Theranos Hype Machine: A Snarky Retrospective

[00:00:00]hey I'm MAC welcome back to my channel let's go back to 2013 come with me all right I'm finishing up my first year of Pharmacy School in Massachusetts and things are going pretty well my lifelong talent for taking exams an ability regularly misidentified by academic institutions as an indication of intelligence and competence was serving me very well and coming from Los Angeles I really had to admire how rude everyone in Massachusetts was like gez you think my idea is stupid don't you act mean you love this idea and would like to schedule a meeting to discuss it and then later we'll cancel the meeting at the same time Rumblings were beginning among my peers and instructors about this new thing happening at the corners of happy and healthy in Arizona a partnership with this upand cominging company Theos to say that Theos had a very ambitious Mission would be an understatement to say that the founder of Theos Elizabeth Holmes was strange would be an even bigger understatement okay despite what the in yourr face mid-range frequency saturation of my speaking voice might make you think my singing range is firmly a base and while I could speak from way down here that would be uncomfortable and feel very artificial for me and it also doesn't project super well I could probably deliver an entire video purring at you like barely sociable does but it doesn't really feel very authentic for me this is like a velvet hug this project so much better it slices right through you okay it's an auditory razor blade okay right out the mask resonating right out the mask dead Elizabeth Holmes apparently did not feel the same way her bizarre affectation of a low speaking voice was just one of many qualities that many found strangely hypnotic but others like me found skin crawling uncanny and this is all before even considering the content of what she was saying which was somehow more absurd than the way she presented herself among myself and my pharmacy school peers and faculty the response was generally intense skepticism or outright dismissal why the founder or CEO of a company is in many respects somewhat like the lead singer of a band sometimes they're just a part of the band and sometimes they're like Maroon Five where I'm pretty sure you could put Adam Lavine and four random people on stage and people would not notice the difference Theos was very much on the Maroon Five end of the spectrum so what exactly was Elizabeth Holmes claiming her company was able to do well in December of 2014 Fortune Magazine secured the second public appearance or public interview from M Holmes but she would go on to have many more shamelessly fawning softball interviews and articles over the coming year I'm going to show you a few clips from it to show what Theos was all about and I'm going to respond with what made me and my peers so skeptical at the time and frankly why so many others should have known better or at least invited more knowledgeable and more critical voices to the discussion because if there's one thing I love doing it's saying I Told You So I think it's a common misconception that there were no critical voices speaking at the time that the hype was kind of peing there were they just we're not listened to or given a platform this is Elizabeth's second public live interview the first was at the most powerful Women's Summit in October um so Elizabeth what have you done and what is Theos and I'd like you to explain it maybe the way you'll you'll explain it to those young girls as you travel the country talking with Elementary School students okay that's a challenge you know if um if you look the word diagnosed up in the dictionary it says to determine the onset of disease from its signs and symptoms right so you're figuring out that someone's sick by the fact that they have a symptom you're figuring out that someone has cancer by the fact they have a tumor in them right but that's too late in the disease progression process to be able to do something about it and Theos means detecting the onset of disease in time for therapy to be effective so being able to see the onset of disease in time to be able to do something about it and we spent a lot of time thinking about that thinking about how could we help to create a world in which people don't have to say goodbye too soon and fundamentally got into Laboratory Testing this is an incredibly simplistic way of looking at it and really reveals a lack of understanding of how complex the body is and how complicated medicine can be and that simplistic view is only becoming more and more of a problem with the rising popularity of unapproved untried tests for cancer like the Grail Gallery test for one it fails to consider what happens next after a positive result okay so the test is positive suggesting you might have cancer it could either be a true positive or it could be a false positive so what happens now how do you confirm the test a CT scan a pet scan a biopsy an MRI let's suppose you get a pet scan and an MRI and they don't find anything I suppose you just have to keep being monitored and getting regular screenings to check in again after all it wouldn't be better to just treat it anyway with extremely costly side effect heavy potentially debilitating drug therapy or radiation therapy just in case would it no it wouldn't right well I'm sure you'll somehow adjust to your new life of maybe having cancer but maybe not having cancer the fact of the matter is that test results