Bad Blood: Secrets and Lies in a Silicon Valley Startup

This book is one of the best I've ever read! It's even more compelling than I'd imagined. I remember reading the Glamour article on Elizabeth Holmes when she and her company first blew up and became famous. I stared curiously at her photo, into her huge blue eyes, thinking: Wow, that's pretty admirable! I, like everyone else, was fooled by her deceit and manipulation. This is an intense story of blind ambition, corporate greed, legal intimidation, and relentless smoke and mirrors. John Carreyrou did extensive research to write this book, and it's written perfectly. I found myself bursting out loud with laughter at so many parts! These scientists, engineers, artistic directors and researchers under Holmes were human beings, trying to make a living, and making the best out of a bad situation that kept getting worse. They tried to get away with practical jokes and humor, and Carreyrou's plain language illustrating each ironic situation and tortured character just made the whole thing funnier. I honestly haven't laughed out loud from a book like this in a very long time. But a lot of what happens is also stunning and very serious. I often shook my head incredulously. Just when you think it can't get any crazier, it does. What was Elizabeth Holmes' end game? For such an intelligent, charismatic and ambitious young woman, how could she think her lies, cover-ups and shortcuts would actually amount to something good in the long run? She hadn't just fooled the world; she had fooled herself into thinking her success would last forever, and that her power and fame would overshadow any problems that arose. And the problems were numerous and consequential from the very start. Hundreds of people suffered as a result of unattainable goals being promised, and employees being forced to work against their own morals and better judgment, in a high stress environment (where people were consistently in fear of being fired, or being fired, then sued). As one confidential source put it, "The way Theranos is operating is like trying to build a bus while you're driving the bus. Someone is going to get killed." And that sums it up perfectly. Thank you to all the people brave enough to speak up about Theranos, despite insane legal pressure to keep quiet. Bad Blood is a fantastic book, one of my absolute favorites! (Unfortunately it got shipped to me slightly damaged in the corner.) Please read it!!

I usually stick to self-help and leadership books, so Bad Blood was a big change of pace for me — and honestly, it was a really intriguing read. The story pulled me in right away. It’s wild to see how much deception, ambition, and absolute chaos was happening behind the scenes at a company that was once hyped as the next big thing. What made the book so gripping is how real it all is. The author does a great job laying out the events, the people involved, and how things spiraled out of control, and it reads almost like a thriller even though it’s all true. Every chapter had me shaking my head at how far the lies went and how many red flags people ignored along the way. As someone who usually reads about strong leadership, integrity, and building good culture, this was almost the opposite — and it made the lessons hit even harder. It shows what happens when leaders chase hype instead of honesty, and how bad things get when no one is willing to speak up. Overall, Bad Blood was a refreshing break from my usual genre and a surprisingly eye-opening read. If you like real-life stories filled with drama, scandal, and unbelievable decisions, this one is definitely worth it.

