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. ( )

This is a story of ambition gone wrong. Theranos founder Elizabeth Holmes patented an ingenious device which was meant to perform a multitude of blood tests all in a small device while using a small amount of blood. The problem, there was so many technology and medical problems that made the device ineffective. Worse, touting the device as accurate and practical caused many people to be harmed by getting unnecessary and wrong treatments that were indicated as needed from the results obtained from the Theranos device. Theranos was able to keep its operations going by deceiving investors and regulators alike. A culture of fear was its management style, and silencing anyone who questioned the reality of the technology. Along the way, showcasing what investigatory reporting is all about.

A few drops of blood from the finger was all that was needed to be used in the Theranos technology. The reader would send the data to Theranos, which would analyze the data and send a report to a medical profession. The whole process was supposed to be done quickly, which would allow patients to alter their medications usage based on the results from the Theranos technology.

Part of the problem with the technology was that to use only a small amount of blood required diluting the blood to get more volume. Some dilution can be helpful, but to get enough liquid for the reader to work required diluting the blood sample even more, which reduced the ability to measure the blood precisely. The engineers and biologists working on the product wanted to use more blood, but even a little bit more was not allowed. Many of the tests that were needed to be done were incompatible. As in, using the blood for a particular test meant there was not enough for other tests. The technology to use the tests themselves were very bulky, which made them hard to miniaturize it. Even with miniaturizing problems, Holmes then requested even more tests that the technology needed to be able to run. What mattered to Holmes was the size of the machine, rather than if the machine worked.

As the technology was nor reliable, to show during investor demonstrations, the results were used from a test when the technology worked. Making the technology appear to always work. Sending data after the ‘outliers’ were deleted. When doing a sales pitch, there were many claims being made about the product working in various locations, military operations, and supported by medical institutions. Even if no partnership was formed between another firm, that supposed partnership was used to support the companies claim. For many investors and partnerships, this was a technology that was too good to pass up. Some people believed in Holmes for the health implications. For others, it was Holmes’s charisma that swayed many important people to her side.

There were investors and advisors to partnerships who had wanted to test Theranos technology by doing comparative analysis, and who had asked the appropriate questions. Most of these people were given a hard time by the decision makers who were enamored in Holmes and believed the claims. The few times that the Theranos technology got tested indicated that the technology was not as stated as the technology still required needles, it took weeks to get the results, many of the tests were outsourced, and that the tests that were not outsourced were so suspicious that people got completely different results when getting retested by other companies.

Many people either wanted to be part of Theranos or were taken in by the vision presented. Most people did not last long in the company. There was a high turnover rate which involved every position and rank. Anyone who questioned the technology were either fired or made their life difficult. To be at the company required absolute loyalty and optimism towards the company. Dishonestly became a prerequisite. There were employees who could no longer be party to the ethical and moral misconduct, left the company. Leaving who were unscrupulous, or who did not have much choice. Life got even more strenuous for employees with the hiring of Ramesh "Sunny" Balwani, Holmes’s romantic partner. It was Sunny who started to fire people, but he also bullied employees. Holmes had effectively created an echo chamber around her. Cutting herself of from reality while only engaging those that were a bad influence.

Management practices involved compartmentalized information between departments which made communicating the problems and potential solutions difficult. High confidentiality was required in the company. Everyone was under constant surveillance as all electronic actions were tracked. Former employees were frequently being sued or threaten by a perceived threat to Theranos hype.

One problem that had occurred to the company was due to a family friend. Richard Fuisz took great lengths to get even with people from whom he perceived offended him, no matter how slight. Fuisz helped the Holmes out before, so took offence to Elizabeth not asking him advice about the company. To get revenge, he acquired a patent that Theranos would need later. Fuisz pride and vanity caused him to try to take down the company. In an ironic turn of events, Theranos sued Fuisz for something that could not be proven but Fuisz was not willing to pay for the legal fees anymore. But, it was Fuisz which made contact with a science blogger who made contact with a journalist, the author of the book, John Carreyrou. It was Carreyrou’s investigation which made salient the problems with Theranos technology. Theranos lawyers tried to put an end to the investigation, but fortunately they were not successful.

Over hyping technology is not new to Theranos, it is the culture of Silicon Valley. The problem with Theranos over hyping was that the technology impacted health, rather than just creating a frustrating mood when the technology did not work.

The book is generally well written but with too much time spent discussing the company culture of firing employees. They were used to highlight the reasons for company problems, but the way it was written did not add much value as the situations became repetitive. The main problem with this book is that the author only express’s directly the views of people who were critical of Theranos, while discussing those who supported Theranos indirectly and usually from a more general perspective. Showcasing the thoughts of those who supported the Theranos would have been a valuable addition as it would have provided more credibility when discussing their beliefs about Holmes and Theranos technology, but also would have provided guidance on how to avoid being seduced by false promises. ( )

BIBLIOGRAPHIC DETAILS:
(Available as Print: ©5/21/2018; PUBLISHER: Knopf; ISBN: 978-1524731656; PAGES: 352; Unabridged.)
(Available as Digital: Yes)

*This version: Audio : ©5/21/2018; PUBLISHER: Penguin Random House Audio Publishing Group; DURATION: 11:41:54; FILE SIZE: 334544 KB; Unabridged

(Feature Film or tv: There is a documentary as well as a film version that is In the making.)

