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The Dramatic Fall of Theranos & Elizabeth Holmes // Book Summary of John Carreyrou’s ‘Bad Blood’

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Bad Blood: Secrets and Lies in a Silicon Valley Startup (2018) is Wall Street Journal investigative reporter John Carreyrou’s remarkable exposé on Theranos, the former high-flying Silicon Valley tech startup founded by Elizabeth Holmes.

Theranos formally dissolved last week after a high-profile scandal revealed that the company not only deceived investors, but also risked the health of thousands of patients.

A Gripping Narrative, A Charismatic CEO, and A Big Fraud

In 2015, Theranos was one of Silicon Valley’s superstars. Valued at some $9 billion, Theranos claimed an out-and-out disruption of the $73-billion-a-year blood testing industry. Elizabeth Holmes pitched a revolutionary technology that could perform multiple tests on a few drops of capillary blood drawn by a minimally invasive finger prick, instead of the conventional—and much dreaded—venipuncture needle method.

The Story of Theranos and Elizabeth Holmes received much adulation by the media Theranos has its origins in 2004, when the brilliant Holmes, then a 19-year old Stanford sophomore, dropped out of college to start the company. Her missionary narrative swayed just about everyone to believe in the potential she touted.

Over the years, Theranos attracted a $1 billion investment, an illustrious board of directors, influential business partners (Walgreens, Safeway, Cleveland Clinic,) and significant amounts of adulation by the media—all of this lent credence to Holmes’s undertaking. She was celebrated as the youngest, self-made female billionaire in the world.

Nobody Asked the Hard Questions

Theranos’s castle in the air started to crumble in October 2015, when Carreyrou’s first Wall Street Journal article reported that the company was embellishing the potential of Theranos’s technology. Based on past employees’ disclosures, the article also cast serious doubts on the reliability of Theranos’s science. Behind the scenes, Theranos performed a majority of its blood tests with commercial analyzers purchased from other companies.

The persistent question in Carreyrou’s Bad Blood is how the many smart people who funded, endorsed, defended, and wrote about this company never set aside their confidence in Holmes’s persuasions and looked beyond her claim of “30 tests from one drop of blood.”

Without much independent due diligence, Theranos’s supporters possibly assumed that everyone else had checked out the company, its founders, and its science. Theranos got away with its actions for as long as it did because no one could conceive of the idea that the business would simply lie as much as it did.

The Story of Theranos and Elizabeth Holmes Appeared so Promising That Everybody Wanted it to Be True

Bad Blood also draws attention to Silicon Valley’s many failings, including the cult of the celebrity founder. Holmes’s smoke and mirrors was enabled by the notion of a “stealth mode” in which many Silicon Valley startups operate to protect their intellectual property. Theranos never proved that its testing technology really worked. It was performing tests on patients without having published peer-reviewed studies, getting FDA certification, or carrying out external evaluation by medical experts.

'Bad Blood' by John Carreyrou (ISBN 152473165X) Carreyrou acknowledges that Holmes’s initial intentions were honorable, even if naïve. What triggered Holmes’s downfall was the characteristic entrepreneurial “fake it till you make it” ethos—it inhibited her from conceding early on that her ambitions were simply not viable.

When things didn’t go as intended, Holmes exploited the power of storytelling to get everyone to buy into her tales. She continued to believe that the reality of the technology would catch up with her vision in the future. Trapped in a web of hyperbole and overpromises, Holmes and her associate (as well as then-lover) Sunny Balwani operated a culture of fear and intimidation at Theranos. They went as far as hiring superstar lawyers to threaten and silence employees and anyone else who dared to challenge the company or expose its deficiencies.

Book Recommendation: Bad Blood is a Must-Read

Every inventor, entrepreneur, investor, and businessperson should read Bad Blood. It’s a fascinating and meticulously researched report of personal and corporate ambition unraveled by dishonesty. This page-turner is a New York Times bestseller and is expected to be made into a movie.

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Beware of Key-Person Dependency Risk

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Key-Person Dependency Risk is the threat posed by an organization or a team’s over-reliance on one or a few individuals.

The key-person has sole custody of some critical institutional knowledge, creativity, reputation, or experience that makes him indispensable to the organization’s business continuity and its future performance. If he/she should leave, the organization suffers the loss of that valued standing and expertise.

Small businesses and start-ups are especially exposed to key-person dependency risk. Tesla, for example, faces a colossal key-man risk—its fate is linked closely to the actions of founder-CEO Elon Musk, who has come under scrutiny lately.

