Bad Blood

Author: John Carreyrou

Rating: 4.5 / 5.0

Audio Program Rating: 5.0 / 5.0

Earlier this week I decided to start the well-recommended “Bad Blood” and, less than 24 hours later, I had finished it. I’ve never listened to an audiobook (admittedly, on 2x-3x speed) in one day, but this story was gripping, staggering, galling, and endlessly fascinating.

The Theranos that emerges is paranoid, vindictive, and capricious. They recall “I, Claudius” under Caligula where at the peak of summary executions and orgiastic excess the ringleader, Caligula, asks “Am I mad?” We, in both the case of Theranos and the Julio-Claudians can only marvel at “How can you not know?”

This all seems pretty normal, right?

This all seems pretty normal, right?

Also appropriately called into question by the author is the culture of the lone genius and the American, if not the world, economy’s need to believe that something special is happening in the Santa Clara Valley and that the people there are doing the quotidian business of business better and grander than ever before, that the people there are titans only on the caliber of Steve Jobs et al.

There are no twists and turns as the startup dreams, launches, grows, metastasizes, fleeces, and then keels over — the seeds of destruction are obvious very early, but the collapse is beyond breathtaking.

As someone who has survived the obsessive, self-reflexive culture of the South Bay, I definitely enjoyed reminiscing about the bars and dives (The Old Pro! The Nuthouse!) name-dropped in the story. Heck, I’m pretty sure I saw exec Sunny Balwani’s luxury car once or twice (memorable personalized plate) out on the El Camino Real. I also winced with uncomfortable recognition as Carreyrou described the workaholism, the myopia, and the surprising amount of self-abnegation that workers in the area endure in order to have a shot at that big exit.

Misogyny Anxiety

One of the big problems in punditry around Theranos is the efficacy of their marketing department of identifying the company with its photogenic and ubiquitous founder, Elizabeth Holmes. I’ve read a number of reactions where Holmes is criticized for caring more about marketing herself and her appearance versus running the company. This criticism unfair because it turns a blind eye to very real rewards patriarchy delivers for fulfilling its expectations.

Women in the sector, especially if they want to be leaders, bear an extra and unfair onus: they must also please patriarchal beauty standards in addition to being competent in a way that, say other unicorn-valuation companies’ leaders do not. While Holmes might not have cared much about her appearance (Carreyrou relates an anecdote that it was not a personal priority for her until confronted about it), to be the figurehead who could get the investment, make the deals, etc. she had to embrace the media icon role her success placed upon her.

Not appreciating this, some writers use Theranos’ disgrace and Holmes’ downfall as an excuse to open the dam on barely-contained misogyny. Their inner Nelson Muntz gets to come out and deliver a ripe “Ha-Ha!”


Carreyrou does a good job avoiding misogyny and Holmes-the-person is characterized sympathetically but Holmes-the-leader’s actions are reviewed critically. I am glad Carreyrou has such a discerning journalistic voice.

The Chronicle

But the facts of the matter, as presented by Carreyrou, suggest a corporation run by men and women that would better fit as part of the Barksdale Organization or Italian city-states of the Renaissance.

Carreyrou records how loyalty tests are wrapped in the psudo-messianic linguistic bullshitfest of Silicon Valley corporate-ese. As presented, under Holmes’ leadership, rationality, prudence, and data-backed assertions are signs of being “cynical” — a scarlet letter prelude to a pink slip. The first anecdote of the book is a cautious CFO finding disturbing evidence that suggested the CEO might have been misinformed, or in error. Bringing this fact to Holmes leads to his immediate termination.

Lack of buying into the founders’ reality-distortion field fueling claims of “this is the most important product in human history” is an invitation to get berated by Dear Leader or her hatchet-men.

Speaking of, coming out particularly poorly in the narrative is Holmes’ (then-) boyfriend and executive of unclear role, Ramesh “Sunny” Balwani. The book presents several episodes where Balwani acts as a thought police: berating, intimidating, belittling, concealing, misdirecting to keep the staff in-line.

Over the course of the book, we see a factionalization of the company: Holmes, Balwani, and their trusted lieutenants (many of whom are personally loyal to Holmes, Balwani, or Holmes’ brother, a later executive hire). They become committed to maintaining the reality of the things Holmes promises, not reality on the product side.