are not simple and false positives are not harmless they're also not uncommon The Grail Gallery test in a recent study of 6,629 participants found cancer signals in 92 or 1.38% of them these participants were then directed to get CT scans biopsies or other confirmatory testing and 29 of the 92 which is 32% of them were found to have cancer by the researchers but they could not confirm a cancer diagnosis for the remaining 63 do those 63 have cancer they might they might not I'm sure they feel great about that and are very glad for this test that has in no way negatively impacted their mental health and well-being and that was the majority of people who got a positive result for that test crazy because ABB data drives 80% of clinical decision making in the context of how a physician is able to take care of a person and if you can make lab data accessible really early in the disease progression process so you're not figuring out that you're already really really sick then you can begin to make it possible to intervene in time to do something about it okay I don't know where the hell this 80% figure comes from I cannot find any primary source on it she's not the only one saying this it's a fairly common claim but I have looked and looked for the original source of the statistic and I I cannot find it it further seems somewhat dubious to me because how would you even study that like what what is true is that 70 to 80% of a patient's medical record tends to be lab tests but this does not necessarily mean that it is used in clinical decision-making nor does it mean that it ought to be used in clinical decision-making the problem is is that it is just not that simple a lab test is not this clean definitive result especially for the type of disease she seems to be referring to such as cancers there are other diseases that can be diagnosed by lab test but typically these don't have quite the level of criticality in terms of being caught early and also this whole like catching it early is the most important thing is sort of becoming an outmoded way of thinking in cancer but that's another thing diabet is another disease state that she commonly references as being underdiagnosed due to lack of blood testing for this I would question how Theos purports to be the solution for that because usually the reason hba1c does not get tested is because the doctor fails to order it when they should have or the patient misses an appointment I suspect that Theos would answer that through their lobbying they could Empower patients to order their own lab tests lab tests that would of course given that they were not ordered by provider would would be costly and require the patient to know which lab test they needed which is not really a solution to this problem since upon receiving the result the patient really ought to be following up with their physician anyway who failed to order this lab test in the first place Furthermore with pre-diabetes the intervention would be to exercise regularly and make healthier food choices like avoiding processed foods high and added sugars and eating more fruits and vegetables which like patients already know they should do hba1c is most useful when it's tracked over time and I have to imagine the type of patient who is going to schedule regular self-paid lab test to monitor the results is a rather thin slice of the population and it's still a suboptimal situation because if this is going to be a long-term thing the best thing would be for them to find a primary care provider who does a better job at ordering appropriate tests this can be a daunting thing to accomplish but that doesn't mean that the Theos solution is any more of a real solution so our work is in making lab data accessible and we've done that by making it possible to do any lab test from a tiny drop of blood from a finger instead of having big needles stuck in your arm and tubes and tubes of blood taken out and by making it possible for every lab test to be affordable for every person no matter how much money they have and and um accessible in locations that are convenient all right right there is the claim that made the most eyebrows rise in my pharmacy school class Any Lab Test from a tiny drop of blood this is impossible why because while some lab tests can indeed be run on a tiny drop of blood for many lab tests a tiny drop of blood is not a big enough sample size Let's do an analogy suppose you want to know what percentage of men in the Salt Lake City metropolitan area are gay okay so Elizabeth Holmes comes along and she knock knock knocks on my door and she goes are you gay and I'm like yes you strange strange woman I am can I help you with something she walks away to my next door neighbor down the hall and she knock knock knocks and she's all are you gay and he's like uh yeah she moves down the hall to one more apartment and terrifies the guy in the next apartment by asking him the same question and she gets another frightened yes answer she asserts that these three apartments are a perfectly acceptable sample size and concludes that 100% of men in the Salt Lake City metropolitan area are gay yes that's actually true of my living situation and no I do not live in any type of gayborhood it really is just a coincidence that there are three gay men in a row because sometimes coincidences happen Okay coincidence has happened all the time they happen all the time that's why it's important that you use a big enough sample size notice how No Matter What technological marbles