Theranos device was “the most important thing humanity has ever built.” Employees were discouraged from questioning this cultish orthodoxy by her “ruthlessness” and her “culture of fear.” Secrecy was obsessive. Labs and doors were equipped with fingerprint scanners.

The heart of the problem, Carreyrou writes, was that “Holmes and her company overpromised and then cut corners when they couldn’t deliver.” To hide those shortcuts, they lied. Theranos invented revenue estimates “from whole cloth.” It boasted of mysterious contracts with pharmaceutical companies that never seemed to be available for viewing. It spread the story that the United States Army was using its devices on the battlefield and in Afghanistan — a fabrication.

Even for a private company like Theranos, disclosure is the bedrock of American capitalism — the “disinfectant” that allows investors to gauge a company’s prospects. Based on Carreyrou’s dogged reporting, not even Enron lied so freely.

Carreyrou’s presentation has a few minor flaws. He introduces scores of characters and, after a while, it becomes hard to keep track of them. In describing these many players he sometimes relies on stereotypes. Of an employee “built like an N.F.L. lineman” the author writes, “his physique belied a sharp intellect.” Actually, it didn’t; big people can also have sharp intellects.

Such blemishes in no way detract from the power of “Bad Blood.” In the second part of the book the author compellingly relates how he got involved, following a tip from a suspicious reader. His recounting of his efforts to track down sources — many of whom were being intimidated by Theranos’s bullying lawyer, David Boies — reads like a West Coast version of “All the President’s Men.” The author is admirably frank about his craft. He feels a “familiar rush” when he hears that patient false negatives could be life threatening — i.e., that he’s onto a big story.

In the end, Carreyrou got the Boies treatment — angry (but ultimately hollow) threats of a lawsuit. Holmes also pleaded with Rupert Murdoch — the power behind The Wall Street Journal and, as it happened, her biggest investor — to kill the story. It’s a good moment in American journalism when Murdoch says he’ll leave it to the editors.

After Carreyrou’s front-page exposé was published in 2015, Theranos’s business prospects collapsed, directors resigned and the S.E.C. sued Holmes for fraud (she settled). The company also settled private suits. Federal regulators, already on the trail, found numerous violations, including sloppy lab procedures and unreliable equipment. Theranos, they determined, put patient health in “immediate jeopardy.” Several of the labs have been shuttered. Carreyrou has reported that Theranos is under criminal investigation and probably headed for liquidation.

The question of how it got so far — more than 800 employees and a paper valuation of $9 billion — will fascinate business school classes for years. The first line of defense should have been the board, and its failure was shocking. Some of the directors displayed a fawning devotion to Holmes — in effect becoming cheerleaders rather than overseers. Shultz helped his grandson land a job; when the kid reported back that the place was rotten, Grandpa didn’t believe him. There is a larger moral here: The people in the trenches know best. The V.I.P. directors were nectar for investor bees, but they had no relevant expertise.

Even outsiders could have spotted red flags, but averted their eyes as if they wanted to believe. Fishy excuses — Holmes blamed a production delay on an earthquake in Japan — were blithely accepted. When a Walgreens team visited Theranos it pointedly asked for — and was denied — permission to see the lab. A company consultant pleaded that the chain not go ahead with in-store clinics. “Someday this is going to be a black eye,” he predicted. But Walgreens was plagued by a “fear of missing out.” Like many executives, they were looking over their shoulder and not at the evidence.

Surely, no one suspected a lie that big. The fundamental premise “was to help people, and not to harm them,” Walgreens recounted, in a legal brief that sounded stunned. Yet another explanation is the gilt-edged and magical status that society confers on Silicon Valley, as a place where fantasies come true.

Roger Lowenstein, formerly a reporter for The Wall Street Journal, is the author, most recently, of “America’s Bank: The Epic Struggle to Create the Federal Reserve.”

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Bad Blood, book review: The rise and fall of Theranos

Bad Blood: Secrets and Lies in a Silicon Valley Startup • By John Carreyrou • Picador • 339 pages • ISBN: 978-1509868063 • £20

First they think you're crazy, then they fight you...and then they prosecute you for fraud because you were lying when you said you could change the world.

To be young, gifted, and blonde rarely hurt anyone trying to make their way through the world, and Elizabeth Holmes was no exception. By now, the basics of her story are fairly well-known: she dropped out of Stanford at 19 with a plan to revolutionise medical blood testing. The idea behind Theranos was transformative. Instead of drawing blood from people's veins, develop methods for testing on the much smaller volume produced by a finger prick. Less fear, less pain, and less medical knowledge needed. People would be able to do their own blood tests in their homes and have the results uploaded to their doctor for interpretation.

The fatal flaw in this plan was that medical testing isn't like software, where it's routine to handwave over the bits that don't work yet -- and anyway you're not liable because, see, it's right there in the clickwrap licence that whatever happens it's not your fault. Instead, with people's lives at stake, you've got regulators and scientists, who are used to inspecting devices closely and expect peer review. These folks lack a sense of humour about fakery.

But young, gifted, and blonde makes an impression, and the collection of names that Holmes collected as investors and board members is astonishing, though weirdly eclectic. Her board included Henry Kissinger, former Secretary of State George Shultz, and a smattering of former senators and other political bigwigs. The leaders of both the drugstore chain Walgreen's, and Safeway saw in Theranos the opportunity to reinvent their businesses at a time when new directions were needed. Rupert Murdoch invested $125 million of his own money. The famed lawyer David Boies took payment in shares to represent the company in attacking critics. On YouTube you can see former president Bill Clinton's enchantment.

