
A former Theranos employee's account of life inside the company - jetrink
https://www.reddit.com/r/tech/comments/8rmudm/i_worked_at_theranos_and_this_is_a_glimpse_of_my/
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amb23
The biggest takeaway here: surround yourself with the right people.

I find it hard to believe Holmes wanted to outright commit fraud with
Theranos. Instead, some combination of startup “disruption” tactics and a crew
of unqualified yes men led to a toxic company culture that cultivated lying
and, eventually, criminal fraud.

On the first point: There’s a very real culture in Silicon Valley where it’s
expected that everyone lies, at least a little bit. Startups will massage
their numbers in VC pitch decks, or launch “Wizard of Oz” products that aren’t
based on new tech. If you’re on a client-facing team, you’re expected to learn
which white lies to tell. Most startups get away with this without a problem,
and Theranos probably expected to as well when they came out of stealth mode
and debuted their testing equipment. But this process doesn’t work in biotech
when it affects real consumer health outcomes; there is a reason behind much
FDA bureaucracy, and it’s to protect people’s health. The tech industry could
use a better ethical backbone overall.

On surrounding yourself with the right people: The anecdote about the manager
who lied about results, was given promotions and accolades, and then promptly
quit when it became time to become accountable, was telling to me. First,
there was a lack of checks and balances in place to prevent these lies—how was
Holmes supposed to know the manager was lying? The board had little technical
or scientific background, and it’s not clear that the company set up processes
to ensure research was sound. And the most likely reason why? They probably
just trusted people and didn’t expect that these problems could happen. The
only way to ensure you’re not blindsided by issues like these is to make sure
those around you are capable, experienced, and have been through this before.

Company culture is everything. As bad as Theranos is, the tech industry is
rife with fraudulent practices and bad apples. I’d hope Holmes’ criminal
charges make executives pause and think about setting up processes to allow
for honesty and accountability. Unfortunately, though, the mainstream
narrative has been to paint Holmes as an unsophisticated crook instead of
looking at the systematic problems of the company as a whole, and that means
people will keep on keeping on with the practices that led to Theranos’
downfall.

~~~
lykr0n
> there is a reason behind much FDA bureaucracy, and it’s to protect people’s
> health.

This is what people don't realize when they try and say the FDA is a
bureaucratic nightmare. Every process in place is designed to make sure that
the drugs that hit the US market work. Look at what happened with Thalidomide.
The FDA didn't allow it to hit the US market due to strict requirements about
what tests and processes the drug companies were required to follow. Europe
had a massive problem, while the US didn't.

What most people don't realize or know, is that the FDA will readily expedite
promising drugs and/or products if results are promising and the data is
valid. Companies, if they have strong data from Phase I or II trials, can be
bumped to the top of the review queue or be granted interim permission to sell
their drugs before Phase III trials are complete.

I personally think the FDA is a great example of a well designed bureaucracy.
The value it adds to the public is insurmountable, while not being
unreasonable.

~~~
beagle3
Are there examples other than thalidomide? Because e.g. the FDA was just as
bad with Vioxx and worse with OxyContin.

~~~
lykr0n
I, personally, don't consider Vioxx a failing of the FDA. I might be wrong,
but reading the Wikipedia article makes it sound like more of issues
surrounding the drug's promotion and marketing- not the drug itself
(considering the US and Canada both voted to allow it back on the market). And
OxyContin's issues (I think) fall on the DEA and not the FDA. Oxy does what it
is supposed to do really well, and the side affects are known.

I just used Thalidomide as an example of where the FDA got it right. The fact
that we havn't see other drugs like that pop up, tells me that the system is
working.

~~~
beagle3
> I, personally, don't consider Vioxx a failing of the FDA.

I was following the case in real time, and it certainly looked like a failing
of the FDA and being way way too cozy with Merck about it; compared to how it
looked then, the wikipedia article looks incredibly white washed.

I'm not sure we read the same Wikipedia article - the one I read said that
Merck withheld information from the FDA, and makes no mention of any resulting
sanctions or penalties (which is exactly how I remember it). Does this sound
like a working regulatory agency to you?

> And OxyContin's issues (I think) fall on the DEA and not the FDA. Oxy does
> what it is supposed to do really well, and the side affects are known.

Not at all. Perdue made false claims about how long acting OxyContin is, and
as a result of the recommended prescription, many people both suffered and got
hooked, see e.g. [0], which was the first result for "oxycontin perdue abuse",
but by no means the only one.

> I just used Thalidomide as an example of where the FDA got it right. The
> fact that we havn't see other drugs like that pop up, tells me that the
> system is working.

... to me, the fact that Thalidomide is basically the only example that
everyone brings up, it means that the European system is essentially equally
effective, despite your implied claim ("Europe had a massive problem, while
the US didn't.") that the US one is superior.

[0] [https://www.nytimes.com/2018/05/29/health/purdue-opioids-
oxy...](https://www.nytimes.com/2018/05/29/health/purdue-opioids-
oxycontin.html)

------
TaylorGood
Just wow:

Q: I heard a rumor that Elizabeth Holmes’ deep voice is fake, as in a part of
the performance, like not blinking, any truth to that?

A: Yep, true. Early on someone gave her advice that if she deepened her voice
the male dominated business scene would take her more seriously.

~~~
watwut
That actually works in meetings or other group situations when people seem
ignore my points - deeper voice works better. Not sure why doing it would be
shocking. It is tiring to do it all the time through. Men chage their voices
based on social situations too.

It works also with students when you are teaching.

I am pretty sure she also carefully selected cloths and hair style to project
the right image and thought in advance about what she is going to say. It is
the same thing. That is what all charizmatic leaders, whether good or bad, do
all the time.

~~~
TaylorGood
Yes, agreed. However, this full-time is very extreme.

------
danso
Pretty good writeup, as it sheds light on what it was like to work at and
tolerate (for a few years) such a poisonous company. Even with all the shady
things observed, and the fact that Holmes's ideas and goals were a big sham,
the author seems to have been engaged enough in the science to think -- at the
time -- that the goals were legit.

~~~
lookACamel
Actually it sounds like early one he decided it wasn't legit. He says he only
stayed with Theranos because he literally couldn't find a position elsewhere.

~~~
danso
His complaints are heavily focused on how the company had a shit culture and
terrible scientific practices. But he doesn't describe it, from the inside, as
being the total scam that it looks like from the outside:

> _If they had used some of the more sensitive methods or invented a new
> method they probably could have made some, but not all assays work._

> _Part of the problem was that they surrounded themselves with people who
> told them what they wanted to hear. Ultimately, even if they hired the right
> people from the get go, and those people pushed for other methods they didn
> 't like, they would have been marginalized, pushed out and replaced by
> people who were "yes" people._