you have in this example it is impossible to ensure an accurate result if you are only going to sample three or 10 or even 20 Apartments you can have all the incredible technology in the world but if your sample size is too small you will have the risk of getting a wildly inaccurate result due to coincidences because the problem is not technological it was perfectly accurate in how many gay men were in the three Apartments surveyed that's not an issue the issue is while the sample was accurately measured the sample was not representative of the population because the sample was too small it might suck to ask a thousand people that question or to get tubes and tubes of blood taken but just because that sucks doesn't mean you can just decide that an inaccurate result is fine there are tests that can indeed be run on a tiny drop of blood but that's not the claim Theos made that you could run some tests on a drop of blood would not be remotely suspicious that you can run any test on a tiny drop of blood is extremely suspicious because that is impossible in regard to the tubes and tubes of blood once you've been stuck with the needle I feel like the quantity of blood they take doesn't really matter the issue that some people have is the needle itself and actually getting it inserted but we'll talk more about this later also the suggestion that the Silicon Val VC funded startup Theos was going to make every lab test affordable for every person no matter how much money they have is so ludicrous that I'm not sure I even need to explain why but for starters yeah I'm sure that your investors are expecting no return on their investment whatsoever at this private for-profit healthcare company and will in no way expect you to maximize profits once your magic blood testing machine arrives from the Hogwarts Medical Technology Center and is fully operational not at all that's that's how this works they just want to help people when I think of people who deep down really just are givers and really want to help people I think of Henry Kissinger it's like Henry Kissinger Clara Barton Florence Nightingale so we've built what we call our wellness centers which are our service centers inside of pharmacies and starting in Walgreens I'm now in Arizona so that people can go get a test done after work or on a weekend and begin to engage in this process of getting information about their bodies which can change their life how long do you think it took the Walgreens Executives to recover from the dehydration resulting from their profuse salivation at the prospect of having yet another profit driver for pharmacists to push I I hope that somebody brought them some Pedialite also so can we just appreciate for a second that once again promises that something will change your life seems to be a reliable red flag whether that's an MLM or a new healthc care initiative okay furthermore most Hospital labs are also open for these hours and that's where a lot of patients get sent for labs and I seriously doubt that Theus would ever have expanded into every W greens more likely they would only be at the high performing hight trffic stores in major urban areas and they probably would not be open the same hours as the store would be okay if they were they would need to charge a lot more money for those labs that that's just a fact it's also a lot more complicated to bill for labs than for prescriptions when a prescription is built to your insurance it happens via instant adjudication as in on the spot right there you know if it's covered or not covered and how much your share of the cost is okay that that's not how medical billing Works while I know that there are no purports to be enabling self-ordered self-paid lab tests the fact of the matter is that most lab tests are ordered by a patient's doctor and most patients have insurance and would expect their insurance to pay for part of it so insurance billing would presumably be something that needs to happen here and that would create its own administrative headaches for the providers at these stores it's a problem that medical billing is Arcane and complicated but that problem is not solved by Theos on top of that I I have to imagine that a lot of patients upon receiving their lab results would perfectly reasonably consult the pharmacist about them while this is something the pharmacist is knowledgeable about the ability of the pharmacist to interpret your results is going to be limited by the fact that they don't have your medical chart and history in front of them which could change the interpretation there are some tests they can interpret just fine but they're going to be limits on how helpful they can be it's also an unfortunate re it that the unrealistic workloads and time pressures the chain pharmacies like Walgreens Place upon pharmacists makes their time extremely limited and leaves them unable to really spend more time with the patient to review these things even though most pharmacists would actually really like to do so which is sad for the record there were murmurs among my Walgreens peers that there was something weird about this Theos crap especially the fact that a lot of it was actually conducted via a normal tubes and tubes the blood draw not a finger stick as promised however with the level of hype that was building at the time it's pretty unlikely that anyone was going to ask a few Walgreens pharmacist what they thought and it's pretty unlikely they would have expressed any strong misgivings anyway because I'm sorry