SEE: Launching and building a startup: A founder's guide (free PDF)

The collapse began in late 2015, when Wall Street Journal reporter John Carreyrou told the world that the devices did not work as advertised. Holmes, who had been giddily enjoying the awards and attention, began facing less friendly interviews. In these , she displayed all the evasiveness and aggressive refusal to answer questions of a recent Supreme Court nominee.

In Bad Blood: Secrets and Lies in a Silicon Valley Startup , Carreyrou tells the entire astounding story, based on the extensive research he did for the 30 articles his newspaper published, beginning with Holmes's personal background and ending with her settling fraud charges with the Securities and Exchange Commission. A two-time Pulitzer Prize winner working for the leading US financial newspaper carries weight that is not easily dismissed, and despite lawsuits, threats and terrified witnesses, Carreyrou has long since been proven right. Holmes has had to pay back millions for voided medical tests and lost investments, and watch her personal net worth crash from $4.5 billion to zero. Now, Holmes and her former COO, Sunny Balwani , are facing criminal indictments for fraud. They are pleading not guilty.

One interesting note on the dynamics of being a woman in business. Carreyrou unearthed a suggestion that Holmes's natural voice is much higher than the unusually deep one sported by her public persona. Some internet commenters appear to find this offensively fake. Yet a young woman with a high voice is genuinely disadvantaged in business, and if Holmes had succeeded we'd call her 'smart'. Margaret Thatcher, who famously took voice lessons to deepen her voice and give it that authoritative ability to cut through the braying House of Commons like a buzzsaw, certainly was.

The lesson here, such as it is, should not be "See? You can't trust women entrepreneurs". Instead, it should be: no matter how charismatic the leader of the business is, and no matter how good their story, you must get appropriate experts to check out their claims. Investors were dazzled by the names on Holmes's board. That was fine in the 1980s when nascent businesses were writing hobbyist software. But today software has real consequences for safety in the physical world, and Silicon Valley investors can't go on "asking forgiveness, not permission". Due diligence has to mean more than following the person-to-person chain of trust.

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Bad blood: secrets and lies in a silicon valley startup by John Carreyrou: Book Review

• Book Review
• Published: 30 May 2020
• Volume 75 , pages 89–92, ( 2021 )

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Bad Blood: Secrets and Lies in a Silicon Valley Startup J. Carreyrou. New York: Knopf (2018) 299 pp. $27.95 ISBN 9781524731656.

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Wheeler, J. Bad blood: secrets and lies in a silicon valley startup by John Carreyrou: Book Review. Crime Law Soc Change 75 , 89–92 (2021). https://doi.org/10.1007/s10611-020-09906-1

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By John Carreyrou, A thrilling and sensational story of ambition, corporate fraud and deceit

Bad Blood: Secrets and Lies in a Silicon Valley Startup by John Carreyrou tells the story of Theranos, a biotech startup that had a staggering rise to a close to $10 billion valuation and an even more dramatic fall.

The very short version of this review: I was really impressed by this book.

Being in the Bay Area, I’ve heard so much about this, but figured it was mostly hype. When it finally popped up on Bill Gates’s list of Best Books of 2018 a few days ago, I decided to take the plunge.

Theranos Website Screenshot

Book Summary

For the Detailed Chapter-By-Chapter Summary, click here or scroll all the way down .

Bad Blood covers the fall of Theranos, a startup that was founded by Stanford drop-out Elizabeth Holmes when she was nineteen. It claimed to offer faster, cheaper blood tests from just a pinprick of blood ( see their demonstration on YouTube ), as opposed to traditional methods which require needles, lab equipment and technicians.

Over the course of a decade, it ballooned to a valuation of almost $10 billion, but within a few short years was defunct once it became clear their technology was not what they claimed. It’s a saga that ensnared a range of tech, legal, political and other industry leaders such as Henry Kissinger, Rupert Murdoch, and our current Secretary of Defense John Mattis.

While a number of articles have profiled the big issues — they were lying, duh — Bad Blood does a deep dive into the company’s culture and the thousand small decisions that preceded Theranos’ downfall. In also covers the war Theranos waged as the walls slowly started closing in on their fraud. Both Elizabeth and the company’s COO are currently facing serious jail time for wire fraud.

The book’s author, John Carreyrou, is the Wall Street Journal journalist who first started reporting on possible malfeasance at Theranos. He first reported in October 2015 that Theranos was secretly using traditional blood testing machines to test blood instead of their own technology.

I think Bill Gates’s description (which sold me on this book) sums it up nicely: “The story is even crazier than I expected, and I found myself unable to put it down once I started. This book has everything: elaborate scams, corporate intrigue, magazine cover stories, ruined family relationships, and the demise of a company once valued at nearly $10 billion.”

Theranos Walgreens Launch Ad

Book Review

Bad Blood was one of the quickest reads I’ve had in a while. It’s so tantalizingly full of lies and terrible decisions and secrets that it hooks you in for the same reasons you can’t help slowing down just a little when driving past the scene of an accident.

The book paints a compelling image of a girl driven by stories of her family’s past greatness and current state of embarrassment, leveraging both powerful family and personal connections to support her grandiose vision.

Lies and secrecy are used to compensate for the unfulfilled promise of the technology itself. And in the company, those who raise concerns are fired while sycophants are promoted — all of which sets up Theranos for its eventual downfall.

Some of my interest was due having familiarity with many aspects of the book (I previously lived in the city the company was based in, visited the same hangouts, I’m all too familiar with startup pitfalls and founders who think they’re the next Steve Jobs, and I worked for the firm that served as their outside corporate counsel) as a Bay Area tech person. But, I’m pretty sure the drama seeping out from these pages is lurid enough to capture most people’s attention even without all that.