A unicorn in the investment world is a startup with a massive valuation, which always felt like an insult to entrepreneurs building very real products and services. A unicorn, in the rest of the world, is a mythical creature that doesn't existed so I guess they finally got it right when Theranos was called a unicorn. Like Ringling Brothers, they strapped a horn on a goat and marketed it as a real thing. And everyone bought it. Bad Blood was a fast and exciting read, and relatively easy, worth mentioning because there's a reasonable amount of science in there. As everyone surely knows, this is the story of a company that lied and the idiots who believed them to the tune of billions of dollars. But ultimately, it's a book about incompetence, and just how many people in this world are completely incompetent and unqualified to do their jobs. At least we can take comfort that investigative journalists are fairly competent and can reveal the incompetence of others. Theranos should never have gotten as far as they did and was only able to do so because of negligence all around. And while I appreciate that I got to read the details of this insane story at this point in time, we'll need a sequel in a few years once the dust settles. This case is still ongoing and therefore the ending is still open, which made the end of this book feel somewhat unsatisfactory. I am especially interested to learn how the good people in this story, the ones with sense and ethics, ended up. I want to know if Rochelle sued Holmes' turtleneck off. I want to know who was behind the surveillance. I want to know what excuses the failed Board members have come up with. I want to know what excuses the VCs came up with. And I want Holmes and Sunny to get what's coming to them. Commentary: Most non-fiction books are actually about incompetence. True crime, history, war, these books are filled with people who should never have been given the jobs they have, and Bad Blood is no exception. Obviously the leadership of Theranos were abject failures. Their Board of Directors were a bunch of doddering, dotty seniors who led a company that has a technology they never understood, and who completely failed in their duty to manage and monitor their CEO on behalf of their shareholders. The Venture Capitalists did not perform sufficient due diligence nor did they properly monitor their portfolio. We know they were too busy drooling over the valuation and pre-counting their investment carry to bother to look into the lies. Have you ever met a finance guy who is a blood science expert? In 20 years in finance, I have never met one, and yet investors believed them when they say a blood testing technology works without a shred of evidence. So the investors failed as well, and continue to fail by giving them a pass on their negligence. The regulators were also a bit incompetent, though I suspect their SOPs prevent them from being as effective as they can be. Nor should regulators be susceptible to pressure from politically connected investors and Board Members, but they are. US military leadership, including Sensible Dog Mattis formerly known as Mad Dog Mattis, also proved themselves to be incompetent and biased to the extent that they're willing to put our soldiers' health at risk. Theranos's corporate partners, who stuck with Theranos after years of continuous failure to deliver on their promises, were hilariously incompetent. I am very grateful that the states, and not the idiot pharmacies, set the standards for patient care in their stores. Anyone still in favor of deregulating the medical field and taking power away from the FDA should exclusively use Theranos testing devices for their family's health decisions. The most inspiring characters in this book were the youngsters like Erika and Tyler, who came out of college with a strong sense of personal ethics that they refused to give up, regardless of what the "grownups" told them to do. Tyler stood strong even as his own grandfather, Secretary of State George Schultz, tried to muscle him with lawyers, but Tyler showed grandpa what honor looks like. I'd hire those kids in a NY minute just based on their conviction, and I hope neither this experience nor any other breaks down their will and sense of right and wrong. Will Silicon Valley and venture capital learn from this mistake? Nope! The fact is that they're still showing returns to their investors who do not care how the money is earned, as long as there are no legal or tax ramifications. But I am especially interested to how pensioners feel about VCs using CalPERS funds to invest in scams like Theranos, since the risk is much greater for them than your average venture investor. Remember Moral Hazard? Silicon Valley doesn't.

On April 30, 2016, I posted a piece titled ““The Theranos evidence, waiting for a story” on my blog, The Weekly Packet. (https://theweeklypacket.com/category/health-care/ ) In the post, I said, “… looking at the facts is like looking at individual organs at an autopsy, after the diener has washed them, weighed them, and put them in clean pans. What we need now is the pathologist to come in, and with knowledge and experience, he or she will tell the story that puts the facts together into a coherent narrative. At some point, the narrative may well make an instructive case study.” John Carreyrou’s new book, Bad Blood: Secrets and Lies in a Silicon Valley Startup , tells the story with spellbinding skill and detail. Those of us who had some background, however minimal, in laboratory work knew that Theranos had almost certainly over-promised and under-delivered. None of us could have imagined the details. Carreyrou’s reporting reveals the astonishing extent of the process in a marvelously “coherent narrative.” He details the scope of the deceptions involved — including misleading deals with Walgreen’s, Safeway and even an attempt to involve the army, the vast sums of money lost, and the lives disrupted. First, no spoilers. Read the book! Then, after the mesmerizing read comes the hard part: what can we learn from this story? One obvious lesson relates to corporate culture. A corporate culture that encourages tough questioning across disciplines and insists on facts may sometimes seem harsh. In such an environment, though, mutual respect and civility make the system work. What we see in Bad Blood, though, is the destructive effect of siloing and secrecy. And we see that destructive process emanating from the top levels of management. There’s another lesson, too. A very old one. The error of hubris provokes the outcome of nemesis. David Ronfeldt explains in his excellent essay for the Rand Corporation, “Beware the Hubris-Nemesis Complex: A Concept for Leadership Analysis.” “In Greek literature, hubris often afflicted rulers and conquerors who, though endowed with great leadership abilities, abused their power and authority and challenged the divine balance of nature to gratify their own vanity and ambition. Thus hubris was no common evil: It led people to presume that they were above ordinary laws…” He goes on, “Hubris above all is what attracted Nemesis, who then retaliated to humiliate and destroy the pretender, often through terror and devastation. Thus she [Nemesis] was an agent of destruction. The battle won, she did not turn to constructive tasks of renewal and redemption—that was for others to do. Yet her behavior was never a matter of pure angry revenge. There were high, righteous purposes behind her acts, for she intervened in human affairs primarily to restore equilibrium when it was badly disturbed, usually by figures who attained excessive power and prosperity.” With Bad Blood, John Carreyrou has written not just a stunning piece of non-fiction reporting, but a cautionary tale for our times.