fellow pharmacists watching right now but pharmacists are generally huge goobers okay like more than any other healthc care professional dentists not as big of goobers as pharmacists if you need a healthc care professional you can just walk all over pharmacists are who you're looking for I'm sorry but it's true okay do you think nurses or Physicians would put up with the [ __ ] that pharmacists put up with I mean they deal with a lot of [ __ ] but not like being monitored to see if you're offering a flu shot every single time you answer the phone by your district manager or like dealing with people through a drivethru and having to pick up their groceries for them no no I was so shocked when they even showed the half a vertebra of a primordial spinal cord that it required for a few of them to walk out last year not that that will accomplish much of anything because they don't have a guild and because pharmacists are goobers and also somewhat conservative overall they'll never form a guild even though that would give them the power to push CVS and Walgreens around quite a bit since they'd have a unified front but that will never happen because they're [Music] goobers the way we described it in the story is 100th to 1 100th to 1 1000 the amount of blood that you would normally need to give blood painfree quicker cheaper and you can do all sorts of tests I don't know where people are getting this idea that finger sticks are painfree but finger sticks [ __ ] hurt they hurt way more than a needle in the vein does okay it's just false a vinous blood draw is mostly painless you barely feel it a finger stick is not it's also not quicker it's an unfortunate irony that for many patients with diabetes their circulation is not great so it takes quite a bit of effort and fuss to get a blood drop they can use to test they might have to try several fingers and then even really have to like milk the finger to get a drop to come out it gets harder the more finger sticks you do because your skin tends to callous over when you test repeatedly as well a finger stick might be less psychologically painful for those with a phobia of needles but that doesn't excuse an inaccurate description of the actual levels of physical pain experienced in a finger stick versus a Venus blood draw with a needle quicker is also false for many people with poor circulation in their fingers a finger stick can be a difficult complicated process of sticking several fingers with the lanet and milking it milking it to get a drop to finally come out it's just not the simple easy process they portray it as a significant amount of the time okay especially for children and elderly people there are also things that they can do for you if you have a needle phobia to help you there are exposure therapies there's psychological therapy a doctor can prescribe you something like Adavan to take beforehand that could help there are things that can help if you need a lab test done and you are unable to do so because of overwhelming fear additionally it is unlikely that many tests would be able to happen on a single drop of blood because a lot of tests are performed by a chemical reaction with the blood meaning you can't use the same sample twice because it it got transformed by the first test so like you can't just do all the tests on a single drop actually this is as good of a time as any to discuss this clearly based on her wardrobe choices and mannerisms she sees some sort of similarity between herself and Steve Jobs right she sees Steve Jobs as this Visionary this revolutionary who changed the world and therefore she can inovate and change the world too except the goal of Apple computer and the goal of Theos are just not the same thing okay the iPod was a game changing product absolutely however the iPod was not any type of technological breakthrough at the end of the day it was composed of off-the-shelf parts from other vendors the technological thing that made the iPod possible was that Apple learned of a new hard drive being made by tashiba that was only 1.8 in instead of the 2.5 in that other hard drive based MP3 players were using at the time and right away they purchased the rights to these tashiba drives for the iPod realizing its potential for a high capacity but also highly portable MP3 player which was unlike anything else on the market at the time at the time you could have either a flash-based MP3 player that couldn't hold very many songs like it was like 64 megabytes or whatever or you could have one with a really bulky 2.5 in hard drive not to mention the clunky difficult to use software through which you would interact with the damn thing Apple came in and filled the Gap in the market with an MP3 player based on the 1.8 in hard drive for an unprecedented combination of portability and capacity delivered with the attention to style that will always be important despite how much Apple haters say it doesn't matter because guess what it does matter if you want your product to sell well and this marketing angle has always been one of Apple's strengths people don't want to use ugly clunky [ __ ] get over it Okay iTunes was also much easier to use than the syncing methods employed by other music players and the click wheel was a brilliant simple input method for the purpose that was really easy to understand and get a hold of but do you see how none of this is a technological breakthrough none of this is like primary research okay it's a breakthrough in the application of various Technologies but