Carryrou has done a commendable job of making the book immensely accessible and readible, helped along by the subject matter itself. It’s a nutty story, even for Silicon Valley standards, mostly because of how out of control things got.

While erratic founders, lack of management skills and startups lying to investors and employees is not remotely notable, Theranos’s scale and subject matter — risking people’s ability to make smart health decisions — took things to another level. Any time you throw billion dollar valuations and cancer patients into the mix, it all gets worse.

And then, by the time the book reaches the point where Carreyrou’s begins his investigation, things have gone totally off the rails, with numerous people risking a lot to help expose the company, private investigators getting called in and armies of lawyers on the march as Theranos was clearly ready to fight to the death.

I was enthralled pretty much throughout the whole book, and I was really impressed by how Carreyrou really took the time to understand the technology, the tech industry, the legal issues and everything else related to the topic. The book wasn’t just interesting, it felt very credible. As someone who routinely whines about the quality of tech and legal reporting, I’m not an easy customer in this department.

Theranos Founder Elizabeth Holmes

Some Small Caveats

That all said, while I clearly enjoyed the book, a quick caveat about Bad Blood I’d point out is that the book is fairly limited in scope — this is one company’s dirty, dirty laundry being aired out. It’s a takedown of two awful people and their massive egos. The schadenfreude in this one runs deep .

I also think the book goes way too easy on the other enablers, decision-makers and people who are supposed to be leaders around them. Theranos attracted top talent (and therefore big dollars) partially due to the deep industry connections and people with deep experience that it was associated with, including a few industry luminaries. The idea that this girl and her boyfriend ran circles around all of these powerless lambs struck me as trying too hard to mold one specific narrative.

Carreyrou routinely dismisses bad behavior from others at Theranos as stemming from “pressure from Elizabeth” or plain ignorance. He also notes often the many, many times people “disapproved” of various unethical practices, but seems to give them a free pass. I get that they’re not really the subject of this book, but ultimately all these people were complicit. Disapproving internally but then doing nothing about it is not good enough.

A Minor Quibble for Music/Science Lovers

Finally, as a very, very minor quibble, it bothered me when he described her natural voice as being “several octaves” above her affected speaking voice (she thinks speaking with a low voice helps her to be taken seriously or something), and that this phrase has been echoed in articles all over because of it. An octave is not some vague indicator of some type of difference in pitch – it is a specific, measurable distance and frequency away from another note. (For you science nerds, the ratio of the frequency of two notes that are one octave apart is 2:1, with the higher note having the higher frequency.)

“Several octaves” is a lot, since most people’s entire vocal range (i.e. the highest and lowest note you can reach) probably spans around two octaves unless you’ve had vocal training — Beyonce likely has a 4-octave vocal range, for example (if judged by her music). Unless Holmes has the voice of a very small chipmunk, I doubt she speaks “several octaves” higher than her affected voice.

Read It or Skip It?

I was entranced by all the drama. Judge me all you want. It’s essentially a thrilling, sensational, schadenfreude-y tale that’s quite frankly fascinating to read. (My apologies to my dog who had to keep begging me to take her to the park instead of reading.)

From the difficulties of designing the blood tests, to the many legal issues involves in various aspects of the story, I was impressed by the level of detail and how accessible Carreyrou made all of that information. It’s excellent in-depth reporting by a highly capable writer. (Plus as a blogger, I loved that Carreyrou acknowledged he was tipped off on the story by a blogger who he’d spoken to in the past.)

It is, of course, drama of the business variety, so you’ll have to decide if that interests you.

Predictably, a movie based on Bad Blood is currently in development with Jennifer Lawrence slated to play the villianous, bleached-blond, steely-eyed disgraced founder.

Is Bad Blood something you think you’d read? Please share your thoughts below if you’ve read it! See Bad Blood on Amazon .

(P.S. I’ve started making notes in Goodreads when I post a review, so feel free to follow along!)

Detailed Book Summary (Spoilers)

1. a purposeful life (elizabeth’s background), 2. the gluebot (the inital prototypes), 3. apple envy (holmes's idolization of apple and jobs), 4. goodbye east paly (therano's move to central palo alto), 5. the childhood neighbor (fuisz's patent), 6. sunny (elizabeth's boyfriend), 7. dr. j (theranos's walgreens partnership), 8. the minilab (development of theranos's new device), 9. the wellness play (theranos's safeway partnership), 10. “who is ltc shoemaker” (theranos's military contract), 11. lighting a fuisz (the fuisz patent case begins), 12. ian gibbons (the fuisz patent case: a missing witness), 13. chiat\day (website and ad launch), 14. going live (walgreens launch lead-up), 15. unicorn (more funding), 16. the grandson (tyler schultz, whistleblower), 17. fame (media attention), 18. the hippocratic oath (theranos skeptics), 19. the tip (carreyrou's involvement), 20. the ambush (tyler vs. theranos's lawyers), 21. trade secrets (theranos on the attack), 22. la mattanza (waiting to publish), 23. damage control (publication and post-publication), 24. the empress has no clothes (theranos shut-down).

If this summary was useful to you, please consider supporting this site by leaving a tip ( $2 , $3 , or $5 ) or joining the Patreon !

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24 comments

Share your thoughts cancel reply.

This story is really crazy its good those two are going to jail I hope they get sentenced to a long time

Haha, I totally agree. Thanks for reading!

