Review of “Bad Blood” by John Carreyrou

John Carreyrou details the fraud that was Theranos, a once $9 billion dollar startup that — with no working technology — claimed to reinvent blood tests, going so far as to testing real patients’ blood with highly inaccurate methods.

There are many potential angles to this story, including that of political connections and people wanting to believe a good narrative without independent verification: many fellows at the Stanford Hoover institution, including Former Secretary of State George Schulz and current (!) Defense Secretary Mattis, were on its board; VP Joe Biden visited its headquarters and praised it; the founder Elizabeth Holmes led a Clinton fundraiser (with Chelsea Clinton!) after the fraud became clear.

One central angle, however, is that Theranos, at first, embodied the startup ethos of “building the bus while driving it.” On its own, this ethos isn’t problematic: every tech company when rolling out a product defines its MVP (minimum viable product) as well as a road-map of future versions; it would be folly (let alone financially nonviable) to try to build an ideal version without seeing how initial versions interact with the real world. However, even software companies realize that these initial versions must still be useful, and that they must manage the potential bad experiences of users. Theranos, on the other hand, falsely claimed to have a working medical device and talked their way into partnerships with Walgreens and Safeway. Many patients experienced real medical harm, some of which is detailed in the book, with no upside.

The book itself is a real-life business thriller. You won’t believe some of the characters that play a role in Theranos’s story. The audacity of some of Holmes’s lies are incredible. She would claim that her devices were being used in the back of Humvees in Iraq and Afghanistan, saving soldier’s lives — when they weren’t yet reliable in the lab. The company claimed to be able to run hundreds of standard blood tests on a single drop of blood, when they were simply diluting the blood and using competitors’ products. And their supposed technology wasn’t even a chemical or biological advance; it was a glorified robotic arm that could supposedly precisely carry out the necessary motions for blood testing — I don’t have the related expertise, but I’m skeptical such an approach could ever be sufficient to match the company’s claims.

The author, John Carreyrou, is the person to write the book; his investigative journalism was what brought the company down, and for his efforts he was tailed for over a year by Theranos’s hired hands.