Adonis Diaries

Archive for the ‘economy/finance’ Category

How to Measure without measuring? Are you measuring what’s Not important?

Note: In experiment, testing or evaluation, what is being measured is called dependent variable.

Seth Godin had to say this June 5, 2013 on “Measuring without measuring”

As an organization grows and industrializes, it’s tempting to simplify things for the troops.

Find a goal, make it a number and measure it until it gets better. In most organizations, the thing you measure is the thing that will improve.

Colleges decided that the SAT were a useful shortcut, a way to measure future performance in college.

And nervous parents and competitive kids everywhere embraced the metric, and stick with it, even after seeing (again and again) that all the SAT measures is how well you do on the SAT (Nothing to do with intelligence or effective performance).

It’s easier to focus on one number than it is to focus on a life.

Paypal and Chase and countless other organizations do precisely this: they figure out a metric, decide it’s important and then create a department to improve that metric.

Consider the Chase Fraud Prevention department.

It costs a credit card company (and especially their merchants) a lot of money when fraudulent charges are made, because they often have to eat the cost.

So this department of thousands of people works to make the number of fraudulent charges go down at the same time they keep expenses low.

Which sounds great until you realize that the easiest way to do this is to flag false positives, annoy honest customers and provide little or no fallback when a mistake is made.

Simple example: I regularly get an automated phone call from the bank with an urgent warning. But even when I answer the phone, the system doesn’t let me ring through to an operator.

Instead, I have to write every detail down, then call, wait on hold, prove it’s me, type in all the information, and THEN explain to them that in fact, the charge was mine.

And this department has no incentive to fix this interaction, because ‘annoying’ is not a metric that the bosses have decided to measure.

Someone is busy watching one number, but it’s the wrong one.

Or consider the similar problem at Paypal.

Stories of good (or great) customers being totally shut down, sometimes to the point of bankruptcy, are legion. There may be people at Paypal who care about this, but the security people don’t. That’s because they’re not measuring the right thing.

Measurement is fabulous. Unless you’re busy measuring what’s easy to measure as opposed to what’s important.



My adventure to secure 3 unites of blood AB-negative to mother in a second class hospital

My 90 year-old mother fell for the nth time. This time was serious: for the first time, she volunteered to ask me to be dispatched to the hospital. Every time she fell, this tough and light woman Julia managed Not to have any bone broken. Just serious bruises and black spots in many parts of her body, and pains. For days, I would cook for her and feed her in bed.

This time also, we thought Nothing of the matter. The X-rays were Not confirming 100% of any broken bone, but the  newly installed scanner at Beit Chabab did.

Mother is the type of people who refuses to piss in a “couche” (those Pampers kinds): she’d rather suffer all kinds of pain in order to reach the bathroom and do it properly. Actually, mother barely drinks on account she will have to go to the bathroom more frequently than necessary

The night before taking mother to the hospital, I installed a potty on a chair in her bedroom. I asked her to holler to me when she needs help. I knew that the “couche” she agreed to wear for the night, because she was in great pain, won’t do: she will try to get up herself and do piss on her own.

My hunch turned correct. The next morning she had used the potty out of the bed. With such feats, who would imagine that she has a broken bone? If it were Not for her first-time insistence of checking at the hospital, I wouldn’t have taken seriously that anything was broken. Though, I had suggested to her to have an X-ray taken anyway.

Actually, a couple of years earlier, she burned her arm, hand and chest and part of her face in the 3rd degree, and she managed for 20 minutes to clean up the kitchen before asking for help.

Mother underwent a 5-hour horror check up in the emergency room for a series of tests, X-rays, scanner, blood extraction… while vomiting from a dizzying travel in the Red Cross van. Every time she saw an equipment that she is wheeled to she gets totally upset and frightened. She was sweating, dizzy and her face pretty yellow.

The last equipment was for checking her heart condition before being taken to her room #306. It was already 9:30 pm. And Cedric showed up to give me a ride home

The operation to replace the head of the hip with a prosthetic is Not difficult and does Not require much blood transfusion, but the surgeon demanded 3 units for any eventual emergency.

We were asked to secure 3 units of Blood AB-negative for the surgery. That was news to me that the family has to go around to find these 3 units of a rare blood type: one in 10,000 donors?

And I had to caught up the cost of the prosthetic in the thousands of dollars since the insurance would Not cover these extra materials. And I had to pay in advance before the administration gives the green light for the operation. Otherwise, the operation will Not take place.

The next day, Marie, a US born and raised citizen, gave me a ride to the Red Cross center in Antelias/Rabiyyat in order to bring the units. Marie had to drop her toddler to the nursery, Garderie (kindergarten) and then to the nearby center. The center had none of such kinds of blood. We called the main headquarter in Spears (Beirut), and they had none. Not even A-, B- or even O-.

