John Carreyrou - Bad Blood

Introduction

I have two degrees in life science related disciplines, however, I did not know the existence of the company Theranos and its “legend” until I watched a book recommendation YouTube video at the end of 2018. I was too busy with my studies in computer science and did not find time to read the book until November 2019. However, I was already deeply astonished by the evil nature of Theranos when I watched the short YouTube video, confirming that my decision of leaving the field of life science or anything related is correct.

I purchased the book “Bad Blood: Secrets and Lies in a Silicon Valley Startup” and finished reading the book in one month. John Carreyrou is a two-time Pulitzer Prizing winning author, the word choices he made in the book were extremely good. As a non-native English speaker who hardly read books other than textbooks, sometimes I would have to look up the words in a dictionary. However, because I have a professional background in the life science academia and industry, and the central idea in the book is extremely strong, I did not have too much difficulty finish reading the book.

In this blog post, I would like to share some of my thoughts after reading the entire book.

Characters

I could not remember how many characters are there in the book, but they could be categorized in three groups, Theranos helmsmen, Theranos zealots, and Theranos breakers.

Theranos Helmsmen

The Theranos helmsmen are of course the CEO Elizabeth Holmes and her elder boyfriend the COO Ramesh “Sunny” Balwani. Although nobody would doubt the initial motivation of Theranos was to make a better world when Elizabeth first founded the company, they did not have as solid background in science and engineering as Thomas Edison who was eventually able to “fake it until you make it”.

The way they treated the employees was extremely disgusting. Threatens, lies, and surveillance were routine. This reminds me of someone I know at Duke University who was very similar to the Theranos CEO. A notorious place to stay, regardless of how revolutionary their “invention” was.

Theranos Zealots

The Theranos board of directors consists of a good number of highly powerful and influential people from academia, politics, and legal services, etc. While they were receiving an extraordinary amount of salaries from Theranos, they had made almost no contribution to the company to make it work correctly. Although most of them did not have a technical background, they should still have some skepticism to tell that there was something unusual going on after having been on board for several years, instead of keeping believing in and advocating Theranos without thinking twice.

Theranos Breakers

The most admirable and honorable people are the Theranos quitters, whistleblowers, and of course the author of the book John Carreyrou who digged into this and exposed the truth to the public. They abided the research integrity, the hippocratic oath, and the fundamental principle of being a good man which is to be honest, even with being constantly threatened by Theranos in various ways. Without them, more investment might be in vain, and there could have been patients died from this. They have truly saved the world.

Theranos Could Not Be Apple

Creating a medicine or medical device is different from inventing an algorithm, writing a piece of software, or developing a conventional electronic device, because human health and life really matter. An Apple device, however, could be malfunctional or miss some features that the users wanted. But it would usually not hurt the user’s health or put the user’s life in danger. Because of this, Apple could usually be more imaginative and creative. More wild thoughts and technologies could be assembled together. The pharmaceutical and medical device company, however, should be more conservative, every single step and component should be evaluated carefully regarding its potential harm to human health, before the products become commercially available. Most of the time, the evaluation results would be no harm but also no effect, or effective but harmful. In the Theranos case, unfortunately, it is not effective but also harmful.

Therefore, advertising Theranos as a next Apple was completely wrong from the root.

Theranos Is Not Alone

Not only in the life science industry, but also in academia, I have seen too many similar stories. People who have taken research ethics training, no matter how prestigious they are, could easily betray the ethics, not even mention those who had no such ethics training at all, such as Elizabeth and Sunny.

In the life science product development and studies, usually it would result in a 1 or 0 binary outcome. This means that either your research is true and helpful, or it is completely failed and useless. However, people care more about power, wealth, and result, instead of the process. Given it is extremely easy to get 0 as the outcome, in order to get the 1 as the outcome, fabricating data, cheating, intentionally misinterpretation, etc., are not new tricks.

So this is why this field has been totally corrupted. People of integrity could hardly survive in the life science field, because when most of the others cheat, you would also have to cheat, otherwise you could not win and you would be kicked out from the game if you whistleblow.

Conclusions

This is a truly well-written book, and I would rate it 5/5. I would recommend it to everyone, especially those who are not familiar with the life science academia and industry.