Alex Gibney creates compelling portraits of zealots in his documentary oeuvre. His latest person of interest, Elizabeth Holmes of Theranos, is particularly engaging because, for a time, she embodied the vision and values we all aspire to. She believed in revolutionizing healthcare, democratizing access to our own records, and prevention of devastating illness. She created a machine that promised to test small samples of blood for hundreds of maladies in just minutes. This machine would break oligopolies and calm fears about medical procedures. Gibney’s The Inventor: Out for Blood in Silicon Valley examines Holmes in all her deceptive magic. We wanted so badly to believe in her invention, in her.
This visually enticing, quirky, funny, and thought-provoking film offers complex and thrilling exposition, but it also poses big and abstract questions. That’s quite an accomplishment, considering the subject of the film is so opaque. And by subject, I mean Holmes and the medical procedures and technical logistics involved in any Theranos breakdown. Nuanced chemical and thermodynamic data could make anyone cross-eyed. I will do my best not to seem like the film studies yokel that I am in describing all this. I may or may not just say “blood stuff” a lot.
The Inventor uses early cinema footage, strategic graphics, and evocative clips to help viewers digest information about the once $10 billion dollar company. Images of horrifying gore and broken glass inside of the malfunctioning machine are particularly effective in showing how far reality was from the vision. And essentially, the fraud of Theranos rests with its “Edison” machine. Chemists and engineers couldn’t quite reconcile the automation of blood testing in such a small container and with such small amounts of blood. Even when the machine worked, the results were filled with errors and disturbing variability. Most of the time, lab associates had to scramble to do tests manually or use third-party machines instead. Then they used those workaround results to submit for regulatory approval of their machine. It was an unsustainable deception.
Holmes and other managers wouldn’t listen to lab technicians or engineers when they questioned the viability of the prototype. The hubris of business had taken over. Momentum built, deals with the federal government and Walgreens preceded the technology, but no matter! If invention is always initially about failure and deception and flawed prototypes, it’s hard to differentiate it from fraud anyway. But at a certain point, “fake it till you make it” is put into hard practice, and jeopardy begins. Misdiagnosing people became a scary reality with this particular machine. In the end, only 15 of over 200 tests offered could even be attempted via the Edison.
Holmes placed herself center stage in this story of invention. She was driven by personal loss, an uncle whose diagnosis came too late. She immersed herself in the engineering and entrepreneurial spirit of Stanford and started filing patents for idealistic solutions to medical problems. She launched Theranos when she was 19. Holmes adopted the look and persona of a tech startup professional and started converting everyone around her. It was almost as if a robot was loaded with a Steve Jobs disc under a “healthcare” setting. The film examines her closely and describes her many uncanny attributes, literally unblinking and intense and singularly driven. Holmes supposedly also deepened her voice to seem more authoritative, but this isn’t addressed in the film. Perhaps the conspiracy theory veers too far into femme fatale territory, so that’s fair.
There was a humanist thirst for Holmes’ idea. American healthcare is, after all, a quagmire of greed and gatekeeping that nobody other than Barack Obama can alter. She in fact surrounded herself with gatekeepers so she could jump some hurdles. Her company’s board was filled with fancy gentleman politicos, including former Secretaries of State Henry Kissinger and George Schultz and General James Mattis.
One of my favorite asides in the film involves Schultz’s boyish grandson Tyler, who worked in the labs at Theranos. He blows the whistle on the lab’s “sinking ship” only to be brutally rebuffed. For a time, even his family thought he was a privileged handsome idiot who just didn’t get what was happening at the company. My alternate title for this review was “Handsome Grandson Vindicated.” Journalists who investigated claims made by company insiders like Tyler are interviewees. They are crucial to understanding the unwinding of illusions. John Carreyrou of The Wall Street Journal, Roger Parloff of Fortune, and Ken Auletta of The New Yorker feature prominently, along with informants. The stories broke in 2015, and Theranos finally dissolved in 2018 amidst conspiracy and fraud charges.
Despite all this, my attitude upon completing the film was bittersweet. What a missed opportunity! So much good intention, just in an inappropriate context. Medical advancements, usually slow because of repeated quality control experiments and peer review processes, did not work with the accelerated timeline and grand projection of startup culture. But what if they had slowed down and limited their offerings? What about those 15 tests that could still possibly work via the Edison? What a pity to oversell and obfuscate something with real sparks of potential. But, then again, maybe I’m just a zealot too.