In 2014, Theranos founder and CEO Elizabeth Holmes was widely seen as the female Steve Jobs: a brilliant Stanford dropout whose startup "unicorn" promised to revolutionize the medical industry with a machine that would make blood testing significantly faster and easier. Backed by investors such as Larry Ellison and Tim Draper, Theranos sold shares in a fundraising round that valued the company at more than $9 billion, putting Holmes's worth at an estimated $4.7 billion. There was just one problem: the technology didn't work.
Bad Blood: Secrets and Lies in a Silicon Valley Startup is the full inside story of the breathtaking rise and shocking collapse of the multibillion-dollar biotech startup by the prize-winning journalist, John Carreyrou, who first broke the story and pursued it to the end, despite pressure from its charismatic CEO and threats by her lawyers.
See also The Inventor: Out for Blood in Silicon Valley, a documentary on the rise and fall of Holmes and Theranos; and The Dropout for a fictional depiction. The Law & Order episode "Imposible Dream" was a No Celebrities Were Harmed depiction.
- A Father to His Men: General Jim "Mad Dog" Mattis supported the development of the Edison devices for the sake of protecting the soldiers under his command.
- Amoral Attorney: Don't be fooled by David Boies's past court battles in support of LGBT rights; he's all too willing to use underhanded maneuvers and strong-arm tactics to help his clients win. His fellow lawyers who work for Theranos, such as Heather King, are about as vicious with little concern as to whether or not the company's products work as intended.
- And Now for Someone Completely Different: Each chapter of the book up until The Tip focuses on a different person dealing with Theranos in their own way with varying levels of disaster.
- Based on a Great Big Lie: Theranos in a nutshell. Its promises were the reason why so many people invested money in it. Most infamously, Walgreens decided to not only invest in it, but also make a deal to open Theranos wellness centers in their stores which would feature their machines. Except their machines never worked, forcing Theranos to use regular blood testing machines and (poorly) rigging them to take the diminutive "one drop" samples they were taking... before giving up on the whole thing and going with venipuncture blood draws for their testing. Which they still couldn't do properly.
- Blatant Lies: To give one example: in some interviews, Elizabeth Holmes touted that the machine was being used by the military in the field (she was merely given some blood samples from active-duty soldiers). The company also claimed that their machines were the fastest and most accurate. In reality, each machine could only process a small amount of samples at once, which made the process slower than traditional testing, and the fingerstick method drew so little blood that each sample had to be diluted so much it ruined the tests' accuracy.
- Broken Pedestal: Many of the people described in the book initially joined Theranos because they genuinely believed in Elizabeth's vision of more efficient blood tests. They quickly grew disillusioned by the unfeasibility of Elizabeth's goals, her nonchalant attitude towards the company's problems, and the fact that this flawed technology put lives in danger.
- Can't Take Criticism: Holmes made a habit of firing employees on the spot if they dared question her.
- Charm Person: Elizabeth tricked a veritable cavalcade of powerful political figures such as Henry Kissinger, Jim Mattis, George P. Shultz, Rupert Murdoch, the Obamas, and the Clintons into believing in Theranos through sheer charisma and a little sleight of hand.
- The Conspiracy: Sunny accused Labcorp, Quest Medical, and at one point John Carreyrou of this. note
- Determinator: The damning articles Carreyrou wrote wouldn't have been possible without the courage of Tyler Shultz (who refused to give up the names of John's other sources) and Erica Cheung (who alerted the relevant authorities as to how Theranos was cutting corners) in the face of the company's very aggressive threats.
- The Dilbert Principle: Elizabeth used charisma, money, and flattery to set up her project; what she lacked was actual know-how or experience to achieve the technical marvels she boasted. Those in Theranos who saw Holmes's true nature ended up quitting the company rather than go along with the deceit, inadvertently creating a system that rewarded cronyism over getting anything done.
- Dissonant Serenity: Elizabeth Holmes to an unnerving degree, even as Theranos collapsed around her and she could no longer lie her way out of it.
- The Dog Bites Back: The last quarter of the book consists of several ex-Theranos employees and other persons the company had wronged helping Carreyrou assemble enough evidence to bring the company down.
- The Dreaded: David Boies has this reputation with every other attorney mentioned in the book. He did win cases against Microsoft and the State of California.
- Exact Words: One employee pointed out to a manager that claims in a profile of Holmes were overblown and misrepresented what the company was able to do, and they shouldn't be making those claims. The manager contended that the article's author had decided to say all that stuff, not Holmes herself, so it was fine—an argument the employee found unimpressive.