I’m definitely intrigued by this! I’m not in the US, so I’m not familiar with it, so I’d be interested to read! Great review!

Thank you! It’s kind of nuts all this actually happened — thanks for dropping by! Hope you like it if you get a chance to read it!

I’m just reading the same book. It’s like a thriller based on the real story! Once I complete reading the book, I would write a review to recommend this one strongly

That’s such an apt way to describe it, I totally agree! Glad to hear others are enjoying it too! Thanks for your thoughts!

This is a non-fiction worth looking into.

Thanks for reading! Hope you like it if you get a chance to read it! :)

I heard about this on one of Book Riot’s podcasts & was immediately intrigued. I’m even more so, given your review. I don’t remember hearing anything about this happening, so I’m so curious to know how she got as far as she did! (& I get your annoyance with the octave thing. I have had to tell a few students with whom I work that they cannot casually use the word “exponentially” when discussing things like statistics or percentages because that word actually means something. I’m surprised the editor didn’t pick up on “octaves.”)

Haha, I think people tend to use “exponentially” to describe any sort of greater than linear growth and it annoys me too!

And yes the book does a good job of covering how she got away with it all (the short answer is a combination of smarts, family background, connections and charisma — but the longer answer is much more interesting)

What a terrific review. Very thorough and thoughtful. Thanks for that. I lived in Silicon Valley for a lot of years and worked in the tech industry, but was gone before all this happened. Still, I think I would enjoy reading this.

Hi Rosi, thank you so much! I’m very curious what you’d think about it since you have some experience in the area as well. I wonder if you think something similar could have happened in Silicon Valley in earlier years — thank you for your thoughts!

I’m really intrigued by this compelling review. I remembered reading about Elizabeth Holmes on a business magazine when she first came up with the company. I hope I can get a hold of this book. It’s been so long since I last heard about her. Fascinating downfall, I wonder where she’s going to go from here.

Thanks Theresa! Yeah, I remember seeing stuff praising her, and then VERY quickly everything fell apart for them — it looks like she was trying to move past it all and start a new startup but if she ends up in jail for long time, that’s probably not going to happen…

Cool that you were impressed with this book! Great that it was so compelling and sounds intriguing. Great review!

Thank you! Thanks for reading :)

Wow! I love nonfiction and I’ve never heard of this book. Thanks for putting it on my radar! Adding to my TBR

Oh yay! Glad to be able to introduce you to this book! Thanks for letting me know and happy reading if you get a chance to check it out! :)

Nice to see the use of the word schadenfreude.

haha thank you :D

This looks really great! I’ve never read books on scandals in the tech industry, and it sounds like it is well-written, so I must read it one day. And the film too if it happens, and as much as I love J-Law, I’d love to see someone else star in it too. Disapproving internally but then doing nothing about it is not good enough. – agreed. Enablers are enablers. It takes a bystander to perpetuate the crimes of a perpetrator at the end of the day.

I just picked this up at the store! I’ll def be cracking it open tonight

I work in biotech in the Bay Area, so I also had an extra interest in this, having followed the story in industry journals as it unfolded. Like you though, I think it’s such an engaging, well told story that anyone could enjoy it. And it did seem like the author had really done his research in terms of writing about the tech.

Yeah, I always feel like a lot of articles written by “tech journalists” (who often have no experience in tech) lack some basic understandings about how the industry works and what influences/motivates people who work in it, and I didn’t get that feeling with this book at all. Thanks for your thoughts!

Tufts Boston Insight

Thoughts on the book “Bad Blood: Secrets and Lies in a Silicon Valley Startup”

I began to read more than usual because of social distancing, going through the list of books I had been planning to read for a while. One of the books that was recommended by a friend was “ Bad Blood – Secrets and Lies of a Silicon Valley Startup ” by John Carreyrou [1], based on the rise and fall of the blood-testing company, Theranos. I was especially interested in it given its relevance to the biotech industry and on recently finishing the book, I realized GSBS students might also find it interesting and thought of sharing a little bit about it. While there are plenty of resources out there that help you understand how to search for a job, determine if it is a good fit and notice red flags, this book paints a picture of life in the biotech industry, both as an entrepreneur and as an employee. I think students interested in careers in industry, entrepreneurship, venture capital, or science policy will gain some perspectives from reading this book. For instance, the book portrays the harsh reality of working in industry when a team of engineers were laid off because the research was headed in a new direction and they were not needed there anymore.

In January 2003, a 19-year-old Elizabeth Holmes founded Theranos with the vision of enabling multiple diagnostics tests to be run from a small volume of blood obtained from a finger-prick rather than the traditional venous blood draw, using the company’s small, portable, automated devices. In October 2015, a reporter from the Wall Street Journal, John Carreyrou, published an article [2] revealing that the company has been misleading investors and consumers, that the blood tests analyzed by Theranos devices were inaccurate and unreliable, and that a lot of the tests were actually performed by third-party commercial analyzers. Expanding the article into a book, Carreyrou walks us through how the company was formed, how it grew to become one worth over $9 billion, and finally, how it dissolved in September 2018 [1]. It is common knowledge that most, if not all, companies in Silicon Valley have skeletons in their closets that make headlines when they are revealed. However, fraud and irresponsibility by a health technology company like Theranos, and at such a massive scale at that, is even more dangerous considering the direct harm to patients’ lives. It is shocking that a company could get so far with technology that never performed as promised, and Carreyrou lays out the various scenarios and circumstances that contributed to it.