That reality, the reality of the other faction, the hard-working staff, is frequently bullied out of existence or simply ignored. Carreyrou’s empathetic prose makes you feel the desolation and aura of Stockholm Syndrome draped over the poor rank-and-file staff.

Sharing the Nightmare

When not battering the staff with impossible demands and insensitivity, the executive staff are playing the media and family connections for access to governmental and business leaders whom they add into their thrall. The list here is so impressive, if Theranos had been working for a foreign country she would have been a powerful asset.

Theranos, and let’s be serious here, Holmes, connects with the Clintons, the Obamas, and then, equally effective across the aisle, Henry Kissinger, George Shultz, and (now Secretary of Defense under Donald Trump) James Mattis. As she builds personal alliances in the style of a “great pretender” novel of the 19th century à la Charles Dickens, she becomes virtually untouchable. I had the feeling that she came to view her job as growing her power base and legion of ghouls, not steering her (battered) team to product success.

In this story I could see a Ponzi scheme of power that, with each millionaire, CEO, investor, professor, or political advisor added, deepened her untouchability, influence, and reach.

With the political class in her corner, she works to partner with the CEOs of Safeway and Walgreens: savvy, time-tested business leaders who should have known better. She harvests their fear of being lapped (with endorsements by the political class above, how could this not win?) to lure them into floating Theranos and providing media and staff glimmers of hope. Holmes’ ruthless compartmentalization of information leaves the rational saying “there’s no way this could work….but there’s so much I don’t know, maybe someone else sees how it could work.”

It’s a compelling demonstration of some skeptical antibodies anyone in startups would be wise to develop.

The Unwinding

At the apex of the power Ponzi scheme and when the influence machine running its best, the work by the journalist Carreyrou and other whistleblowers threatens to collapse the glass house. Like a trapped tiger, Theranos unleashes its full might to cajole, inveigle, intimidate, and menace.

Theranos retains David Boies, the master litigator. At the end of the story Boies, with a legal career of legends, comes out very poorly. As noted in The Times:

…it has baffled legal observers that, in what could have been his gilded years, Mr. Boies ended up representing both Mr. Weinstein and Theranos, led by Elizabeth Holmes, in ways that arguably helped prolong their misdeeds. 1

Recently asked whether he considered his defense of Theranos to be a black mark on his storied career, Boies responded:

“If we decide any class of accused is not deserving of aggressive representation simply because of what they’re accused of, then we undermine the protections that are essential for all of us.” 2

Carreyrou, in an interview noted the presence of Boies’ reputation was used to stifle dissent that would have helped investors, staff, and the medical public who had become associated with Theranos:

Carreyrou, in an interview, told me he sees Boies’ role in the Theranos saga as that of a “scarecrow.” Employees who considered voicing their qualms not only had to reckon with Theranos executives, Carreyrou said, “they also had to take into account that the [company’s] lawyer was David Boies, arguably the most famous and feared attorney in America.” “His role as the lawyer in terms of dissuasion was really important,” Carreyrou added 3

And recall the pyramid of power among those attached to Holmes: as the unwinding proceeds, Theranos tries to goad Rupert Murdoch (owner of Carreyrou’s paper, the WSJ and investor in Theranos) to kill the story. Murdoch, stymieing liberals, refuses and it willing to damage an investment to produce an electric story (cynics might see in this a canny sort of investment strategy).

Aside: Bill Gates, infamously deposed by the selfsame Boies recommended this book as a book of the year. Boies, in the 90’s stood to me as a hero, working to stifle the monopoly of Microsoft. No, in the twenty-tens, Boies’ actions seem as unsavory as the Microsoft of yore. As a good liberal, I despise Fox news and view its progenitor as unsavory. Here, Murdoch does the right thing. It’s all a baffling jumble of interests.

But ultimately the house of cards falls apart and the company collapses into a singularity. While I can’t say that the story achieved some deeper literary arc in its narration, it was a wonderful synthesis of top-notch journalism.


1.Stewart, James B. “David Boies Pleads Not Guilty.” The New York Times. (retrieved December 20, 2018).
2.Stewart, James B. “David Boies Pleads Not Guilty.” The New York Times. (retrieved December 20, 2018).
3. Lionstar, Michael. “Yahoo! Finance.” (retrieved December 20, 2018).