Elizabeth Holmes: The Woman Who Convinced Everyone She Was the Next Steve Jobs
By Trinity Barnette
Who Was Elizabeth Holmes Before Theranos?
Before the black turtlenecks, the suspiciously deep voice, the piercing blue eyes, and the multibillion-dollar company that would eventually land her in federal prison, Elizabeth Anne Holmes was an incredibly ambitious little girl who seemed pretty convinced that she was going to do something important with her life.
Holmes was born on February 3, 1984, in Washington, D.C., to Christian Holmes IV and Noel Anne Daoust. She grew up in a family where achievement—and particularly the idea of living a purposeful life—appears to have been taken pretty seriously. Her father worked in government and humanitarian-related positions, including roles with USAID, the State Department, and eventually Enron, while her mother had previously worked as a foreign policy and defense aide on Capitol Hill. On her father’s side, Holmes also descended from the family behind the Fleischmann Yeast fortune, although much of that wealth had reportedly disappeared generations before Elizabeth was born. Still, the stories remained. Holmes later recalled growing up hearing about greatness and what happened to people who failed to spend their lives doing something meaningful.
In other words, this was not exactly a household preaching, Just find something that pays the bills and makes you happy, sweetheart.
And Elizabeth apparently took the message to heart.
From an early age, she was intensely ambitious. Holmes later described herself as an unusual child, recalling that she read Moby-Dick from beginning to end around age nine and once designed an entire time machine in a notebook when she was approximately seven years old. She credited her parents with raising her in an environment where nobody told her that her ideas were impossible.
Her father’s career also meant that the Holmes family moved several times, which reportedly made maintaining long-term friendships difficult. Holmes described herself as a “happy loner” who spent time collecting insects and fishing with her father. As she got older, that independence apparently didn’t disappear.
While attending St. John’s School in Houston, Texas, Holmes developed a reputation for being extraordinarily determined—even when she wasn’t particularly good at whatever she was determined to do. One of her former classmates, Megan Long, later recalled Holmes running distance on the school’s track team. According to Long, Holmes consistently finished last.
And yet, she always finished.
Honestly, I think that’s one of the more interesting details about her childhood—not because losing track meets somehow foreshadows committing wire fraud, because that would be ridiculous—but because the stubbornness is a personality trait that will become extremely relevant later. Elizabeth Holmes did not seem particularly interested in being told when something wasn’t working.
Socially, she was apparently much more reserved. Long described Holmes as “disconnected” from the other girls at school and remembered her as intensely private and focused on her studies. Those studies weren’t exactly light either. Holmes learned Mandarin and developed an interest in computer programming while still young.
Her interest in Mandarin would eventually help her get into a Stanford summer program in Beijing, but the motivation behind all of this seems to have been larger than simply getting into a good college. Holmes had already developed an obsession with doing something big.
Her father’s work appears to have played a role in that. Holmes later recalled growing up surrounded by photographs of children living in difficult conditions because of Christian’s disaster-relief work. Initially, she imagined herself pursuing something similar. Eventually, however, she became interested in another way of changing people’s lives: building a company.
That distinction matters.
Elizabeth Holmes didn’t just want a successful career.
She wanted impact.
She wanted to build something.
She wanted to change the world.
And eventually, she would convince a staggering number of extremely wealthy, extremely powerful and, theoretically, extremely intelligent people that she had done exactly that.
But first, she had to get to Stanford.
Stanford, Sunny, and the Beginning of an Idea
In 2002, Elizabeth Holmes arrived at Stanford University to study chemical engineering.
For most teenagers, getting into Stanford would probably qualify as enough of an accomplishment for the time being. Elizabeth Holmes, as we have already established, was not particularly interested in doing things normally.
Before beginning her freshman year, Holmes participated in a Mandarin language program in Beijing, China. It was there that 18-year-old Elizabeth met a man who would eventually become one of the most important—and controversial—people in both her personal life and the Theranos story: Ramesh “Sunny” Balwani.
And yes, his government name is Ramesh. We are going to be calling him Sunny for the remainder of this article, but I needed everyone to know what we were working with first.
Balwani was approximately 19 years older than Holmes and was pursuing an MBA at the University of California, Berkeley when the two met. Unlike the teenage Holmes, Sunny had already lived quite a bit of adult life. He had worked in the technology industry, had been involved with a software company that was sold during the dot-com boom, and had accumulated considerable wealth. He was also married at the time he met Holmes.
Their first meeting didn’t immediately turn them into the secretive Theranos power couple we’ll eventually come to know. Their relationship developed over the following years, with reports generally placing the beginning of their romantic relationship around 2004, after Holmes left Stanford. By 2005, they were reportedly living together.
Sunny won’t officially join Theranos until years later, so we’re going to leave Mr. Balwani on the sidelines for a minute. Don’t worry. He’ll be back.
At Stanford, meanwhile, Holmes quickly began pursuing the kind of work she’d spent her childhood dreaming about.
During the summer following her freshman year, Holmes worked at the Genome Institute of Singapore, where she was exposed to laboratory testing involving blood samples. When she returned to Stanford, she began developing ideas for medical technology of her own. She filed a patent application for a wearable drug-delivery device that she envisioned being capable of monitoring a patient’s blood, identifying potential problems, and administering medication accordingly.
One of the professors who became particularly important to Holmes was chemical engineering professor Channing Robertson. Robertson would eventually become one of Holmes’s earliest and most influential supporters, lending something incredibly valuable to a teenage entrepreneur trying to enter an industry she had very little experience in: credibility.
And we’re going to see a lot of that as this story progresses.
Elizabeth Holmes was extremely young. She did not have a medical degree. She had not completed her undergraduate degree. She had never successfully built a medical device company.
But she was extraordinarily good at finding accomplished people who believed in her.
And once accomplished people believed in Elizabeth Holmes, other accomplished people became much more willing to believe in Elizabeth Holmes.
That pattern will eventually become one of the most important parts of the Theranos story.
By 2004, Holmes had decided that sitting in a Stanford classroom wasn’t the fastest route to changing the world. At just 19 years old, she dropped out of Stanford during her sophomore year and used the money her parents had saved for her education to pursue a company instead. Source: CNN Source: The Straits Times
And listen.
I am 20 years old while writing this.
The idea of dropping out of college tomorrow and informing everyone that I will instead be revolutionizing the healthcare industry is fucking insane to me. I still have to Google things I learned in class three weeks ago.
But Elizabeth didn’t seem particularly concerned by the fact that she was 19, had no completed degree, and was attempting to enter one of the most scientifically complicated and heavily regulated industries imaginable.
She had an idea.
The basic concept was seductive in its simplicity: What if blood testing didn’t have to require large needles, multiple vials of blood, expensive laboratories, and long waits for results? What if dozens—or eventually hundreds—of tests could instead be performed using only a tiny amount of blood taken from the tip of your finger?
For someone who reportedly disliked needles herself, Holmes believed there had to be a better way.
And if she could build it, she wouldn’t merely have a successful startup.
She could fundamentally change medicine.
So Elizabeth Holmes left one of the most prestigious universities in the world at 19 years old, took her tuition money, and bet it on herself.
Her first company was called Real-Time Cures.
That name wouldn’t last.
The idea would.
Soon, Real-Time Cures would become Theranos—a combination of the words therapy and diagnosis.
And Elizabeth Holmes was about to begin convincing some of the most powerful people in America that she had invented the future.
The Birth of Theranos
When Elizabeth Holmes dropped out of Stanford at 19 years old, she wasn’t leaving because she had failed.
She was leaving because she believed she had something more important to do.
Holmes founded the company that would eventually become Theranos in 2003, initially calling it Real-Time Cures. Her earliest concept wasn’t actually the tiny blood-testing machine that would later make her famous. She initially envisioned a wearable patch that could continuously monitor a patient’s blood, detect abnormalities, and deliver medication accordingly.
It was an extraordinarily ambitious idea.
It was also being proposed by a teenager who had completed approximately one year of college.
