Bad Blood Book Review

I just finished reading John Carreyrou’s Bad Blood: Secrets and Lies in a Silicon Valley Startup. This book is a true story with true documentation from emails and quotes taken from interviews. I thought this book was a phenomenally written piece about a terrible, tragic saga. Bad Blood is about a startup that was founded in 2003 by a Stanford University dropout, Elizabeth Holmes. The company was developing technology that would quasi-instantaneously perform several laboratory blood tests inside a machine from one drop of finger-prick blood. This machine had the potential to revolutionize the medical industry, detecting diseases several times faster, assisting doctors in treatment, and allowing patients to be more health-conscious since these machines were intended to be available for consumers to buy. This was a noble idea, however the technology they were developing was less than performative. As seen in the book and numerous media articles and interviews about these events, the blood tests were highly inaccurate. Despite the technology’s flaws, Theranos lied to investors, proceeded in putting their machines in clinics, and deceived the media and their own employees resulting in a multi-million dollar lawsuit and several years in prison.

So why did Theranos’ technology fail? First was that it was extremely difficult to do as many tests as Theranos claimed to be able to do from one drop of blood. The blood had to be diluted a lot and that resulted in a lower concentration of the analytes (substances they were looking for) and decreased the accuracy of the tests. Second was that blood obtained from the finger, which was inherently different from the veins in that it was polluted by several other substances, so it was much harder to find the presence of disease-associated proteins. However, apart from the technical obstacles, one of Theranos’ main flaws was their secrecy, even within the company. Bad Blood talks about how the different parts of Theranos were guarded from each other - the only people who had the full picture of the progress within the company were the founder, Holmes, and her number two executive, Ramesh “Sunny” Balwani. This kind of secrecy is detrimental to the development of a company because if each team is only responsible for their part, they can never fill the gaps and make their work integrated. In nearly all of Elon Musk’s companies, for instance, the design, engineering, and manufacturing teams all work together when developing a product. This ideology is that when creating a product, each of these parts goes hand in hand, so the people responsible should also work side by side. Another issue was that employees were discouraged from bringing up flaws in the product and brown-nosers were praised. An environment in which you cannot bring up the inherent flaws in a product inherently prevents any kind of advancement of the product, which is precisely what led to the many lies that were told about the state of Theranos’ technology.

Despite Theranos’s inadequate technology and secretive company culture, their vision may not be entirely fictitious. I saw an article recently about how some Stanford researchers may have developed an informative blood test that requires only a few drops of blood. Unlike Theranos, this research has been vetted and peer-reviewed. Many experts who are not affiliated with the study are saying that it has scientific backing. If this technology does work, it could truly change many lives and revolutionize the pharmaceutical industry.

Ultimately, Theranos lied and deceived their customers, business parters, and investors. Their technology didn’t work, they said it did, and they put hundreds of patients at risk of false positives, or worse, false negatives. But there are people out there who are working to bring the vision of a multitude of tests being able to be performed from a drop of blood, and, who knows, maybe this time the technology will actually work.