Bad Blood: Secrets and Lies in a Silicon Valley Startup

As I got stuck into this astonishing story about a Silicon Valley company that was going to change medicine forever, but didn’t, I was instantly thinking, “Someone really needs to make a film about this!”

Well, it turns out they are, with Jennifer Lawrence slated to play Elizabeth Holmes, the CEO of Theranos, the company this book looks at in forensic detail.

But let’s take a step back. I think lots of people will be well aware of the Theranos story, it’s rise and fall. But many more may not be. While the company’s CEO, Elizabeth Holmes, became very famous in Silicon Valley, I’m not sure that was true more widely, and certainly not beyond US shores.

Theranos was a unicorn company; a startup that quickly became valued at over $1B. Their big idea was that they had a machine that allowed people to have blood tests, using just a finger pin-prick’s worth of blood. From that, many tests – upwards of 200 – could be run. This would revolutionise medicine. People who needed to, could closely monitor their blood. Diseases would be caught early. The machine would be so portable that it be used in placed regular lab tests couldn’t, like military front lines.

The major problem was that the machine didn’t really work. Building medical kit takes lots of R&D, and lots of time. But Theranos was not willing to wait. It was rushing to market, trying to sell machines to clients before the technology was ready. Meanwhile Holmes herself became famous, adopting the traits of her hero Steve Jobs, and getting cover stories on some of the biggest magazines following Silicon Valley.

Behind the scenes, as John Carreyrou reveals in this fascinating book, things were not great. There was a massive turnover of staff in the laboratories where they were trying to make things work. If you raised problems with management, you would be considered the problem, and you’d probably get fired.

It ended up cultivating a company of yes men. Sunny Balwani, the company’s number two for many years, was a particular tyrant. He had a temper on him, and had a trigger finger when it came to firing people. More problemmatical was his lack of technical understanding of what they were trying to do. He was also in a relationship with Holmes, something they tried to keep secret.

Carreyrou, who broke the story in the Wall Street Journal, tells the story behind the story fantastically well. It’s almost like a thriller that you can’t put down. Theranos was obsessed with secrecy; partly because they didn’t want competitors to learn what they were doing, and partly because they didn’t want others to know how badly they were doing it. Employees were served with draconian non-disclosure agreements and legal threats when they left, and when it began to emerge that some people were talking to Carreyrou, Theranos hired the most aggressive lawyer they could. They intimidated those speaking out, and almost certainly putting lots of people under constant surveillance.

Meanwhile Theranos had managed to gather together an astonishingly high-profile board that included Henry Kissinger and George Schultz. Holmes seemed to have an ability to wow these people with her drive and determination. In one of the sadder aspects of the story, when Schultz’s own grandson, who did some work for the company, saw it’s true colours, he was unable to persuade his grandfather. Schultz senior was more willing to believe Holmes than he was his own kin.

Holmes even managed to get $125m out of Rupert Murdoch – his biggest single personal investment. Entertainingly, when Holmes realised that Theranos was being investigated by the Wall Street Journal (proprietor R Murdoch), she tried to persuade Murdoch to intervene. To his credit, he would not. He ended up losing all $125m.

This is a story of secrets and lies. But it’s also a story of some of the gung-ho Silicon Valley attitude being adopted in sphere where there are real world dangers. If your blood tests aren’t accurate then you run the real risk of either not having something diagnosed, or believing that you are healthier than you truly are. It’s one thing if some software like an app doesn’t work straight away – that can be fixed later, or patched. You might just end up with annoyed customers. But health is different. I do wonder sometimes, if we face similar issues with self-driving cars. It’ll be one to watch.

Highly recommended, and I can’t wait for the film!

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