Much of Berkshire Hathaway’s performance over the decades has been based on CEO Warren Buffett’s reputation and his ability to wring remarkable deals from companies in duress. There’s a great deal of prestige in selling one’s business to Buffett. He is irreplaceable; given his remarkable long-term record of accomplishment, it is important that much of what he has built over the years remains intact once he is gone. Buffett has built a strong culture that is likely to endure.

Key Employees are Not Only Assets, but also Large Contingent Liabilities

The most famous “key man” of all time was Apple’s Steve Jobs. Not only was he closely linked to his company’s identity, but he also played a singular role in building Apple into the global consumer-technology powerhouse that it is. Jobs had steered Apple’s culture in a desired direction and groomed his handpicked management team to sustain Apple’s inventive culture after he was gone. Tim Cook, the operations genius who became Apple’s CEO after Jobs died in 2011, has led the company to new heights.

The basic solution to key-person dependency risk is to identify and document critical knowledge of the organization. (Capturing tacit knowledge is not easy when it resides “in the key-person’s head.”) Organizations must also focus on cross-training and succession planning to identify and enable others to develop and perform the same tasks as the key-person.

Idea for Impact: No employee should be indispensable. A well-managed company is never dependent upon the performance of one or a few individuals. As well, no employee should be allowed to hoard knowledge, relationships, or resources to achieve job security.

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  5. The Dramatic Fall of Theranos & Elizabeth Holmes // Book Summary of John Carreyrou’s ‘Bad Blood’

Power Corrupts, and Power Attracts the Corruptible

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Picture of Statue of Demon Mahishasura atop Chamundi Hills in Mysore, India The recent sexual misconduct allegations of influential men abusing their towering positions for contemptuous behaviors provide yet another reminder that power corrupts. As the British politician and historian Lord John Dalberg-Acton famously wrote in an 1887 letter to the Anglican Bishop Mandell Creighton,

Power tends to corrupt and absolute power corrupts absolutely. Great men are almost always bad men, even when they exercise influence and not authority: still more when you superadd the tendency or the certainty of corruption by authority. There is no worse heresy than that the office sanctifies the holder of it. That is the point at which … the end learns to justify the means.

The recent scandals lay bare the three distinctive characteristics of the intoxication of power: the inflation of the self, the devaluation of the helpless, and a dreadful shortfall in self-awareness of actions and consequences.

In the case of studio executive Harvey Weinstein, the worse outrage is that, many prominent people, despite their awareness of Weinstein’s uninhibited abuse, stayed silent—and possibly benefited. Some Hollywood celebrities are said to have overlooked his transgressions. Meryl Streep, one of Hollywood’s most successful actors, who once referred to Weinstein as ‘God,’ had to contend the blame that everyone in Hollywood knew of Weinstein’s conduct. His staff sheltered him or paid off victims, many of whom chose to remain silent for fear of derailing their budding careers. Going public would have hurt them more than it would have damaged Weinstein, until those accusations reach a critical mass and suddenly everyone flipped against him.

The Intoxication of Power

The British philosopher Bertrand Russell first wrote about the “intoxication of power” in A History of Western Philosophy (1945,) and best described what develops in the minds of many people who, in all walks of life, exercise a measure of power and dominance.

The Greeks, with their dread of hubris and their belief in a Necessity or Fate superior even to Zeus, carefully avoided what would have seemed to them insolence towards the universe. The Middle Ages carried submission much further: humility towards God was a Christian’s first duty. Initiative was cramped by this attitude, and great originality was scarcely possible. The Renaissance restored human pride, but carried it to the point where it led to anarchy and disaster. … Man, formerly too humble, begins to think of himself as almost a God.

…

In all of this I feel a great danger, the danger of what might be called cosmic impiety. The concept of ‘truth’ as something dependent upon facts largely outside human control has been one of the ways in which philosophy hitherto has inculcated the necessary element of humility. When this check upon pride is removed, a further step is taken on the road towards a certain kind of madness—the intoxication of power which invaded philosophy with Fichte. I am persuaded that this intoxication is the greatest danger of our time, and that any philosophy which, however unintentionally, contributes to it is increasing the danger of vast social disaster.

