Book review Entrepreneurship Unputdownable

Book Review | Bad Blood: Secrets and Lies in a Silicon Valley Startup

A blistering expose of fraud and deception

Rating: 4 out of 4.

“First, they think you are crazy, then they fight you and all of sudden you change the world.”

Those were the opening lines of Elizabeth Holmes’ brazen defense on Jim Cramer’s Mad Money in October 2015. The same day a devastating article in the Wall Street Journal had blown to smithereens the world-changing claims of Holmes’ startup, Theranos. The two times Pulitzer award winner and the author of Bad Blood, John Carreyrou had penned the article.

Despite the damning allegations against her company, Holmes appeared nonchalant on TV, fending off every question and blaming Carreyrou and the Journal for jumping the gun.

A Unicorn without the horn

Elizabeth Holmes became the first female self-made billionaire when her startup hit the valuation of $9 billion. At the height of its glory, Theranos even leapfrogged the combined valuations of companies like Uber and Spotify.

Elizabeth Holmes
Elizabeth Holmes during her heyday graced the covers of many a business magazine (pic courtesy

At the core of Theranaos was the ‘groundbreaking’ finger-prick blood testing technology which could perform hundreds of tests using only a few drops of blood.

This was in stark contrast to the traditional venous drawing, which was both painful and expensive and had to be repeated for different tests.

The truth, however, was different. Carreyrou declares in his book that Edison, Therano’s blood-testing device, could only perform 15 out of 240 tests on its menu. And, those 15 tests were also prone to the high rates of error.

In short, since its inception in 2003, Theranos never got its technology right.

Steve Jobs II? A far cry

I relished Carreyrou’s account of Holmes’ adulation with Steve Jobs. She wanted to emulate his management style and vision. She wanted her medical devices to be the biomedical equivalents of iPhones.

Sadly, the only thing she could emulate was Jobs’ sartorial elegance. Those black turtlenecks, you know.

Theranos biggest problem was that it was built on the half-baked imagination of its CEO. Holmes did have a vision, but she had no clear roadmap to get there.

One thing she sure had – something that Carreyrou also professes to – was oodles of confidence which she oozed with even when she indulged in good old chicanery.

She wanted to be like Steve Jobs, but on her way to fame forgot that hers was essentially a medical company and not a tech company like Apple.

The usage of her products meant millions of lives would be at stake. For some reason, this significant nuance did not get through to her. Despite grumblings from her co-workers – most of whom were fired for doubting her – she went live with her product in 2013.

The Cult of the Empress

The company culture at Theranos, reveals Carreyrou, was that of fear and secrecy.

Those who dared stand up to Holmes were unceremoniously kicked out. Those who questioned the ever buggy technology were labeled traitors or simply, inept. Some were even bullied and harassed by the powerful battery of lawyers at Theranos’ disposal.

Of particular interest is Carreyrou’s account of Ramesh Sunny Balwani – Holmes’ then boyfriend and the brute enforcer at Theranos. He played a key role in building the culture of intimidation. He took a special interest in humiliating people and firing them. Perhaps, it was these qualities that endeared him to Holmes.

When both Holmes and Balwani were busy perpetrating lies and defrauding investors of millions, the distinguished board at Theranos kept mum.

Such was the spell of Elizabeth Holmes that even the most seasoned of investors and statesmen could not see through her fabrications. She led the best of people like Henry Kissinger, Joe Biden, George Schultz, James Mattis, the current US Secretary of Defense down the garden path. Her lies just flew under everyone’s radar.

How did Theranos get this far?

That’s the million dollars question – how did Theranos get this far? Exactly when did Elizabeth Holmes decide to let her obsession consume her morality?

Was she morally bankrupt from her Stanford days or did she take on the trappings of power as her wealth and reputation soared? It’s difficult to put a handle on what led to Holmes’ decadence. But I think Carreyrou gets it right in one of the initial chapters when he remarks:

In her relentless drive to be a successful startup founder, Holmes had built a bubble around herself that was cutting her off from reality.

John Carreyrou

When the bubble finally did burst, so did her aura. Her net-worth tumbled to zero. Those who put her on the pedestal once are now baying for her blood. If convicted, she could face an imprisonment of over 20 years.


Bad Blood is an unputdownable book. It captivates you from the first page and doesn’t let go until the last. The last such book I read was Glenn Greenwald’s No Place to Hide.

Carreyrou deserves plaudits for his uncompromising pursuit of Theranos story and then telling it only as he could. Even though this is a nonfiction book, he makes the reader sympathize with some of the characters. At the same time, you loathe the likes of David Boies and Sunny Balwani.

Though the book works in a chronological fashion, John hops from one jaw-dropping event on Theranos timeline to another keeping you riveted.

The sheer number of people the book features could overwhelm the reader, but then, this is an investigative book. By his own admission, Carreyrou interviewed over 60 ex-employees and most of them I believe feature in Bad Blood.

In the end, Theranos will be remembered for its founder’s hubris and blindfolded crew. It was one of the biggest scams in the Valley, but we all know it won’t be the last. It won’t be long before someone else’s staggering ambitions drive them over the hill.

Bad Blood Book review

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