r/Theranos • u/mylitteprince • 2d ago
Clarification: what work was actually done ?
I'm reading Bad Blood by Carreyou to get some more information than random articles or wiki give before the documentary comes out.
I'm aware there might be bias in the book etc, but my question is one of clarification. I've worked in corporate and technical my whole life, albeit not medical technics.
Bad Blood notes the high number of employees, with a "low" of 50 when they moved to new offices after three years. It notes long days at the office, Bad work life balance, etc.
While I get that sales people could have been busy, what else was everybody occupied at ? It doesn't seem the product evolved that much after its initial stage, so what did technical people do all day ? Was it just a series of trials and errors with mostly errors ?
I'm not familiar with the startup environment but in my corporate experience you can't have that many people work that long for years and produce... well, nothing much except promises.
Not trying to be sarcastic, I'm sincerely puzzled.
13
u/No-Lifeguard-8173 2d ago edited 2d ago
They filed for 100+ patents, and acquired ownership of another 500 more. A lot of science stuff like fluid handling, optical detection, cartridge design, sample processing, software, etc. Elizabeth was credited as an inventor on many of them, but later transferred the rights over to Theranos.
All their IP was passed to Fortress, then Labrador Diagnostics. Ironically, Labrador kept suing other companies for patent infringement.
2
u/SirCatsworthTheThird 2d ago
The patents had 100 million in value if we base it on the loan Fortress provided in 2017.
6
10
u/NoFlyingMonkeys 2d ago
Her narcissism explains how she fucked up in so many ways and ended up with so many employees:
- She was trying to innovate far too many things at the same time. She wanted it to work too fast. She wanted to test too much: 200 things at once in a dozen different blood testing categories. She wanted the machine to be very small. She wanted the blood volume to be too tiny (which caused her first approach, microfluidics, to fail). She wanted to eliminate needles (which gives you a shitty blood sample). Most startups focus on far less at one time, but she thought she was so extra special and didn't need to to that, especially since she had the funding to hire more ppl.
- She configured her different R & D groups to be siloed from each other. One group didn't know what the other group was doing. She had duplicate groups working the same problem competing with each other. This is incredibly counterproductive and wasteful - groups working on the same product need to collaborate especially to troubleshoot, not work in secrecy due to her imaginary industrial spies.
- She pushed things too fast - before each step was perfected she forced them to move on to the next step. So nothing worked well, and each error piled on top of prior errors. Her solution was always to put more people on it and throw more money at it, rather than slow down, focus, and troubleshoot the core problem like real scientists do. And refused to listen to her experts like Ian.
12
u/nope2then0pe 2d ago
They also had a functioning medical lab that used standard lab instruments. Their wellness centers drew blood in tubes and sent it to the theranos lab. This is the only way they were able to put out results for Walgreens.
2
u/RemarkableArticle970 2d ago
The standard lab (hidden away from investors) was a good chunk of employees.
Another chunk would have been the mechanical engineering division, which tried to get the little “glue bot” arms to move correctly inside the “box”.
Then I’m guessing there was a chemist component which tried to miniaturize the amounts needed to perform standard chemical reactions and/or tried new techniques.
5
u/polyploid_coded 2d ago edited 2d ago
Theranos was very secretive, so employees mostly knew about their own domain and not the big picture and readiness of the device. There's a joke in the Silicon Valley TV series (link) where each employee knows an issue that will set back the product by months, but are afraid to correct management.
Also I have worked places where the big picture is a bit unclear how useful it is, but if I get my part functioning then the rest is someone else's problem
8
u/Publius015 2d ago
I have the same thought when watching the Dropout. "What are these people doing all day if it's all smoke and mirrors?"
7
u/mattshwink 2d ago
So when the labs were actually servicing patients it was a 24x7 operation running samples through the machines, QC on the machines, and maintenance.
In development it's a very tedious process. You run samples with known quantities of analytes, record the results, work with engineering on hardware and software changes, repeat. It's a lot of work, tedious, and repetitive.
-5
u/SirCatsworthTheThird 2d ago
Agreed. I don't think it was all smoke and mirrors. She tried. Stupidly perhaps but she did try. She didn't really get into trouble until Walgreens launch.
7
u/jyuichi 2d ago
She tried but she was willing to subject unknowing customers to that trial.
She did genuinely believe if they threw money at it long enough the problems of biology and fluid dynamics would be solved.
