*Originally published Jan 15, 2019. Updated September 2026

While visiting a friend, she pulled out a hefty book, handed it to me, and explained that she had barely seen her wife for two days because she was so engrossed in it.  That sort of endorsement is, for me, as seductive as a dirty martini at Friday Happy Hour. 

I settled into the book right away: Bad Blood Secrets and Lies in a Silicon Valley Startup. It details the founding, rise, and ultimate downfall of the company Theranos.  A medical device was promised to revolutionize blood-testing.  People bought in.  There were millions invested.  Publicity ensued.

The engineers of the company told the founder, Elizabeth Holmes, the promise of this technology could not be kept.  Her solution: hide the malfunctions and continue to promise the technology anyway.  Eventually, the truth surfaced.  The blood-testing device produced false results and the consequences, if left unchecked, could have been dire.  Since medications, diagnosis, and procedures hinge on the veracity of a blood test result, Holmes’s failure to confront the problem with the device put people in danger, and she’s now a textbook case for fraud and engineering ethics (or lack thereof). 

Three things come to mind as I reflect on this book. 

1. Ambition Without Excellence: There was a genuine desire to report on the success of a young woman in the
   technology industry.  Yet, the media frenzy over Elizabeth Holmes eclipsed the most important element: the actual integrity of the blood-testing device. 
   The very notion of ambition must be revisited here and I yield to the writings of Aristotle for clarity. 
   Ambition proper must be in conjunction with excellence.  Its expression, or quality of it rather, reflects a practice of contemplation and a steady work of character.  By definition, it’s not to be obfuscated with notions of power and domination.  Holmes’s handling of investments and empty guarantees did not demonstrate ambition, but rather greed. 
   In Aristotle’s terms this constitutes an excess of character or a vice.  Financial gain and power are not in and of themselves problematic, but they can be when in lieu of excellence as opposed to the by-product of excellence.  
2. Why Investigative Journalism Matters: The unraveling and deceit of Theranos is an important story to tell.  It also highlights the gravity of journalism in a day when the field finds itself under attack and called “fake” or “enemy of the people.”  In truth, many people could have suffered from this poorly designed tool; yet, quality journalism unearthed the magnitude of the company’s flaws and outright false claims.  Indeed, one woman spent a Thanksgiving evening in the ER due to a false blood test result from this Theranos device.  After undergoing a deluge of further testing that ultimately cost her $3,000 out of pocket, she learned there was nothing wrong with her.  Now consider the reverse possibility: What if a patient had a serious medical condition but received a reassuring result? The consequences of inaccurate medical testing remind us why evidence, independent verification, and the willingness to question an appealing story matter.
3. Theranos and the Challenger disaster: I cannot help but draw parallels between Theranos and the Challenger Space Shuttle Disaster (1986). In both cases the engineers informed management of serious difficulties.  With the case of the Challenger, the O-ring was a vulnerable part of the shuttle, and in cold temperatures would fail.  This was explained to the business side of the launch and ignored. Seven astronauts lost their lives.  Why would the Challenger launch when on the eve before the engineers told management it was doomed to fail?  Why would Holmes ignore her own engineers?  Scheduling.  Business.  Because management told too many people it was ready.  The essence of the failures underscoring both cases looks eerily similar; namely, the image of the company and possible profits, drowned out the very purpose of these endeavors: human excellence, knowledge, and innovation.

Learn more about Engineering Ethics on Good Is In The Details podcast

Coffee and Contemplation

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