Eventually, Holmes’s focus shifted toward blood testing itself. Real-Time Cures became Theranos, a name created by combining the words therapy and diagnosis, and Holmes began developing the idea that would eventually make her one of the most celebrated entrepreneurs in Silicon Valley.
Blood testing—but supposedly better.
And honestly, the pitch was fucking fantastic.
Traditional laboratory testing often requires blood to be drawn from a vein and sent through established laboratory equipment. Holmes envisioned something dramatically different: patients would have their fingers pricked, only a tiny amount of blood would be collected, and Theranos’s proprietary technology would supposedly be capable of performing numerous laboratory tests from that small sample.
Think about how revolutionary that would be if it actually worked.
People afraid of needles could avoid traditional blood draws. Testing could potentially become faster, cheaper, and more accessible. Patients could theoretically receive an enormous amount of information about their health from a few drops of blood.
Holmes wasn’t pitching another Silicon Valley app that delivered your lunch fifteen minutes faster.
She was promising to fundamentally change healthcare.
And people started listening.
One of the earliest people whose belief in Holmes mattered tremendously was her former Stanford professor, Channing Robertson. His support gave the teenage entrepreneur something she desperately needed: credibility.
Because there was one extremely obvious issue with Elizabeth Holmes positioning herself as the woman who was going to revolutionize laboratory medicine.
Elizabeth Holmes was not a doctor.
She wasn’t an experienced medical researcher.
She hadn’t completed a bachelor’s degree.
She was a 19-year-old Stanford dropout attempting to revolutionize an extraordinarily complicated scientific industry.
But Holmes was developing a talent that would prove almost as important to the rise of Theranos as the technology itself: getting accomplished people to believe in her.
One impressive person believing Elizabeth made the next impressive person more comfortable believing Elizabeth. Every respected person who attached their name to Theranos gave the company another layer of legitimacy.
It created a fascinating cycle.
Why should I trust this 19-year-old?
Well, that incredibly successful person trusts her.
And if they trust her, surely someone has made sure this shit actually works.
Right?
Holmes also had something every ambitious startup founder desperately needs:
Money.
One of Theranos’s earliest investors was venture capitalist Tim Draper, whose daughter had been Holmes’s childhood friend. Draper’s investment helped Holmes begin attracting outside funding, and Theranos would eventually raise hundreds of millions of dollars from an extraordinarily wealthy collection of investors.
And this is where I start becoming fascinated by the people surrounding Elizabeth almost as much as Elizabeth herself.
Because imagine the pitch.
A teenager who dropped out of college after roughly a year is telling you she intends to completely transform diagnostic medicine using technology that could supposedly perform numerous blood tests using a fraction of the blood traditionally required.
And instead of responding, That’s fascinating. Can an independent laboratory scientist please show me that it works?
People started writing checks.
To be fair, Holmes wasn’t selling complete nonsense as a concept. That’s precisely what made Theranos so compelling. If somebody really could make reliable laboratory testing dramatically faster, cheaper, less painful, and more accessible, the implications would be enormous.
The problem wasn’t that the dream sounded terrible.
The problem was going to be proving that the dream actually worked.
And Theranos was becoming an extraordinarily secretive place in which to answer that question.
Now, secrecy by itself does not make a startup fraudulent.
Obviously.
If I spend ten years inventing a machine that makes me a billionaire, I’m probably not leaving the blueprints sitting beside the office Keurig either.
Companies protect intellectual property.
But as we’ll eventually see, Theranos’s secrecy went much further than protecting trade secrets.
Meanwhile, the promise was getting bigger.
That distinction is important: those were allegations in the federal indictment, not proof that Holmes had been running a deliberate fraud from the moment she founded Theranos. We’ll get to what prosecutors ultimately proved at her trial much later.
For now, we’re still watching the promise develop.
The device that became synonymous with Theranos’s technology was called the Edison.
Yes.
Edison.
Because apparently subtlety had already left the building.
The challenge facing Theranos, however, was significantly more complicated than simply making a smaller blood-testing machine. Different laboratory tests rely on different chemical reactions, methodologies, equipment, sample requirements, and preparation procedures. Theranos wasn’t merely trying to shrink something that already existed.
It was attempting to make an enormous variety of testing work reliably using extremely small quantities of blood.
That is a considerably harder problem than tiny machine go brrrr.
And while Theranos worked on its technology, Holmes continued building something else remarkably effectively:
Theranos’s reputation.
That dynamic is going to become absolutely insane as we move forward.
Elizabeth Holmes was young.
She was charismatic to the people she needed to charm.
She had an enormous mission.
She had respected people validating her.
She had investors giving her money.
And every new person who believed in Theranos made it slightly easier for the next person to believe too.
At 19 years old, I was worried about college assignments.
Elizabeth Holmes was walking around Silicon Valley essentially saying, Hello, I have decided to revolutionize diagnostic medicine. Would you like to invest?
And these people were saying yes.
The money grew.
The company grew.
The promises grew.
And eventually, Elizabeth Holmes wouldn’t simply be treated like another Silicon Valley founder.
She would be treated like a visionary.
There was just one tiny, microscopic, somewhat inconvenient issue standing between Elizabeth Holmes and becoming the next Steve Jobs:
The technology had to actually fucking work.
Becoming the Next Steve Jobs
At some point, Elizabeth Holmes stopped being simply the founder of Theranos.
She became Elizabeth Holmes™.
The black turtlenecks. The red lipstick. The unnaturally deep voice. The intense speeches about changing the world. And, of course, those enormous piercing blue eyes that looked like they were attempting to access the contents of your fucking soul.
None of this is particularly subtle in hindsight.
Especially the Steve Jobs part.
Holmes became famous for wearing black turtlenecks reminiscent of the late Apple cofounder, whom she openly admired. Her fascination with Jobs apparently extended far beyond sharing a wardrobe preference. Notes belonging to Holmes that surfaced during her criminal trial included the words “Becoming Steve Jobs.”
Girl.
You could’ve at least written becoming better than Steve Jobs or something.
Instead, we’re apparently putting BECOMING STEVE JOBS in the manifestation journal.
And to be fair, there were obvious similarities between the story Holmes was creating for herself and the mythology surrounding Jobs. Both were college dropouts. Both positioned themselves as visionaries disrupting established industries. Both understood the value of simplicity when explaining complicated technology. Both became heavily associated with a particular personal aesthetic.
But Holmes had something Steve Jobs never did.
She was a young woman trying to become one of the most powerful people in Silicon Valley.
And that became an enormously important part of her story.
The technology industry was—and remains—overwhelmingly associated with male founders. Holmes offered the media something different: a young female entrepreneur who wasn’t merely succeeding in Silicon Valley but was supposedly building technology capable of changing healthcare itself.
Elizabeth Holmes wasn’t being presented as a successful woman.
She was being presented as the woman who proved women could build the next world-changing technology company too.
And Holmes looked the part.
Or, more accurately, she created the part.
One of the most recognizable components of Holmes’s public persona was her extraordinarily deep voice. If you’ve never actually watched an Elizabeth Holmes interview and have only read about her, I strongly encourage you to listen to one because describing the voice does not adequately prepare you for The Voice™.
It is deep.
Not slightly deep for a woman.
I’m talking Good evening, Gotham City deep.
For years, speculation followed Holmes about whether the voice was natural or deliberately lowered. But Holmes herself has since spoken about the broader artificiality of the person she presented during the Theranos years.
Which honestly explains quite a bit.
Because watching old Elizabeth Holmes interviews now is a bizarre fucking experience.
Maybe hindsight is doing some of the work here. I already know how this story ends, so obviously I’m watching her differently than someone sitting in an audience in 2014 who genuinely believed they were looking at the future of healthcare.
But I cannot understand how this woman walked into rooms full of billionaires, stared directly through their souls with those piercing blue eyes, spoke in that unnaturally controlled cadence about changing humanity, and walked out with their money.
I would have had approximately seventeen follow-up questions, and at least twelve of them would have been variations of:
Why are you looking at me like that?
