Bad Blood: Secrets and Lies in a Silicon Valley Startup

Perfect book to snap a reading slump. It kept getting more and more implausible that people kept believing in this charlatan. Important people! I went into this almost completely cold. I only had vague notions that Theranos did something with blood draws. This was well explained without being pedantic, didn't overly repeat itself, and walked a great line between helping an uninformed reader like myself understand the science and litigation piece without getting too in the weeds.

If you like non-fiction at all I recommend this.

The journalistic work that went into this book is A++, but did I like this book? Nope. I read a lot of this book with gritted teeth because it was breaking my brain that there were so many warning signs and yet Elizabeth Holmes had so many enablers, and was able to raise so much money even as her employees were operating in such a toxic environment. 

A less coherent review? 
Aaaaarrrghhhhhuwgsudusfai

I watched the documentary about Elizabeth Holmes on HBO when it came out and I was astonished by it all. I later got to know about this book but never got the chance to read it before. But I've been on a bit of a binge of non fiction recently and this showed up in my next to read recommendations as soon as I finished Empire of Pain and I thought why not. And this was riveting as hell.

The last investigative reporting book that read like a thriller novel was Ronan Farrow's brilliant Catch and Kill and this one is written very closely in that vein. Similar to Ronan, the author John is the main catalyst behind bringing the truth about Holmes and Theranos in the open and this gives us a deep inside look into the company and the people involved. The author gives us a great account of the kind of person she was growing up and her privileged upbringing, her dream of being an entrepreneur and changing the world, the many brilliant scientists and engineers and executives she managed to recruit for her company and the kind of bullying and revolving door culture that she and her boyfriend Sunny Balwani built at Theranos. It's a thoroughly engaging book, especially the beginning and the last third - the middle can get slightly repetitive because it's about the many employees who arrived at Theranos excited to work on something innovative and ultimately felt disillusioned, couldn't handle the stress of all the lying that they could see happening in all aspects of their work and ultimately left but not without being incessantly bullied and threatened with legal actions for any disclosures - even though their stories are similar and we might be bored reading the same things happening over and over, it clearly shows how many numerous employers could see the scam happening, couldn't continue to be a part of it, but also couldn't speak out because money and lawyers have all the power in corporate America.

I had many different takeaways from this book and it might become a long review but I just feel like venting.
- [ ] Silicon Valley culture is all about talking of innovation and disruption and changing the world but ultimately it's all empty words and everyone is in it for the money, have grandiose ideas about how great they are which are not in touch with reality, and usually give a backseat to ethics and morality because who cares about the means if the end result is a lot of money for the investors. Capitalism has created a world where earnings and profits matter and if people are harmed in the process, it's all acceptable collateral damage.
- [ ] Another point which probably reflects on corporate America's culture, but this whole idea that employees have to be loyal to their companies and be available 24x7 to work because they are changing the world is complete bullsh*t. One can be loyal to the work they do, be honest when talking about it, and have big dreams - but pledging undying loyalty to companies and CEOs who will ensure it forcefully with ironclad non disclosure agreements is just another way that the billionaire and corporate class makes sure that the people who work for them know their place.
- [ ] White privilege really opens doors that are forever closed to many POC aspiring entrepreneurs, even if they have degrees from the Ivies unlike Holmes who is a Stanford dropout. I really can't even dream of a Black or Brown woman ever being able to head a company that was at one time valued at almost $10 billion without ever producing a working end product. If you are a blonde blue eyed charming young woman with an interesting life story and access to an elite network, apparently it's not that hard to convince old white men who happen to be former senators and cabinet secretaries and company CEOs and elite venture capitalists and even someone like General Mattis to believe in you, never ask for proof of what you have developed, be your board members or invest millions. Reading this felt like I was being asked to suspend disbelief even more than any SFF novel. But it's also not that surprising that this is the world we live in.
- [ ] As in Ronan's book, this story also brings to light how the rich use their high priced lawyers to intimidate and bully the normal people and employees and journalists to shut them up and cover up their own wrong doing. David Boies is a repeat figure and after the way he threatened and surveilled journalists and victims during the Harvey Weinstein reporting, seeing him use the exact same tactics here made me very angry. It's the constitutional right for everyone to have legal representation but seeing these so-called “prolific” lawyers always take the side of billionaires and oppress the ones who can hardly stand up to them definitely makes them feel reprehensible in my eyes.

