2019-10-14

Book Review: "Bad Blood" by John Carreyrou

I've recently read the book Bad Blood by John Carreyrou, who is an investigative journalist with the Wall Street Journal. It is essentially a reworking of a series of investigative articles he did with that newspaper about the company Theranos and its founder Elizabeth Holmes, showing how that company's promise of a revolution in medical diagnosis and treatment by replacing expensive medical testing equipment and the need for large blood draws with small devices that can do hundreds of tests using only a few drops of blood was based on fraud, through fabricating and falsifying test results submitted to investors & regulators and even when demonstrating their devices to investors in person. While it does give some background about the early life & motivations of Elizabeth Holmes as well as some of the other key players in Theranos, and though it does give at least a little background on everyone introduced by name, the story makes clear that lies and falsification of data were occurring even within the first couple of years of the company's existence, and shows how as more people got involved, it became clear just how much more deceit was occurring. In this sense, I expected there to be a sharper transition period from reasonable activity to fraud but was surprised to see such fraud taking place so early on and so consistently throughout the story, though there certainly was a transition from fraudulent behavior being limited to occasional circumstances mixed with typical Silicon Valley hyperbole to fraudulent behavior being the modus operandi of the company at a systemic level especially as the company neared its product rollout through corporate partnerships, to the point where Holmes and her second-in-command/boyfriend Ramesh Balwani had basically turned the company culture into a religious cult that tolerated no dissent or raising of ethical concerns.

The book is quite well-written for the most part. The introduction of each character in the story is clear & relatable, and the progression of events is fairly easy to follow, making for a compelling & engaging story. There are two minor criticisms that I have of the book, and in some sense they may not really be addressable given the way the events themselves unfolded. One is that the last 6 (out of 24) chapters, in which the author suddenly introduces his own role in the story after describing how one of the people involved calls the Wall Street Journal, felt a bit disjointed. In particular, the chapters before seemed to tell a cohesive story from the points of view of those directly involved in the story, whereas those final chapters had rougher transitions between the author's own conflicting attachment to the story and detachment from the various players' personal lives versus those players' own attachment to the scandal as they directly observed it; this could have been made smoother, though I think the suspense built by reading about the extremes to which Theranos went to harass & intimidate its former employees (without having direct proof of their involvement with journalistic activities) made up for this deficiency. The other is that perhaps just because of how early fraudulent activity played a role in the operations of Theranos, there wasn't much room to really meditate on how Holmes and the others who really believed in Theranos could willingly resort to fraud (apart from a short statement about this in the epilogue), so in that sense, I felt a little let down as I simply read a straightforward story about corporate fraud without being prompted to think about broader ethical & moral implications. Overall, I enjoyed reading this book, and would recommend it to anyone who wishes to read a nonfiction thriller about corporate fraud involving medical technology.

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