
Elizabeth Holmes' Final Months at Theranos - exogeny
https://www.vanityfair.com/news/2019/02/inside-elizabeth-holmess-final-months-at-theranos
======
exogeny
So many unbelievable parts, but this one stood out to me:

>She tells former colleagues, according to the two executives, that she is
greeted by well-wishers on the street who are rooting for her resurrection.

That says it all. Beyond the fraud, beyond the obscene breaches of fiduciary
duty, it all basically reduces down to a severely delusional person, operating
in an environment where delusion in it's more acceptable forms is seen as a
positive attribute.

~~~
pen2l
We shit on Holmes all the time, but sometimes I wonder if she's really so
different from the average tech CEO/founder.

Consider that the requirements and circumstances are totally different in our
industry vs. hers. She _has_ to do a shitload of testing, she has to wait
years... but our M.O. is to move fast and break things. Could you imagine
being in her industry, and having the patience to go through years of trials
and testing and passing through regulations?

She seems to have some good qualities needed to be a founder: believing in
yourself to a delusional degree, being good at getting money an getting people
to believe in you, etc. Maybe if she was in our industry, she could have been
quite impressive and successful in running a company.

~~~
seem_2211
I think you make a good point, and broadly agree with you. I think the problem
with Elizabeth Holmes (vs. the traditional tech founder) is that she's in
biotech, where the stakes are much higher and the industry is much more
controlled. It'd be the same if she was in the aviation space. If she ran a
SaaS platform, this wouldn't really be a story - it'd just be a crappy place
to work, and a service that's not ever properly implemented, and there might
be some level of fraud at a financial level, but nothing as bad as what she
did. A business CRM breaking is bad, but not as bad as giving inaccurate
medical results to someone leading to a misdiagnosis or worse.

~~~
randycupertino
That is the part that is craziest to me. They took a software developer (Sunny
Balwani) who had an information systems degree and plopped him down to run a
life sciences company like it was nbd.

I think a lot of technology people don't understand the scope of regulatory
and medical implications of working in life sciences. It's not just simple as
"code it up and flip the switch!" Theranos isn't the only firm I've seen crash
and bail due to that cavalier attitude.

~~~
jhbadger
Yeah, although they didn't crash and bail but just get penalized a bit, 23 &
Me didn't really get that they actually had to obey FDA rules for genetic
testing. They literally ignored the FDA's complaints and were eventually
stopped from making diagnostic (rather than ancestry) analyses for a while.

~~~
denzil_holles
There's a big difference between the tests from 23andMe and Theranos. 23andMe
produces data that's risk-based (i.e. your risk of developing coronary heart
disease) but isn't immediately actionable. Most of what you could do to
address the risks reported by 23andMe is stuff you should already be doing --
eating healthy, sleeping more, exercising, quitting smoking/alcohol.

Theranos was doing standard lab tests, like blood electrolytes. Blood
electrolytes are highly regulated by the body and are only abnormal in serious
medical illness. If your blood sodium level is too low (hyponatremia) that's a
medical emergency and you need to be in the ER (hyponatremia can indicate end-
organ failure like renal failure, heart failure; it can also indicate serious
endocrine abnormalities like SIADH or too much water intake 'frat-boy'
syndrome). Uncorrected hyponatremia can lead to permanent neurological disease
(classically brainstem herniation).

------
CompelTechnic
>Despite their unequivocal role in upending our democracy, Zuckerberg and
Sheryl Sandberg still run Facebook. Dorsey is still the C.E.O. of Twitter,
even though he has not been forthright about the number of bots on the
service, and has done almost nothing to stop the spread of hate speech on his
platform. The C.E.O. of Tesla, Elon Musk, has been charged with securities
fraud, and yet he’s still running the company

The CEO's mentioned in the quote above operate at demonstrably higher level of
competence than Holmes. The article kind of jumps the shark with this bit.

~~~
mda
I also didn't like the tone, lots of assertions without much backing.

------
AngeloAnolin
I've read the book by Carreyrou - Bad Blood [1] and up until this time, I am
left wondering if she really was insane, or on the firm belief that she can
revolutionize something.

For her to be able to convince a lot of people - companies, investors, CEOs
and perhaps a multitude of bright people to do what seems to conclude as a big
fraud is still mind boggling to say the least.