Marie said: “I appreciate Lebanon system. It is an opportunity to gather friends and ask for their contribution”

We called the NGO “Donner sans compter”. They told us they will do their best to call upon their volunteers. We received no feedback from them.

We had to wreck our minds for alternative sources. I called Jeanine who works at B7aness hospital for help. Hanane posted a request on her social platform. I posted this demand on FB and Twitter. Victor also posted this request on his list of retired army officers.

Tony suggested that Victor calls the military hospital because once his late mother Therese needed urgent blood transfusion and the former army officer Victor managed to secure the required quantity from volunteered soldiers.

Jeanine called back and said she secured 2 units and they’ll be delivered at 6 pm.

Meanwhile, mother was fretting and hysteric: she was denied any food and drink in the last 24 hours, on account that the surgery is very soon. Actually, mother has been forgetful in the last couple of years. And keeping her in the dark is Not an excellent method of securing her cooperation.

I went to the administration at 1 pm and told them I am taking a decision to transfer mother to another hospital. An hour later, the surgeon called me and said that the operation is scheduled for 2 pm.

The night before the surgery, she woke up at 3 am, sat up, removed all the tubes and syringes, dangled her feet from the bed and waked to the bathroom. After a while, the night guard saw blood all over the room and the bed. They had to tie her up.

After her surgery and waking up from the local anesthesia, mother did it again, and twice within an hour: her eccentric behavior forced her to remove whatever were attaching her to the bed and dangled her feet, and blood running every-which way. And she did it again after things were cleaned up before the Chieftain called me at home, angrily telling me: “We are unable to manage your mother”. And I am thinking: “If an entire hospital is unable to care for a patient after surgery, how am I to care for her when she is back home?”

My conjecture is that Mother antics of constantly trying to stand up before going to the hospital exacerbated a tiny fissure, and made it “observable” with the scanner. Someone said we should have asked for a second opinion. Sure, he is Not the one doing the calling for the Red Cross ambulance and transferring mother to various hospitals for confirmation.

This time around the nurses figured out to tie her wrist to the bed guards, with about 15 cm leeway for mother to move her arms without being able to remove any tube and sit up, instead of wrapping her hands in a boxing fashion. She kept telling the nurses that she has arthritis and her fingers hurt her when wrapped this fashion. I guess they thought she had lost it and there was no need to take her observations seriously.

I explained to mother: You don’t have to go to the bathroom. anymore or have to suffer a couche. After surgery they insert a tube for pissing in a bag. Your behavior is normal after anesthesia since it take a while to recover your normal reflection. And she said: Why didn’t they explain all that to me?

All that time mother was in a limbo and unaware of what was happening and nobody cared to explain anything to her.

The morning after the surgery, the nurses wheeled her to the ground floor for another X-ray to check on the prosthetic status, then they infused a unit of blood and performed many task on mother, without even caring to explain to her every step of what she should expect and why?

Since no one of her relatives was there, mother felt totally disoriented and abandoned and she cried non stop for hours. A couple of visitors showed up around 9:30 am and found her sleeping out of exhaustion.

Apparently, “second class” hospitals, which don’t have the backing of serious health institutions, delay Non-urgent surgeries so that the family of the patient do “the due diligence” in securing the flow of fresh blood to replenish depleted reserves in blood.

Two main institutions in Lebanon can fresh blood supply to hospitals: The army (if connected) and the hospital of “Rassoul A3zam” of Hezbollah. This is a great means to indirectly financially support the resistance forces.

People think that since you live in a catastrophic environment (and also caring for the eldest members in the family), it is your duty to resume this untenable life.

I spent my birthday in the hospital by mother after her surgery. A few visitors demanded that I sleep over the night there to tend to the “dangerous” eccentricities of mother. I refused. They blamed me.

The last of mother’s visitors in the hospital left at 9:00 pm. He said he no longer lives in Konetra where I live. Those who promised to return and pick me up did’t show up. My calls to a couple of Taxis didn’t respond to my call. I walked home, as usual.

Last night at 9:30 pm, I had to walk home from the hospital, about 70 minutes walking at my slow pace. The weather was fresh, but I managed a sweat after all. Someone asked me what I have in my backpack. I replied “Delivery”.

Someone had asked me: Why you didn’t dispatch your mother to a more professional hospital, such as Bhaness, 12 km away. And I’m thinking: and return walking at home from there?

Why most elder people, reacting to local anesthesia after a surgery, need to take off their hospital gown and every syringes attached to their body? They wouldn’t mind removing their skin too.

On se croit plus intelligent quand on devient malade? Do you think sick people, and the terminally ill, exhibit more reflective opinions that are confused with increased intelligence?

Not when you are 90 and physicians and nurses think they don’t need to explain anything to the hapless patients, since they are the professionals and they treating a disease, Not a person.

General Electric  vying to plunder Lebanon water resources?

