Theranos – Illustration made for the story of Nathan Englander. Client: La Stampa


“Nonfiction accounts of Silicon Valley startups aren’t my go-to reads, but I do love a good psychological thriller. Which is why I found myself devouring John Carreyrou’s book, Bad Blood. It’s a journalistic narrative of the meteoric rise and fall of Theranos, a hi-tech blood-testing company founded by Elizabeth Holmes after dropping out of Stanford University.

The invention that Holmes promised was a revolutionary way to test blood. People could be spared the needle. They could stroll into a drugstore for a finger prick, instead of going to the doctor’s office for a venipuncture. That tiny fingertip sample would be fed into Theranos’ compact Edison machine, which would run scores of tests that previously could only be done on the giant contraptions in traditional laboratories.

The company’s valuation increased exponentially, making Holmes the youngest self-made female billionaire. At one point, her net worth was estimated to be 4.5 billion dollars, based on her 50% stake in the company.

But Holmes never delivered. Despite that, and despite what, in retrospect, are endless red flags, some very smart and very savvy and very-very powerful people—former secretaries of state Henry Kissinger and George P. Schultz were on the board—kept throwing their support and their money behind her until the scandals hit. By last year, the company had “burned through most of the $900 million” entrusted to Holmes by investors. And as for her 4.5 billion dollar fortune, Forbes magazine recalculated that number as 0.

What I found more and more riveting as I read was the mentality of the book’s two main subjects, Holmes and her then executive vice chairman and boyfriend, Sunny Balwani.

It seemed as if Holmes and Balwani were intentionally defrauding everyone, engaging in what appeared to be a giant confidence game, while simultaneously and sincerely embracing their vision of the product. It’s like the pair could actively deceive while deeply believing in their own deceptions. I kept thinking about the personality mix it takes to boldly present what isn’t as what is, in a way that would convince seasoned and sophisticated investors again and again. How does one maintain the appearance of calm and control, claiming progress and groundbreaking advancement, when behind the scenes everything is in disarray, and a dysfunctional company is being run as a kind of cult of fealty, propped up on a culture of fear?

One employee told Carreyrou about Holmes’s “unpredictability and [the] constant chaos at the company,” about the shocking number of firings, and how Holmes “demanded absolute loyalty from her employees” and “could turn on them in a flash.”

After a series of resignations, a staff meeting was called where, “still visibly angry, Elizabeth told the gathered employees that she was building a religion. If there were any among them who didn’t believe, they should leave. Sunny put it more bluntly: anyone not prepared to show complete devotion and unmitigated loyalty to the company should ‘get the fuck out.’”

Carreyrou writes, “Holmes and Balwani regarded anyone who raised a concern or an objection as a cynic and a naysayer. Employees who persisted in doing so were usually marginalized while sycophants were promoted.”

As for Balwani’s credentials, he “had no background in medicine, much less laboratory science. Nor did he have the patience to listen to the scientists’ explanations.” Employees eventually “devised ways to manage him, as it dawned on them that they were dealing with an erratic man-child of limited intellect and an even more limited attention span.”

And I can tell you, when you read a story like this, one that follows a trail of mismanagement and negligence, when you see a medical testing company willing to defraud doctors and put unsuspecting patients at great personal risk, when you see the lengths to which people will go to avoid being unmasked and to protect their continued self-enrichment, when you are reading along in the comfort of your own home, and get to the phrase “erratic man-child” you just might suddenly understand why you yourself are so mesmerized, staying up late into the night to read right to the end. You might even start to notice some terrifying and zeitgeist-like parallels to the current situation in which you find yourself living.

Because the culture at Theranos, the leadership at Theranos, the fear and intimidation in the workplace, the endless smoke screens, the shocking turnover, the boundless greed, the demands of loyalty, and the unwillingness to hear anything that doesn’t jibe with one’s reality, suddenly sounded familiar.

What else could it possibly conjure in one’s head but a terrifying metaphor for the way the White House is currently run? All that reliance on bad science. All that narcissism and paranoia. In that light, the book presents itself as a prescient and urgent cautionary tale.

At the end of Bad Blood, Carreyrou states, “A sociopath is often described as someone with little or no conscience. I’ll leave it to the psychologists to decide whether Holmes fits the clinical profile, but there’s no question that her moral compass was badly askew.”

So I guess I’ll leave it to history to decide if we, as Americans, are currently living inside the same kind of confidence game. I just pray that, as a nation, we don’t come to the same end. As there’s a lot more at stake than dollars and cents.”

Story by: Nathan Englander
Client: La Stampa

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