I think I've gone on for long, so I'll just stop here. If you want to read a thrilling real life story about a sociopathic narcissistic entrepreneur, her idea of changing the world, the cheating and lies and grand self-delusions that became a part of the company's culture and the brave people who decided to do something to stop the company before lives were destroyed, do checkout this book. Elizabeth Holmes said many times and probably believed that she was creating one of the most important things for humanity and maybe even creating her own religion, and I hope this book is an eye opener and maybe will help people recognize such cult like figures before they go very far.

It is absolutely staggering how far you can get in life if you're a cute blonde girl with no shame and the ability to remind powerful men of their daughters. The Theranos technology literally never worked, but that didn't stop Walgreens from putting it in their stores or people like Henry Kissinger and James Mattis from supporting Elizabeth Holmes (including one board member believing her word over his own grandson who worked in the lab, which is just heartbreaking to me). This is a fascinating story, particularly the last third or so, which is all about how hard Theranos fought to keep the author from writing his first article exposing the fraud.

(Also, someone who practices civil law will have to tell me if David Boies's actions in this whole thing are considered ethical - taking shares in a company and a seat on the board as payment certainly seems sketchy to me, but it's certainly not my area.)

Rating: 8.6/10

Going into this book, I had a rough outline of the Theranos story. Billion-dollar Silicon Valley startup Theranos and its charismatic founder Elizabeth Holmes were embroiled in controversy over whether their groundbreaking blood testing technology actually worked. I knew Theranos had been publicly embarassed by John Carreyrou after his brutal expose in the Wall Street Journal. What really hit home after reading this book was the extent of Theranos's deceit. For more than a decade, Elizabeth Holmes and her boyfriend/COO Sunny Balwani were deceiving regulators, investors, and eventually patients themselves.
I really enjoyed the amount of detail Carreyrou has documented here, like specific employees's conversations with Holmes. It was a bit hard to keep track of all the names of employees or confidential sources and the like, but that's been the case for the last few nonfiction books I've read. I listened to this book in audiobook form and really enjoyed the medium. Normally, I would've spent maybe a week or two reading this but in audio form, I was able to devour it in two or three days. Overall, I loved the book and was incredibly engrossed in the drama of a unicorn company collapsing into controversy and ultimately, irrelevancy.

Henry Kissinger writes a birthday limerick, a megalomaniac plays at 4-dimensional patent application, and they're not even the principal criminals detailed in Carreyrou's investigation into Theranos' amazing scam.

Obviously the major takeaway from this book is the vaporware applied to medicine is a chilling novelty of Silicon Valley's questionable moral culture, but I wonder if the most stunning revelation of Carreyrou's research is how Palo Alto seems to nurture world-class psychopathy as a business virtue. Nearly every major player selected in this story is an elite, privileged douchebag. No doubt Elizabeth Holmes is a marquee villain, but so much of this story is about the rank and file weakness of character in pursuit of glory that animates Silicon Valley.

I knew a little bit about this story before beginning this book, but the absurdity of what these people got away with for so long is fascinating. CEO Elizabeth Holmes and COO Sunny Balwani are cartoonishly evil, constantly intimidating and manipulating people internally while outwardly projecting a completely different persona to stakeholders and the public.

I actually thought it felt a bit too editorialized in their portrayals. There's a little bit here and there about how charming and intelligent seeming Holmes is, but none of it was as specific as the bad things she does, so it was hard for me to understand how she got away with some things without filling in a lot of blanks. Balwani meanwhile seems to have no redeeming qualities besides the fact that Holmes likes him. He comes across as a pure thug.

The accounts of all the goings on in Theranos are crazy though and described in great detail, clearly a lot of research was done and many people consulted. I listened to this via audiobook from the library and the ~12 hours blew by, I listened at any chance I had. I'll be checking out the HBO documentary and maybe the podcast soon as well.

Amazing book! I can't stop reading this book; in every single free time I have, I can't hold myself to opening my kindle and opening this book.

The confusion, the frustration, the anger, the thrill, I can feel all of those feelings when I read this book. In the last 5 chapters, when the point of view changes to a first-person (the author) is really thrilling.

I will definitely recommend this book to my colleagues.