John Carreyrou displays the very best in investigative journalism through his writing, at personal risk, in the Wall Street Journal and this book. This documents the brazen success of a very young and blond Stanford sophomore dropout (Elizabeth Holmes) and her much older boyfriend (Sunny Balwani) in getting money and support for their supposed well-meaning efforts in bringing better medical care to the world. They had created a fake gold mine and did not want to give away any specifics for risk of discovery. The subtitle of the book Bad Blood is : Secrets and Lies in a Silicon Valley Startup. (2020). All of this was too good to be true. It hoped to offer one-stop medical care in grocery stores such as Safeway and drug stores such as Walgreens using prompt, painless finger-stick and accurate blood testing with rapid return, store pharmacies, and reasonable and affordable on-site "minute clinics" staffed by medical professionals who make rapid diagnoses. The Department of Defense considered using the technology. The author states that 70% of medical diagnoses and treatment are based on laboratory results and imaging studies. Virtual telemedicine, tests, time consuming electronic medical records, and procedures, are now replacing in-person physical examination and direct physician-patient interchange. "A pill for every ill." This could be another much needed topic of examination by Carreyrou. The narrator of this 301 page book correctly changes to first person singular on page 223. Very prominent older men were on the board of Theranos, the parent corporation which was closed in 2018. The board included its chairman George Shultz (died at age 100 on 7 Feb 2021 and a former US. Secretary of State, Treasury, and Labor who was in a marine in combat during WWII), Henry Kissinger, General Mad Dog Mattis, former secretary of defense William Perry, US Senator Sam Nunn, Heart and Lung Transplant Surgeon Senator Bill Frist, and more. They were given shares of Theranos stock for their presence on the board. Other famous names such as former Secretary of Education billionare Betsy DeVos, Rupert Murdoch, a billionare world leader in journalism, and Walton heirs lost a total of a billion dollars in their Theranos investments. Three U.S. Presidents and the Stanford University president were captivated by the charm, intelligence, and persona of the photogenic Holmes who was once worth five billion dollars and featured on the covers of American magazines. Innocence or guilt for Holmes and Balwani will be determined in a federal court the summer of 2021 or later. This book also provides much information and insight about our country's influential media, legal system, and attorneys. Tyler Shultz, a former employee of Theranos who helped identify the scam and was the grandson of George Shultz who introduced him to Holmes, and John Carreyrou are prominent among the many heroes, female and male, in this book which includes patients, physicians, scientists, and the many honest people in the health care industry. Lost documents, Holme's current pregnancy, the COVID pandemic, politics, the medical-industrial complex, and this book may influence the legal outcome. Read this book and form your own opinion. Carreyrou is able to describe the laboratory terminology, equipment, and techniques along with the wild and brainy world of Silicon Valley to the average reader in a most exciting and very readable manner.