You got the best engineers, doctors, laboratory technologists, medical techs,
pharmacists, and just about everyone in science, and yet they continued for so
long on this path of bizarre development of a product. Why did these people
only realized when it was too late and that everything would crumble down at
some point? They must have shared her vision with an intensity that has out
shined their conscience and common sense.

[1] [https://www.gatesnotes.com/Books/Bad-
Blood](https://www.gatesnotes.com/Books/Bad-Blood)

~~~
JohnJamesRambo
I’ve never understood what the real world-changing part of Theranos was. Ok
great you can do lab tests with less blood, is it to save people squeamish
about larger blood draws? Maybe I don’t understand it but this always seemed
silly to me and more about convenience. The disruption was about replacing
phlebotomists? We make plenty of blood.

~~~
C1sc0cat
It can be a real PITA if you have to do regular bloods. At one point I had to
take an extra day off a week before my regular clinic just to do bloods. It
can also be a time consuming process to find a vein and draw blood.

If I could pop into my local GP (family doctor) or have a mobile service come
to work and quickly do the tests id be saving a lot of annual leave

~~~
brandon272
I believe Holmes' claimed their eventual goal was to eventually enable people
to have their finger stick blood testing devices in their own homes.

------
sizzzzlerz
A lot of comments about Theranos not being different from other start-ups and
Holmes being like other CEOs. I disagree. Theranos was an out-and-out fraud
from its beginnings. They knew their product did not work and was unlikely to
ever work yet they kept on pushing it to investors as well as firms
(Walgreens, Safeway). What is so disturbing is that their defective product,
when used by naïve people without medical supervision, could report both false
hits as well as missed. The former causing unneeded concern and anguish, the
latter, resulting is not receiving needed treatments for something that would
have been detected with real blood tests.

A CEO lying about some unneeded product or service, while bad, does not come
close to lying about a product that can impact one's health and well-being.
She and Sonny both deserve substantial fines and jail time.

~~~
godzillabrennus
The company was not a fraud from the beginning. Tim Draper invested before a
product was "ready" or FDA approved.

Let's not forget that the FDA gave Theranos a CLIA waiver to sell this thing
outside of laboratories.

The CEO lied but the regulators failed massively here as well.

~~~
sabizmil
I just finished reading Bad Blood and it details how they went to extreme
measures to ensure that the FDA never saw their Edison machines like barring
entry to the lab on the day of an inspection, putting security guards in front
of the door, and lying when asked what was inside.

While the inspector could have pushed the issue, I don't think they 'failed
massively'.

~~~
godzillabrennus
The inspector didn’t inspect anything. That’s a massive failure on their part.

How else can you reasonably assess the work of someone titled “inspector” when
they fail to “inspect”? Especially when they approve a device they haven’t
“inspected” as an “inspector”.

If you see logic in calling them something other than a massive failure then
I’d like to understand your thought process.

------
chmaynard
One interesting definition of sanity is “the relentless pursuit of reality”.
If this definition holds, then Holmes is clearly insane. A long prison
sentence might motivate her to begin a journey on the road to sanity, but I
doubt it.

~~~
woozyolliew
I recently read “A First-Rate Madness” by Nassir Ghaemi [1]. Although it
focuses on mental illness (or the lack thereof) in historical leaders during
times of crisis, I saw many parallels with tech leaders and their companies at
different stages.

[1] [https://www.penguinrandomhouse.com/books/305742/a-first-
rate...](https://www.penguinrandomhouse.com/books/305742/a-first-rate-madness-
by-nassir-ghaemi/9780143121336/)

------
algaeontoast
Elizabeth Holmes deserves to be sacked by the full extent of social and legal
punishment. She's poisoned the waters for a lot of good people - especially
professional women engineers / entrepreneurs.

As engineers and entrepreneurs alike - we need to show that regardless of your
history, wealth, gender etc. this kind of behavior is not okay and will get
you blacklisted.

