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)

Give me the wind

I realize how different this is.

How alone I am... 

  not lonely, but surely, alone.

The longer I swallow my own identity,

  the more I feel like no one can ever be "right."

The more grounded I am,

  the harder it is to be swept off my feet.

Also, opening up my heart --

  opening up my life --

  letting someone in,

  knowing someone deeply,

  I'm damn scared.
Somehow that scares me now
  more than it ever has before.

Give me the wind instead,

  the open roads...

Race Recap: Giro di SF 2018 - My first crit!

I said I'd never race a crit. But here we are now.

Just some word regurgitation below --

First Criterium Race: Giro di SF

I decided to sign up for this thing on impulse, less than a week before the event. I was feeling confident in my fitness and happy with my bike handling and cornering skills despite the fact I hadn't ridden in a peloton since Lodoga RR. My mental preparation, therefore, for the race was sorely lacking - perhaps for the better.

My training is a different story. Because I'm not a "serious" racer trying to win anything, I take a lot of liberties with training. But I still have goals. I just can't allow myself to take them too seriously. My goal the past two years has always been to become stronger and injury-resistant. In the last two months, I've taken to training with a power meter and approached it in a more structured fashion. VO2 max and threshold intervals have not been a part of my vocabulary since college intramural track - but I threw them in and saw rapid improvements in my bike fitness (in some ways, I also feel my run fitness has benefited but that theory needs to be tested). After just one serious training block, training and riding with a lot of fast men, and some successful PR snagging, and marked improvements in bike handling, I wanted to see where I stacked in the women's fields.

And that's basically what got me to sign up for my first crit. Racing was always something that intrigued me and based on my progress as a cyclist, it was a natural thing for me to feel. I've skirted around bike obsession for two years now. Being on two wheels is fun and training hard and going on recreational rides all increase my fitness and strength as the sole engine of my machines.

Then when I consider racing.... it's basically a chance to demonstrate all of your hard work and passion.

Anyway.... the women's 4/5 field was pretty small with only 12 registered before the race and 16 total on race day, which also gave me a bit of confidence signing up. A smaller field means we're not as packed together in the peloton. The course was notorious for involving train tracks (seen in pics below), a small hill (but hills are nothing to me these days!), and asphalt that needs some serious repavement. But it's my first one and the only one I'd ever witnessed in person last year so I had no frame of reference for what makes a course easy or hard.

The day before the race probably did not go as it should have. No openers were involved hah:

• I went on my first motorcyle ride (pillion), which was incredibly fun but the sport geometry had me a bit sore and I didn't get home until 10PM-ish. Motorcycle rides are deserving of a whole 'nuther blog post, by the way.
• My knee had been bothering me (this is a normal occurrence as I sometimes have inflammation flare-ups when I don't ice or stretch consistently *guilty look*) so I taped her up.
• After getting home, I FINALLY cleaned my drivetrain after 4 weeks of UTTER NEGLECT.... but I derped and I got my finicky SRAM Red rear brake out of alignment and spent an hour trying to get it back to perfect. Total mechanic time was maybe 2.5 hours.
• I went to bed at 1am but couldn't sleep because the adrenaline and nervousness were getting to me! Like "why the heck did I sign up for this, I wish I could back out but I told all my friends about it already...."

RACE DAY:

I got to the venue at 7am to give myself adequate time to register and warm-up and all was going well. Except one series of unfortunate events ensued.

5 minutes before 8AM race start, I felt the call of nature for a number 1, so I quickly went to the restroom and came back rolling with 2 minutes before 8AM. For some damn reason, as I was tossing my arm warmers to my friends so I could roll up to race start ASAP, my bike and I decide to do a front flip. James said I must've feathered my brakes and lost control. So my bike flipped on top of me while I did a ninja roll and said my greetings to a new spot of road rash on my shoulder. Apparently, I popped up right away after my fall and said "I'M OKAY!" It's something my friends back during my Track/XC and Basketball would say was in true Andrea Villaroman fashion so I found it both stupid and hilarious. But I was kind of mad that I undid the 3 hours I spent working on my bike the night before... James and Yao rushed to help me loosen my from brakes after the front wheel went out of true (thankfully, I spent time fixing the rear brake last night and didn't just go for a quick fix so the rear brake was reliable *pats self on back*). We also had to straighten out my stem alignment with a torx screwdriver (thank goodness for Yao's multitool) and throw my chain back on.

The adrenaline was pumping at this point but I was lucky enough that the race started late at 8:15.

I felt really strong and focused the entire race. The weighted average power was 203 for the duration of the race but it was unsurprising that I felt strong since I tested my FTP at 210 two days before. I felt very comfortable being surrounded by bikes and riders and my cornering was on point that day and I had tons of confidence in my tire grip and centripetal motion. Unfortunately, the whole tumble and dry changed my bike's handling in terms of braking and I could no longer have 100% trust in my ability to control speeds in the peloton. So I opted to stay near the front of the pack instead of "conserving" energy. As a result, I found myself the recipient of a $5 preme lap prize (I had no idea what preme laps were before the start of this race... hah..) but I also didn't "conserve" energy for the final lap...

The 30 minutes went by in a flash and when the last lap was called, I really had no idea how to approach it. Again, I was stuck in the front and took the last corner before the straightaway in the front. With no prior experience or dedicated training in sprinting, I think I was too "reactive" in the final bunch sprint. I waited till I saw other people sprinting and by that time it was too late -- 5 other ladies got past me. I missed the podium and finished in 6th place and had SO MUCH still left in the tank. The lack of experience was huge and so was not being familiar with the course or my sprinting abilities. When I looked back at the data, I saw that the last sprint was less than 25 seconds and I could have sprinted out of the corner and showed off my prowess because I know how much I can dish out in that short amount of time. I should not have waited to react. That's NOT WHAT PEOPLE DO. UGH. Oh well... overall, I'm pretty happy because I learned a lot and got the crit nerves out of my system and I'll definitely have a better sense of how to approach these kinds of races in the future.

It was also awesome to have some of my favorite friends there to support me at my first crit. It really took the nervousness away and gave me some peace of mind. Anthony, James, and Kyle all showed up for an 8AM W4/5 race! And Viv was racing the same race (with Yao there as well) so that inspired me to keep a "survival" mindset. Survive I did. And I demonstrated my potential. It's only a matter of time before the Velo Promo Early Bird series. SEE YA THERE.

Takeaways:

• I need to adjust my drops (angle them more downward) so reaching into the drops is more comfortable.
• Arrive 1.5-2 hrs before race start to give ample time to prepare.
• Study the course and know where the potential attacks will be. Know where the sprints will be. Know what your positioning should be if you wanna win. 
• You should always want to win. ;) That's the point of racing.
• I love my friends so much <3.