Bad Blood: Secrets and Lies in a Silicon Valley Startup by John Carreyrou tells the story of Theranos, a biotech startup that had a staggering rise to a close to $10 billion valuation and an even more dramatic fall.
The very short version of this review: I was really impressed by this book.
Being in the Bay Area, I’ve heard so much about this, but figured it was mostly hype. When it finally popped up on Bill Gates’s list of Best Books of 2018 a few days ago, I decided to take the plunge.
Bad Blood covers the fall of Theranos, a startup that was founded by Stanford drop-out Elizabeth Holmes when she was nineteen. It claimed to offer faster, cheaper blood tests from just a pinprick of blood (see their demonstration on YouTube), as opposed to traditional methods which require needles, lab equipment and technicians.
Over the course of a decade, it ballooned to a valuation of almost $10 billion, but within a few short years was defunct once it became clear their technology was not what they claimed. It’s a saga that ensnared a range of tech, legal, political and other industry leaders such as Henry Kissinger, Rupert Murdoch, and our current Secretary of Defense John Mattis.
While a number of articles have profiled the big issues — they were lying, duh — Bad Blood does a deep dive into the company’s culture and the thousand small decisions that preceded Theranos’ downfall. In also covers the war Theranos waged as the walls slowly started closing in on their fraud. Both Elizabeth and the company’s COO are currently facing serious jail time for wire fraud.
The book’s author, John Carreyrou, is the Wall Street Journal journalist who first started reporting on possible malfeasance at Theranos. He first reported in October 2015 that Theranos was secretly using traditional blood testing machines to test blood instead of their own technology.
I think Bill Gates’s description (which sold me on this book) sums it up nicely: “The story is even crazier than I expected, and I found myself unable to put it down once I started. This book has everything: elaborate scams, corporate intrigue, magazine cover stories, ruined family relationships, and the demise of a company once valued at nearly $10 billion.”
Bad Blood was one of the quickest reads I’ve had in a while. It’s so tantalizingly full of lies and terrible decisions and secrets that it hooks you in for the same reasons you can’t help slowing down just a little when driving past the scene of an accident.
The book paints a compelling image of a girl driven by stories of her family’s past greatness and current state of embarrassment, leveraging both powerful family and personal connections to support her grandiose vision.
Lies and secrecy are used to compensate for the unfulfilled promise of the technology itself. And in the company, those who raise concerns are fired while sycophants are promoted — all of which sets up Theranos for its eventual downfall.
Some of my interest was due having familiarity with many aspects of the book (I previously lived in the city the company was based in, visited the same hangouts, I’m all too familiar with startup pitfalls and founders who think they’re the next Steve Jobs, and I worked for the firm that served as their outside corporate counsel) as a Bay Area tech person. But, I’m pretty sure the drama seeping out from these pages is lurid enough to capture most people’s attention even without all that.
Carryrou has done a commendable job of making the book immensely accessible and readible, helped along by the subject matter itself. It’s a nutty story, even for Silicon Valley standards, mostly because of how out of control things got.
While erratic founders, lack of management skills and startups lying to investors and employees is not remotely notable, Theranos’s scale and subject matter — risking people’s ability to make smart health decisions — took things to another level. Any time you throw billion dollar valuations and cancer patients into the mix, it all gets worse.
And then, by the time the book reaches the point where Carreyrou’s begins his investigation, things have gone totally off the rails, with numerous people risking a lot to help expose the company, private investigators getting called in and armies of lawyers on the march as Theranos was clearly ready to fight to the death.
I was enthralled pretty much throughout the whole book, and I was really impressed by how Carreyrou really took the time to understand the technology, the tech industry, the legal issues and everything else related to the topic. The book wasn’t just interesting, it felt very credible. As someone who routinely whines about the quality of tech and legal reporting, I’m not an easy customer in this department.
Some Small Caveats
That all said, while I clearly enjoyed the book, a quick caveat about Bad Blood I’d point out is that the book is fairly limited in scope — this is one company’s dirty, dirty laundry being aired out. It’s a takedown of two awful people and their massive egos. The schadenfreude in this one runs deep.
I also think the book goes way too easy on the other enablers, decision-makers and people who are supposed to be leaders around them. Theranos attracted top talent (and therefore big dollars) partially due to the deep industry connections and people with deep experience that it was associated with, including a few industry luminaries. The idea that this girl and her boyfriend ran circles around all of these powerless lambs struck me as trying too hard to mold one specific narrative.
Carreyrou routinely dismisses bad behavior from others at Theranos as stemming from “pressure from Elizabeth” or plain ignorance. He also notes often the many, many times people “disapproved” of various unethical practices, but seems to give them a free pass. I get that they’re not really the subject of this book, but ultimately all these people were complicit. Disapproving internally but then doing nothing about it is not good enough.
A Minor Quibble for Music/Science Lovers
Finally, as a very, very minor quibble, it bothered me when he described her natural voice as being “several octaves” above her affected speaking voice (she thinks speaking with a low voice helps her to be taken seriously or something), and that this phrase has been echoed in articles all over because of it. An octave is not some vague indicator of some type of difference in pitch – it is a specific, measurable distance and frequency away from another note. (For you science nerds, the ratio of the frequency of two notes that are one octave apart is 2:1, with the higher note having the higher frequency.)
“Several octaves” is a lot, since most people’s entire vocal range (i.e. the highest and lowest note you can reach) probably spans around two octaves unless you’ve had vocal training — Beyonce likely has a 4-octave vocal range, for example (if judged by her music). Unless Holmes has the voice of a very small chipmunk, I doubt she speaks “several octaves” higher than her affected voice.
Read It or Skip It?
I was entranced by all the drama. Judge me all you want. It’s essentially a thrilling, sensational, schadenfreude-y tale that’s quite frankly fascinating to read. (My apologies to my dog who had to keep begging me to take her to the park instead of reading.)
From the difficulties of designing the blood tests, to the many legal issues involves in various aspects of the story, I was impressed by the level of detail and how accessible Carreyrou made all of that information. It’s excellent in-depth reporting by a highly capable writer. (Plus as a blogger, I loved that Carreyrou acknowledged he was tipped off on the story by a blogger who he’d spoken to in the past.)
It is, of course, drama of the business variety, so you’ll have to decide if that interests you.
Predictably, a movie based on Bad Blood is currently in development with Jennifer Lawrence slated to play the villianous, bleached-blond, steely-eyed disgraced founder.
Is Bad Blood something you think you’d read? Please share your thoughts below if you’ve read it! See Bad Blood on Amazon.
(P.S. I’ve started making notes in Goodreads when I post a review, so feel free to follow along!)