Series: No

SUMMARY/ EVALUATION:
I saw the print version of this while in my favorite bookstore, Newport Beach Public Library’s Friends Used Books, and overheard a fellow-patron who’d spotted it as well, telling the volunteers how thoroughly he enjoyed this book. Indeed, he claimed it was his all-time favorite (and this fellow was around MY age, no Spring chicken). He was asking the volunteer if she was familiar with it and with the case that was currently in the news which the book focuses on. The volunteer was aware, but wasn’t interested in hearing about the book. I got a sense of disapproval on her part, but of what (Book? Author? Biographee?) Anyway, I made a mental note to check my Los Angeles Public Library’s (LAPL) Overdrive for the audio version, and, when I did, was thrilled to find I didn’t even need to place a hold. . . .not for the first check-out. By the time I needed to renew it however, I would have, had I not been rescued by my other favorite library’s (Palos Verdes Library District) Overdrive. I suspect by this time the news had been more regularly airing snippets and the fact that a verdict on the Elizabeth Holmes/Theranos trial was going to run over into the new year.
Even if you have no interest in medical devices/technology; business, startup companies, or white collar crime, this book is fascinating, not to mention exceedingly well written.

AUTHOR:
John Carreyrou: According to Wikipedia, “John Carreyrou (/ˌkæriˈruː/)[1] is a French-American journalist and writer who worked for The Wall Street Journal for 20 years between 1999 and 2019[2] and has been based in Brussels, Paris, and New York City. He has won the Pulitzer Prize twice and is well known for having exposed the fraudulent practices of the multibillion-dollar blood-testing company Theranos in a series of articles published in the Wall Street Journal. . . . A book-length treatment titled Bad Blood: Secrets and Lies in a Silicon Valley Startup (2018)[34] won the Financial Times and McKinsey Business Book of the Year Award.[35] A film version is in the works starring Jennifer Lawrence, written by Vanessa Taylor, and directed by Adam McKay.[36] . . .”

NARRATOR:
Will Damron: According to Tantor Media, “Will Damron is an Audie Award–nominated narrator who has recorded books in every genre, from science fiction and fantasy to romance, YA, and nonfiction. Raised in rural southern Virginia, he has appeared Off-Broadway and on stage and screen throughout the country. He lives in Los Angeles, California.”
VERY good narration here.

GENRE:
Biography; Biography; Nonfiction; Technology

LOCATIONS:
Palo Alto

TIME FRAME:
2003-2018

SUBJECTS:
Family; Start-ups; Nepotism; Business; Medical Devices; Labs; Blood tests; fraud; criminal; politicians; celebrities; marketing; Theranos (firm) history; hematologic equipment; industry; Economics; Entrepreneurship; Finance; Biomedical; technology and engineering; trade secrets; whistle blowers; Elizabeth Holmes; deceit; management; ambition; venture capital

DEDICATION:
I didn’t see one in the digital sample on Amazon.

SAMPLE QUOTATION:
From the Prologue
"November 17, 2006
Tim Kemp had good news for his team.
The former IBM executive was in charge of bioinformatics at Theranos, a startup with a cutting-edge blood-testing system. The company had just completed its first big live demonstration for a pharmaceutical company. Elizabeth Holmes, Theranos's twenty-two-year-old founder, had flown to Switzerland and shown off the system's capabilities to executives at Noartis, the European drug giant.
'Elizabeth called me this morning,' Kemp wrote in an email to his fifteen-person team. 'She expressed her thanks and said that, 'it went perfect!' She specifically asked me to thank you and let you all know her appreciation. She additionally mentioned that Novartis was so impressed that they have asked for a proposal and have expressed interest in a financial arrangement for a project. We did what we came to do!'
This was a pivotal moment for Theranos. The three-year-old startup had progressed from an ambitious idea Holmes had dreamed up in her Stanford dorm room to an actual product a huge multinational corporation was interested in using.
Word of the demo's success made its way upstairs to the second floor, where senior executives offices were located.
One of those executives was Henry Mosley, Theranos's chief financial officer. Mosley had jointed Theranos eight months earlier, in March, 2006. A rumpled dresser with piercing green eyes and a laid-back personality, he was a veteran of Silicon Valley's technology scene. . . ."

RATING:
5 stars. GREAT book.

STARTED READING – FINISHED READING
12/27/2021 – 1/25/2022 ( )

Surprisingly readable investigative story. I was worried that there would be too many characters to keep track of, but each chapter concentrates on a certain group that then disappears from focus (often because they get fired).
( )

This is an incredible expose about Elizabeth Holmes, 20 years old, college drop out before sophomore year, charismatic and with a desire for "a purposeful life". She patented her idea to develop an in-home mini lab where individuals can administer their own blood test with a single drop of blood and transfer the info to their doctor for treatment recommendations, if necessary.
In the span of 10 years Theranos, the start-up which Holmes created, went from a little blood testing machine to, well, a little non-functioning blood testing machine. Through quick thinking, being evasive and using outside testing facilities for accurate results was she was able to receive the backing of the US Army and former Secretaries of State, George Schultz and Henry Kissinger.
How does this flimsy start-up come to an end? A phone call to a Wall Street Journal journalist named John Carryrou from a suspicious employee. ( )