But when Tevanian raised doubts about the technology, Holmes ignored him and then instructed another board member to ask him to resign. ‘I was done with Theranos,’ he said. ‘I had seen so many things that were bad go on, I would never expect anyone would behave the way that she behaved as a CEO. And believe me: I worked for Steve Jobs. I saw some crazy things. But Elizabeth took it to a new level.’
Yet despite the setbacks and the dysfunctional culture in Theranos, Holmes seemed bulletproof.
The one percenters in her thrall
In 2011 she was introduced to George Shultz, who agreed to join the Theranos board, enthusing in interviews that Holmes was ‘the next Steve Jobs or Bill Gates’. Shultz opened the door to other board members and investors, including Henry Kissinger; the former US senator Sam Nunn; William J Perry, a former defense secretary; and America’s most famous soldier, General James ‘Mad Dog’ Mattis, who would later serve as secretary of defense under Donald Trump.
All were powerful older men with little to no expertise in the worlds of medicine or tech, but who seemed in thrall to Holmes and the revolutionary promise of Theranos. In a 2014 New Yorker profile of Holmes, Kissinger rhapsodised about her ‘sort of ethereal quality – that is to say, she looks like 19. And you say to yourself, “How is she ever going to run this?”’ His answer was, ‘by intellectual dominance; she knows the subject’.
For Holmes, the array of powerful and influential figures on the board also served as an insurance policy against the medical authorities becoming too inquisitive about her claims. Who would question a company that had Kissinger and ‘Mad Dog’ Mattis on the board?
By now, Theranos had struck up a partnership with the giant pharmacy chain Walgreens to instal the Edison device in ‘Wellness Centers’ in branches across America. Holmes claimed the Edison would be capable of performing up to 200 tests in a few minutes, for everything from STIs to cancer – and at half the cost of conventional lab tests.
But the claim was untrue. The Edison was able to provide only a small fraction of the tests that Theranos claimed it could.
In an attempt to work around the inadequacies of the device, Theranos acquired conventional testing machines manufactured by Siemens and other companies, hacking them in an attempt to analyse the single blood samples. When prospective investors came to the Theranos lab, a blood sample would be taken and fed into the Edison. The customer would then be ushered out of the lab, led on a tour of the offices and given a seductive sales presentation – while their blood sample was furtively hurried downstairs for tests on the other machines, before the customer returned to be given the results.
Holmes assured Walgreens that the technology was ‘viable and consumer-ready’. But that claim was false. Only a single Theranos test, for herpes, was approved by the Food and Drug Administration (FDA).
‘A big unauthorised research experiment’
One Theranos employee, appalled at the deception, described going live in Walgreens as being tantamount to ‘exposing the general population to what was essentially a big unauthorised research experiment’.
Walgreens would also subsequently state that in selling it the Theranos package, Holmes had further asserted the technology had been used by the US military in Afghanistan – a claim she had repeated various times, including to Shultz. In 2017, in an investigation by the Securities and Exchange Commission (SEC) into whether she had helped to orchestrate an ‘elaborate, years-long fraud’, Holmes was asked whether Theranos technology was ever ‘deployed in emergency rooms, hospitals, on the battlefield or in medevac helicopters’. She admitted the claim was untrue.
Theranos technicians made frantic attempts to modify the Edison to match the promise, but by the time the device was being installed in Walgreens pharmacies in 2013, it could still manage only a handful of tests. Furthermore, some customers were angry at receiving venipuncture (using a needle to draw blood) rather than a single finger-prick test, and alarmed to get results suggesting they were suffering from serious conditions, which were contradicted when they checked by having independent tests done.
Nonetheless, the Walgreens deal was sufficiently impressive – or at least appeared to be – to enable Theranos to raise a further $650 million from a raft of new investors. Rupert Murdoch invested $125 million, the largest investment he had made outside the world of media. The Mexican media magnate Carlos Slim invested $30 million. The DeVos family, one of America’s wealthiest, invested $100 million. And it was not just the super-wealthy; any number of smaller investors put their faith, and money, into Theranos. If Murdoch and Slim were prepared to back Holmes, how much of a risk could it be?
‘The story was great, and still would be great if it were possible’
‘Quite simply, people didn’t ask hard questions,’ says Reed Kathrein, a California lawyer who would later litigate against Theranos on behalf of eight private individuals who invested $60,000 to $500,000 in the company – in at least two cases, their entire life savings. ‘Elizabeth created an aura of credibility around her by associating herself with people like George Shultz and other political, well-known people who had credibility. And if anyone dared ask to see what was inside the black box, she’d tell them, “Well, there’s plenty of other people behind you waiting to invest, we don’t need you.”
‘The story was great, and still would be great if it were possible – people would flock to these kinds of blood tests if they could be done – and she sold it with such a great appearance of honesty and conviction that people believed her. Sincerity just flows off her: sincerity, false empathy, charm… she’s amazingly charming.’
As money poured into the company, Holmes began to behave like the magnate she had always dreamt of being. She became wildly profligate. She flew by private jet with a posse of assistants, security guards and a personal chef. She retained a personal publicist supposedly on $25,000 a month. By 2014 Theranos had 700 employees and was valued at $9 billion; the Forbes 400 list estimated Holmes’s personal worth at $4.5 billion.
She appeared at healthcare conferences, producing a nanotainer from her pocket and holding it up, like a priestess offering holy wine at communion, and repeating one of her favourite lines about seeing ‘a world in which no one ever has to say, “If only I’d known sooner.” A world in which no one ever has to say goodbye too soon.’
By 2015 Walgreens had 40 testing centres in pharmacies in California and Arizona. Holmes was named in Time magazine’s list of the 100 most influential people; President Obama appointed her as a Presidential Ambassador for Global Entrepreneurship, and in April 2015 she was a guest at a White House dinner for the visiting premier of Japan, Shinzo Abe. But the cracks were beginning to appear.