Because THE EYES.
If you’ve watched her interviews, you know exactly what I’m talking about.
Holmes had an incredibly intense style of eye contact. She could seemingly lock onto the person interviewing her and just…stay there.
👁️👁️
Ma’am.
Blink.
Please.
I’m uncomfortable.
And before somebody turns this into TikTok University psychology: not blinking does not mean someone is lying.
Neither does staring at someone.
Neither does having unusual facial expressions.
Body language isn’t a magical fraud detector, and I’m not about to diagnose this woman through archival footage because she looked at people strangely.
I’m simply saying that personally, if Elizabeth Holmes had been sitting three feet away from me maintaining that level of eye contact, we would have needed to address it before discussing my investment.
But the persona clearly worked differently on the people Holmes actually needed to impress.
And this is where the Elizabeth Holmes story becomes more complicated than weird woman somehow tricks rich people.
Because Holmes wasn’t simply walking into meetings and hypnotizing billionaires with her eyeballs.
By the time Theranos reached its peak, she had spent years constructing an enormous network of credibility around herself.
She had investors.
She had respected advisers.
She had influential supporters.
She had business partnerships.
She had glowing media coverage.
And every additional layer made the next layer easier to acquire.
The Stanford dropout wasn’t merely telling you she was brilliant anymore.
Other important people were telling you she was brilliant.
The media increasingly presented Holmes as a visionary entrepreneur. The Steve Jobs comparisons became part of her mythology. Her age made her story more remarkable. Her gender made her success particularly significant in Silicon Valley. Her secrecy made Theranos seem mysterious and innovative rather than necessarily suspicious.
And the company’s enormous promises gave journalists an irresistible story.
Here was a young woman who supposedly looked at one of medicine’s oldest, most routine procedures and said:
I can do this better.
That is a fantastic story.
There’s just one problem with fantastic stories.
Eventually, reality gets a turn.
Elizabeth Holmes had successfully created the image of a visionary founder.
Theranos had successfully created the image of a revolutionary healthcare company.
And Silicon Valley was becoming increasingly willing to treat Holmes like the second coming of Steve Jobs.
Meanwhile, behind the black turtlenecks, magazine profiles, carefully controlled interviews, and those goddamn eyes, employees inside Theranos were confronting a considerably less glamorous problem.
The technology still had to fucking work.
Meanwhile, Inside Theranos…
From the outside, Theranos was becoming one of the most exciting companies in Silicon Valley.
Inside the company, there was a considerably less exciting problem.
Blood is fucking complicated.
Elizabeth Holmes’s pitch made the science sound beautifully simple: prick a patient’s finger, collect a tiny amount of blood, place it inside a Theranos device, and receive accurate results for an enormous range of laboratory tests.
Tiny sample.
Tiny machine.
Lots of tests.
Healthcare revolution.
Except shrinking the amount of blood being collected did not magically shrink the complexity of laboratory medicine along with it.
Basically, blood testing isn’t one universal process where you insert blood, press GO, and the machine tells you everything happening inside someone’s body.
Which is unfortunate because that’s essentially the future Theranos was selling.
The company’s proprietary analyzer became known as the Edison.
And this distinction becomes incredibly important:
Theranos did develop technology that could perform some testing.
This wasn’t a cardboard box with blinking Christmas lights that Elizabeth carried into investor meetings.
The problem was the enormous gap between developing a machine capable of performing some tests and developing a machine capable of reliably performing the massive range of tests Theranos’s broader vision promised.
Those are two very different accomplishments.
And Theranos had another option when its own technology couldn’t perform a particular test.
Existing laboratory machines.
You know.
The big traditional machines Theranos was supposedly making significantly less necessary.
One manufacturer whose equipment became particularly important was Siemens.
And this is where things start getting fucking ridiculous.
So imagine being sold the following story:
We have invented revolutionary proprietary technology capable of changing blood testing forever.
Meanwhile, somewhere inside Theranos:
Siemens: 👁️👄👁️
Even that description needs another layer, though, because the issue wasn’t simply that Theranos owned conventional laboratory equipment. Using commercially available equipment isn’t inherently suspicious. Laboratories use equipment made by other companies every day.
The important question was what Theranos was telling investors, business partners, doctors, and patients about how its testing was actually being performed.
And, eventually, that question would become extremely important to federal prosecutors.
The technical problem also created an incredibly awkward reality.
Theranos’s entire brand was built around needing less blood.
Traditional machines were generally designed to work with larger samples.
So if you have a tiny amount of blood but need to run it through equipment designed for something else, you have to somehow make those two things compatible.
Theranos’s solution included dilution.
Samples could be diluted so there was enough volume for conventional analyzers to process them.
Which sounds simple until you remember we’re discussing medical testing.
Diluting a sample also dilutes whatever you’re attempting to measure.
And now the laboratory has to accurately account for that while producing a result reliable enough for a physician to potentially make medical decisions from it.
This was no longer:
Can we make the machine work?
It was:
Can we make the machine work accurately enough that a human being can trust what it says about their body?
That is a significantly more serious question.
Because Theranos wasn’t selling Spotify Premium.
A glitch didn’t mean your music stopped playing.
A bad laboratory result could tell someone that something was wrong when it wasn’t.
Or tell someone everything was fine when it wasn’t.
And inside Theranos, scientists were beginning to understand just how serious those stakes were.
One of the most important was Ian Gibbons.
Gibbons wasn’t some random disgruntled employee who wandered into Theranos and decided Elizabeth Holmes annoyed him.
He was a legitimate scientist.
That last part matters.
Because one of the easiest ways to misunderstand the Theranos story is to divide everyone into two categories:
People Elizabeth fooled and people who always knew she was full of shit.
Reality wasn’t that clean.
Some of the people who eventually became deeply concerned about Theranos had once genuinely believed in it.
Ian Gibbons appears to have been one of them.
He wanted the technology to work.
But wanting science to work does not make science work.
And imagine how fucking frustrating that position must have been.
You’re a scientist.
You understand that laboratory results have to be reproducible and accurate.
You understand that patients and physicians may make actual medical decisions using the numbers your company produces.
And you’re working for a company whose identity increasingly depends on everyone believing the technology is already revolutionary.
Because by this point, Theranos wasn’t merely trying to invent something.
Theranos had built a story.
Elizabeth Holmes was the brilliant young founder.
The Edison was the revolutionary machine.
Finger-stick testing was the future.
Theranos was going to democratize healthcare.
Powerful people believed it.
Investors had funded it.
The media was beginning to celebrate it.
What happens when the scientists inside that story say:
Wait.
That question became particularly important for Gibbons.
His situation at Theranos eventually became intertwined with a patent lawsuit involving the company. Gibbons possessed technical knowledge that could become relevant to questions about the development of Theranos’s technology, placing him in an extremely difficult position between his scientific knowledge and his obligations to the company.
There isn’t really a joke to make here.
Ian Gibbons was a human being whose life and career became entangled with this company long before the rest of the world understood what was happening inside it.
And his death should not be reduced to some dramatic piece of Theranos mythology.
We cannot know every factor that contributed to another person’s suicide, and it would be irresponsible to reduce his death to “Theranos caused it.”
What we can say is that one of the company’s most senior scientists had developed serious concerns about the technology years before the public collapse of Theranos.
And the public still had absolutely no fucking idea.
That’s what makes this stage of the story so disturbing.
Outside Theranos, Elizabeth Holmes’s reputation was exploding.
Inside Theranos, scientists were struggling with the limitations of the technology she was becoming famous for.
Outside Theranos, tiny blood samples represented innovation.
Inside Theranos, tiny blood samples created enormous analytical challenges.
Outside Theranos, the Edison represented the future.
Inside Theranos, conventional laboratory machines—including modified Siemens analyzers—were helping perform patient testing.
Two versions of Theranos were beginning to exist at the same time.
The one the world could see.
And the one employees were experiencing.