This book exemplifies the importance of validated and peer-reviewed data, the need for rigorous testing and quality-control checks, and the need for adhering to regulations – things we already know and are trained to practice. The book also highlights the need for communication within and between different departments in a company, so employees are aware of what stage of development the product is in, identify what exactly is holding up progress and work together to solve the problem. This lack of communication and the unusually high level of secrecy was frustrating to the employees at Theranos [1]. It is therefore important to find a balance between protecting proprietary information and facilitating communication to ensure highest productivity. Besides the need for effective communication between employees, the book also shows how there is a need for open, honest communication and understanding between the employees directly involved in developing the product and higher-level management. Without it, as a leader, you risk facing the dangers of being surrounded by yes-men – a false sense of security that you are doing things right, that the technology is working perfectly, experiments are returning expected and reliable results, and experiments that are not actually feasible can be done – hence wasting both time and money. You do not improve because you do not know where improvements are needed. However, at Theranos, the yes-men were not the only ones contributing to this culture. Holmes was not only a bad listener; she seemed to consider anyone who challenged her as disloyal [1]. She was surrounded by yes-men because she did not foster an environment that welcomed ideas, suggestions, and opinions opposite her own. Employees did not come forward with concerns because they did not want to get fired. This may be especially true of employees with H1-B or other work visas who have much more to lose, considering how their ability to stay in the country is tied to their employment. Abuse of H1-B visa workers is not unheard of; a recent example is Cloudwick Technologies Inc., based in Newark, California, paying their H1-B employees a much lower salary than what was agreed upon, and making illegal deductions from their salaries.

A negative (and savage!) review on the Glassdoor website (a website where employees can leave information about a company they work or worked in, such as CEO approval ratings, company reviews, salary reports) mentioned in the book prompted me to look at what else the ex-employees of the company had to say. Many of the reviews for Theranos are very detailed, with some ex-employees especially taking the time and effort to explain the “Pros” and “Cons” of working there. The most common “pro” mentioned was free food and snacks – something we, as grad students, can easily relate to. The “Cons” part of the negative reviews is where things got interesting. You could get an insight into how the employees felt and how they were treated. Most of them were overworked and underappreciated. It may be typical of employees to put in extra hours or feel like they have no work-life balance at a start-up firm, but at Theranos, they would not only track the number of hours the employees would spend at work, but would also monitor their social media activity [1]. The employees’ dedication was measured by how long they stayed at work and whether they would come in during the weekends. I imagine such a working environment would be suffocating and counterproductive, and it was no surprise that the employee turnover was high. What you can also glean from the reviews is the shattered hopes and dreams of the employees who were inspired by Holmes’s visions and dedicated their time to actualize it. As scientists, we all hope to contribute to making this world a better place. On top of not being able to do that at Theranos, they also feared that their time in the company will work against them in future applications. The book also mentioned how the HR department would post fake positive reviews on Glassdoor, and some of the reviews did spin the “cons” in a way to show Theranos in a positive light. For example, one of the reviews listed the cons as “truths” with statements like, “If you are unable to work in a highly self-directed environment where you are counted upon to create clarity from ambiguity, you will not be successful at Theranos.” This reminded me of reading about people answering the common interview question “What is your biggest weakness?” with “I work too hard.”

All things considered, Theranos did not really ruin the prospects of a biotech-startup in Silicon Valley. As a couple of articles in Wired mentioned, investors may be more skeptical now and that may actually be better. The increased scrutiny will hopefully mean rigorously tested data and more valid claims. Carreyrou points out how tech companies usually exaggerate about how their devices perform, but the same cannot be done with a medical device. No one ever died from a buggy Candy Crush app, but a misdiagnosis can be potentially fatal.

It is also interesting how Elizabeth Holmes and her downfall (from a net worth of $4.5 billion to zero) is discussed by the public. After she and her company were exposed for fraudulent practices, the focus skewed towards her appearance rather than her transgressions. They talked about how her unblinking stare (described as a “hypnotic” gaze in the book) is “ sociopathic ”, how she is not naturally blond, how her makeup is weird, and her deep, baritone voice is fake. Also, concerns about Theranos’ technology and the company’s practice were brought forward to some highly intelligent and experienced investors. Granted, they were not experts in the field of medical technology, but it would not be difficult to get an expert’s opinion and some of them were indeed alerted about Theranos by experts. If they genuinely did not have the power, even as a member of the company’s board of directors, to do anything about Holmes, why continue to be investors and not step down? Were they all simply manipulated and “bewitched” [1] by Holmes’s charm?

People have lots of ideas and opinions on where things went wrong, what Holmes could have and should have done, but the bottom line is, she blew the chance to be an inspirational leader and a role model. The struggle of female entrepreneurs, especially women of color, is no secret. Holmes did have a better chance than most women to become the “first female billionaire tech founder” [1] – she is smart, motivated, hard-working, charismatic and understands how Silicon Valley operates. She comes from a privileged family, had access to opportunities and was well-connected enough to benefit from the support of famous investors at a very early stage of the company. It is unfortunate that what was going to be a huge success story is now in the news for all the wrong reasons.

This book is a cautionary tale for biotech start-up founders and venture capitalists interested in biotech start-ups – providing insight into what makes an effective leader and the responsibilities that come with it, and what employees and venture capitalists should look for when looking to work or invest in a biotech firm. In my opinion, the story of Theranos could be an interesting case study for discussion in an ethics class or at the Tufts Biomedical Business Club. Regardless of whether you are interested in the biotech industry, I think anyone who is a fan of thrillers will enjoy this book. For those interested in something more visual and/or sensationalized, there is an HBO documentary covering this story called “Inventor: Out for Blood in Silicon Valley” and a movie based on Carreyrou’s book is set to release sometime this year.