none of these is a new invention the 1.8 in hard drive already existed the MP3 player already existed touch controls already existed it's not like apple had to invent hard drives from scratch to create the iPod the innovation is the way in which Apple applied and marketed pre-existing Technologies to make it a compelling and gamechanging product that's not what Theos claimed to have done Theos was claiming that they had somehow invented a revolutionary way to conduct a blood test in a way that was previously considered to be impossible and that had never been done before people can learn how to program computers and apply technology through their own study but it's very rare that we have self-taught biochemists or molecular biologists it seems very unlikely to me that someone without the years of coursework on biochemistry and molecular biology let alone engineering would have the knowledge base needed to create a brand new lab test far better than anything that had ever been done before it also takes a lot of coursework just to understand what you're even testing let alone how you test it or why you test it my point is building a computer or creating the iPhone is very different from revolutionizing biochemical assays and medical lab science it is a lot simpler to build a computer or write a piece of software or create the iPhone humans are very complex and therefore medicine is very complicated and the stakes are a hell of a lot higher it's not something you just drop out and do you don't have the knowledge base to even understand what you are doing and why oh oh also Elizabeth whenever Steve Jobs would announce a new product like the iPhone or iPod he actually had one he could show the audience okay actually one more thing remember when the iPhone 4 came out and there was that massive Firestorm because of the antenna like people were absolutely outraged and legal action was taken and multiple Regulatory Agencies were considering getting involved yeah that was because their phone didn't get very good signal some of the time if they held it a certain way you know because that's a big deal unlike something trivial like I don't know telling someone they have hepatitis when they actually don't or something silly like that making a computer or a consumer electronic device or an app or a software package is not the same as single-handedly creating one of the biggest breakthroughs in biomedical science of the 21st century okay it's just not what's worse is Not only was Theros claiming to have one of the most significant advances in biomedical Sciences of the 21st century to date but they apparently had done so without any publication in any scholarly Journal this further aroused suspicions among many in the medical sector including me and my peers groundbreaking research and Innovation like what Theos was describing should be shared and disseminated so that it can be peer-reviewed and built upon by others Theos defended its lack of Publications by asserting protection of its Trade Secrets see when you invent something you can choose to either keep it a trade secret or you can patent it a trade secret would be something like the Coca-Cola recipe its exclusivity is maintained purely by keeping it a secret if you figure out what the Coca-Cola recipe is either through it being legally disclosed to you or by reverse engineering there's nothing stopping you from using it because it's not patented it's a trade secret your other option is to patent it which will require you to disclose a lot of details publicly but will secure you exclusivity that can be legally enforced for a period of time and also protects against being reverse engineered most Innovations in the medical and pharmaceutical industry are patent protected not trade secrets and that's largely because there is an expectation that data and research will be published and made publicly available and that devices will be submitted to external validation that's not how Theos was playing so Elizabeth dropped out of Stanford after after one year at 19 to start this company and Elizabeth it actually started out in 2003 as a as a different idea a wearable patch to Monitor and transmit blood information to to doctors right okay did you hear the actual [ __ ] that just came out of her mouth right now like how dumb that is okay I mean like companies already do that but you know and that's also questionable utility and yet that's not actually what the original stated goal of Theos in 2003 was but I'm guessing this interviewer is is kind of softball it because the actual original idea sounds so [ __ ] stupid by now that it's embarrassing see according to the book Bad Blood by The Wall Street Journal reporter John KERO who also wrote the 2015 articles that really managed to expose Theos in a way that turned the tide of public opinion the actual original idea Elizabeth had that caused her to drop out of Stanford and start her own company was a patch that would be able to run lab tests and then administer medications based on those lab tests you see the name Theos was created by Holmes as a portmanto of the word therapy in the Spanish word anos which means anus because she was constantly talking out of her ass oh wait I'm sorry I'm just kidding it's from the word therapy and the word diagnosis meaning her magic patch could do both at once somehow this is one reason why we have medical professionals attend more than one semester of college because that is such an absurdly simplistic view of medicine that it should