But keeping those two realities separated becomes considerably harder when the people inside the building decide they aren’t willing to stay quiet.
And soon, two young Theranos employees would make that decision.
Their names were Erika Cheung and Tyler Shultz.
The Whistleblowers
By the time Erika Cheung arrived at Theranos, Elizabeth Holmes had become exactly the kind of person a young scientist might dream of working for.
She was young.
She was a woman.
She had founded a multibillion-dollar healthcare company.
She was supposedly revolutionizing laboratory medicine.
And she was offering young employees the opportunity to help change the world.
For a recent graduate looking to begin her career, Theranos sounded fucking incredible.
And this is another reason I find the Theranos story so fascinating.
Elizabeth wasn’t exclusively convincing technologically illiterate old billionaires.
She convinced scientists too.
People went to work for Theranos because they genuinely believed they were joining something extraordinary.
Then they actually got inside the laboratory.
And Erika started seeing problems.
This is where the stakes become impossible to ignore.
Because you can bullshit investors about projected revenue.
You can bullshit journalists about how revolutionary your company will eventually become.
You can even bullshit yourself about whether your startup is going to succeed.
You cannot bullshit someone’s potassium level.
There is an objective answer somewhere inside that person’s blood.
And if your machine gives the wrong number, the patient’s body does not give a fuck about your $9 billion valuation.
Cheung became particularly troubled by Theranos’s quality-control practices and eventually raised concerns internally.
And this is an important distinction throughout this story:
The whistleblowers didn’t immediately sprint to a journalist.
They tried raising concerns inside the company first.
Meanwhile, another young employee was beginning to ask some extremely inconvenient questions.
His name was Tyler Shultz.
And Tyler’s presence at Theranos was particularly interesting because he wasn’t simply another employee.
His grandfather was George Shultz.
Yes.
That George Shultz.
Former United States Secretary of State George Shultz.
And more importantly for our purposes:
Theranos board member George Shultz.
Elizabeth Holmes had developed a remarkably influential board filled with extremely powerful people, and George Shultz became one of her most important supporters.
Which meant Tyler entered Theranos with a personal connection to one of the people closest to Elizabeth.
This should have made raising concerns easier.
It did not.
There is a recurring theme here.
They believed her.
Tyler believed her.
Erika believed her.
Ian Gibbons initially believed in the company.
Investors believed her.
Journalists believed her.
George Shultz believed her.
And every person who believed made Elizabeth slightly easier for the next person to believe.
But once Tyler began working in the laboratory, what he observed didn’t match the company he thought he had joined.
And then this story becomes absolutely fucking bonkers.
Because Tyler had access to somebody who sat on the Theranos board.
His own grandfather.
You would think this would be the easiest whistleblowing situation imaginable.
Hey Grandpa, I work in the laboratory of the company whose board you sit on, and I am telling you there are serious problems with the blood-testing technology.
Grandpa:
Holy shit. We should investigate immediately.
Right?
RIGHT???
No.
Imagine being Tyler.
You are approximately the age Elizabeth Holmes was when she founded Theranos.
You work inside the fucking laboratory.
You are telling your grandfather—who sits on the company’s board—that what he believes about this technology does not match what you are seeing.
And your grandfather essentially trusts Elizabeth more than you.
I would’ve lost my fucking mind.
But Tyler kept going.
He also attempted to raise his concerns through Theranos itself.
MR. BALWANI HAS RE-ENTERED THE CHAT.
Remember Sunny?
The significantly older man Elizabeth met in Beijing?
The man who eventually became her boyfriend?
Well, while Elizabeth was becoming the public face of Theranos, Sunny had become an enormously important figure inside the company.
And we’re going to have plenty more to say about that relationship.
For Tyler, however, the message was becoming pretty clear.
His concerns were not going to disappear because management told him he was wrong.
So he resigned.
And then he did something much more dangerous to Theranos than quitting.
He started talking.
Tyler eventually connected with journalist John Carreyrou of The Wall Street Journal, who had begun investigating Theranos.
And Theranos did not exactly respond to the possibility of an investigative journalist examining its technology with:
We welcome transparency and look forward to answering his questions.
Absolutely the fuck not.
This is another point where the power imbalance matters.
Theranos was worth billions of dollars on paper.
Elizabeth Holmes had wealthy investors, influential board members, and extremely expensive attorneys.
Tyler Shultz was in his twenties.
Erika Cheung was in her twenties.
These weren’t rival CEOs launching a corporate attack.
They were young former laboratory employees saying:
The testing isn’t reliable.
Cheung took a different route.
And this is where Elizabeth’s greatest asset—secrecy—started becoming her greatest problem.
Theranos had survived for years by controlling information.
Employees knew pieces of the technology.
Investors knew what they were shown.
Business partners knew what Theranos told them.
Journalists largely knew the story Elizabeth presented publicly.
Different people possessed different pieces of the puzzle.
Now those pieces were beginning to meet.
Erika knew what was happening in the laboratory.
Tyler knew what was happening in the laboratory.
Former employees had stories.
Regulators were receiving information.
And one investigative journalist was beginning to ask questions.
His name was John Carreyrou.
And if Elizabeth Holmes had spent more than a decade carefully constructing the story of Theranos, Carreyrou was about to start pulling on one thread after another.
The $9 billion valuation.
The finger-stick blood tests.
The Edison.
The Siemens machines.
The secrecy.
The patients.
The whistleblowers.
Everything.
For years, Elizabeth Holmes had been extraordinarily successful at controlling who knew what about Theranos.
That was about to end.
Because in 2015, The Wall Street Journal started asking questions.
John Carreyrou Starts Pulling the Thread
October 15, 2015.
For most people, it was a Thursday.
For Elizabeth Holmes, it was the beginning of the end.
By this point, Theranos had spent years constructing one of the most impressive stories Silicon Valley had ever seen.
Elizabeth Holmes was a billionaire.
Theranos was valued at approximately $9 billion.
Its founder had appeared on magazine covers, spoken at conferences, attracted some of the most powerful people in America to her board, partnered with Walgreens, and been celebrated as the female Steve Jobs.
And then John Carreyrou started asking an extremely inconvenient question:
Does this shit actually work?
Carreyrou was an investigative reporter for The Wall Street Journal, and information from people familiar with Theranos’s laboratory operations—including former employees—had led him toward a reality that looked dramatically different from the one Holmes had been presenting publicly.
And on October 15, he published it.
In an investigation titled “Hot Startup Theranos Has Struggled With Its Blood-Test Technology,” Carreyrou reported that Theranos was performing only a small portion of its tests on its proprietary Edison devices and was relying on conventional laboratory equipment for many of the tests it offered. The article also raised serious questions about the accuracy of Theranos’s technology and whether the company could actually deliver the revolutionary testing capabilities it had promoted.
And suddenly, the two versions of Theranos we talked about earlier collided.
There was Public Theranos:
Tiny blood samples.
Revolutionary proprietary technology.
Faster testing.
Cheaper testing.
Hundreds of tests.
The future of healthcare.
And then there was the Theranos described by former employees and Carreyrou’s reporting:
A company struggling with its proprietary technology, relying heavily on conventional laboratory equipment, and facing serious questions about whether its testing was as reliable as patients had been led to believe.
That’s not exactly a minor discrepancy.
That’s the fucking company.
Because Theranos’s value wasn’t based on Elizabeth Holmes inventing a particularly pleasant Walgreens experience.
The technology was the point.
If Theranos couldn’t reliably perform the testing that made it revolutionary, then suddenly you had to start asking what exactly this multibillion-dollar company was worth.
And Elizabeth Holmes was not about to watch more than a decade of work collapse because some journalist started asking questions.
Theranos fought back.
Hard.
Which, importantly, isn’t inherently suspicious.
Companies have every right to challenge journalism they believe is inaccurate.
And at this moment, the public did not know how the Theranos story was going to end.
We do.
That’s the benefit—and danger—of hindsight.
But on October 15, 2015, Elizabeth Holmes was still Elizabeth fucking Holmes.
