Don't Forget Elizabeth Holmes
A new persona doesn't absolve Theranos founder of past harms
I opened the New York Times Sunday morning to find a full-page photo of Elizabeth Holmes staring at me. The black turtleneck and red lipstick were traded for a camel sweater and jeans. It reminds me of dressing defendants in sympathetic costumes for court.
The Sunday Business title reads, “Liz Holmes wants you to forget about Elizabeth. As she awaits prison, the convicted Theranos founder has adopted yet another persona: devoted mother.” The next two full pages of the article include an intimate account of the author’s time with the convicted start-up founder, accompanied by another giant photograph of Homes with her husband and kids saturated in beachy light.
It’s a shockingly positive piece considering the mountains of evidence against Holmes and her admission her entire founder persona was a lie. I’m sure Elizabeth Holmes would love everyone to forget how she defrauded people and put patients in harm’s way with Theranos’ fake lab tests. (If you manage to read the whole essay, you can see how Ms. Holmes still seems *very* delusional about science and her potential future contributions.)
I’m not ready to forget.
Fall of a Silicon Valley Celebrity
It’s weird for me to look at Ms. Holmes. We are about the same age and look similar with blue eyes and blondish hair, but our lives couldn’t be more different. While I was finishing college, working in clinical and research ethics, and then training to be a physician, she dropped out of Stanford.
She built an empire around an unbelievable idea - that she could perform hundreds of laboratory assays on a few drops of blood.
After leaving the Bay Area for medical training in Chicago, my partner and I followed the boom and bust cycles of Silicon Valley. I remember hearing about Theranos’ $45 million round of funding in 2010. The company was a unicorn, even rarer for being a biotech startup rather than a software or social media company.
As I gained more personal experience in point-of-care testing (lab tests we do at the bedside), I couldn’t understand how her claims could be valid. Often, laboratory equipment needs a certain volume of blood to give an accurate result. The testing I do in the operating room doesn’t take that much blood, but we are limited in how many tests we can conduct on such a small sample. We also get a lot of training on the shortcomings of individual results and sometimes send larger vials of blood to the laboratory to confirm the results.
Was I suffering a failure of imagination?
Too soon after, Theranos announced a partnership with Walgreens, where they would use thousands of real patient samples. I was floored. No robust data was publicly available on any one test, let alone on the high number of tests they claimed to perform.
When my family returned to the Bay Area for my anesthesiology fellowship at Stanford in 2014, Holmes was at the height of her fame, gracing countless magazine covers with her teeny-tiny test tubes. My partner interviewed for a job at Theranos, and everything about it felt off. The experience was so clandestine (even compared to the ultra-secretive Apple interview process) and left him feeling so unsettled that we knew he shouldn’t work there.
A year later, John Carreyrou published the Wall Street Journal article that toppled the Theranos house of cards. The company collapsed by 2016.
The world’s youngest female self-made billionaire became the plaintiff in an 11-count indictment from the federal government.
When the documentaries started rolling out about Holmes, HBO plastered El Camino Real (Silicon Valley’s main drag) for miles with posters portraying Holmes as our homegrown villain.
Not a Feminist Martyr
Sexism in STEM industries is common. As a result, women-led start-ups struggle to get funding and press coverage.
There’s plenty of misogyny to go around in the Holmes case.
I’m not surprised that Holmes adopted a lower voice and Steve Jobs’ adjacent wardrobe to be taken more seriously as a young woman in a male-dominated culture. It wasn’t lost on me when she was accused of getting pregnant to delay her trial and sentencing.
“Women CEOs are proactively taken down based on behavior that men don’t even get noticed for, while men are retroactively taken down based on extreme missteps that have already come to light.” - Gender Disparities In CEO Takedowns
While gender bias is real, it doesn’t change the fact that Holmes’ company had a product they knew didn’t work and still foisted it on human beings trying to make important health decisions.
Being a woman and a mother doesn’t absolve Holmes’ massive fraud, conspiracy, and patient harm.
Lots of Mothers Go To Prison
I take no joy in imagining the harm Elizabeth Holmes and her children will suffer from their forced separation when she goes to prison.
Incarceration separates hundreds of thousands of parents from their children. For example, 58% of all women in U.S. prisons are mothers. According to the Prison Policy Initiative, 80% of the women who will go to jail are mothers. Fifty-five thousand pregnant women will begin their jail and/or prison time. Many are stuck in jail because they can’t afford bail. Most women are also primary caregivers for their children, leaving their kids with uncertain and unstable care.
Yet the masses of incarcerated women do not get three-page spreads in major newspapers.
Professional photographers do not capture these mothers on the beach with their families. They do not get a personality re-brand in the New York Times. They will not avoid jail to care for their children. Their incarceration will not be delayed.
These mothers will spend Mother’s Day incarcerated, alone.
Fraud and Patient Harm
Elizabeth Holmes isn’t looking to be forgiven for some minor lapses in judgment. Her business and fame choices would have harmed even more people if the fraud had carried on.
About a year after Theranos started testing actual patient samples, physician complaints and concerns about testing accuracy became unavoidable.
Christian Holmes, Ms. Holmes’s brother who managed physician complaints, told his sister in a September 2014 email that “there seem to be issues with their accuracy,” referring to certain lab tests, and asked if the company should stop the tests because doctors were asking questions about the results.
While Theranos offered 200 tests to consumers, only 12 were done using their technology - and stopped using their Edison device in 2015. Federal investigators found the tests rarely met the company’s internal accuracy standards. So they ultimately voided two entire years’ worth of tests - though they delayed notifying patients and doctors.
When Holmes presented to the American Association of Clinical Chemistry (AACC) in August 2016, the audience was appropriately skeptical. Expert panelist Stephen Master, MD, PhD, told reporters, “It is certainly not yet a game changer…I certainly didn’t see anything that lives up to the expansive claims they made.”
Bad Blood
If you’re unfamiliar with Theranos or forgot the details, now is an excellent time to dive into John Carreyrou’s Bad Blood or watch HBO’s The Inventor.
You can be a parent and love your children, own a dog, take lovely photographs, and commit heinous, unethical acts. Fraudulent medical research and inaccurate testing on human beings should not be swept aside with glossy reputation rehab. Elizabeth Holmes does not deserve special treatment just because she was once a Silicon Valley celebrity or because she has become a parent. Being a mom now doesn’t change the harmful choices she made while running her unicorn biotech company.
We must remember the evidence about Elizabeth Holmes and Theranos, no matter how different she may wish to be seen now.