"Bad Blood" is an important book. It chronicles the rise and fall of Theranos, which we all now know to have been a total scam company which promised that it could perform a range of blood tests using one drop of blood rather than having to ask patient to give several vials of blood. The problem? Founder Elizabeth Holmes wasn't a medical professional, and there are many technical reasons why her vision is unlikely to ever happen- especially not yet, and not from her. This is a case of some incredible, risk-taking journalism. I think we're all getting used to an age where news agencies have stopped funding good journalism in favor of clickbait nonsense. This is real journalism. People's jobs were at stake. John Carreyrou was in real trouble in the worlds of journalism and Silicon Valley for questioning sacred wisdom. I'm glad that real investigations still happen. There was a real chance he could have gotten stonewalled and forever been called crazy for his allegations. Luckily, it all paid off, and now we know. Theranos was Silicon Valley's darling company, valued at billions of dollars before they ever produced a working prototype. Elizabeth Holmes was essentially a confidence trickster, who got people to share her vision without ever producing a working product. Elizabeth Holmes told people that her company was going to revolutionize medical blood tests, allowing elderly people to do a pin-prick at home instead of traveling to a lab for a blood draw. There are many reasons why larger quantities of blood are required. To take an oversimplified case, many blood tests rely on very accurate measures of the relative concentrations of various chemicals in the blood. The larger the sample, the more accurate the count. If you only draw one drop of blood and try to use it for 20 separate tests, your sample size becomes incredibly tiny. There is absolutely no way around hard limits like this. Any of the billion-dollar investors who invested in Theranos could have talked to a doctor and gotten this information. It seems like none of them did, or they chose not to listen. Elizabeth Holmes is also a great target. It turns out her whole public persona was- probably- an act. When she came into the public eye she chose to dress like Apple's Steve Jobs, striding around in a black turtleneck. This contrasted with her blonde hair and always-a-little-too-open blue eyes. She cut a startling figure, seeming not to blink for vast stretches of time. Was she crazy or just intense? Then there was her voice. Again, modeled after Jobs' rather slow presentation style, but she spoke in a deep baritone. The first time most people saw her, they laughed at how obviously fake she was. But everyone else in the room was taking her seriously- was there something to it? As it turns out, no, it really was just trickery. Carreyrou slips in a few reports from people who worked with her that- in very stressful moments- she sometimes slipped into the usual sort of "valley girl" banter that would be typical of her upbringing. It was a pure act all along. The book mostly focuses on a blow-by-blow of Carreyrou's investigation, Holmes' background, and how the world reacted. He only gingerly brings up many of the big controversies. To name one- everyone in the current culture claims that women aren't allowed in Silicon Valley, that's it's a "boy's club". Yet the case of Theranos seems to indicate that many people believed Holmes specifically because she was a woman. Maybe there's a lot more nuance that we need to read into the situation. That's why Bad Blood is such an important book- there are a lot of crucial conversations that need to be had. Understanding what happened here is a good first step.