She was still the celebrated founder of a company worth billions of dollars.
She still had extraordinarily powerful people supporting her.
And she immediately went on television to defend herself.
Then she delivered a line that probably sounded inspirational as hell in 2015.
In hindsight?
Girl.
Holmes argued that people trying to change things are initially considered crazy, then face opposition, and eventually change the world.
Basically:
Of course they’re attacking us.
We’re disruptive.
This is what happens to visionaries.
And that response perfectly fit the character Elizabeth Holmes had spent years creating.
Steve Jobs wasn’t always understood.
Great innovators aren’t always understood.
Revolutionary ideas threaten established industries.
People resist change.
So if people were suddenly attacking Theranos…
Maybe that just proved how revolutionary Theranos really was.
It’s actually a fascinating defense because it transforms criticism into validation.
You think I’m wrong?
That’s because I’m ahead of you.
Scientists are questioning the technology?
They don’t understand what we’re building.
A journalist says my company isn’t doing what I’ve claimed?
This is what happens when you try to change the world.
Suddenly, disagreement doesn’t weaken the mythology.
It strengthens it.
But Carreyrou had something Elizabeth Holmes’s inspirational speeches couldn’t make disappear.
Sources.
And some of those sources knew exactly what was happening inside the laboratory.
Tyler Shultz had provided information to Carreyrou despite the enormous personal and legal risk involved. Other former employees also helped the Journal understand what Theranos’s technology could—and couldn’t—do.
This is why whistleblowers matter so much.
John Carreyrou could investigate Theranos.
He could interview people.
He could obtain documents.
He could ask the company questions.
But he couldn’t magically teleport himself into a Theranos laboratory years earlier and watch everything happen.
The people who had actually been there could tell him where to look.
And Theranos understood how dangerous that was.
Because once employees started talking, secrecy stopped working.
The company could require nondisclosure agreements.
It could compartmentalize information.
It could threaten litigation.
It could send lawyers.
But it couldn’t force someone to unknow what they already knew.
And it couldn’t unpublish The Wall Street Journal.
The October 15 article also did something that Tyler and Erika couldn’t accomplish alone.
It made the problem public.
Until then, concerns about Theranos existed largely behind closed doors—in laboratories, emails, conversations with management, complaints to regulators, and secret discussions with journalists.
Now anyone could read them.
Patients could read them.
Doctors could read them.
Investors could read them.
Walgreens could read them.
Regulators could read them.
And other Theranos employees could read them.
Imagine working inside that building when the article dropped.
Imagine knowing pieces of what Carreyrou was reporting were true.
Imagine also knowing your employer had lawyers who appeared extremely enthusiastic about reminding former employees what they had signed.
I would’ve been at my desk like:
👩🏽💻 I have never seen a blood sample in my entire life.
But Theranos didn’t immediately collapse.
That’s important.
There wasn’t some dramatic moment where the Journal published at breakfast and Elizabeth was carrying a cardboard box out of headquarters by lunch.
Theranos continued fighting.
Holmes continued defending the company.
Supporters continued supporting her.
The company continued disputing Carreyrou’s reporting.
And for a while, Theranos attempted to maintain the same basic narrative it always had:
The technology works.
The critics are wrong.
We are changing healthcare.
But Carreyrou didn’t publish one story and move on.
He kept reporting.
And once the first crack appeared in Theranos’s carefully constructed image, other questions became much harder to contain.
What tests was Theranos actually performing on its own machines?
How accurate were those tests?
Why was the company using conventional analyzers?
What had employees told management?
What had Theranos told Walgreens?
What had Theranos told investors?
What had Theranos told patients?
And perhaps most dangerously:
What were federal regulators going to find when they started looking for themselves?
For more than a decade, Elizabeth Holmes had been remarkably successful at convincing people to focus on what Theranos could become.
John Carreyrou forced everyone to start examining what Theranos actually was.
And inspirational speeches weren’t going to be enough anymore.
Because journalists were no longer the only people asking questions.
The government was coming.
The Empire Starts Crumbling
John Carreyrou had opened the door.
Now the government was walking through it.
Theranos could attack a journalist.
It could challenge former employees.
It could send lawyers after whistleblowers.
It could insist that outsiders simply didn’t understand its revolutionary technology.
What becomes considerably harder is telling federal regulators:
You just don’t understand my vision.
Because regulators weren’t particularly interested in Elizabeth Holmes’s vision.
They wanted to know whether the fucking laboratory worked.
And what they found was not great.
After The Wall Street Journal began exposing problems inside Theranos, federal scrutiny of the company intensified. The Food and Drug Administration and the Centers for Medicare & Medicaid Services—better known as the FDA and CMS—became increasingly important characters in a story Theranos had spent years trying to control.
The FDA had already begun examining Theranos’s practices.
And then CMS—the agency responsible for overseeing clinical laboratories under federal law—started looking inside Theranos’s laboratory operations.
This was different from a magazine profile.
This was different from an investor presentation.
This was different from sitting across from a television host and explaining how you’re going to democratize healthcare while staring directly into their fucking cerebral cortex.
Regulators could inspect the laboratory.
They could examine records.
They could evaluate quality-control procedures.
They could look at employee qualifications.
They could determine whether Theranos was meeting the standards required of a clinical laboratory.
And they found problems.
A lot of fucking problems.
Immediate jeopardy to patient health and safety.
That phrase matters.
Because for years, Theranos had framed criticism as resistance to innovation.
This wasn’t somebody on Twitter saying Elizabeth Holmes gave them weird vibes.
This wasn’t a former employee complaining that Sunny was an asshole.
This wasn’t a journalist interpreting confidential sources.
This was a federal agency responsible for regulating clinical laboratories concluding that deficiencies inside Theranos posed an immediate threat to patients.
And suddenly, the stakes of everything we’ve discussed become much more tangible.
Theranos’s technology wasn’t being used to recommend movies.
It wasn’t deciding which advertisement appeared on your Instagram feed.
It was producing numbers that people could interpret as information about their bodies.
A blood-test result can influence whether someone believes they’re healthy.
Whether they believe they’re sick.
Whether additional testing is ordered.
Whether a physician becomes concerned about a particular condition.
Whether a patient becomes fucking terrified.
The entire Theranos promise depended on one assumption:
The numbers had to be right.
And by 2016, even Theranos was beginning to invalidate some of those numbers.
Read that again.
Two years.
The Edison wasn’t some irrelevant prototype Elizabeth had abandoned in a Stanford dorm room.
This was the machine at the center of the Theranos mythology.
The tiny machine.
The revolutionary machine.
The machine that represented the entire idea that Theranos had discovered a better way to perform blood testing.
And now results produced by those devices were being voided.
Imagine being a patient receiving that notification.
You gave Theranos your blood.
You received a medical result.
You reasonably assumed the laboratory producing that result knew what the fuck it was doing.
Maybe the number scared you.
Maybe it reassured you.
Maybe you discussed it with your doctor.
Maybe you spent months believing something about your body based on that piece of paper.
And then:
Heyyyyyyy.
Remember that medical information we gave you?
About that.
This is where I lose basically all ability to find Theranos funny.
Watching billionaires hand Elizabeth Holmes millions of dollars because she wore a black turtleneck, had Henry Kissinger sitting nearby, and told them she was changing the world?
I’m sorry.
That’s a little funny.
Patients receiving potentially unreliable medical information?
Not fucking funny.
And when Holmes eventually went to trial, the human consequences of Theranos testing were no longer hypothetical.
There is an important distinction here, though.
Not every disputed Theranos result can automatically be blamed specifically on the Edison, and an inaccurate laboratory result by itself does not establish that Elizabeth Holmes personally caused it.
Laboratory testing can produce errors for numerous reasons.
But by this point, that wasn’t the only problem facing Theranos anyway.
The company’s credibility was collapsing.
Its laboratory practices were under federal scrutiny.
Its proprietary results were being voided.
Its former employees were talking.
Carreyrou was still reporting.
