Thanks for all your questions. I have to wrap this up for now. I may log back on later and answer the remaining questions if my schedule allows. I hope you'll check out the book (for those of you who haven't read it).


I'm an investigative reporter for The Wall Street Journal. I started looking into Elizabeth Holmes and her Silicon Valley blood diagnostics startup Theranos in early 2015. I published the first of many stories on the company, which was then valued at $10 billion, in October 2015 and have since published a book on the scandal called "Bad Blood: Secrets and Lies in a Silicon Valley Startup." I'm here to answer any questions you might have about the book or this saga.

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Comments: 960 • Responses: 26  • Date: 

DiagnosticsChick815 karma

I have been in a start up diagnostics company, with actual point of care technology. Our potential investors nearly gave all of us colonoscopies to vet our technology. No stone was left unturned and this was 2014. They wanted to know why we weren't like Theranos then. Post your article, the potential investors were " you're not like Theranos are you?". Having gone through the process of getting investors, I do not comprehend how her "carisma" got her all of that money. Not one investor I saw was that loose with money -(and it was much smaller - in the $5-10mil range). How did this happen?

BTW - we knew she was a fake in 2014 as our entire Boston based company followed the antics. We viewed Theranos as possible competition and vetted them as we did with other potential competitors.

JohnCarreyrou1118 karma

Part of the answer is that she scrupulously stayed away from sophisticated VC firms with experience in medical technology and diagnostics. She targeted billionaires and their families, people like the Waltons, the DeVoses, Rupert Murdoch, Carlos Slim, etc. If I were to be blunt, I would call this the dumb money. She targeted these unsophisticated investors and claimed to them that she couldn't show them the technology because it was "a trade secret." And they bought it.

model_citizens131 karma

As someone who grew up next to the Cambridge biotech scene, I'm curious: could Theranos ever have come out of that area? I guess the Bay Area has more VCs and stuff, but does the Boston biotech scene have a different "vibe" than the west coast biotech scene?

JohnCarreyrou454 karma

I think there's something to what you're saying. Cambridge has Harvard and MIT, where super smart people do real science and engineering. In SV, people have built up this myth that a young Stanford dropout can wave a magic wand and solve difficult problems. The cult of personality out there has gotten out of control. Elon Musk is another example of it. People in and around Boston are more grounded and more anchored to reality.

emm42392297 karma

Hi John,

I loved the book. It was phenomenal. I'm curious if you have any insight of what Elizabeth Holmes' life is like in 2018? I know that she was still the CEO until a couple of weeks ago. But she is a known pariah and she couldn't possibly make any public appearances with all the allegations against her.

JohnCarreyrou519 karma

She showed up at work on Tuesday. I'm told she continues to feel she did nothing wrong and is planning on taking this to trial. You could say she's in complete denial.

definitively_maybe250 karma

How do you see the moral and ethical responsibility of the Boies Schiller lawyers in perpetrating the fraud?  Do you think they went beyond their duty to zealously represent their client through the bullying and lying you described in the book? 

JohnCarreyrou405 karma

Yes, I think they went way too far. Ambushing Tyler Shultz at his grandfather's house and then pressuring him relentlessly and threatening to bankrupt his entire family, that's simply beyond the pale. These are methods you associate with thugs. There's also the fact that Boies Schiller held $5 million worth of Theranos stock. To me, that was a big conflict of interest. They were the company's legal representatives but also had a vested interest in keeping the fraud going to preserve and increase the value of their shares.

harddata232 karma

You mark a turning point in the book when you point out that “they decided to cheat” on the tests because the Edison didn’t work.

Stepping back to the broader question, when do you think Holmes decided to commit a crime? Was it more like the frog boiling in the pot that got out of her control, or was she the type of person that, from the beginning, just didn’t care if people got hurt? You address this a bit in the epilogue, but I’m curious if you can point to a specific moment.

As an aside, it was fun chatting with you on a flight back from DC about two years ago. I remember you said the book was gonna have a lot of incredible details that weren’t in the WSJ articles. You weren’t kidding.

