A review by katiealex72
Bad Blood: Secrets and Lies in a Silicon Valley Startup by John Carreyrou

4.0

Elizabeth Holmes was a young white American woman who was raised to believe that the sky was her limit. She’d come from a privileged background of wealthy entrepreneurs on one side and health professionals on the other, educated in private schools and encouraged to believe in her own brilliance. She was also a great self-starter and had more than the usual dose of chutzpah. So how did it all go so terribly wrong, both for her, and for nearly everyone around her?

As a pathologist, I came at this book from a slightly different place than most people. The story of how this very young person with no more than a high school diploma managed to convince a raft of millionaires to give her money for her pie-in-the-sky idea is unimaginable to me, while at the same time, it irritates me on a deep level. If someone came up with an idea about a new kind of surgical device, or a new anaesthetic drug with no side effects, or a new kind of chemotherapy, and started a company to sell it without any kind of medical training or research or clinical trials,
you’d know that person was insane from the get go.
So why was it different when the medical tech involved pathology testing?

I wonder how much the average person really understands about pathology. It is a medical specialty, and requires 5 or more years of subspecialised training after qualifying as a doctor…no exceptions. In Australia at least, all labs doing clinical pathology testing on any kind of human or animal tissue must be accredited by a federal government body, and that means that a pathologist (a doctor) must supervise each one of those labs. Every single pathology test result has to be sent to the treating doctor and interpreted in the context of that patient. It is the cornerstone of all medical treatment. It seemed to me, on reading Bad Blood, that a lack of this very basic understanding of what pathology tests are and how they are used lay at the heart of the Theranos tragedy.

Someone commented here that there was little examination of the gender (and I would add, race) aspects of what happened. It is not hard to imagine that a young Black woman trying to get her big idea off the ground wouldn’t have even got to the first floor. But so much for the meritocracy…the big name investors were all so sure of themselves that they forgot that she wasn’t a Stanford graduate but a sophomore dropout. She knew bugger all about science and less about medicine. But she fit the mental picture of a young female techbro wannabe. And they wanted to believe.

I read the recent edition of the book with the 2023 afterword, which is an extremely satisfying ending. But it is a shame that the investors were legally cast as the main victims of the fraud while the patient impact was deliberately minimised (due to the burden of proof, I guess). In my opinion, even though they lost a lot of money, those investors were also culpable. They literally enabled a dangerously stupid person with an inflated sense of self worth to carry out her plans which ultimately harmed innocent patients.