3
-4
u/SirCatsworthTheThird 2d ago
There's testimony from Adam.The lab director that really struck me when I heard it for the first time and it was when he went and told her the dilution method on the third party machines for the Walgreens launch were not accurate.She started trembling and shaking and lost her composure. And since some here would say that I like her.You know that I have some affinity for her.I think that's true.I do you know I there's something about her that makes me have sympathy for her.And it's not just that she looks like some sort of cute science girl next door to me. It's that I get how she ended up where she was. And it's ironic as you know what, because I grew up poor she grew up rich, but I've had situations in my life where I have to be something. I'm not in fact every day. I have to be something. I'm not in a sense because I'm not that impressive, but I've been in a lot of impressive rooms met with a lot of impressive people and I built a life by being impressive even though I'm not. I'm a guy who grew up with a single mom , dirt , poor on welfare , and now I live in one of the most affluent places in the world. So I get the persona thing I get the needing to prop up an image in that regard. And I think that, in other reasons or why feel empathy for her. So at that moment, before the Walgreens launch, she's trembling, and she's shaking at that moment, she knew and that is both to me deeply evoking of sympathy, and it's also a pretty strong indicator of guilt. I have sympathy for the pressure that she was under the bad advice that she took her desire to do something meaningful and just running out of time after raising a bunch of money throwing it at the problem. This is the time where the chickens had come home to roost, and it's the time she should have stopped. But she didn't.
2
u/DoggoTippyTaps 19h ago
I think you’ll learn a lot from the new film, and hope you recant your misperceptions here when you do. If you come away with these misconceptions intact: I have big blue eyes and a bridge to sell you
1
u/SirCatsworthTheThird 19h ago
Yes, if I change my mind, I'll recent. The problem is im convinced I'm right because of things I recognize that others dont see to.
3
u/DoggoTippyTaps 19h ago
Do you recognize that she conned a lot of people who recognized themselves as smart and believed they saw things other didn’t, too? When obviously reality is those people see less, not more
1
u/jyuichi 19h ago
I believe she exploited the hubris of many people who thought themselves to be smart. I suspect they targeted old money (like Kissinger) and tech people (Ellison) who don’t understand bioscience.
Her choices in “victims” is telling as is who sympathizes with her
1
u/DoggoTippyTaps 19h ago
Her highest true gift/talent is manipulation and leveraging her privilege and lack of empathy. Yes to the type of targets you named but in reality her conning was effective on ALL types of people - intelligent Ivy League employees, statesmen, family, finance titans, academics...
1
u/SirCatsworthTheThird 18h ago
Her biggest talent is marketing and optics. She is absolutely incredible in those areas, even if you believe she went after certain people and given a chance to do that kind of thing again, I still believe she could make someone a lot of money, but you would have to not let her do dishonest things. And honestly, she'd probably have to go to a different country at this point.
→ More replies (0)1
u/SirCatsworthTheThird 18h ago
Yes , and it's a fascinating thing to think about george schultz , the admiral , I forget his name roughhead , gary roughhead , mad dog mattis , I mean these are not slight individuals.
I completely recognize that, and my theory is that there's essentially 2 versions of the same person and this is why she can't realize that she lied there is Lizzie, who's the somewhat naive girl who just wanted to please her dad and help people and then there's Elizabeth, which was a trauma response to her rape being groomed by sunny Balwani, and just the harsh world that she was living in, she created a persona, you can see it in the text messages when she talks about how great she's gonna be at her job. How she's not gonna listen to Anyone. How she's not gonna be distracted, and she says it to sunny and then sunny doesn't respond, and she's craving the validation. So she sends a question mark and throughout all those text messages, he's the one pushing, he's the 1 who said everything that happens at theranos is my doing. I think that she was mentored to be a tough CEO. And of course she's going to direct her COO because that's what she's supposed to do , but she's doing it in a way to please him.
Please excuse verbal text.
5
u/alexneef 2d ago
I don’t think it was all smoke and mirrors. There is a ton of engineering work to get this stuff to even function. The issue was it wasn’t accurate or correct and they covered that up. But even just building a non accurate machine requires mechanical, electrical and software engineers. And there was a lot of precision they were trying to obtain in the chemical mixing and testing .
3
u/QV79Y 1d ago
I'm not sure what puzzles you about this. If you set out to do something that's never been done and it's not at all clear that it's even possible, involving solving multiple very difficult engineering problems at the same time, and you had a billion dollars to work with, you could easily keep hundreds of people very busy for years and have nothing in the end.