And one of Theranos’s most important business partners was apparently finished participating in this fucking circus.
Walgreens.
The Walgreens partnership had been enormously valuable to Theranos because it made the company feel real to ordinary consumers.
You didn’t need to understand venture capital.
You didn’t need to know who George Shultz was.
You didn’t need to read a biotechnology journal.
You knew Walgreens.
Theranos Wellness Centers inside Walgreens locations transformed Elizabeth’s futuristic pitch into something patients could actually walk into.
That relationship was now becoming a liability.
All 40.
Done.
Imagine watching this happen if you’re Elizabeth Holmes.
A few years earlier, you’re being celebrated as the youngest self-made female billionaire.
You’re being compared to Steve Jobs.
Your company is valued at billions.
You’re appearing on magazine covers.
Powerful old men are sitting on your board.
Walgreens is putting your company inside its stores.
And then, within months:
Your technology is being questioned publicly.
Federal regulators are documenting serious deficiencies.
Two years of Edison results are being voided.
Walgreens is closing every Theranos Wellness Center in its stores.
And John fucking Carreyrou is still writing.
The story Elizabeth Holmes had spent more than a decade constructing was beginning to collapse faster than she could control it.
And there was another major consequence coming from CMS.
Federal regulators didn’t merely write Theranos a strongly worded letter and wish everyone the best.
The problems eventually threatened Holmes’s ability to operate a laboratory at all.
The regulatory crackdown, combined with the loss of Walgreens and mounting public scrutiny, gutted the business model that had once made Theranos look unstoppable.
Because what exactly was Theranos now?
The company’s revolutionary technology had been publicly questioned.
Its laboratory operations had been condemned by regulators.
Its proprietary Edison results had been invalidated.
Its most recognizable retail partner had walked away.
Its employees had become whistleblowers.
Its founder’s credibility was deteriorating.
And yet, somehow, this still wasn’t the end.
Theranos would continue operating.
Elizabeth Holmes would continue defending herself.
And the company would attempt to reinvent itself around new technology.
But the Elizabeth Holmes who could walk onto a stage and simply announce that Theranos was changing the world was disappearing.
Now people wanted evidence.
Documents.
Test results.
Financial information.
Regulatory records.
And eventually, federal investigators would begin asking an entirely different question.
Not:
Did Theranos fail?
Companies fail every day.
Technology doesn’t work every day.
Founders make overly optimistic predictions every day.
Being spectacularly wrong is not automatically a federal crime.
The question was becoming:
Did Elizabeth Holmes know what Theranos could actually do while telling investors something different?
Because if she did, we were no longer talking about an ambitious startup that failed.
We were talking about fraud.
And in 2018, the Securities and Exchange Commission was ready to make that accusation.
The Government Calls It Fraud
There is an important line we need to draw before going any further.
Building a company that fails is not a crime.
Being overly optimistic isn’t automatically a crime.
Developing technology that doesn’t work isn’t automatically a crime.
Promising something you’ll eventually discover you can’t deliver isn’t necessarily a crime either.
Silicon Valley would probably have approximately four remaining CEOs if being catastrophically overconfident were itself a federal offense.
Fraud requires something more.
And by 2018, the federal government believed Elizabeth Holmes had crossed that line.
On March 14, 2018, the Securities and Exchange Commission publicly accused Theranos, Holmes, and Sunny Balwani of fraud.
And the numbers involved were fucking enormous.
That accusation gets us much closer to the central question of the entire Elizabeth Holmes story.
Because the government wasn’t simply saying:
Elizabeth Holmes believed in technology that ultimately failed.
The SEC was alleging that Holmes told investors specific things about Theranos that weren’t true.
And some of the alleged discrepancies were fucking astronomical.
Remember Siemens?
Siemens remembers.
But the technology wasn’t the SEC’s only concern.
The agency also accused Theranos of misleading investors about relationships with pharmaceutical companies and the United States military.
That’s not exactly:
Our scientists thought we’d have this feature ready by March and unfortunately it took until August.
Either your revolutionary blood-testing technology was being used on battlefields in Afghanistan or it fucking wasn’t.
The SEC also focused on Theranos’s financial projections.
And this one might be my favorite example simply because of the sheer difference between the numbers.
I’m sorry.
$100 million.
$100 thousand.
Those numbers are not cousins.
They’re not neighbors.
They’re not even attending the same fucking family reunion.
And this is where the distinction between visionary and fraud becomes extremely important.
There is nothing illegal about saying:
I believe my company can eventually make $100 million.
Founders make projections.
Businesses have goals.
People are wrong.
But knowingly giving investors materially false information so they will hand you money is an entirely different situation.
And that was essentially the SEC’s accusation.
Holmes chose to settle.
And this part needs to be phrased carefully because settling a civil enforcement action is not the same thing as being convicted of a crime.
So at this point, Elizabeth Holmes had been publicly accused of fraud by the SEC.
But she had not been criminally convicted of fraud.
That distinction isn’t going to last forever.
Because exactly three months and one day after the SEC announced its case, Elizabeth Holmes’s problems became significantly more serious.
June 15, 2018.
Federal prosecutors announced that a grand jury had indicted Elizabeth Holmes and Ramesh “Sunny” Balwani.
Mr. Balwani has officially returned for the criminal portion of our program.
And once again, at this stage these were allegations.
An indictment is not a conviction.
Holmes and Balwani were entitled to defend themselves in court, and the government would eventually have to prove criminal charges beyond a reasonable doubt.
But the allegations showed how dramatically the Theranos story had changed.
Elizabeth Holmes had spent years convincing people that she had discovered a better way to test blood.
Now federal prosecutors were alleging that she and her former boyfriend/business partner had participated in schemes to defraud the very people who believed them.
And if Elizabeth thought the SEC settlement might allow her to somehow rebuild, rebrand, pivot, manifest, become Steve Jobs harder, or whatever the fuck the plan was…
Theranos itself was running out of time.
By September 2018, it was over.
Fifteen years.
That’s approximately how long it took Elizabeth Holmes to go from a 19-year-old Stanford dropout using her tuition money to start a healthcare company to watching that company disappear while she faced federal criminal charges.
The transformation is genuinely insane.
2003 Elizabeth Holmes:
I’m going to revolutionize blood testing.
2014 Elizabeth Holmes:
Billionaire.
Magazine covers.
Steve Jobs comparisons.
Powerful board.
Walgreens partnership.
Silicon Valley royalty.
2018 Elizabeth Holmes:
Company dissolving.
SEC fraud settlement.
Federal indictment.
Facing the possibility of prison.
Theranos was dead.
But the most important question still hadn’t been legally answered.
Was Elizabeth Holmes a failed visionary who genuinely believed in technology that never lived up to her expectations?
Or had she knowingly lied to investors to keep Theranos—and the Elizabeth Holmes mythology—alive?
Elizabeth had spent years answering questions in interviews, investor meetings, conferences, and presentations.
Now she would have to answer them somewhere very different.
A federal courtroom.
The Trial of Elizabeth Holmes
By the time Elizabeth Holmes finally went to trial, Theranos had been dead for three years.
The black turtlenecks were gone.
The magazine covers were old news.
The $9 billion valuation had evaporated.
The Walgreens Wellness Centers were closed.
And the woman once celebrated as the youngest self-made female billionaire in America was sitting in a federal courtroom facing the possibility of spending years in prison.
The question was no longer whether Theranos had failed.
Everyone knew it had.
The question was much narrower—and legally much more important:
Had Elizabeth Holmes intentionally defrauded people?
Because, as we’ve already established, being catastrophically wrong isn’t necessarily criminal.
You can build terrible technology.
You can run a company into the fucking ground.
You can genuinely believe your mediocre invention is going to revolutionize humanity.
You can even be an insufferably optimistic CEO who refuses to accept reality.
None of those things, by themselves, make you guilty of wire fraud.
Federal prosecutors had to prove something more.
They had to convince a jury that Holmes knowingly participated in a scheme to defraud.
And Elizabeth Holmes maintained that she was a believer.