References: [1] Carreyrou, John. Bad Blood: Secrets and Lies in a Silicon Valley Startup. New York, Knopf Publishing Group, May 21st, 2018.

[2] John Carreyrou, “A Prized Startup’s Struggles,” Wall Street Journal, October 15, 2015.

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SECRETS AND LIES IN A SILICON VALLEY STARTUP

by John Carreyrou ‧ RELEASE DATE: May 21, 2018

Already slated for feature film treatment, Carreyrou’s exposé is a vivid, cinematic portrayal of serpentine Silicon Valley...

A deep investigative report on the sensationalistic downfall of multibillion-dollar Silicon Valley biotech startup Theranos.

Basing his findings on hundreds of interviews with people inside and outside the company, two-time Pulitzer Prize–winning Wall Street Journal reporter Carreyrou rigorously examines the seamy details behind the demise of Theranos and its creator, Elizabeth Holmes. Founded in 2003, when Holmes was just 19, the company’s claim to “fame” was its revolutionary blood-testing system, which touted the detection of everything from high cholesterol to hepatitis C to cancer using only one drop of blood. While raising $9 billion through a series of aggressive (and falsified) claims and dozens of private investors, the company’s spiking net worth caught Carreyrou’s attention a few years ago. His eye-opening reporting on the company’s inaccurate, voided, or corrected test results, as well as the loss of major retail partnerships with Walgreens and Safeway, knocked Theranos off the tech radar and left it irreversibly devastated. The author glosses over Holmes’ history as an unpopular high schooler and, later, Stanford dropout, focusing on her early vision of the specialized blood-reading equipment, the rapid evolution of Theranos, and the early skepticism about the device’s efficacy and reliability. The well-integrated employee profiles and testimonies effectively support Carreyrou’s damning narrative and discredit Holmes as a power-hungry, avaricious young leader who courted venture capitalists with specious claims. Former Theranos employees paint Holmes as an increasingly tyrannical leader who demanded allegiance and who swiftly terminated those who she felt fell short of ultimate loyalty. The author brilliantly captures the interpersonal melodrama, hidden agendas, gross misrepresentations, nepotism, and a host of delusions and lies that further fractured the company’s reputation and halted its rise. More recently, the Securities and Exchange Commission slapped Theranos and Holmes with fraud charges, though she still touts her device as having improved accuracy and importance.

Pub Date: May 21, 2018

ISBN: 978-1-5247-3165-6

Page Count: 352

Publisher: Knopf

Review Posted Online: April 15, 2018

Kirkus Reviews Issue: May 1, 2018

SCIENCE & TECHNOLOGY | BUSINESS | ENTREPRENUERSHP | GENERAL BUSINESS

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GOOD ECONOMICS FOR HARD TIMES

by Abhijit V. Banerjee & Esther Duflo ‧ RELEASE DATE: Nov. 12, 2019

Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.

“Quality of life means more than just consumption”: Two MIT economists urge that a smarter, more politically aware economics be brought to bear on social issues.

It’s no secret, write Banerjee and Duflo (co-authors: Poor Economics: A Radical Rethinking of the Way To Fight Global Poverty , 2011), that “we seem to have fallen on hard times.” Immigration, trade, inequality, and taxation problems present themselves daily, and they seem to be intractable. Economics can be put to use in figuring out these big-issue questions. Data can be adduced, for example, to answer the question of whether immigration tends to suppress wages. The answer: “There is no evidence low-skilled migration to rich countries drives wage and employment down for the natives.” In fact, it opens up opportunities for those natives by freeing them to look for better work. The problem becomes thornier when it comes to the matter of free trade; as the authors observe, “left-behind people live in left-behind places,” which explains why regional poverty descended on Appalachia when so many manufacturing jobs left for China in the age of globalism, leaving behind not just left-behind people but also people ripe for exploitation by nationalist politicians. The authors add, interestingly, that the same thing occurred in parts of Germany, Spain, and Norway that fell victim to the “China shock.” In what they call a “slightly technical aside,” they build a case for addressing trade issues not with trade wars but with consumption taxes: “It makes no sense to ask agricultural workers to lose their jobs just so steelworkers can keep theirs, which is what tariffs accomplish.” Policymakers might want to consider such counsel, especially when it is coupled with the observation that free trade benefits workers in poor countries but punishes workers in rich ones.

Pub Date: Nov. 12, 2019

ISBN: 978-1-61039-950-0

Page Count: 432

Publisher: PublicAffairs

Review Posted Online: Aug. 28, 2019

Kirkus Reviews Issue: Sept. 15, 2019

GENERAL CURRENT EVENTS & SOCIAL ISSUES | GENERAL BUSINESS | CURRENT EVENTS & SOCIAL ISSUES | BUSINESS | PUBLIC POLICY | ISSUES & CONTROVERSIES | ECONOMICS