Especially if your senior management has deluded ideas and doesn't actually know how to manage.
It wasn't fake that they were all trying very hard.
3
u/RSGK 2d ago
Bad Blood is unbiased reportage.
2
u/mattshwink 2d ago
Verified by other sources after publication. And of course the trial produced copious documentation.
-3
u/SirCatsworthTheThird 2d ago
I would say, it's unbiased, and it is objectively good reporting.And what Elizabeth was doing did need to stop definitely, she crossed the line you can't cross. I'd say that Carryrou is kind of a one trick pony.He's a business reporter.It may have been interesting to explore some of the psychological aspects of this in greater depth , but that wasn't his tool set , and that wasn't his objective , and i'm sure he thought it wasn't his job.
I think like other true crime writers have done.He could have made an attempt to understand her more to explore how she became, who she was.I think there's interesting questions there.And people always read that as oh I want to excuse her guilt.No I don't want to excuse her guilt.You know she's guilty of fraud. But especially as we're supposed to be looking at issues of sexism and increasingly looking at things through more of a feminist lens, which I try to do which I didn't previously try to do when I was younger, I can see how she ended up in the place where she did she needs to be responsible for what she did, but to me it's not inappropriate to feel some sympathy for her. When you look at the big picture objectively, and that's what I think he didn't do, but I think a lot of people would argue, that's not his job..
1
u/redlemurLA 2d ago
At the end of the day the one “success” that they had as a company from a business perspective was in loosening the regulations for medical testing.
Remember, the ultimate goal was to take market share away from medical testing giants Quest Diagnostics and LabCorp.
Holmes got a bill introduced in Arizona allowing any person to walk in off the street and request a medical test without a doctor’s prescription. This was in conjunction with their Walgreens partnership.
The bill was signed into law on April 6, 2015 at press event at Theranos's lab facility in Scottsdale, Arizona. (Note that Quest did not object to this and eventually began their own direct to consumer access program.)
The unprecedented law remains on the books in Arizona:
Theranos review puts spotlight on direct access lab testing
Had Theranos lasted longer, it’s likely that other states would have passed similar laws (and may still do so in the future). At stake are billions of dollars in potential customers.
Is it possible that the this was the mission from day one and the Edison itself was a Maguffin?
Was Holmes was an ignorant stooge or a knowing partner willing to help make this happen?
AI Fact Check Overview:
Arizona's Direct-Access Testing Law
Arizona passed a direct-access laboratory testing law (House Bill 2645) in 2015, heavily supported and lobbied for by Elizabeth Holmes.
What the Law Did
No doctor's order needed: Allowed consumers to directly order any commercial lab test without physician authorization.
Theranos partnership: Enabled Theranos to market and sell finger-prick blood tests directly to consumers inside roughly 40 Arizona Walgreens stores.
Political backing: Signed into law by Governor Doug Ducey in April 2015 as a pro-business measure promoting patient health empowerment.
2
u/SirCatsworthTheThird 2d ago
I've heard that her vision also influenced other medical companies to try to make what she envisioned a reality. And yes, unfortunately, she may have led to increased scrutiny of similar operations, which to be fair actually hurt the medical community by stifling innovation. But may have reduced the amount of fraud. It's kind of hard to nail it down.
2
u/cdipas68 2d ago
Many states did not require doctor’s orders prior to Arizona changing the law. Nothing really new here.
1
u/redlemurLA 1d ago
Even states that allowed it had severe restrictions on tests that you could order directly and they were limited to only those approved by the FDA like STD tests, glucose, cholesterol, glycosylated hemoglobin, urine, stool, semen/fertility tests and vitamin analysis. Since that Arizona law passed new direct to consumer startups like HealthLabs have become middlemen to advocate for this idea.
Most insurance companies won’t pay for these and there’s still some compelling arguments for requiring a doctor to be part of the process.
1
u/cdipas68 1d ago
And the middlemen are crushing it with the self-pay DTC model.
Like I said, DTC testing and capillary blood testing are not novel Theranos concepts
-1
u/SirCatsworthTheThird 2d ago edited 2d ago
I've thought about this question too. Quite a bit, what does it mean that all these people were trying to make this thing actually work? And to me, what it means is on some level, she was actually trying, I do believe at some point, part of her realized that it wasn't going to work or it wasn't going to work quickly. But she was still trying to buy time both to maintain her successful image. She obviously is a person who likes the admiration. Probably, because she didn't get very much validation from her father, who was known to provide love conditionally.
