: New: Book Report: Bad Blood

Content warning: all the gross bodily fluids

Today I was walking along, minding my own business, and I felt something wet on my hip. I looked down and saw blood and guts on my sweatshirt. My brain slewed into heavy diagnostic mode for a couple of seconds while I figured out that this wasn't my blood and guts. My best guess: fish guts. This was near San Francisco's Fisherman's Wharf neighborhood. I guess a seagull was flying around with a mouthful of fish guts and dropped some. Or maybe a seagull vomited on me. Does that happen? Do seagulls vomit up fish guts? If I ate some of the gross fish-stuff that seagulls eat, I'd throw up all the time. But I don't know how often seagulls throw up. I don't even know for sure that a seagull was involved. Maybe some street lunatic was flinging guts around. Stranger things happen in this city every day. I'm used to the idea that, walking a lot around the city without a hat, every so often a bird is going to poop on my head. There's a superstition that's good luck. I never really thought of bird poop as good luck. But the next time it happens, I guess I can think I'm lucky it's not a glob of bloody fish guts because that is nasty. Anyhow. I got home and spent a couple of whiles rinsing blood out of my clothes. The problem: too much blood.

There's this book Bad Blood about Theranos, that company with the opposite problem. Theranos was trying to make an automatic blood testing machine. There were already such machines around. But Theranos was trying to make a portable machine that didn't need to use much blood in its test. It failed. Well…some of the medical nerds working at the place succeeded in developing a few new mechanisms/processes to test blood, but nowhere near the capabilities promised by Elizabeth Holmes, Theranos' liar CEO.

Along with the scariness of the general situation—how many people were harmed by acting on incorrect blood tests before Theranos was shut down?—tech workers get some additional frights by seeing some tech-company-tropes used to great harm.

E.g., Steve Jobs famously kept departments at Apple in the dark about what other departments were working on. This allowed him to make surprise product announcements—very few people knew of the existence of any new product, and thus leaks were rare. Holmes kept Theranos' departments in the dark about what other departments were doing. In theory, this was following Jobs' example. In practice, this meant that few folks within the company knew how poorly the blood-testing machines worked. There's a pattern to this book's stories of whistleblowing Theranos workers. Worker gets hired. Worker is enthusiastic—portable blood testing machines that can work with small samples would make many people's lives better! As far as worker knows, everything is hunky-dory. Worker is in one of the few parts of the company that actually uses the machines. Worker notices that one aspect of the machines doesn't work well, the aspect they're testing. Worker reports this to a higher-up. Worker gets fired for their bad attitude. Other workers off in other departments still assume everything's working fine.

E.g., working around government regulation. Is it right that a company should follow medical-testing rules made to stop wild-west snake oil salesmen? We're in a new age of engineering, skilled in rapid innovation and we're trying to save lives here— And it all probably sounded pretty convincing at the time. But in the end, it just reminds us that the snake oil salesmen have kept up with the pace of innovation just as well as the honest folks.

The book also points out how folks found Holmes' deep voice to be very compelling. I've worked with a couple of managers who had deep voices; in more than one case I'd find myself nodding along to something one of these guys said… only to head back to my desk, sit down, replay the conversation and realize that they'd been talking nonsense. These occasions weren't happy, but looking back I guess I can say it was lucky that those guys weren't working on medical devices.

Tags: book mad science

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