Inspire laughter not mil ions of dollars in VC funding but I suppose when you have parents who think you are incredibly gifted in VCS with no medical knowledge whatsoever they assume that the nonsense ideas you're speaking are even remotely possible or profitable like wow that's a great idea I have an idea too it's a patch that fixes all your problems puts $1,000 in unmarked bills in your pocket every five and a half hours Whispers The Perfect comeback in your ear every time you're in an argument and gives you a hand job on demand that runs on the power of Moonlight and smooth jazz seriously these [ __ ] rich people truly live in a completely different Universe from the rest of us she drops out of Stanford with that utterly brain dead completely impossible Flatout [ __ ] stupid ass obvious so-called idea and her parents' response is to give her the rest of the tuition they saved up so she can start a business based on it based on that idea based on the [ __ ] idea of a patch with like a little doctor and Pharmacy inside of it like if I dropped out of USC with that idea my parents would have been like are you high right now did California get you with that weed nonsense no well that sounds imbecilic guess you won't be needing any tuition money good luck with the whole earning a living thing like God damn it I can't believe my parents won't let me have their tuition savings for my idea simply because it's not possible and sounds insane damn it Mom I mean the most common prescription medications in this country are blood pressure medications and anti-depressants and those are not diagnosed and prescribed based on lab test and usually antibiotics are given before the lab test even comes back so I don't know man furthermore how would this even work is it going to check for drug drug interactions what about informing the patient of side effects before it just decides it's time to shoot them up with whatever drug it has stored in there what about drug food interactions does the patch know what medications the patient might be be taking later or what they're going to eat later is all the medication stored in the patch what if the patch gets damaged how would this miniature pharmacy even fit in the patch who the hell are these patients that are Contracting so many lab diagnosed diseases and what the hell are they doing with their lives that is causing this who pays for the malpractice damages when the patch [ __ ] up oh oh you didn't think of that right because you had two semesters of college in no relevant clinical non-tech experience but you somehow think you know more than people who went to undergraduate and then medical or Pharmacy or nursing or other professional schools because you're literally 19 years old and like most 19-year olds you're an idiot I'm sorry 19-year-old but you'll agree with me in a few years [Music] I think that many people especially those not in any type of medical field not to say that many in a medical field were not also Bamboozled but just that they were more likely to be skeptical than others look back and think we were all fooled well there were actually many highly qualified people raising concerns but it turns out that nobody was listening instead we had the media fawning over a startup founded by someone with no medical qualifications whatsoever guided and funded by a board largely composed of politicians and ex-military officers who oh yeah also had zero medical qualifications making claims about research that supposedly happened behind closed doors that was never submitted for peerreview where it could you know actually be reviewed by literally anyone who is remotely qualified to do so I mean at some point you have to stop and realize that the clowns are running the circus here so here are a few choice Reddit comments for example that could have saved a lot of money for investors and a lot of Anguish for patients I'm not going to read the entire comment each time because a lot of them are very long but I'm going to grab the key points and then leave out anything that is repeated and just put anything that's different from each comment okay February 26 of 2014 from user slme I guess in response to a link to a wired article titled this woman invented a way to run 30 lab tests on a tiny drop of blood posted in r/ offbeat preface I am a Medtech and have managed a lab this looks like [ __ ] she's invented a marketing campaign for her lab her Nano tube is the exact same thing that already exists called a microtainer made by BD finger Pricks also get done daily usually on kids finger Pricks are undesirable samples for the following reasons number one manual manipulation which is milking the blood out of the finger results in a higher chance of hemalis which can render the results of many tests invalid number two finger Pricks have a higher volume of interstitial fluid in the sample possibly skewing the results number three finger Pricks take longer number four finger Pricks hurt more than a needle and number five finger Pricks tend to clot in the tube which is a big no no for a complete blood count modern chemistry and hematology analyzers only use microl ler amounts of serum per test every day Labs do full chemistry panels on micro containers of blood so I'm not sure why her system is better the reason we take tubes with quote unquote large amounts of blood I put large in quotes because each tube holds about a teaspoon of blood I could literally take hundreds of them out before you'd feel the effects of blood loss are