Her trial began in September 2021 in federal court in San Jose, California, after delays that included the COVID-19 pandemic and Holmes’s pregnancy.
The government’s case lasted for weeks.
Former employees testified.
Investors testified.
Patients testified.
Scientists testified.
Documents were introduced.
Emails were introduced.
Text messages were introduced.
And prosecutors began reconstructing the story we’ve spent this entire article following—except now every statement mattered because twelve jurors would eventually have to decide whether it amounted to a federal crime.
One of the government’s central arguments concerned what Holmes told investors about Theranos’s technology and business.
Investors described being presented with an extraordinarily compelling company
.
Theranos supposedly possessed revolutionary proprietary technology.
It was supposedly capable of performing an enormous range of blood tests using tiny samples.
The company supposedly had major commercial opportunities.
And Elizabeth Holmes herself was at the center of the pitch.
Which brings us back to something I’ve wondered throughout this entire fucking story:
Did nobody ask to see the machine work?
Obviously, that’s oversimplifying what happened.
Theranos wasn’t raising money from people who walked past Elizabeth at Starbucks and handed her $20 million because they liked her turtleneck.
Investors reviewed information, met with Holmes and other executives, evaluated the company’s supporters, and made their own decisions.
And the defense repeatedly emphasized that investors had responsibilities of their own.
That’s actually an important point.
Being wealthy does not make someone immune from fraud.
But being defrauded also doesn’t mean you necessarily performed excellent due diligence.
Both things can be true.
An investor can fail to ask enough questions while somebody else intentionally gives them false information.
The jury’s job wasn’t to determine whether Theranos investors deserved an award for investigative excellence.
It was to determine whether Holmes committed the crimes charged.
And prosecutors had something particularly useful when trying to answer what Holmes knew:
Her own communications.
Remember Sunny?
Of course you fucking remember Sunny.
By the time of Holmes’s trial, Elizabeth and Sunny Balwani were no longer a couple, no longer running Theranos together, and weren’t even being tried together. Their cases had been separated, meaning Holmes faced the jury without her former boyfriend and COO sitting beside her.
But their relationship was everywhere.
And so were their text messages.
These texts are fascinating because they aren’t polished CNBC interviews.
They aren’t investor presentations.
They aren’t Elizabeth standing on a stage explaining that she wants everyone to have access to actionable health information.
They’re Elizabeth and Sunny talking to each other.
And that private relationship would eventually become one of the most personal—and controversial—parts of Holmes’s defense.
But first, Elizabeth Holmes made a decision that dramatically changed the trial.
She testified.
Elizabeth fucking Holmes took the stand.
A criminal defendant does not have to testify.
The government has the burden of proving guilt, and defendants have a constitutional right not to take the witness stand.
But Elizabeth did.
And honestly?
Of course she did.
This woman had spent her entire adult life convincing people of things.
She convinced professors.
She convinced investors.
She convinced Walgreens.
She convinced Henry fucking Kissinger.
She convinced journalists.
She convinced employees.
She convinced an impressive portion of Silicon Valley that she was going to revolutionize healthcare.
Now she needed to convince twelve jurors that whatever had happened at Theranos, she had not intentionally defrauded anyone.
And there is something really important about that defense.
Elizabeth Holmes did not need to prove Theranos worked.
By 2021, that ship had sailed, hit an iceberg, caught fire, sank to the bottom of the Pacific Ocean, and been investigated by CMS.
She needed to create reasonable doubt about intent.
Essentially:
Yes, Theranos failed.
Yes, things went wrong.
Yes, I made mistakes.
But I believed we could make it work.
That is a much stronger legal argument than attempting to convince a jury in 2021 that the Edison was secretly fantastic.
Holmes also acknowledged some decisions that prosecutors had scrutinized.
During cross-examination, the government confronted her with statements she’d made to investors and evidence about what she knew while Theranos was operating.
And this is where taking the stand becomes a massive gamble.
When your own lawyer is questioning you, your defense team gets to structure the story.
They know what you’re going to say.
They know where they’re going.
They can ask questions designed to let you explain yourself.
Then they sit down.
And the prosecutor stands up.
Suddenly, Elizabeth Holmes—the woman who spent years carefully controlling interviews, company information, demonstrations, presentations, and access to Theranos—couldn’t control the conversation anymore.
The government got to ask the questions.
And she had to answer them under oath.
But the most dramatic portion of Holmes’s testimony wasn’t about Siemens machines, investor presentations, or revenue projections.
It was about Sunny Balwani.
Holmes testified that the relationship we’d been following since Beijing had been profoundly different behind closed doors from what outsiders saw.
This part of the trial requires more nuance than Elizabeth blamed everything on her boyfriend.
Her testimony about alleged abuse was relevant to understanding her relationship with Balwani and her mental state.
But Holmes did not simply testify that Sunny remotely controlled her body like a Sims character and therefore made every Theranos decision for her.
In fact, she acknowledged that Balwani did not dictate all of her business decisions.
That’s important.
A person can experience abuse in a relationship while still exercising agency in other areas of their life.
And whether Holmes’s allegations were true was not itself the ultimate question the jury had to decide.
They had to determine whether the government proved the specific fraud charges against her beyond a reasonable doubt.
Still, the testimony dramatically complicated the public image of the Holmes-Balwani relationship.
For years, we’d had:
Elizabeth Holmes, visionary founder.
Sunny Balwani, secret boyfriend and company president.
Together running Theranos.
Now Holmes was describing a relationship in which she said she had been subjected to abuse and control.
Balwani denied it.
And because his trial was separate, he wasn’t sitting there as a co-defendant able to testify in response during Holmes’s case.
The jury had to absorb all of this alongside weeks of scientific evidence, investor testimony, patient testimony, internal documents, emails, financial information, and approximately fifteen years of Theranos history.
Then, finally, the case went to them.
And on January 3, 2022, the jury came back.
This is where a lot of summaries of Elizabeth Holmes’s story become annoyingly simplistic.
Elizabeth Holmes was found guilty of fraud.
True.
But that’s not the entire verdict.
The jury didn’t convict her of everything.
Not even close.
The jury found Holmes guilty on four counts: one count of conspiracy to commit wire fraud against Theranos investors and three counts of wire fraud involving investors.
But on other charges?
Not guilty.
Those hung counts were ultimately dismissed.
And that split verdict matters enormously.
The jury did not conclude that prosecutors proved every accusation against Elizabeth Holmes beyond a reasonable doubt.
They specifically rejected some of the government’s case.
Most notably, the patient-related charges did not result in convictions.
But when it came to particular investors and the conspiracy to defraud investors?
The government had convinced them.
Beyond a reasonable doubt.
Elizabeth Holmes—the woman who had once been celebrated as the youngest self-made female billionaire, who had been compared relentlessly to Steve Jobs, who had stared into cameras and promised to change healthcare—was now a convicted felon.
And honestly, there is something almost poetic about what ultimately convicted her.
Theranos hurt real patients.
Scientists warned about the technology.
Whistleblowers risked their careers.
Regulators documented serious laboratory deficiencies.
Two years of Edison results were voided.
But the criminal convictions Holmes ultimately received were centered on investor fraud.
The billionaire-making machine became the thing that sent the billionaire to prison.
And still, there was one more person whose role in Theranos hadn’t been legally resolved.
The man who had been there near the beginning.
The older businessman Elizabeth met in Beijing when she was 18.
Her secret boyfriend.
Her president and COO.
The man who helped run Theranos while Elizabeth became its public face.
The man Holmes had just accused under oath of abusing and controlling her.
Ramesh “Sunny” Balwani.
Mr. Balwani was finally getting his own trial.
Mr. Balwani was finally getting his own trial.
And unlike Elizabeth, Sunny didn’t walk away with a split verdict.
Balwani was tried separately from Holmes, and on July 7, 2022, after a four-month trial, a federal jury convicted him onall 12 counts he faced—including charges involving both Theranos investors and patients.