I’m an entrepreneur. I resolved to read this story from the angle of heroine Elizabeth Holmes. My first company, book2eat.com, was, honestly, “the world’s first live, online restaurant reservation service” and, boy, did we cut corners to be the first. We had six restaurants signed up to our hub before our “client software” (running on the PC that lives in the restaurant and keeps track of the reservations) had even compiled. My girls would demonstrate the software to the restaurant owners by clicking on judiciously picked “buttons” on powerpoint presentations. We got it to work, of course, but we sold it way before it did. Our early consumers were also part of an experiment. We went live with 13 (yes, thirteen) restaurants but from the press we bought (thank you Hill and Knowlton for putting me on CNBC and the BBC and everywhere else) you’d have thought we had all of London covered. Oh, and the “live, online” bit was shaky: restaurants that failed to hit the “update” button to activate our free ISDN line (remember ISDN???) failed to receive notice of the (precious few, that’s why) reservations we’d sent them. So I hired a very polite, non-threatening, 16-year-old kid who’d call them up and say in his best voice “Hello, this is Damiano from book2eat.com, could you please hit the lightning button on the console, it looks like we have a reservation for you.” (Damiano went on to become the maître d’ at the Clapham Grand) During funding rounds, I’d live next to my computer and await restaurant reservations from the sundry VCs doing their “due diligence” and phone them through. And them guys would also try the funky features too. They’d click on the free glass of champagne and stuff. So I’d call the restaurant and tell them it’s a royal. Restaurants LOVE royals. I did worse things than that. Don’t think we would have passed muster with GDPR, I’ll tell you that much. And this wonderful employee I had, who was from Serbia, came and asked me for a recommendation for his status application and I did not give him one. I had investors, how could I tell them I knew for triple sure he was OK to work in the UK? Where could I find the time to become an immigration expert? I still hate myself for that one. Sorry Misha. I cut some corners, bottom line. Elizabeth Holmes did not cut corners: She had no worthy destination, no path and no morals. Only ambition. She basically: 1. Set out to solve a non-existing problem (people who hate needles get used to them pretty damn quick when there is a need for them, and this I know from personal experience) 2. Never had a visible path to deliver on her promise to run the blood tests on three drops of blood. 3. Illegally repurposed commercially available blood-testing apparatus to run tests hers couldn’t. 4. Built a structure whereby the scientists she employed lived in terror. 5. Employed both a vast security apparatus and a vast legal apparatus to ostensibly protect trade secrets, but in practice to suppress the truth: her product was putting human lives at risk. In short, she’s evil incarnate. That story lacks sex appeal, of course, so John Carreyrou, who deserves immense plaudits for persevering with it (he saved lives, no question and her undoing is his work, no question) also fills in the exciting bits: You find out about where Elizabeth Holmes got her unbounded ambition from (she had to live up to very distinguished ancestors), you meet her Lambo-driving, H1B-visa slavedriver Svengali and you get to hang out with all the senescent and senile luminaries she seduced into supporting her, from former Secretary George Schultz to current Secretary “Mad Dog” Mattis. Most fascinating are the stories of the Theranos whistleblowers, and the genius of the book is to build its plot through their testimonies. These testimonies are both the backbone of the book and, with no doubt, what makes it so impossible to put down. Especially so when Theranos goes in persecution mode and they have to fight for their lives. I warned you, though, that I’d read this from her angle and on one issue I disagree with John Carreyrou: John Fuisz was a friend of her family who heard the Theranos idea from Elizabeth’s mom and did not hesitate to phone-in the only pertinent patent to his patent attorney. That’s what I call a scumbag. I’m very happy she humiliated him. Every cloud has a silver lining. Oh, and Rupert Murdoch (strong candidate for most destructive human being alive, IMHO) comes off well! Against pressure from the entire US establishment he backed up his journalist. Who woulda thunk? Not that I’d ever consider switching from BBC 5live for my F1 coverage, but still. Overall, however, this is an important book from an important author. Hundreds of thousands of people took the phony Theranos blood test. Thanks to the investigative work of John Carreyrou, millions were probably saved. It was very exciting to be a fly on the wall in this investigation.

Not sure why they would pad the book up to the top of the box, and put no protection on it… I scored open the tape on the box and accidentally scored on the book cover too. Should have padded the top of the book. It kinda annoys me that I damaged my book bc of poor packaging. The book itself is great.

Bellissima lettura estiva: libro interessante, l’ho divorato durante le vacanze. In inglese ancora meglio! Very enjoyable reading. The story itself is incredible - you wouldn’t believe if it wasn’t a true one! The author knows how to make you stay stuck on every page. Ideal reading on the beach :)

I am so glad that the world still has some talented investigative journalists left. I bought the book because I saw the news articles and was intrigued how a diagnostics company could get things so wrong. I don't work in diagnostics but I do work in the blood industry and am a user of diagnostic products so I know the regulatory hoops these guys have to jump through and the years of research required to get their products to market. I applaud John Carreyrou for taking this on and exposing what was a complete sham of a company. I was fascinated and incredulous at how a Stanford dropout, with no knowledge of how to run a diagnostic company or do research, managed to set up her own company and get enormous amounts of funding by charming and hoodwinking so many wealthy older men. But the way she threatened her own staff was appalling. Her avoidance of regulatory requirements for so long was also unbelievable. I want to pay tribute to the whistleblowers who were brave enough to talk to the author - and they took enormous risks and paid high costs. Excellent read.