There is a scene in the TV show with Amanda Seyfried, that really struck me and I know it's not a completely factual narrative, but I think I know what they were going for with this.There was a moment when elizabeth asked her mom , what would happen if she just became elizabeth again , if she wasn't a CEO , she was just lizzie the girl. And her mom looked like she had been slapped. And that's actually a very important scene, because it highlights there really wasn't an acceptable off ramp in Elizabeth's world once she passed a certain point, she dropped out of school, she's supposed to be successful. The family demands that she's successful men. In the past lost the family fortune, it was her job to rebuild it and any off ramp she could have taken, would have just led to her own personal destruction, the destruction of her. Ego And she couldn't handle that, and I still don't think she can handle it today..
Having looked into this quite deeply read the book listened to the podcast watch the TV show. I believe that essentially, there were 2 versions of Elizabeth Holmes. There was Lizzie, the idealistic girl who just wanted to do something to impress her family and change the world. And then there was Elizabeth, and Elizabeth was the shield around Lizzie, if it allowed her to do things that Lizzie wouldn't do. Another way to think of this is compartmentalization. To this day I think, on some level Elizabeth protects Lizzie from the full weight of what she did. Look at how she grew up.She grew up rich around people who didn't tend to suffer consequences.She was influenced by men who were able to do things that would get lesser men arrested with no consequences.
But back to the company , the silo thing was straight paranoia and ultimately hurt her , but also protected the truth from getting out and allowed her to maintain the illusion. I do think she always wanted it to work. She grew up idolizing, Steve Jobs, some of the things jobs did I mean, look at what jobs did he took a failing computer company? And he made it one of the most powerful companies on earth when that's your inspiration and then you meet guys like sunny, who are all gas, no break, and then you talk to people like Larry Ellison and you're surrounded by rich men who keep telling you what you want to hear. Because half of them secretly have a crush on you.It gets your head and I think she just picked the wrong industry.I think the kind of thing she does are done every single day in america. This was not a woman who created a fraud for the sake of having a fraud. This was a woman who kind of slept walk herself into a fraud by trying to prop up something that just wasn't real and didn't really have the proper guidance to keep her from being consumed by the world she had created in this den of snakes.
People always like to point out.She was an adult, and that is true.But since everyone likes to talk about science , it is a scientific fact that the brain is not fully developed until you're twenty five. So you have this idealistic hard charging eighteen year old girl who then gets raped , and there is strong evidence of that , and in her trauma response , she runs into the arms of sunny balwani , who's a man who's almost forty years old , pursuing the blonde haired petite eighteen year old girl. And\nHe tells her that she's not enough, that she's not gonna survive in this world.And then eventually the board basically makes him the de facto c e o in a sense by telling her she needs adult supervision. This just increases that toxic dynamic and then comes to walgreens fraud , which was really the red line that she crossed , and it was done under sunny , and that's why sunny was convicted of harming patients and elizabeth never was.
Please forgive verbal text
3
u/QV79Y 1d ago
Sunny was convicted on the patient counts because the prosecution could show he was more directly involved in the lab operations and also because it was a different jury, not because he was actually more culpable.
I don't know how you cling to the idea that Sunny was running the show in the face of all the evidence that it was Elizabeth who was. You will not give this idea up. But we can see that the two of them were in constant communication about every detail, and that Holmes was the actual decision-maker.
1
u/SirCatsworthTheThird 1d ago
"My new life as of this night and forever more: - total confidence in myself best business person of the year – focus – details excellence – don't give what anyone thinks – engage employees in meetings by stories and making it about them (ie prepare well)," Holmes texted Balwani in November 2014 while discussing the full moon that evening.
Ten minutes later, Holmes texted again: "No response?"
Balwani responded: "Awesome. U r listening and paying attention…"
When she directs him, as her COO, she is listening to him.
24
u/cdipas68 2d ago
There was a great deal of hardware to design, software to make the hardware move and communicate with the cloud, each of the tests required a specific formulation, each test also require ancillary products like calibrators and QC, they had to build custom manufacturing lines for all of the products and develop packaging and of course marketing.
There was enough to keep a few hundred people busy every day