JohnCarreyrou330 karma

The pivotal moment was when she went live with the blood tests in Walgreens stores. That was the bright red line not to cross and she crossed it. She had overpromised and acted unethically for years, but the stakes weren't as high. No patient lives were in the balance. So the way I see it, her lies snowballed over the years, but she could have refrained from going live with the blood tests and those lies would probably not have gotten her in trouble. The cardinal sin was going live with the tests in Walgreens stores in the fall of 2013 and putting patients in harm's way. Not to mention the fact that she raised most of her money after that, by pointing to the live Walgreens partnership as proof that her technology worked.

rn75223 karma

What do you think about Tim Draper still defending Elizabeth Holmes? Isn’t this very detrimental to the image of DFJ?

JohnCarreyrou379 karma

Yes, it's very bad for DFJ and I think associates and partners at DFJ are aghast and rolling their eyes behind the scenes. Draper represents the worst of Silicon Valley: enormous arrogance and hubris. His position seems to be that being an entrepreneur in SV with a cool idea excuses everything, even breaking the law and committing white collar crimes. I think 99.99% of people would disagree: SV startup founders should play by the rules we all have to play by. We get punished if we break the law; they should too.

GrizzleMeElmo193 karma

Your book was fantastic. I still had a lingering question, though. Did Theranos actually ever invent anything useful or push the micro sample technology forward in a meaningful way?

JohnCarreyrou298 karma

In a nutshell, not really. Their most ambitious attempt came in the early years when they tried to do microfluidics. But they hit a wall and she pivoted to the Edison, which was a glorified glue-dispensing robot. So you could say they abandoned trying to do something really game-changing as early as late 2007.

freewil182 karma

John - would love to see you on Joe Rogan’s Podcast to talk about Bad Blood. His audience is huge and I think the long-format would be great for drilling deeper into the psychology of Holmes and Balwani. Have you reached out yet?

JohnCarreyrou148 karma

Good idea.

model_citizens170 karma

Hi John, loved your reporting and the book. As a journalist, I know the WSJ news side has a fairly testy relationship with the WSJ editorial side, and that subtext was sort of part of the book: you noted how an uncritical WSJ editorial gave Holmes an early platform. Did the news and editorial sides ever have conversations with each other re: their respective Theranos coverage? Has the WSJ writer who wrote the early editorial ever expressed regret?

JohnCarreyrou250 karma

Joe Rago has unfortunately passed away. He was the writer who wrote that September 2013 Weekend Interview piece that put Holmes on the map. Joe was really smart and a great editorial writer, but he clearly didn't do any due diligence in that instance. And that's the difference between opinion journalism and reporting. I never write anything that I can't support with rigorous reporting.

There was never any contact between the news and opinion sides of the paper about Theranos until I went on book leave and reached out to Joe, who kindly helped me reconstruct how his interview piece came about.

I57i9143 karma

Hi John, loved the book and couldn't put it down.

I am awed by the courage of your sources, especially the most junior former staff of Theranos (Tyler and Erika). Have they been able to successfully move on in their careers?

I presume other large blood testing companies and scientists in universities had spent considerable funds trying to accomplish Elizabeth Holmes' initial idea. Why do you think they didn't do more to undermine the secrecy of Theranos' research and its lack of independent replication? It's astounding that EH and Sunny were able to fool so many people for so long through sheer bravado and lies.

JohnCarreyrou198 karma

1) My confidential sources, including Tyler and Erika, are doing very well. They have moved on and are having fruitful careers. Tyler just closed a first round of funding for a startup of his own.

2) A lot of people in diagnostics were suspicious and there were whispers. But no one had proof. It's hard to call someone's bullshit when you don't have proof they're bullshitting, especially when their lawyer is named David Boies.

NK_Schmidt129 karma

Were you ever concerned for your personal safety during the investigation? Second, what actions did Theranos take to surveil you (or your family) during the investigation?

JohnCarreyrou203 karma

It was a stressful period, but my stress was more linked to their efforts to destroy the scaffolding upon which my reporting was built by turning my sources than it was about my personal safety. I don't know whether Theranos ever surveilled me. I make a pretty convincing case in Bad Blood that, at the very least, they placed Tyler and Erika Cheung under surveillance. But I don't have any evidence proving that they also surveilled me.

ragingrage93 karma

If you could go back and give advice to yourself maybe 3-4 months before you publish that first story, what would it be? Do you feel your journalistic methodology stayed pretty much the same throughout (and it was just a matter of patience and doggedly hard work) or do you feel you improved/changed/grew as a journalist (or a person?) over the course of your work.