~~~
P_I_Staker
I do wonder if we're doing society a disservice by wanting "powerful women" to
happen so much, that we abandon all reason. I'm not a big fan of how we put
"powerful people" up on a pedestal in general, and our reverence for
leadership/ management. These things need to happen organically, and these
people need to be relentlessly criticized for this type of behavior. They have
power, so they aren't. This isn't limited to Holms, it's been a big problem
with Steve Jobs and Elon Musk as well.

~~~
arcaster
I agree, I think the fact that we laude those with money or power on a
pedestal based on immutable attributes is a problem.

Just as many imply money with power and evil - but seem to make passes for
their favorite actors or celebrities.

I think we'd be in a better place if we could accept as a culture that
gluttony in money and power without reason, irregardless of what someone
thinks is "enough" money, should be met with criticism agnostic of race,
gender, etc.

My only caveat is for people to assume that anyone with more money than them -
moreover anyone who owns a business is "evil" by design. This seems to be one
the more present falsehoods of Hollywood as of late. IMO, to take the
potential gains out of act of taking risk to build something is wholly un-
american. I think making more public those who fail in business or make huge
sacrifices more present in media would help this. I only bring this up because
the general public seems to tie certain attributes to people they're "okay"
with being successful and others who they deem evil just because popular media
told them those people don't "deserve" their success or wealth. Et al - the
farmer in Iowa or small business owner in Chicago making $250k +.

------
V-2
This piece makes lots of interesting points.

 _" If You Watched This Elizabeth Holmes TED Talk From 2014, It Was Clear She
Was a Fraud From Day One"_

[https://www.inc.com/john-brandon/the-truth-about-theranos-
ho...](https://www.inc.com/john-brandon/the-truth-about-theranos-how-we-were-
all-laundered-by-this-spin-machine.html)

Indeed - lots of fluff and buzzwords, without much substance.

~~~
albntomat0
> lots of fluff and buzzwords, without much substance.

I'd say that about the majority of TED talks that I have seen.

What would that talk have looked like if they had the successful, proprietary
solution that they claimed? I'd argue that it would not be all that different.

Trying to do scientific due diligence for proprietary technology via analysis
of PR seems to have incredibly poor signal to noise.

------
drcode
I respect the journalist here, and the Theranos story is endlessly
fascinating, but I'm kind of underwhelmed by the content of this particular
article- It kinda makes the "final months" at Theranos sound really boring...

...besides a heavily-played story that she brought a puppy to the office, was
there really anything in this article that wasn't already covered in better
ways in previous articles?

------
rdiddly
Had a nice LOL at the dog relieving itself while they met with Kissinger.
Anyone who remembers the Vietnam War would probably laugh even harder!

------
socrates1998
It's not surprising that she lied to everyone. Lots of people lie all the
time. It's amazing that people BELIEVE her.

I just don't get why people are convinced by these pathological liars whose
only skill is confidence?

Con-men tell people what they want to hear. It's not shocking that she is a
con-man, it's shocking that she was able to con people who are so rich and
powerful.

I remember her Forbes article and I was like "there is something wrong here".
It takes DECADES to make breakthroughs in medical science and she did it in as
a 19 year with a couple of into to bio classes?

If could have shorted Theranos then, I would have.

The only good thing about this is there are a few horrible people that lost a
lot of money investing in her, so that has been entertaining.

~~~
ellard
I'm not sure why it's hard to understand why someone could be convinced by
words that match their bias backed by confidence. That's sales 101 and there's
a reason why it works.

Now, yes, the medical breakthrough part should have been a red flag to serious
investors, but my guess there is that once someone bought into it, other
investors were scared that they might miss out on what could be the next big
thing and jumped on it.

~~~
socrates1998
It's hard for me to understand because after I was about 19 years old, I
learned to not trust people who tell me everything I want to hear.

~~~
ellard
It's not about yourself, but about understanding others. People grow up
differently, have had different experiences, and hence have different risk
assessments on who they trust and what they're willing to lose when that trust
is misplaced.

------
nyrulez
This entire story makes me much more curious about the enablers of this kind
of behavior i.e. the investors and not Holmes herself. Are the big investors
really that incomplete or "naive" in their diligence if pumping a big sum like
$50M or more ?

If I was in that situation (i.e I was a VC), I would at least ask for a
working demo of their tech (where I was present to see it go through even if
that took an entire day) along with corroboration of their results with
conventional tech before I decide to give them a dime. I mean I did this even
when I invested just $15K as an angel investor in a company long time ago.

This seems obvious to me - why isn't this a thing for big name investors?

~~~
JumpCrisscross
> _Are the big investors really that incomplete or "naive" in their diligence
> if pumping a big sum like $50M or more ?_

Her early backers were big-name individuals. Not firms. The healthcare VCs (
_e.g._ Annie Oakley) passed on Theranos.

