We are re-reading Bad Blood, Secrets and Lies in a Silicon Valley Startup by John Carreyrou (published by Alfred A. Knopf, 2018 – Buy a copy and read along).  Chapter 10 focuses on what when Hollywood makes a movie from Bad Blood will be a titanic battle between the indomitable Elizabeth and a career military officer, but what is really a struggle between right and wrong.  In the chapter, Elisabeth forms a relationship with General James Mattis, a Marine Corps General (now Secretary of Defense). Elizabeth and Sunny convince General Mattis to deploy the minilab in Afghanistan; enter Lieutenant colonel (LTC) Shoemaker.  As Mattis would put it later in the chapter, who is LTC Shoemaker?  Who he is, is the gatekeeper between Theranos and the troops.  The premise sold to Mattis is that the miniLab would be able to improve the treatment and survivability of injured soldiers. Mattis is renowned as being very loyal to his troops. As with everything Theranos there are problems, including the chronic ‘say anything and deliver very little’ (over promising).

Medical devices are closely regulated.  Mistakes or over promises can lead to injury or deaths.  In Chapter 9, one of Safeway executives was originally diagnosed with prostate cancer by the Theranos machine/process.  The executive was saved from invasive surgery when a blood sample was re-tested by a reputable firm. Unlike in the Safeway saga where the CEO overrode all controls, the military has a process for vetting and managing medical device acquisitions and trial that is much more difficult to override.  When meeting with Elizabeth, Shoemaker is shocked that Theranos is not following the standard FDA review process and that they have no intention of following the process, because in the opinion of Theranos’ lawyers they do not need to. Shoemaker asks for a written opinion from the FDA to support Theranos’ position. Elizabeth is livid and decides to go around Shoemaker.

This chapter goes into detail about the back and forth that ensues.  One of the most telling moments is late in the chapter when Shoemaker needs to brief Mattis on why the miniLab has not been deployed. The term briefed, might be better translated to being called on the carpet for not making the test happen.  Reputedly being called to brief Mattis in this type of scenario was considered career unpleasant and limiting.  In the end, Mattis brokers a “compromise” test that uses the remainders from blood samples. The “test” would validate the Theranos process.  Theranos never moved forward on the compromise.

If we boil the message of the chapter down – we witness a clash of two very different personalities.  Each is a force of nature. Elizabeth with her single-minded focus on attaining her own goal versus LTC Shoemaker who stands up people well above his pay grade to follow the process.  Not for process sake, but rather because he knows the process values not putting human life and safety at risk.

One of the most important lessons in this chapter is that personal force of will needs to be tempered by the process.  I know that statement is an anathema to many; however, almost every development manager or testing (QA) manager can recount a story where they bow to pressure to put weak or untested code into production. Early in my career, I was advised by my manager to promote a release that had been promised to a client even though it had not completed testing. I folded to his pressure and promoted the code which ended up being a fiasco.  He was promoted and I ended up with a bad review when we backed out the release. Much later in life, I heard that the scales have been balanced – but who is keeping score. Interestingly the gatekeepers that give in and abort the process are the one held accountable not the people who create the problems in the first place.  In the last chapter, the chairman of Safeway lost his job, and in this chapter, Shoemaker would have been thrown under the bus just like a QA manager.


Previous Entries:
Week 1 – Approach and Introduction – https://bit.ly/2J1pY2t     
Week 2 — A Purposeful Life and Gluebot – https://bit.ly/2RZANGh 
Week 3 — Apple Envy, Goodbye East Paly and Childhood Neighbors – https://bit.ly/2zbOTeO
Week 4 — A Reflection – https://bit.ly/2RA6AfT
Week 5 — Sunny – https://bit.ly/2AZ5tRq 
Week 6 – The miniLab –  https://bit.ly/2rfmwJh

Week 7 – Wellness Play – https://bit.ly/2rqUYk6