JohnCarreyrou192 karma

My advice to myself would have been "move faster" because these people are ruthless and they will pull every stop to squelch your investigation. We gave them too much time to address my questions and they used that time to go after my sources.

rn7588 karma

Can the threatened employees such as Tyler Schultz ask for financial compensation from Theranos?

JohnCarreyrou165 karma

They could, I suppose. But the money is quickly running out. Holmes has been using it to pay her and the company's legal fees for the past 2 1/2 years. I doubt she would agree to reimburse Tyler for the half-million dollars his parents spent on lawyers. That's not in her character. It would first take admitting that she committed fraud, which she refuses to do to this day.

SarahARolph86 karma

Loved the book. David Boies seems to have acted like a real thug. Was his behavior normal for a high-powered lawyer? Will his reputation suffer for his role here?

JohnCarreyrou158 karma

It was not normal behavior. The term "thug" is apt. I believe his legacy has already suffered greatly, not just because of his role in the Theranos affair but also because of what he did in the Harvey Weinstein scandal.

AloysiusRex76 karma

I read your book and was in absolute disbelief the prominent board members Theranos attracted. Was your sense one early director (Shultz) lent credibility to the company and thereby attracted more heavy hitters?

JohnCarreyrou104 karma

Yes, Shultz was crucial. He introduced her to all his buddies at Hoover. That's how she met Kissinger, Perry, etc. He also introduced her to Mattis as a Marine Memorial event in SF in 2011.

PepperoniFire70 karma

Can you see a world where Elizabeth Holmes postpones everything enough (e.g., where maybe there is far less investigative reporting) to "fake it 'til she makes it" and become another Silicon Valley success story? Or was it just too big a lie to be at all tenable?

JohnCarreyrou137 karma

I think she would have been found out eventually. The miniLab was years from being viable. To this day, they haven't gotten it to work with tiny finger stick samples. I don't how long it would have taken for her to be exposed, but the moment of reckoning would have come one way or another, especially if Theranos and Walgreens had expanded the partnership nationally (which was the plan). At that point, the number of faulty results would have skyrocketed, and doctors and patients would have raised alarm bells through the press or a regulator.

dontlemmedown65 karma

One of the themes of your book revolves around the hysterical excitement around biotech, and how so many of the people involved ignored certain signs or appeals because they were so focused on Saving The World. Looking at the business world right now, what's the next (or current) craze? Where are we not looking close enough?

(PS loved your book, thanks for stopping by!)

JohnCarreyrou129 karma

I think there's a lot of hype and craziness around self-driving cars. That technology is still a long way from being reliable and safe, but companies like Uber are already testing it on the roads with the disastrous consequences that you know.

freewil64 karma

It seems like the Theranos fraud was equally perpetuated by both Holmes and Balwani. What led to Balwani leaving the company in 2016? Was the relationship strained by legal issues, the pressure of your reporting, or did Elizabeth start to see the bully tactics that employees had try to talk to her about? Was there any conflict? Do you have any insight into what the disagreement might have been about, if any, or maybe a series of things over time?

JohnCarreyrou122 karma

You're right that this was a fraud perpetrated by two partners in crime. But as I wrote in the epilogue of Bad Blood, Elizabeth always had the last say. When it started becoming apparent to her that she would have no chance of persuading people she was really trying to change the company's culture and fix its problems, she threw Sunny under the bus. She fired him and broke up with him. His departure was dressed up in a press release as voluntary retirement, but it wasn't.

oldspice7562 karma

How unusual do you think Theranos' attempts to silence employees and critics were, compared to other companies trying to cover up their scandals?

Why do you think George Shultz sided with Elizabeth Holmes over his grandson? Is her personality that charming or forceful?

Do you think that most of Theranos' employees realized that the company lacked innovative technology?

Do you think that Holmes, being so young at the beginning, could have been the more attractive front for Balwani?

Do you think that Theranos could have had a path to success if they had succeeded in shutting down bad publicity, or that their actual poor diagnostic testing would have taken them down sooner or later anyway?

JohnCarreyrou86 karma

1) Not that unusual, though you could argue Theranos went farther than most would.

2) For one thing, George Shultz has always been passionate about science, so he really wanted to believe that she had invented this game-changing technology. And yes, to some extent, I think he began to see her as his granddaughter. She really cultivated him. He was in his early 90s and I think was flattered that a young woman would spend so much time with him and seek his advice and counsel. She truly did charm him.

