Bad Blood, a story of the tell-tale start-up

Back in 2014 while studying for my master's degree, I remember touring Silicon Valley for the first time. It was a brand new world to me and I was, for lack of a better term, starry-eyed. Everything about the Bay Area told us to look for new ways to innovate and to make money out of technology or some big idea. It's what got me out of the idea that I wanted to do anything drug-related or something where the impact timeline would be 10+ years down the line.

Four years later, a Wall Street Journal investigative journalist publishes a book titled "Bad Blood: Secrets and Lies in a Silicon Valley Startup." All there is to be said about the book has already been said. In my opinion, it's worth the read if you're in biotech, basic sciences, or even just interested in a startup in the healthcare landscape.

There are so many facets to the story of Theranos. First, it's valuable to understand that the vision of Theranos was one of wanting to change the world and revolutionizing the healthcare industry. The mission was noble. The difference it could make to healthcare and medicine was profound (along the lines of preventative healthcare, drug reaction monitoring, etc.). There was a lot of money to be made. If the technology challenges had actually been overcome in the time that Ms. Holmes led Theranos (it called for advances and innovations in chemistry, microfluidics, scale-up, etc.), it would have truly been the next step to the tricorders of Star Trek. Combine this with the Silicon Valley hype train that the starry-eyed VCs rode in the 2000s and early 2010s. Combine that with Ms. Holmes' captivation with Steve Jobs and the idea of changing the world from a young age.

It's a very cautionary tale. Many profess that Ms. Holmes' was genuine in her desire to make a great technology that would help the world, but that she surrounded herself with the wrong people who encouraged her to cross too many lines, tell too many lies, and cut too many corners. It could have been her youth and the naivety that comes with it. It could have been she was a pathological liar.

In other industry spaces, (software, specifically), you might be able to get away with vaporware. But to continue on without conscience for the souls you affect when your technology affects medical decisions for patients -- it's naive to allow yourself to fall into a reality-distortion bubble. Whatever judgement you want to make on her, she's apparently paid her dues in a settlement (no shares for Theranos, 10 year ban on chairing or directing public companies, and $500,000 penalty) and it's interesting to note that she's now trying to start yet another company [Vanity Fair]. I'm not sure how she didn't get jail time for fraud and endangering the lives of patients...

Some interesting items explored in this book:

• Elizabeth Holmes surrounded herself with higher ups who championed her cause and gave her start-up credence in the eyes of the more naive.
• Elizabeth Holmes had a romantic relationship with her "second in command" Sunny Balwani (20 years her senior).
• The company lied to the military and several federal agencies, including the FDA, CLMS (Clinical Laboratory Management Systems).
• There is an interesting saga of how she suckered Walgreens into partnering with Theranos and spending millions of dollars on renovating their own stores to make wellness centers that accommodated the Theranos devices.
• An oppressive atmosphere was cultivated within Theranos, surrounded by secrecy, paranoia, and constant surveillance of employees.
• Theranos' persistence and bullying in silencing employees and former employees resulted in the SUICIDE of Ian Gibbons.
• John Carreyou (the journalist and author of the book) details his experiences in trying to gather sources for the story. Once news broke to Theranos that The Wall Street Journal was working on the story, Theranos began threatening and bullying those who they believed were Carreyou's sources, both public and confidential. Scary effing stuff.

A slew of other things but some food for thought:

"Hyping your product to get funding while concealing your true progress and hoping that realtiy will eventually catch up to the hype continues to be tolerated in the tech industry. But it's crucial to bear in mind that Theranos wasn't a tech company in the traditional sense. It was first and foremost a health-care company. Its product wasn't software but a medical device that analyzed peoples' blood. As Holms herself liked to point out in media interviews and public appearances at the height of her fame, doctors base 70 percent of their treatment decisions on lab results. They rely on lab equipment to work as advertised. Otherwise, patient health is jeapordized."

"This book, which flowed from my work exposing the Theranos scandal in the pages of the Wall Street Journal, would not have been possible without the help of the confidential sources who spoke to me at great personal peril throughout 2015 and 2016. [...] All were moved to talk to me, despite the legal and career risks they faced, by one overriding concern: protecting the patients who stood to suffer harm from Theranos' faulty blood tests. I will forever be grateful to them for their integrity and their courage. They are the true heroes of this story."

If you're in the healthcare industry and want to make a difference in the space, the industry, or your community, don't forget the reasons you are in it.

Another good read: http://nymag.com/selectall/2017/04/why-silicon-valley-keeps-getting-biotechnology-wrong.html

Currently Reading: The Three-Body Problem (Cixin Liu)