One of the best investigative pieces I've ever read - and also, by the nature of the case, horrifying.
This book deals with Theranos, the famous Silicon Valley unicorn (a term coined for a tech startup which is valued at more than $1 billion) and its neurotic founder, Elizabeth Holmes and her equally neurotic boyfriend, Sunny Balwani.
Many people have heard that Theranos has had shady dealings (myself included), but how shady they were is revealed by this book - a treatise on Theranos spanning from its foundation till its demise (of which the author was the main catalyst). The amount of laws and regulations that the startup flouted is staggering in itself. But what is more staggering is that the premise on which Theranos was founded (that hundreds of blood tests could be performed on a tincture of blood nipped from your index finger) and which gave Holmes a personal valuation in excess of $5.5 billion, was all a hoax. How this hoax came about, who all were wittingly (and unwittingly) involved in the hoax, and how the hoax could have led about to hundreds of deaths, forms the basis of the investigative novel.
On reading this book, one can easily understand how Carreyrou has won the Pulitzer Prize twice - his treatment is precise and cutting, and very easy to decipher and absorb - even medical laymen like me will have a ton to draw from the book, as is the book's intention.
TL;DR - roller-coaster work spanning the rise and fall of a Silicon Valley startup that got too ambitious for its own good, and in sight of its goal, flouted everything there was to flout. A dense but fulfilling read.

Fascinating story that is stranger than fiction. It's hard to believe what Holmes and her partner got away with for so long. Amazing the amount of support she managed to get and the lengths she went to in order to perpetuate this fraud.

Despite all the investors she cheated, and the patients that didn't get the proper treatment, my sympathy was strongest for her employees, the ones that she harassed after they quit/got fired.This is no doubt because John Carreyrou focuses mostly on the former employees and those that had the nerve to share the incriminating information with him. It actually puts you on the edge of your seat because Holmes and her partners' harassment techniques include stalking and they were pretty scary.

There was one thing that really killed me about Elizabeth Holmes, although all things considered it was rather minor. There were multiple mentions in the book of how Holmes would flirt and use her charms on older men to get their support, investment money, etc. When she finds out what Carreyrou is writing about her, she accuses him of bias against her because she's a woman. No way, Holmes. You can't use your femininity in your favor and then turn around and accuse someone else of using it against you.

But all things considered, this is the least outrageous thing that Holmes did or said.

Want to be pissed for 300 pages?
Want to feel never-ending waves of righteous anger?
Want to feel like you could scream and throw a book across a room?
Then READ THIS BOOK.

Holy hell, I had no idea the length and depth of the fraud behind this company. I heard the story when it blew up, like we all did, but I didn't know that there was over 10 years of fraud, lies, blackmail, arrogance, intimidation, career destruction, and patient endangerment behind it. It begins on page one and has you screaming “WHY WHY WHY NO NO NO” nonstop for 300 pages. The story is so well reported and laid out by Carreyou, he does a great job of guiding you through the details of medical testing procedures, ethics, and regulations and how they relate to this insane story of a sociopath flouting them at every turn because she is so caught up in her own mythos and web of lies.

Whew. I need a break. Maybe something light and uplifting after this.

I have a lot of respect for John Carreyrou's work and tenacity in bringing Elizabeth Holmes' fraud to light. The story is a fascinating one, and the book is definitley worth reading, however I feel like it could have been summed up more concisely, perhaps in reading Carreyrou's original Wall Street Journal pieces.

It just became really depressing to read all of the ins and outs Theranos structure, the rate of firings, the many different ways the supposedly ground breaking technology didn't work, the lengths they went to hire lawyers and private investigators to prevent whistle blowers. After awhile I found myself skimming since it was years and years of repeated heinous corporate practices. There's no real satisfaction in learning why Holmes and her partner Balwani acted like such megalomaniacs, similar to how detectives interviewing sociopaths must feel frustrated when asking “Why did you commit this crime,” often there's just no answer to be found.

Like 19 out of every 20 people who apply to Stanford, I got rejected. Not everyone who does get in to one of the county's most selective institutions stays there, though, and one dropout is more notorious than the rest: Elizabeth Holmes. At 19, she left the university to found her own company, Theranos, the rise and fall of which is chronicled in John Carreyrou's Bad Blood. Holmes' original idea was a patch that could administer medications directly to the bloodstream. When that proved untenable, though, she turned to blood testing. Terrified of needles, she came up with the idea of being able to run diagnostics using just a few drops from a finger stick instead of the giant scary needles in the arm. It promised to revolutionize the industry, making testing cheaper and easier. There was just one problem: it didn't work.

For a long time, though, she was able to convince people that it did. She raised billions in capital. She built a prestigious board of directors. She was courted by the CEOs of pharmacies and supermarkets, desperate for a chance to implement her technology. And if anyone seemed like they might get in her way or slow her down, she terrified them into silence with legal threats. Eventually, though, a leak sprung, and Carreyrou began to write about the company's struggles in The Wall Street Journal. Despite high-powered lawyers doing their best to separate him from his sources, he was eventually able to expose the massive house of cards that was all Theranos ever was. Holmes and her ex-boyfriend, Sunny Balwani (the company's COO), currently face federal criminal charges that could imprison them for years.