3) A lot of employees did realize it. What many did not know was that Theranos had hacked those Siemens machines and was using them for most of the blood tests it offered patients.

4) I think Balwani definitely thought Holmes was the much better figurehead for the company because she was young and a woman and a Stanford dropout. He was older and male. That made him a less attractive proposition to investors, the press and the public.

5) Already answered.

foxh8er52 karma

Hey John! Loved the book!

Do you think a bigger part of Holmes' "reality distortion field" was her pedigree as a Stanford dropout, or her family connections, or something else entirely?

JohnCarreyrou128 karma

I think both were part of it: the mystique of her ancestors being the Fleischmanns, who were the equivalent of today's billionaires at the turn of the 20th century (Don Lucas cited that as something that he took into account when he first met a 20-year-old Holmes); and the Stanford pedigree and connections (Channing Robertson, her Stanford engineering school professor, was her first enabler). But more than anything, it was the way she channeled Silicon Valley's cult of personality, this notion that young SV dropouts who go on to found startups walk on water and see around corners.

SarahARolph43 karma

I'm interested in hearing about your writing process. For example: How long was your book leave? Did you do a lot of additional reporting for the book or did you already have most of the information from your WSJ reporting? How do you organize your material, do you make an outline or use some other method? And what is your revision process like?

JohnCarreyrou77 karma

I took almost a year of book leave, which is roughly how long it took me to write the book. I had to do a ton of new reporting for the book. I basically reported and wrote simultaneously. When I started my book leave, I knew very little about the company's early years and wanted to reconstruct the whole story so readers would understand how things got to this point. I also wanted to build up suspense and make my exposure of the fraud the culmination of the narrative. I wrote a detailed outline to begin with, though I strayed from it some at times. I didn't do much revision because I sweat each sentence I write. I only write about 500 words a day on average.

AnlamK33 karma

What sort of regulatory reforms can prevent or aid in detecting earlier frauds like Theranos in the future? Has researching this company given you ideas for regulatory reform?

JohnCarreyrou73 karma

I don't know that any regulatory reforms will prevent future frauds like this one. People who are determined to cut corners and cheat will do so no matter what. The more important thing in my view is to punish this fraud to deter future fraudsters. That's why I think it was so important for the Justice Department to bring criminal charges. They're sending a message to Silicon Valley with this case: if you go too far with fake-it-til-you-make-it and lie to people and put them in harm's way, we will throw you in prison.

SecondRyan28 karma

Do you have any predictions about when a faulty Theranos test would have led to a death?

JohnCarreyrou95 karma

Theranos's faulty prothrombin time tests could easily have led to a death. For those unfamiliar with that test, it measures how fast your blood clots and doctors use it to determine dosage for patients on blood thinners. The wrong dosage, if it's too low, can results in blood clots and strokes. Too much blood thinner and you can bleed out.

duchessfancypants19 karma

Hi John! Have been watching the unfolding of Theranos since the first story broke while I was in journalism grad school and I am looking forward to reading the book, which I suggested to my current colleagues for our book club. I have two questions for you:

1.) The public has recently learned the extent that some powerful individuals will go (i.e. Harvey Weinstein) to keep tabs on people, including hiring outside security or investigative firms. Did you ever have a concern that Theranos/Holmes were doing something like that to you to such a severe extent? If so, did you ever think about your safety?

2.) I've noticed that you consistently point out that Holmes and Sunny Balwani were (are?) dating. Wondering what your thinking is in terms of why it's important to mention that when discussing the scandal?

JohnCarreyrou59 karma

I already answered the first question above. As to the second, I think the relationship--the fact that they were in one and living together--is important to understanding the whole picture. This is a woman and a man who were very close and did everything together and in coordination. She may try to claim at trial that Sunny led her astray, but the truth is that she was his willing partner at all times. They may have been 19 years apart, but she always had the last say. He was a terrible influence, but she embraced him. In the end, they're both equally guilty.

duchessfancypants9 karma

Also, any hopes of who plays you in the film? Are you consulting with the filmmakers in any way?

JohnCarreyrou32 karma

Yes, I'm a consultant on the movie. Those casting decisions are still a ways away. Vanessa Taylor needs to finish writing the screenplay first.

NRaush5 karma

Why did you choose those books to hold up your monitor ? Also, what are those books ?

JohnCarreyrou12 karma

This is someone else's office at Penguin Random House. I have not read those books...