The deeper question is to what degree are David Boies, George Schulz and
others who actively suppressed whistleblowers complicit in her crimes.

~~~
nyrulez
Are you saying the question doesn't apply to individuals? IMO it should
probably even more so. I guess you have to be insanely rich to not actually
care about a $xxM investment and related diligence.

And maybe it highlights an interesting lesson: it's much easier to hoodwink
individual investors with charm and lies and Holmes nailed that part down to
perfection.

~~~
JumpCrisscross
> _the question doesn 't apply to individuals?_

Institutional investors have an institutionalised diligence process.
Individual investors have their own diligence process. For some, it’s nothing
more than a gut check. (Which is okay. There are plenty of successful
companies that were founded on checks written on a gut feeling.)

The bigger question is why a few of those people kept doubling down, to the
point of attacking whistleblowers, after they had enough evidence it was a
scam.

------
iambateman
The podcast "The Dropout" does a great job of telling the story of Elizabeth
Holmes and Theranos: [http://abcradio.com/podcasts/the-
dropout/](http://abcradio.com/podcasts/the-dropout/)

I get the feeling that she is a lot like Steve Jobs 'pre-getting fired from
Apple'. Mercurial, unrelenting, quick to lie, charming.

The "greatness" we remember of Steve Jobs comes after a decade long process of
humbling and nearly losing everything at Pixar. Even then I wouldn't have
wanted to be around him.

(This comment brought to you via my 2015 Macbook Pro. Thanks Steve).

------
Jun8
I think the lesson to be learned here, obvious though as it is, is that there
doesn't seem to be any difference in the early stages between startup ideas
that are delusional, which seems to be case for Holmes, and those that are
"frighteningly ambitious"
([http://www.paulgraham.com/ambitious.html](http://www.paulgraham.com/ambitious.html)).
The execution determines which is which.

~~~
gwbas1c
The distinction is usually painfully obvious to people who understand the
field.

But, in this case, Holmes wouldn't pivot to more reasonable products that fit
into her vision. It looks like her scientists did rather excellent work and
made great incremental improvements in the blood testing field. Had she
capitalized on those improvements; we'd see her as a success story.

~~~
janj
I've been trying to figure out if Theranos had produced anything of value. Do
you have sources you can share that describe these incremental improvements?

~~~
gwbas1c
Read through "Bad Blood" by John Carreyrou. He describes a lot of the research
that went on by Theranos engineers.

There were attempts to do good work by people who believe in the vision.

Now, to put things in perspective, if you're anywhere near or over middle age,
you've probably had blood drawn. It's freaking scary every time the needle is
pushed in for me, and I frankly had to flat out reject my doctor's request to
get blood tests every 2-3 months. (I got a second opinion.) If these tests
could be done with a much smaller amount of blood, things would be much
easier. I'd be much more willing to run into my local CVS for whatever test my
doctor wanted if the test involved a lot less blood.

That's why the engineers believed in the vision and did a lot of good work to
try to lower the amount of blood needed for tests.

------
blueberry_47
[https://news.ycombinator.com/item?id=6349349](https://news.ycombinator.com/item?id=6349349)
\- Theranos discussion from 2013. Fun read.

~~~
Udik
The most spot-on comment is second from the bottom, of course :)

------
thorwasdfasdf
they shouldn't be comparing theranos to facebook or twitter. Theranos is
another level of wrong-doing that far outpaces the minor inconveniences of FB
and twitter.

------
Udik
Does anybody know if there have been, or there should be, any consequences for
members of the Board of Directors? Talking about Kissinger, Mattis, William
Perry, etc?

------
joshenglish
There is a very common pattern here with both Theranos and Fyre Festival. The
CEOs were both charming and charismatic leaders. The problem is the one's who
do it best tote the line of being a great sociopath or a great leader.

~~~
csours
There was also a huge element of "fake it till you make it" with both of them.

~~~
joshenglish
Very true and a common pattern in Startups and even large companies. Sell what
you don't have. Not sure it works out all the time, but it has for some.

~~~
cobookman
I believe most enterprise shops sell what they don't have. But they also know
by the time the customer is ready they'll have it built & ready. The customer
is also aware of the current state and timelines.

For theranos and fyre festival. I'd say it was less playing timing to their
advantage and more fraud.

------
iblaine
NPR has a great podcast on Theranos called The Dropout. There seems to be a
growing trend that it's ok to fake it till you make it...consider Theranos,
The Fyre Festival, Trump.

