Bad Blood

By John Carreyrou

Published by Knopf, a division of Penguin Random House
ISBN: 9781524731656

Book review by Andrea Bandelli, Executive Director, Science Gallery International, Dublin, Ireland

The rise and fall of Theranos is the largest scandal in the history of Silicon Valley and a brilliant case of investigative journalism. I found it a fascinating story of how easy is to forgo ethics, misjudge passion, leadership and charisma, and blur the lines between reality and delusion.

Theranos was a medical tech company founded in 2003 by Elisabeth Holmes, a Stanford dropout with a vision to revolutionise blood testing. The company promised to build a technology capable of performing hundreds of tests using only a few blood drops from a finger prick. Quick, painless and cheap, Theranos’ tests would change medical diagnosis forever. Holmes raised to stardom as the next Steve Jobs, and the media named her the youngest self made woman billionaire. Henry Kissinger and George Shultz, both former US Secretaries of State, and William Perry and James Mattis, Secretaries of Defense, sat on the board of directors of Theranos. Walgreens entered into a partnership to use Theranos tests in all its pharmacies. Holmes raised $900 million in funding and at one point her company was valued at $10 billion. But there was one problem: Theranos never developed the technology to do the tests.

This was not a scam intended to fool investors and stakeholders; rather, it is the story of a woman who managed to surround herself with powerful men unable to question her unreliable behaviour. Her intentions were initially in the right place: she really wanted to create something of great value to humanity. But her self-confidence and optimism, fuelled by the “culture of disruption” of Silicon Valley quickly degenerated into delusion, and delusion is contagious. When people started to realise the unethical and plain illegal practices necessary to sustain that delusional behaviour, it was too late. In 2018 Holmes was charged with massive fraud, and in that year Theranos ceased operations.

“Bad Blood” is written by John Carreyrou, the Wall Street Journal (WSJ) journalist who uncovered the malpractices of Theranos. The first part of the book is an account of the first 12 years of the company. In hindsight, there were several signals that something wasn’t right: excessive secrecy, a narcissistic leader, and a dramatic lack of diversity at the board level, to name a few. But the company managed to thrive, mostly thanks to questionable practices to silence those who dared to dissent. The second part describes how the author of the book brought down Theranos, starting with an article in the WSJ and the work of two whistleblowers. Until the very last, those who supported Theranos were unwilling to see reality for what it was, preferring instead to believe that the vision of Holmes to “disrupt the industry” and to change the world would eventually prove to be right. A perfect example of cognitive dissonance at its best.

The book is a real page turner. In the first part the characters take us into an endless downward spiral. There seems to be no end to the deception, the questionable practices, the plain mistakes, and yet the company gets stronger and stronger. Until Carreyrou enters the stage and with the help of some incredibly brave whistleblowers, ends up being the real disruptor. Immune to Holmes’s staring blue eyes and deep baritone voice, Carreyrou sets an example of journalistic practice by documenting the events that will make Theranos capitulate.

The Theranos scandal was huge; but there are numerous “mini-Theranos” that keep happening around us, where people are blinded by ambition and aspirations. In these cases, the belief that the mission is so important leads some people to bend not only reality, but also ethical norms. In most cases, those who are involved do not consciously engage in unethical practices: they simply don’t see their behaviour as unethical, because they can’t distinguish between aspirations and reality.

Reading “Bad Blood” is more than a cautionary tale: it is a good antidote to avoid ending up in a Theranos-like bloody mess.

(If you are interested in the Theranos story, HBO recently released a documentary on the Theranos story called "The Inventor: Out for Blood in Silicon Valley."; ABC News has produced the feature documentary “The Dropout”, available as a podcast)