Review: Bad Blood

The meteoric rise and fall of Theranos is fantastical, to the point where reality feels like fiction, and its characters and events seem like the work of an overenthusiastic author. Bad Blood is a book that chronicles the startup, tracing back its roots as the dreams of its Stanford-dropout CEO, all the way to its demise at the investigative journalistic hands of the author himself. Given the rich story—as evidenced by the multiple documentaries, movies, and even podcasts about the company—Bad Blood stands out as one of the first, and may possibly end up as the most authentic1, treatments of the Theranos tale.

Having read other non-fiction works by journalists who cover the tech industry, I knew going in that writers of biographic books can embellish minor points and project nefarious motivations for the sake of reader interest. That said, I was surprised how much I was enthralled by Bad Blood; in part, because of the dramatic retelling, in part, because it’s both close to home and recent enough that its events can be easily cross-referenced and verified. For me in particular, my last job was at a genetics-testing startup2, so the procedures and nomenclature of medical labs are hauntingly familiar.

A compelling story requires compelling characters, and Bad Blood centers itself around the pair of executives at the center of the company. Elizabeth Holmes, the CEO, is obvious: a dropout woman founder of a $9 billion company, who is charismatic and determined and presents herself as the next Steve Jobs, hits on all the traits that fascinate the media both on the way up the ladder of fame and now on the way down. Sunny Balwani, the COO, has more ink spilled here than I’ve seen in other articles and documentaries about Theranos; he’s portrayed as an egotistical tyrant, equal parts intimidating to lesser employees and ignorant of medical technologies at large.

This would be one of the few areas of the book where I’d question how much is fact versus creative liberties taken. Holmes, in particular, goes through an evolution that feels like a fictitious character arc: it starts out as determined and leverages her charm with the right political connections to establish an impressive board of directors, but as the story progresses gets increasingly paranoid3, ruthless, and driven singularly by her own rising star that earlier caricatures of humanity just disappear. Sunny, on the other hand, sounds so much like an asshole that, if the portrayal is accurate, makes me wonder why anyone would want to work for Theranos, stay there for any extended amount of time, or even want to interview there at all.

Despite the outsized attention given to the people at the top, I found that some of the stories from the lab technicians, engineers, quality control associates, doctors, and patients to also be interesting. After all, it’s through their collective actions that revealed all of the issues with Theranos’s products, and their lack of extreme personality traits makes them more relatable and believable.

The story of Theranos isn’t completely over quite yet; as of this writing, there is still a looming criminal trial for wire fraud that hasn’t gone to court yet. Bad Blood does capture most of the saga, though, and does so through the lens of investigative journalism, piecing together multiple stories and perspectives across a decade’s worth of company history. It’s rare to see a startup go through such extreme highs and lows, and for that, Bad Blood is a story worth reading.

  1. Mostly in the amount of embellishment given to the actual events, on the account that it’s written by the investigative journalist who broke the story in the first place.

  2. Which was acquired last year in a deal worth less than the last funding round.

  3. After the initial damaging article, it seemed like all Theranos did was hire more security for their executives and sue whistleblowers.

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