This is a very engaging read and I can recommend this book to those who have yet to read it. One vital piece is missing though ... statements from the protagonist herself. She declined to give her own account of what actually transpired and her true motivations. When did the falsehoods begin? And why? Elizabeth Holmes is certainly adept at selling ice to Eskimos. But even so, how did experienced investors such as Tim Draper, Larry Ellison, Rupert Murdoch, Carlos Slim, and the Walton family among others get conned so easily? And how did her professor at Stanford get taken in by her? How did the Theranos board with illustrious names such as Henry Kissinger (former US Secretary of State), Jim Mattis (retired Marine Corps four-star general), George Shultz (former US Secretary of State), Richard Kovacevich (former CEO of Wells Fargo), William Perry (former US Secretary of Defense), and William Foege (former director of the Centers for Disease Control and Prevention) get hoodwinked? Why and how did corporate governance fail? The reasons for all these are not truly explored but despite this, Bad Blood is certainly a gripping tale where greed and "fear of missing out" (FOMO) met with hubris and deceit. The tale also points to the fallibility and/or vulnerability of our minds/reasoning. Often times, we believe what we want to believe and ignore all evidence to the contrary. We become even more gullible when confirmation bias is present. Rest assured. Investors and venture capitalists will learn nothing from this episode. History will repeat itself somewhere and sometime in the near future.

As a medical laboratory scientist VERY familiar with this lab diagnostic industry, I was SHOCKED beyond words at how Ms Holmes was able to convince so many for so long that she had invented a unicorn in lab medicine. I've been in the biz for 45 years and usually use venous drawn blood samples. However we have used fingerprick blood collection (or heels on premis and newborns) to get blood samples to perform basic heamtology and chemistry tests. 'No way Jose', given the different anticoagulants needed for various tests could all these tests be performed on one drop (5 ml) of blood...period...full stop. Ms Holmes was one heck of a salesperson though and using a similar ptich as Bernie Madoff did with 'get on board now with all THESE bright rich people ' she perpetuated the FOMO mindset that so many fall victim to....and they did...to the very last one. Mad Dog Mattis, Henry Kissinger, Larry Ellison to name just a few. Do I feel sorry for the rich and famous who lost upwards of $100 million each? No. Do I feel sorry for the harm done to patients, doctors ? You bet...'First do no harm' is the very basis of the Hypocratic oath. I even feel bad for the CEOs of Walgreens and Safeway who, in an effort to be at the leading edge, got duped big time. The author, a respected Wall Street Journalist, dumbed down the lab medicine verbage part so that I believe even a reader completely unfamiliar with the actual science, could easily follow the bread crumb story line in the story. We've all had blood tests drawn and have a basic understanding of the process. Go to doctor, get a requistion, get blood drawn which goes to the 'lab' and results are transmitted to your doctor with high and low values that are concerning being flagged as out of normal range. In Canada, we have universal health care so don't 'pay' for 99.9% of these tests. In the US however, the cost can be exorbitant whether covered with extended insurance or private pay. THAT was the motivation behind Ms Holme's 'invention' ---to save money, make access to tests easy and without needing a doctor's requisition AND so patients could access their results. When the story narrative changes to the first person in the last quarter of the book , it becomes even more interesting. Thank goodness for whistle blowers Erika Cheung and Tyler Schultz who came forward to support the Missouri pahtologist blogger with his concerns which caught the eye of the author John Carryerou. I hope a movie can be made of this fascinating story to reach an even wider audience and everyone can watch and learn that 'if it sounds too good to be true, it probably is'. Mothers' wise words ring true once again.

No sólo la recopilación y el trabajo periodístico hacen que este libro valga la pena. También, es una excelente guía para empleados, entrepreneurs y empresarios sobre que no hacer en un ambiente laboral. Temas como el "burnout", "bossing", liderazgo, lealtad y la delgada línea que hay entre cada uno de ellos, se puede encontrar durante el relato de esta historia, que a veces pareciera una novela y no un fragmento de la historia real.