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Let us now praise famous laboratory professionals

The Drop Out has ended. The rot found at the heart of "disruptive bro" start-ups lives on. Why we still have lessons to learn about the Theranos fraud.

Let us now praise famous laboratory professionals

2022 Hulu The Drop OutHow ethics "Dropped out" of Theranos, Deception came in, and the Laboratorians saved us

Sten Westgard, MS
May 2022


Belated Happy Medical Laboratory Professional Week to all.

A few weeks ago, The Drop Out came to a close. If you haven’t heard of The Drop Out, it’s a streaming series on Hulu about the rise and fall of Elizabeth Holmes and Theranos. It’s not as if there wasn’t already enough media coverage of the crash of Theranos. The original Wall Street Journal reporting became the New York Times bestselling book Bad Blood by reporter John Carreyrou who took the company down (and he also had a podcast which followed the trial of Elizabeth Holmes on charges of investor fraud). HBO had a documentary. The Drop Out was first a podcast, before it was elevated into a dramatic series.

And I highly, highly recommend it. It's not just a compelling true story. It's an important expose of some of the worst strains of our current "entrepreneurial" culture. It should be required viewing for anyone joining the laboratory workforce.

One could make petty criticisms about how small a role the actual laboratory features in the series, how the choice of actors for the lab director and lab inspector play into stereotypes of laboratory professionals (geeky, meek, unkempt, etc.) But those are minor quibbles. Laurie Metcalf’s gravitas as Stanford University School of Medicine’s Phyllis Gardner deserves special praise. Dr. Gardner was one of the first people to be publicly skeptical of Elizabeth Holmes, unflinching in her ability to see through the lies of Theranos. It may be hard to remember now, but at the time, very few in the healthcare industry were willing to stand against the tidal wave of hype and investment money behind Theranos. In the absence of evidence, and feeling the overwhelming pressure of marketing and Silicon Valley myth, too many laboratory leaders remained silent. We should remember and reward those few that did speak out.

The biggest thing I got out of the series was this: it’s crystal clear is how almost everyone involved or touched by the Theranos scandal was afraid, craven, or fully compromised. The founder had no problem with outright lies about Theranos testing capabilities. The executives had no reservations about misleading investors, regulators and the public. The board of directors was at best blind, possibly willfully blind, and at worst, complicit, to the problems and deceptions. The story of Theranos isn’t just the story of a single individual and a fraudulent medical device, it’s a searing indictment of the start-up model. “Fake it ‘til you make it” and “Move fast and break things” are catchy mottos, but truly horrible ways to provide patient care.

The heart of the Theranos story is rooted in America’s mythology of the self-made man/woman/person. You can start here with nothing, with just your idea and your ego, and you can make a fortune. The sinister underbelly of that story, that you can also con your way to the top, is an equally enduring story about America. The Great Gatsby, Bernie Madoff, Enron, Subprime Mortgage crisis, WeWork, and on and on. We root the former and fall for the latter, over and over.

It took the bench technologists and clinical lab scientists to have courage, to listen to their conscience, to remember the ethics of their profession, and rise above fear, above greed, above all that pressure to conform, and make a stand.

In other words, thank God for Erika Cheung and all like her.

Of course, the story is not even finished yet, as Sunny Baldwani’s trial is unfolding right now, and Elizabeth Holmes awaits her sentencing in September.

Our future needs more people like Erika Cheung and Tyler Schultz, and far fewer people like Holmes and Baldwani, and a more mature understanding of entrepreneurship, one that doesn’t confuse fraud with marketing, that doesn’t prioritize disruption and destruction over safety.

You can't drop out on Quality. You have to step up.