THESE ARE THE FACTS OF THE CASE: HOLMES studied chemical engineering at Stanford but dropped out in 2003, in the fall of her sophomore year, with the dream of commercializing something called a TheraPatch. It would stick to the skin and use tiny needles to draw blood into a microfluidic sensing system, which would diagnose an infection or imbalance and deliver an appropriate drug, all without a standard blood draw by a phlebotomist. (Holmes told everyone she was terrified of big needles.)
The idea was half science fiction and half nonsense. A patch could never hold enough antibiotic to reverse an infection, to mention just one of the myriad technical problems. Phyllis Gardner, a professor of medicine at Stanford who reviewed Holmes’s sketches, congratulated the 19-year-old for her creativity but warned her the idea would never work. Holmes also encountered pushback from venture investors familiar with medical technology. Carreyrou describes an abortive visit to Emeryville, CA-based MedVenture Associates: “Unable to answer the partners’ probing technical questions, [Holmes] got up after about an hour and left in a huff.”
Others were more willing to suspend judgment. Some of the advisers and backers drawn in by Holmes had scientific training, like her chemical engineering professor, Channing Robertson, but most did not. Older men seemed especially impressed by Holmes’s passion and determination. Tim Draper, the founder of venture firm Draper Fisher Jurvetson, was one of the first to invest. As Holmes refined her plan—she soon scrapped the patch idea in favor of scheme to build a small, automated box that could run hundreds of standard lab tests simultaneously on just milliliters of blood from a finger-stick—Theranos would go on to attract a herd of other grandees from corporate, finance, and government, including Don Lucas, Larry Ellison, Robert Kraft, Carlos Slim, and Rupert Murdoch. The company’s board would eventually include such aging luminaries as George Shultz, Jim Mattis, Bill Frist, William Perry, Henry Kissinger, and Sam Nunn.
With the robotic lab-in-a-box technology still in its early prototype phase, Theranos began to ink agreements with big partners who wanted to use the system, including Walgreens and Safeway. In 2012 Safeway began sending the company blood samples collected at new “Theranos Wellness Centers” built inside some California stores. Walgreens followed suit in 2013.
But what only Theranos insiders knew was that the technology didn’t work. The effort to combine immunoassays, general chemistry assays, hematology assays, and DNA amplification assays in a single machine required a nightmarish tangle of tubes, centrifuges, and spectrophotometers, with robot arms moving samples around in tiny pipettes. The pipettes regularly broke. The centrifuges exploded. The instruments fell out of alignment. (Gibney’s documentary evokes the chaos of Theranos’s lab-in-a-box with a harrowing computer-generated sequence imagining the machines’ blood-spattered innards.)
To test all the blood flowing in from Safeway and Walgreens, Holmes and Balwani