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SEEN & HEARD

THE RIGHT STUFF

by Tom Wolfe ‧ RELEASE DATE: Sept. 24, 1979

Yes: it's high time for a de-romanticized, de-mythified, close-up retelling of the U.S. Space Program's launching—the inside story of those first seven astronauts. But no: jazzy, jivey, exclamation-pointed, italicized Tom Wolfe "Mr. Overkill" hasn't really got the fight stuff for the job. Admittedly, he covers all the ground. He begins with the competitive, macho world of test pilots from which the astronauts came (thus being grossly overqualified to just sit in a controlled capsule); he follows the choosing of the Seven, the preparations for space flight, the flights themselves, the feelings of the wives; and he presents the breathless press coverage, the sudden celebrity, the glorification. He even throws in some of the technology. But instead of replacing the heroic standard version with the ring of truth, Wolfe merely offers an alternative myth: a surreal, satiric, often cartoony Wolfe-arama that, especially since there isn't a bit of documentation along the way, has one constantly wondering if anything really happened the way Wolfe tells it. His astronauts (referred to as "the brethren" or "The True Brothers") are obsessed with having the "right stuff" that certain blend of guts and smarts that spells pilot success. The Press is a ravenous fool, always referred to as "the eternal Victorian Gent": when Walter Cronkite's voice breaks while reporting a possible astronaut death, "There was the Press the Genteel Gent, coming up with the appropriate emotion. . . live. . . with no prompting whatsoever!" And, most off-puttingly, Wolfe presumes to enter the minds of one and all: he's with near-drowing Gus Grissom ("Cox. . . That face up there!—it's Cox. . . Cox knew how to get people out of here! . . . Cox! . . ."); he's with Betty Grissom angry about not staying at Holiday Inn ("Now. . . they truly owed her"); and, in a crude hatchet-job, he's with John Glenn furious at Al Shepard's being chosen for the first flight, pontificating to the others about their licentious behavior, or holding onto his self-image during his flight ("Oh, yes! I've been here before! And I am immune! I don't get into corners I can't get out of! . . . The Presbyterian Pilot was not about to foul up. His pipeline to dear Lord could not be clearer"). Certainly there's much here that Wolfe is quite right about, much that people will be interested in hearing: the P-R whitewash of Grissom's foul-up, the Life magazine excesses, the inter-astronaut tensions. And, for those who want to give Wolfe the benefit of the doubt throughout, there are emotional reconstructions that are juicily shrill. But most readers outside the slick urban Wolfe orbit will find credibility fatally undermined by the self-indulgent digressions, the stylistic excesses, and the broadly satiric, anti-All-American stance; and, though The Right Stuff has enough energy, sass, and dirt to attract an audience, it mostly suggests that until Wolfe can put his subject first and his preening writing-persona second, he probably won't be a convincing chronicler of anything much weightier than radical chic.

Pub Date: Sept. 24, 1979

ISBN: 0312427565

Page Count: 370

Publisher: Farrar, Straus and Giroux

Review Posted Online: Oct. 13, 2011

Kirkus Reviews Issue: Sept. 1, 1979

SCIENCE & TECHNOLOGY

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by Tom Wolfe

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53 pages • 1 hour read

Bad Blood: Secrets and Lies in a Silicon Valley Startup

A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.

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Summary and Study Guide

One of the great corporate frauds of the 21st century, the Theranos blood-test scam, is brought to light in the award-winning bestseller Bad Blood: Secrets and Lies in a Silicon Valley Startup, published in 2018 and updated in 2020 . Author John Carreyrou , a Pulitzer Prize-winning reporter and bureau chief at The Wall Street Journal , brings his years of experience to the case against tech startup Theranos and its spellbinding CEO, Elizabeth Holmes . The Vintage Books Edition (2020) is the basis for this guide.

Descended from a famous family, Elizabeth Holmes entered Stanford University surrounded by high expectations. As a first-year student of chemical engineering, Elizabeth worked out the basic theory of a blood-assay skin patch that would subject a few drops of blood to test for diseases, a technology that might revolutionize healthcare. In 2003, Elizabeth dropped out of her sophomore year and formed a company to produce a desktop machine that would assay tiny blood samples with dozens of tests and report them quickly to doctors.

Elizabeth captivated everyone she met, eventually rounding up millions in venture capital and hiring engineers and lab technicians to develop her device, which she dubbed the Edison . Her new company, Theranos—a mashup of “therapy” and “diagnosis”—was headquartered in Palo Alto, California at the center of Silicon Valley's startup culture. However, from the beginning, problems cropped up with the machines. Undaunted, Elizabeth forged ahead and contacted pharmaceutical companies, the Walgreens drugstore chain, and Safeway supermarkets, proposing that each install clinics within their stores that featured Theranos blood-test devices. Patients would give a few drops of blood from a finger prick instead of a vial of blood from a vein. Both companies signed on.

Problems persisted with the blood readers, but Elizabeth responded impatiently, berating or firing those employees who warned of trouble. She also started a relationship with a shadowy dot-com millionaire, Sunny Balwani , whom she installed as her second-in-command. The Edison machines at regional test centers proved balky, and Theranos quietly adopted a policy of shipping blood samples back to its lab for testing on conventional assay machines. Elizabeth announced plans for a new device, the miniLab , touting it as capable of performing up to 200 assays per blood draw. She continued to recruit new investors, and in 2014 her company was valued at $9 billion.

Theranos’ board of directors included such luminaries as Henry Kissinger, Sam Nunn, and former Secretary of State George Shultz. Shultz’s grandson, Tyler, a recent Stanford graduate with a degree in biology, took a job at Theranos. Inspired by Elizabeth’s vision, Tyler expected great things but quickly discovered incompetence and cover-ups at the company’s labs. Worse, he learned that the blood assays generated dangerously inaccurate results that could lead to life-threatening complications for patients. Tyler tried to warn Elizabeth, but she was deaf to him, and he resigned. Immediately he found himself threatened with lawsuits unless he returned all work documents and named others who were disgruntled. He also discovered that he was being followed. Several other ex-employees found themselves in similar straits. One Theranos scientist, faced with covering up fraudulent lab practices, committed suicide.