number one it's a better sample so that means less Recollections we have extra in case there's a problem in analysis which means less recollections number three the doctor can add on more tests if something comes back weird which means less Recollections and number four the doctor can order imuno assays or esoteric testing that requires more volume again less Recollections are you seeing a pattern here the lab does not want to be recollecting it's a waste of your time and a waste of our time why not take the extra that you're not going to miss in the first place instead of having to come back a second time unless she has some breakthroughs testing methodology that require significantly less blood than is currently used and I don't think some Stanford Dropout working in her garage is better able to develop these tests than multi-billion dollar Diagnostics companies trust me if some company came along with an analyzer that required 10 times less blood sample with no downsides they would win this entire market and sell billions of dollars in reagents of course they'd be doing it if they could she goes on about automated analysis in her interview a bit but labs are already high automated the trouble comes from shitty collections such as finger Pricks and shitty delivery times she mentioned the problems of people not coming to get their blood work done because they are scared of needles this is a problem but it's not a pre-analytic problem and it's not going to be solved with a new micro sampling technique [ __ ] unquote well said but I guess these investors just know better than a Medtech who has managed a lab right June 2 third of 2014 from talon3 in response to the same article on r/ technology the claim that Theos is able to do all the testing using a single micro sample as opposed to having to draw a dedicated tube for each type of test is a fallacy you do not need to take a separate tube of blood for each test you may see your dr/ Nur fotus taking multiple tubes but that's because the blood is going to different places for example over here we have a yellow top top tube for biochemistry samples and a purple top tube for hematology samples why can't we perform the test on the same tube well there's anti-coagulant in the purple top tube so that they can do blood counts and that interferes with the assays that biochemistry does unless she has invented a completely novel anti-coagulant this still is going to be an issue or she won't be able to perform every test talon3 then quotes where in the article the interviewer asks so if I got a blood test and my doctor saw the results and wanted other tests done I wouldn't have to have more blood drawn and Miss Holmes answers exactly and on their lab form the physician can write if a given result is out of range run this follow-up test and it can all be done immediately using that same sample and talon3 responds yep we can do this already too the reason that it's not done a lot is that the doctors won't check the results straight away and might only look at them the next time the patient is in that might be a week later and the serum blood at that point has either been sitting around for a week and isn't good for anything or it has been disposed of there are countless comments like this just on Reddit alone from qualified individuals making great points based on their experience and their expertise now here are a few items from Reddit that I want to share with you from that time period simply because they're extremely juicy on August 13th of 2015 a user posted a text post in r/ biotech reading master of science MD but no bioengineering background job prospects in biotech laboratory medicine let's just take a moment to admire the spectrum of confidence ranging from Elizabeth Holmes over on one end revolutionizing laboratory science and medicine as We Know It with no degrees and then on the other end we have this medical doctor with a masters in science who is worried that they have no bioengineering background and therefore might not be qualified to get a job in biotech or laboratory medicine incredible anyway in their post they mention being fascinated by the booming consumer industry for example Theos and U CBF 88 responds to the question and in their PS writes I interviewed and declined a position at there and know that place does not have their [ __ ] in order incredible incredible but right here I think I have found the mother of all juicy red thos content okay although I should preface that apparently there was already a YouTuber that found this post magnets media because there's a comment saying LOL so who's here from YouTube on March 7th of 2022 like over two years ago I was excited because I found it using social grap but apparently it's all news but I was very excited whatever uh I'm sure some people haven't seen it on April 4th of 2012 in r/ jobs you/ biotinilated great username by the way posted a text post titled I have a high-paying job in an organization based on lies and fear is this normal I'm not going to read the whole thing but I'll give you the highlights okay they write I work at a biotech company developing a platform for Diagnostic assays vague I know but I definitely can't be specific my job entails developing assay chemistries to be used on this platform my team is under a ton of pressure from the CEOs to churn out developed chemistry as fast as possible they explain that they're new to this industry and they're frequently partnered with other chemistries due to their lack of experience