- Fluffy the Terrible: Ramesh "Sunny" Balwani is a deeply unpleasant (and probably racist) businessman.
- Honest Corporate Executive: Media mogul Rupert Murdoch (yes, really) purchased a large amount of Theranos shares during the company's prime, but when Elizabeth (who had been trying to cozy up to the chairman for quite some time by that point) tried to manipulate him into killing Carreyrou's story before it was published, Rupert refused and cited his faith in The Wall Street Journal's staff for quality content.
- Ignored Expert: Walgreens hired an expert that told them Theranos looked a lot like a fraud. They invested anyway out of paranoia that their arch-rival CVS would do it first.
- Impoverished Patrician: Elizabeth's father's family was once one of America's richest thanks to her great-great-great grandfather's founding of Fleischmann's Yeast. However, poor management and investment of the family's fortune over the succeeding generations left her father without much inherited wealth, which Joseph Fuisz believed drove Elizabeth's ambition to become a billionaire.
- Improperly Paranoid: Elizabeth and Sunny's insistence on keeping all information about Theranos classified and compartmentalized was born out of a belief that Labcorp and Quest Medical, America's two largest medical lab test companies, were determined to learn the company's secrets and undermine it as a competitor. In reality, both companies had been unaware Theranos even existed for over a decade and once they did learn about it, quickly surmised through expert opinions that its claims about its products were false.
- Intrepid Reporter: Carreyrou.
- Know-Nothing Know-It-All
- Elizabeth's status as a college dropout is frequently mentioned every other time she personally appears in the narrative. Finally brought to a head in the final chapters, where it is explained that, contrary to other fields in Silicon Valley where you can "Fake it till you make it", a big reason Holmes failed was that you really CAN'T pretend to know about the medical industry when you dropped out of college in your first year. A college education may have helped give Holmes a realistic assessment of her goals and dreams for Theranos.
- Finishing college would have at least given her more terminology to throw around. A big point is that she wasn't even good at making up plausible lies - all of her claims sounded ridiculous, or used comically vague descriptions and talking points. She got away with so much just based on her charisma and ability to confidently present brazen lies. The professors she actually did take classes with during that brief time period all considered her an idiot.
- Loophole Abuse: Theranos used various gray areas in regulations to avoid getting full certification, or at least tried. For example, they tried to say that only their central lab needed to be certified, as their machines were just sending data back to be analyzed. That ultimately didn't work and their deal with the army fell through, but other attempts did, which is how they managed to run tests on actual patients.
- May–December Romance: Holmes and Sunny were in a relationship for most of Theranos's existence. He is 19 years her senior.
- Nepotism: Holmes hired her younger brother, fresh out of college with no work experience, for a high position at Theranos. By all accounts, he spent his time there browsing sports articles on the internet or hanging out with his old fraternity buddies, whom he also convinced Elizabeth to hire.
- Never My Fault: Elizabeth Holmes' basic modus operandi. She has yet to apologize for her actions, instead blaming everyone and everything else for Theranos failing as it did.
- Not So Stoic: Carreyrou eventually lost his cool during an interview in the Wall Street Journal's offices with a Theranos delegation of 7 people, 4 of them lawyers including Heather King and board member David Boies. He realized very soon that not only he was going to get no answers out of them, but that they were basically approaching the interview as a deposition for a legal proceeding. To his credit, he wasn't the first; by the point he raised his voice the whole interview had already devolved into a shouting match between Theranos' lawyers and Carreyrou's editors.
- Screw the Rules, I Have Connections!: Elizabeth Holmes attempted to surround herself with some of the most powerful people in Washington in the hopes of becoming untouchable. She wasn't. It only worked in the short term.
- Screw the Rules, I'm Doing What's Right!: Tyler Shultz and Erica Cheung.
- The Spook: For all his supposed decades of experience in the tech industry, there is almost no information online about Ramesh "Sunny" Balwani. Some employees speculate that he somehow scrubbed all of his info. Up to mid 2018 there were next to no photos of Balwani available online (this finally changed when 60 Minutes found some video footage of Balwani giving a speech about Theranos).
- With Us or Against Us: Taken to insane levels by Elizabeth Holmes and Sunny. Anyone at Theranos who was not 100% behind Holmes or who voiced even the slightest bit of concern about the company's tech was immediately branded a "cynic" or "not a team player" and would invariably be marginalized or outright fired from their jobs. Meanwhile, sycophants were always promoted to better positions, regardless of competence.