Corporate malfeasance can make for highly entertaining movies, but there's a reason most true crime writers shy away from white collar stuff in favor of murder: it's hard to render bad business practices as exciting on the page. But in Holmes and Balwani, Carreyrou has two striking personalities to work with and he makes the most of them. It might be easy to write Holmes off as a deluded posturer, but he shows how her vindictiveness towards those that might have been able to expose her is the behavior of someone who knows full well what she was doing. And Balwani's fiery temper, the fear he inspired, leap off the page. The writing does sometimes veer into the technical, but the outlines are fundamentally of a confidence scheme, and Carreyrou keeps the book engrossing by focusing on the way it plays out, the way Holmes so often seems trapped in a corner and manages to escape yet again.

Between Holmes, Anna Delvey, and Fyre Fest, scammers are having a moment in American culture. There's something revolting and yet fascinating about people who operate without any of the fear many of us seem to feel about deserving our place. Anyone inclined to feel sympathy for Holmes, to feel like she just got in over her head, will have a hard time maintaining that once they read the truly heartbreaking account of how a prominent scientist who tried to get things back at least adjacent to the track was preyed upon by both Holmes and Balwani. When he eventually committed suicide, the company's only response was to get his work laptop back. We live in a time when technology companies, and the people who run them, are effectuating enormous changes with very few probing questions asked. This book, which I really enjoyed and highly recommend, demonstrates why we should ask more.

The Theranos story is so fascinating. Carreyrou paces the book evenly, slowly building his case. I borrowed this from a clinical chemist who plays (per him) a bit role in the story, appearing in a couple sentences within the book. When I returned his copy, the two of us sat in his office just marveling at how things progressed so far. Within my own little clinical chemistry domain, CLIA looms like a Greek god – all-powerful and all-knowing. Should we accidentally make a typo in our data, CLIA will send bolts of lightning to destroy us. The idea that a lab somehow became CLIA-certified with such significant variance in their data even before the straight-out fraud is almost unbelievable.

In addition, this seems like any doctor in their right mind would know what to make of Theranos. My best friend who works with silicon valley startups asked me about it several years ago, when I was still in residency, and I told her that the problem with capillary draws was hemolysis (blood cells splitting) and that you could never get some accurate results do that - and that's baked in to the blood draw, before you even get to the machinery. Any doctor worth their salt knows this.

So this is an almost fantastical story about how someone by force of personality alone paraded out technology that everyone knew was impossible, and somehow, without ever really inventing anything became a billionaire running laboratory testing in clinical labs on patients. It's pretty serious and scary stuff.

While reading it, I couldn't help but be amazed by the number of smart, well-educated people who were at least temporarily a party to this, often bullied by fancy lawyers and nondisclosure agreements. I think there's a lot here about how much the assumptions of civil society are really what keep us in check more so than institutions like CLIA or CAP. Once someone starts operating in bad faith, it's pretty scary how far they can get. On the other hand, Theranos was pretty much brought down by Carreyrou assisted by a pair of early-twenty-somethings who felt they had to speak out. So I think there's also a lot here about the importance of protecting whistle-blowers and the media.

Absolutely riveting, and a great example of what journalism is supposed to be. I've been aware of the Theranos saga over the last couple years so I was interested to get the full scoop in long form, but wow. It was hard to put down. As in I didn't. Highly recommended if you're interested in Silicon Valley drama, human nature and how not to run a startup. Also recommended for those who enjoy train wrecks.

One takeaway I want people to pay attention to is how risky it is to rely on the knowledge of someone else when it comes to technical/scientific processes or devices. It's crazy that with all the red flags about feasibility it took so long for people to catch on to the fact this device could not possibly do what she claimed it could do. On the other hand, I work with small businesses in a technical space and I see the same semi-blind trust that can lead to wasted funds or worse. If you're investing in a business or even just paying someone to do your website, please do enough research to understand rudimentary principles. It's really hard to make good decisions if you don't understand at least some of the technical process behind things. I also believe a competent vendor should be able to explain their product or service in layman's terms. If they can't, or they refuse, it's a red flag.

This is also a rather extreme example of the importance of the business rule: “under-promise and over-deliver.” And, you know, honesty. Also that.