and have frequent meetings with their boss and team advisers they explain quote I have come to understand that in these meetings it is recommended to be extremely selective about what you tell the bossmen as in ignoring the bulk of the evidence we've gathered that suggest the formulation is not working but instead present the one graph that looks okay and tell them that everything's passing with flying colors once the LIE is in place I then have to back it up with data that is simply unattainable and I get [ __ ] from my boss for it the reditor goes on to say that what they've described seems to be the common practice at their workplace with an overall culture of lying to each other in order to look better in the short term even though the product actually doesn't work at all and that the CEOs quote reward those who tell them exactly what they want to hear and punish those who bring them problems and suggestions for improvement I firmly believe this system is going to drive the company into the ground because the CEOs are training everyone to lie to them when they try to implement the product it's going to fall apart because there is just no accountability I can't stand it I left at noon today because I couldn't keep myself from crying I hate lying to people in and I hate discrediting myself by pretending I'm okay with it I relate to that this entire organization is hollow and fear-based this person did end up editing their post to clarify that yes indeed as suspected they did work at Theos yeah not great October 15th of 2015 The Wall Street Journal publishes an article by John kery R titled A prized startups struggles it's an excellent piece of investigative journalism and it is devastating for Theos detailing the inaccurate results knowingly given to patients the misleading claims the use of commercial analyzers from other companies while claiming they were using their own machines the dozens of complaints from doctors and nurses and blatantly fraudulent submissions to Regulatory Agencies on October 16th of 2015 krie R strikes again with a second article reporting that Theos has been ordered by the FDA to stop performing any test with their nanotainer other than the single herpes test they had gotten approval for on the grounds that the nanotainer was an unapproved Class 2 medical device on October 24th of 2015 a team of Wall Street Journal journalists including K Ru reported that Walgreens was halting any expansion of their partnership with Theos until they received satisfactory answers about the the questions raised by that October 15th bombshell and then on November 11th of 2015 kri re reports that Safeway was backing out of a $350 million deal with daros to put testing centers in over 800 of their supermarkets the article notes that despite one Safeway executive being given a terrifyingly high prostate specific antigen test and being told by Theos that it suggested he had prostate cancer that later turned out to be inaccurate Safeway still had planned to go forward with the deal until that first Wall Street Journal article you see what I mean red flags everywhere and yeah at this point the writing was on the wall for there no The Jig was up okay honestly it's extremely lucky that more harm was not done by this colossal cluster [ __ ] it's always important to be skeptical when extraordinary claims are made it's it's worth asking what the qualifications are of those involved and if it were all [ __ ] would anyone be able to tell from the outside seek out critical voices from those with expertise and credentials in the relevant Fields those voices existed for Theos they existed in my pharmacy school class they existed with my Pharmacy School faculty and they existed in the mutterings of the goobers behind the counter at the corner of happy and healthy and can I just say that there was one particular angle that was so frustrating for those of us who are skeptical of Theos okay it is okay to say that it is unlikely that a person has done something because that something is impossible and the fact that the person is a woman does not make it a misogynistic statement to say that what they are attempting to do is impossible and therefore you do not believe they have done it I'm sure there were many misogynistic comments made about M Holmes but if you are going to label any assertion that what she is claiming to be able to do is impossible as misogyny that's going to leave you open to a lot of scammers all right that's it thanks everybody I've been Mac peace out if you have another hype machine company that you'd like me to cover and Shred up leave it in the comments bye oh actually one more thing hi I'm Karen solder from Google my question is uh 500 employees in a $9 billion valuation we all want to know if you're hiring I'm teasing don't don't worry Lizzie I got this one go [ __ ] yourself Karen from Google thanks okay we know Google had a real chubby thinking about all the data they could acquire VI a partnering with Theos but you know I'm sure you'll find another database of personal health information to Hoover up okay just don't [ __ ] with my ability to root and block ads in tracker system wide okay I can't handle it okay when you okay when you when you when you don't steal out of ads every single one feels so intrusive and offensive okay okay all right [Music] bye R Jerry CL Tony Liar Liar oh Liar Liar oh liar liar Flim Flam self dumpster fire buiness cosplay J Financial Blood Fire Liar Liar Liar Liar Li Liar Liar Liar Liar Liar Li liar [Music]