So while Elizabeth’s jury convicted her on four investor-related counts, acquitted her on the patient-related charges submitted to them, and deadlocked on three additional investor counts, Sunny’s jury went 12 for fucking 12.
Again, that doesn’t mean we can turn two separate criminal trials with different juries into some kind of Theranos Fraud Olympics and declare Sunny “more guilty” than Elizabeth. But it does mean the two people who had spent years privately running Theranos together had now both been convicted of federal crimes.
On December 7, 2022, Balwani was sentenced to 155 months—12 years and 11 months—in federal prison.
And that’s about where we’re leaving Mr. Balwani.
Because this isn’t his story.
It’s Elizabeth’s.
And one month before Sunny received his sentence, the woman who had once been worth billions walked into a federal courtroom to learn exactly how much her Theranos empire was going to cost her.
From Billionaire to Federal Prison
One month before Sunny Balwani received his sentence, Elizabeth Holmes returned to the same federal courthouse where a jury had convicted her.
Except this time, there was nothing left to sell.
No investors to persuade.
No magazine profile to pose for.
No revolutionary machine supposedly waiting around the corner.
No Theranos.
Elizabeth Holmes was there to find out how long she was going to prison.
On November 18, 2022, U.S. District Judge Edward Davila sentenced Holmes to 135 months in federal prison—11 years and three months—followed by three years of supervised release.
Eleven years.
For a company she started when she was nineteen years old.
The same company that had once made her a billionaire on paper was now going to take away more than a decade of her freedom.
And the amount of money involved in the counts of conviction was fucking insane.
According to the Justice Department, the three investor wire-fraud counts on which Holmes was convicted involved wire transfers totaling more than $140 million.
Think about where we started this story.
A little girl reading Moby-Dick.
A teenager learning Mandarin.
A Stanford student with an idea.
A nineteen-year-old dropping out because she believed she could build something bigger than whatever waited for her at graduation.
And eventually?
$140 fucking million in wire transfers connected to the counts that sent her to prison.
That escalation is genuinely difficult to comprehend.
Holmes didn’t immediately enter prison after sentencing. Her original surrender date was set for April 2023, and litigation over her attempt to remain free while appealing delayed it further.
The transformation was complete.
Elizabeth Holmes: Stanford dropout.
Elizabeth Holmes: founder.
Elizabeth Holmes: CEO.
Elizabeth Holmes: billionaire.
Elizabeth Holmes: America’s favorite female tech founder.
Elizabeth Holmes: defendant.
Elizabeth Holmes: federal inmate.
And even prison wasn’t the end of the legal story.
Holmes appealed her conviction, challenging several decisions made during her trial.
But that didn’t work either.
The appeals court also upheld an absolutely staggering restitution order.
Holmes and Balwani were held jointly and severally liable for more than $452 million in restitution to Theranos investors.
Four hundred and fifty-two million dollars.
At this point, I feel like Theranos stopped using normal-person numbers somewhere around 2013.
Everything is millions.
Hundreds of millions.
Billions.
Eleven years.
Hundreds of millions in restitution.
Meanwhile, this entire story started with the premise that getting your blood tested fucking sucked.
That’s what makes Theranos so fascinating to me.
Because after researching Elizabeth Holmes for this article, I don’t think the most interesting question is whether she was a genius.
She wasn’t the scientific genius the mythology surrounding Theranos made her appear to be.
I don’t think the most interesting question is whether Theranos failed, either.
Obviously it did.
And I don’t even think the most interesting question is whether Elizabeth Holmes committed fraud.
A federal jury answered that question on four counts, and her convictions survived appeal.
The question I keep coming back to is the one I’ve been asking throughout this entire article:
How the fuck did she get everyone to believe her?
Because Elizabeth Holmes didn’t build Theranos alone.
She couldn’t have.
She needed investors.
She needed employees.
She needed scientists.
She needed executives.
She needed business partners.
She needed board members.
She needed journalists.
She needed powerful people willing to attach their reputations to hers.
And once enough impressive people believed in Elizabeth Holmes, their belief became evidence for everyone else that Elizabeth Holmes was worth believing.
That’s one of the most fascinating parts of this entire story.
Imagine you’re considering investing in some nineteen-year-old’s blood-testing startup.
Sounds risky as fuck.
But then you learn that respected professors believe in her.
Then successful venture capitalists invest.
Then prominent political and business figures join her board.
Then major companies partner with Theranos.
Then magazines put Holmes on their covers.
Then she’s being called the next Steve Jobs.
At some point, instead of asking:
“Has somebody actually verified this?”
People start thinking:
“Surely somebody else already has.”
And that assumption can travel surprisingly far.
Theranos also had something working enormously in its favor:
The idea was fucking amazing.
That’s almost easy to forget underneath all the fraud.
Imagine walking into Walgreens, getting your finger pricked, giving a few drops of blood, paying less money, and receiving dozens of accurate test results without sitting through a traditional blood draw.
WHO WOULDN’T WANT THAT?
I hate needles.
You probably hate needles.
Nobody has ever woken up excited because today is finally their chance to have multiple tubes of blood drawn.
Elizabeth wasn’t pitching investors on a solution to a problem nobody had.
She was pitching them on a future people desperately wanted to exist.
And then she wrapped that future inside one of Silicon Valley’s favorite stories:
The visionary founder.
Young.
Obsessive.
College dropout.
Unconventional.
Secretive.
Demanding.
Changing the world.
Sound familiar?
Steve Jobs had already helped establish the mythology.
Elizabeth Holmes stepped directly into it.
The black turtleneck wasn’t the reason people invested hundreds of millions of dollars in Theranos.
The deep voice wasn’t the reason.
The intense eye contact wasn’t the reason.
There isn’t one weird personality trick that explains how she pulled this off.
It was the entire package.
The story.
The connections.
The secrecy.
The confidence.
The respected people surrounding her.
The media attention.
The enormous potential market.
The fear of missing out on the company that might transform healthcare.
And, critically, a culture that sometimes treats extreme confidence as evidence that somebody must know something everyone else doesn’t.
Sometimes they do.
And sometimes the machine doesn’t fucking work.
That’s also why I don’t buy the cartoon version of Elizabeth Holmes where she woke up every morning, put on her black turtleneck, practiced her villain voice in the mirror and thought:
Time to scam some billionaires.
Real life is usually more complicated than that.
Holmes testified that she genuinely believed Theranos could succeed.
Maybe she did.
Believing in your company and deceiving people aren’t mutually exclusive.
You can believe something will eventually work while lying about how well it works right now.
You can believe you’re building the future while misrepresenting the present.
You can convince yourself that today’s exaggeration won’t matter once tomorrow’s breakthrough finally arrives.
But tomorrow has to come eventually.
For Theranos, it never did.
Scientists kept encountering problems.
Employees raised concerns.
Whistleblowers spoke.
Journalists investigated.
Regulators arrived.
Partners left.
The company collapsed.
And eventually, twelve jurors were asked to separate the mythology from the evidence.
On four counts, they found Elizabeth Holmes guilty beyond a reasonable doubt.
So was Elizabeth Holmes the next Steve Jobs?
No.
But for a while, she convinced an extraordinary number of people that she might be.
And maybe that’s the real lesson of Theranos.
Intelligence isn’t immunity from manipulation.
Money isn’t immunity.
Education isn’t immunity.
Power isn’t immunity.
And surrounding yourself with other impressive people doesn’t magically mean somebody in the room has checked whether the fundamental premise is actually true.
Sometimes everybody is looking at everybody else.
The investor trusts the board.
The board trusts the founder.
The journalist trusts the investors.
The next investor trusts the journalist.
The public sees all of them and assumes there must be something there.
And sitting in the middle of that enormous circle of credibility was a Stanford dropout in a black turtleneck saying she was going to change the world.
For years, people believed her.
Until they finally started checking.
And by then, Elizabeth Holmes had already become exactly what she’d spent years trying to become:
One of the most famous entrepreneurs in America.
Just not for the reason she wanted.
