Bad Blood

I mentioned on Twitter a few days ago that I’d finished reading John Carreyrou’s Bad Blood, which I was interested in, but had forgotten about until hearing an interview with the author on the education podcast Have You Heard. As with pretty much every episode of the podcast, it’s a bit slanted for my taste, but on the other hand, I know what the bias is, and I learn a lot from every episode.

                Anyway, about the book, it was amazing and enraging, the latter on many levels. First of all, the book reads well, and while it certainly is not a detached telling either, for reasons that become apparent at the end of the book, I never once doubted the essential veracity of the tale. For those of you that might be unaware, it is about the start-up Theranos that was the darling of Silicon Valley and the biotech industry for nearly a decade, both for what it promised, easy, less invasive blood testing done quickly and for its charismatic founder, Elizabeth Holmes. In particular, it was such a good story because in the male dominated world of Silicon Valley, it was the story of a woman that was every bit as good as if not better than the boys, after all, she wasn’t promoted to an executive spot, the whole thing was her idea. Who wouldn’t want to root for that story?

                Following tech news over the past few years will let you know the outcome ahead of time, and I had a pretty solid interest from the very first time I heard about it. I spent some pretty formative years, five or so during and after college, working in the blood testing arena for 3 different pathology labs. For a while I wanted to be a medical technologist but chose another path. That is part of the first reason this book was so enraging. The whole time the actual work, the testing of blood samples wasn’t the top priority, heck, it wasn’t even the third or fourth. It was all fakery and illusion the whole time, and throughout the whole process there was really no medical oversight in any way. As Carreyrou rightly points out, this isn’t just some app that sells ads or does microtransactions that rip people off. People’s lives are at risk with medical testing, and yet no one that had power in the situation gave a rip about that. That’s not really shocking considering the acidic effects of unbridled lust for riches and notoriety, but it certainly is maddening.

                That leads me to the other thing that enraged me. As much as the book is the story of a company and a person, Holmes, gone very bad, it was also very illuminating about what really matters in a world where profit is king. Connections…with the right connections, you don’t have to have a good idea, you don’t have prove anything, you can put anyone at risk as long as you can sell it and posit a solid ROI. Again, not shocking, but the blind spots shown by the people who already had wealth and power in the attempts to get more wealth and power were truly heart wrenching. It brought back to me the feeling I’ve had ever since reading C.S. Lewis’ The Inner Ring, that of powerlessness, of knowing that no matter how hard one works, no matter what you know, it is really about who you know. And those networked connections matter even more than familial ones, see the case of George Schultz and his grandson. The grandson blows the whistle on the problems at Theranos, but his grandfather doesn’t believe him. Probably because believe him would mean admitting that the connections that led him there were wrong.

                The final piece of the anger I had while reading the book was just this, that there are few consequences for those in the inner ring. The oligarchs never seem to pay the price, Rupert Murdoch just wrote off his $100 million loss and called it a day. And yes, Holmes may end up with some jail time, but the rest of the folks who backed the company, well, no worries, their investment just didn’t pay off. But this wasn’t just an investment, this was coercion, stalking, dirty underhanded legal tactics (I feel I could write a whole other paragraph on that), and as stated before, risking people’s lives.

                The truly painful thing is that it didn’t really have to be this way. Holmes had a laudable idea, if of course zero knowledge or seeming desire to attain the knowledge, or to listen to those who had the knowledge. Had she hired some real doctors, listened to them, had some humility, really wanted to help people instead of trying to be someone else (Steve Jobs in her case). If the investors and companies that bought into Theranos looked for more than a nice sales pitch and claims of disruption and revolution, something really good could have been accomplished.

                To go full circle back, I totally agree with Ms. Berkshire’s assessment in the Have You Heard podcast that a lot of ed-tech promises sound the same way. The world is promised, disruption is the byword and school systems jump on the hot new thing with little study, little idea of how to implement things and just believe that tech = magic and some wand waving will make it all right. And as a teacher, that is what ultimately worried me the most as I read the book.

                Wrapping up, the book was great, I highly recommend it. It reads almost like a fiction book in many ways, intriguing throughout. The added benefit is the timeliness of the whole story.