Reporter Carreyrou received a tip that things at Theranos weren’t as rosy as the company had led the media to believe. Carreyrou investigated the matter, contacting Tyler and others from Theranos. Accompanied by a doctor, he also tried out blood readers at an Arizona Walgreens; they each got inaccurate results. Renowned attorney David Boies , Theranos’ litigator, learned of Carreyrou’s investigation and threatened him and the Journal with a lawsuit if they published their findings, but they held firm. The exposé was published and caused a sensation. Government agencies launched thorough inspections of the company; they validated the Journal's findings and banned the company from further blood testing. Investors and patients filed lawsuits; Walgreens and Safeway quit their collaborations with Theranos and took the firm to court. Elizabeth and Sunny were charged with criminal fraud, and their high-flying company collapsed. Nearly a billion dollars of investor money was lost.

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Bad Blood: Secrets and Lies in a Silicon Valley Startup Kindle Edition

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• ASIN ‏ : ‎ B078VW3VM7
• Publisher ‏ : ‎ Vintage; 1st edition (May 21, 2018)
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• Language ‏ : ‎ English
• File size ‏ : ‎ 13644 KB
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John Carreyrou is a Pulitzer Prize-winning reporter and a nonfiction author. His first book, "Bad Blood: Secrets and Lies in a Silicon Valley Startup," chronicles Silicon Valley's biggest fraud. Please direct any speaking queries to [email protected]

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Bad Blood (Carreyrou)

Bad Blood:   Secets and Lies in a Silicon Valley Startup John Carreyrou, 2020 Knopf Doubleday 368 pp. ISBN-13: 9780525431992  Summary In 2014, Theranos founder and CEO Elizabeth Holmes was widely seen as the next Steve Jobs: a brilliant Stanford dropout whose startup "unicorn" promised to revolutionize the medical industry with its breakthrough device, which performed the whole range of laboratory tests from a single drop of blood . Backed by investors such as Larry Ellison and Tim Draper, Theranos sold shares in a fundraising round that valued the company at more than $9 billion, putting Holmes’s worth at an estimated $4.5 billion. There was just one problem: The technology didn’t work. Erroneous results put patients in danger, leading to misdiagnoses and unnecessary treatments. All the while, Holmes and her partner, Sunny Balwani, worked to silence anyone who voiced misgivings—from journalists to their own employees. Rigorously reported and fearlessly written, Bad Blood is a gripping story of the biggest corporate fraud since Enron—a tale of ambition and hubris set amid the bold promises of Silicon Valley. ( From the publisher .)

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Secrets and Lies in a Silicon Valley Startup

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Book summary.

The full inside story of the breathtaking rise and shocking collapse of Theranos, the multibillion-dollar biotech startup, by the prize-winning journalist who first broke the story and pursued it to the end, despite pressure from its charismatic CEO and threats by her lawyers.

In 2014, Theranos founder and CEO Elizabeth Holmes was widely seen as the female Steve Jobs: a brilliant Stanford dropout whose startup "unicorn" promised to revolutionize the medical industry with a machine that would make blood testing significantly faster and easier. Backed by investors such as Larry Ellison and Tim Draper, Theranos sold shares in a fundraising round that valued the company at more than $9 billion, putting Holmes's worth at an estimated $4.7 billion. There was just one problem: The technology didn't work. A riveting story of the biggest corporate fraud since Enron, a tale of ambition and hubris set amid the bold promises of Silicon Valley.

November 17, 2006 Tim Kemp had good news for his team. The former IBM executive was in charge of bioinformatics at Theranos, a startup with a cutting-edge blood-testing system. The company had just completed its first big live demonstration for a pharmaceutical company. Elizabeth Holmes, Theranos’s twenty-two-year-old founder, had flown to Switzerland and shown off the system’s capabilities to executives at Novartis, the European drug giant. “Elizabeth called me this morning,” Kemp wrote in an email to his fifteen-person team. “She expressed her thanks and said that, ‘it was perfect!’ She specifically asked me to thank you and let you all know her appreciation. She additionally mentioned that Novartis was so impressed that they have asked for a proposal and have expressed interest in a financial arrangement for a project. We did what we came to do!” This was a pivotal moment for Theranos. The three-year-old startup had progressed ...

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Carreyrou's work has won many accolades; his Wall Street Journal articles on Theranos won the George Polk Award for Financial Reporting, and Bad Blood was awarded the Financial Times and McKinsey Business Book of the Year Award. It also appeared on many "best of" lists for 2018. My vote can be added; I certainly found it to be one of the finest non-fiction accounts I've read, and I highly recommend it to those interested in cautionary tales about the business world or great non-fiction reads in general... continued

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(Reviewed by Kim Kovacs ).

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Immunoassay: a medical diagnostic test.

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Bastille: Bad Blood – review

W ith a sold-out tour ahead, and the single Pompeii straight on to this week's charts at No 2, everything seems set fair for Dan Smith, the creative heart of Bastille. By bolting on the merest hint of dance beats to his absolutely conventional, mildly melancholic piano ballads (descending chord sequences, the internationally recognised signifier of mild melancholy, abound), he has spruced up the formula that has dominated mainstream pop-rock for more than a decade. That said, it's hard to work out why these songs have made a greater connection than those of a hundred like-minded songwriters. Presumably, the likes of Overjoyed , which combines those descending piano chords with the most mild-mannered take on UK bass music imaginable, offer the sensation of currency without the confrontation actual bass music provides. Mind you, there's occasional unintentional amusement in the lyrics: Oblivion sees him gazing at a sleeping lover, then asking "Are you going to age with grace?" Which, as sensible questions to ask a lover, ranks up there with: have you put on a bit of weight recently?

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