Idea for Impact: People with even the smallest amount of authority can and will find ways to abuse it

People can become corrupt with power, fame, wealth, and influence, and, as I’ve written previously, they regularly get away with it. The solution, I believe, is to subject our elites (and the sycophantic supporters who are disposed to collude in self-interest) to as many restrictions, supervisions, and checks and balances as possible, and scrutinize them closely so as to spot hubristic traits and symptoms of the abuse of power.

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The Cost of Leadership Incivility

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Steve Jobs’ Misguided Advice for Being a Good CEO: “Throw Tantrums!”

When Indra Nooyi became CEO of PepsiCo in 2006, she met with Steve Jobs, the famously driven but short-tempered and ruthless leader of Apple. One advice Jobs had for Nooyi on being a good leader: “throw tantrums.”

During this 2016 interview at the Stanford Business School (YouTube video), Nooyi acknowledged Job’s advice as “a valuable lesson.” She elaborated that Jobs advised, “don’t be too nice … when you really don’t get what you want and you really believe that’s the right thing for the company, it’s OK to throw a temper tantrum. Throw things around. People will talk about it, and they’ll know it’s important for you.”

During another 2016 interview, at the New York Times’ DealBook Conference (YouTube video), Nooyi recalled Jobs advise again. “If you really feel strongly about something—if you don’t like something people are doing—throw a temper tantrum. Throw things around, because people have got to know that you feel strongly about it.” Though Nooyi hasn’t gone as far as to throw things around, she disclosed, “I’m beginning to use certain words a little bit more freely and I am screaming a bit more, pounding the table … which is really not the way I was … it is effective. It shows the passion that I have for what I’m doing.”

No Need to Ape the Style of the Icon-of-The-Moment

Leadership Throw TantrumsPeople will go to extraordinary lengths for causes they believe in. Nonetheless, this advice of throwing tantrums and using “certain words a little bit more freely” to express passion is abhorrently misguided, even if it worked for Steve Jobs and Indra Nooyi!

The ultimate impact of a leader hinges on his/her enthusiasm to make the organization’s endeavors personal, to engage others openly, and to draw attention to successes as they emerge. For that reason, Nooyi’s anecdote is demonstrative of Jobs’ passion for building great products.

My primary protestation relates to the reality that leaders model the behavior they want in their organizations. Admissibly, there may be a time and a place to throw temper tantrums at Apple, PepsiCo, or at your organization. However, unchecked and unhindered outbursts of passion, and cursing and incivility are certainly counterproductive.

Steve Jobs could throw temper tantrums because he could! As I have written in previous articles, brilliant men and women can get away with fanatical pride, temper, abuse, and other disruptive behaviors because their spectacular success can and does cover many of their sins, even in the eyes of those at the receiving end of their crudeness.

Aggressive—and successful—managers and leaders can pressurize, scream, intimidate, and even terrorize their employees. They vindicate that their offensive behavior works because they “deliver the numbers.” Others rationalize their behavior by exclaiming, “Yeah, he’s tough on his people, but judge his abrasiveness in the context of everything he’s achieved.”

The Leader Sets the Tone for Workplace Culture

Workplace incivility can take many subtle forms and it is often provoked by thoughtlessness more willingly than by actual malice. A leader’s behavior tells employees what counts—and what’s rewarded and what’s punished. Leaders are role models. Therefore, others pay attention to everything they say and every move they make.

The tone at the top is the foundation upon which the culture of an organization is built. A leader is the face of an organization and the figurehead to whom employees ultimately look for vision, guidance, and leadership. When leaders throw temper tantrums, swear, or engage in appalling behavior, the message they convey within their organizations is that such behavior is acceptable.

The human brain is wired to learn by imitation. For instance, a child is wired to mimic the behaviors of higher status individuals like parents and teachers. Similarly, adults emulate the behaviors of those they deem of higher status—employees look at their boss to determine how to behave in the organization and what it takes to be promoted. In competitive work environments of the modern day, when employees see that those who have climbed the corporate ladder tolerate or embrace uncivil behavior, they’re likely to follow suit.

Postscript: Don’t blatantly imitate a hero. Those of you who worship Steve Jobs had better perceive his operative style as an anomaly rather than as a model of leadership worth imitating. Simply lifting his methods from anecdotes such as Indra Nooyi’s and the Walter Isaacson biography and imposing them on your employees will not necessarily yield Jobs-like results. As I’ve written previously, the career advice that works for the superstars is not necessarily what will work for most ordinary folks. So, don’t be misled by their “it worked for me” advice.

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