General Electric is trying to do in Lebanon what ARAMCO did in Saudi Arabia in the 1960’s, where they formed a joint mutual interest entity between Saudis & Americans to exploit exclusively Saudi Oil fields at the very early times of the Oil revolution.
And then to commit Saudi Kingdom to sell it only in US dollars for them to keep printing US Dollars of the recurring  inflation.
Lebanon wealth is in its waters for it being a natural basin reservoir in the Near East (Levant States), where GE says we have 3 trillion m3 of renewable waters every year, to exploit it they’d dig at 400 m of altitude and let this underground basin of water burst into waterfalls and lakes, then channel it to the Arabian gulf countries like Saudi and Kuwait and sell them 1 trillion m3/year each.
Our government is asked here to manage  the monetization of our waters as a natural resource and ask market makers in the USA to create future contracts in this resource and price it  same like Oil and float it as a basic commodity before any step or contract is undertaken
If this happens, we’re the wealthiest nation on earth to become!
Lebanon holds all the waters the middle east needs and it is renewable from melting snow and rainfalls every year. (Climate change is reversing this trend: rain fall and snow capping mountains have become rare events in the latest years)
GE runs most of the 23 desalinisation plants in Saudi Kingdom and they consume 287,000 barrels of Oil a day to purify 3 million m3 of sea water each day, representing 60% of water needs. This produced water still lack minerals and many natural component to be drinkable.
The very high cost to get water in the Arabian peninsula has sent GE staring at Lebanon waters as the natural basin of the Middle East.
When this commodity is priced, monetized and floated in the financial markets it can be the major component of Peace in the region, and properly distributed to all, to drink, use it in agriculture and power generation dams. It is as scarce as Oil but more valuable.
Kiwan opinion is “I am for the fact to return other giant companies in the deal to implement competition although I believe sincerely that there need the United States of America in order to conclude an exploitation of our resources in waters, for several reasons.
One, this will be a strategic alliance as the future markets of amenities exist exclusively in the USA, a vital factor has the monetization of our water resources.
Two, our wealth of waters is strategic for Israel and a major component of peace in the region (What kind of peace? “What is ours is ours, and what is yours is still ours”?)
Three most of “our clients” who crave potable water like the Arab Gulf countries are of Allied strategic with the USA, where our re-entry for this convenience and our economic stability based on the sale of the Lebanese waters has abroad”.
Note 1: Turkey has been adopting this strategy of using its vast resources in water to blackmail other regional States like Syria, Iraq and Iran. It has been foolishly building many dams, just to retain water from other countries and be paid for this natural resource.
Note 2: Israel is keeping Syria Golan Heights for its vast sources of water and denying the Palestinians their share in water.

Tidbits and notes posted on FB and Twitter. Part 200

Note: I take notes of books I read and comment on events and edit sentences that fit my style. I pa attention to researched documentaries and serious links I receive. The page is long and growing like crazy, and the sections I post contains a month-old events that are worth refreshing your memory.

Toussaint Louverture (1743-1803) revolted against the French troops in the island of Haiti/Dominican and sent Napoleon a respectful letter in 1801 declaring a new Constitution to Haiti and the wish to stay part of French protectorate.  The constitution stated that:

First, “there cannot exist slaves on the territory of Haiti”;

two, “slavery is abolished and all men, regardless of color of skin, are born, live, and die free men”;

third, “Any man is admissible to all kinds of jobs and employment”; and

fourth, “The constitution guarantees liberty and security to all citizens”.

Napoleon didn’t find this declaration funny

In 1802, a lieutenant to Toussaint, Jean-Jacque Dessalines defeated the French troops in “La Verriere” and was appointed Emperor to the Haiti Empire.  The new constitution of 1805 stated that:

First, “The people living in the island decided to live in a free State, sovereign, and independent of any foreign powers”;

two, “Slavery is abolished and no white individual will be permitted to own properties as master”; and

third, “Every citizen will be called Black regardless of the color of his skin and will enjoy the same equal citizenship rights”.  That was the first time that Negro or “negritude” was advanced as a culture.

The fanatic Zionists are running out of excuses Not to establish two separate States and have no recourse but to appealing to mythical divine claims in order to usurp Palestinian rights.

The Palestinian religious extremists had to infuse divine rights to Justice and Humanity, since the successive US government, Congress, and Senate refused legitimate natural and human rights to Palestinians as an identity and as a State.

War against Da3esh (ISIS) will never be over as long as there is this huge pool of young refugees in camps. Actually, Da3esh was created within the vast US camp in Iraq which lasted too long

It turned out that the Koran:
1. Never mentioned an Islamic State
2. Never mentioned al Shari3a
3. Never believed in miracles (How more rational it can be?)
4. Had no punctuation whatsoever: it could be interpreted widely by any educated person

I wish everyone connected to the social netwrok to contribute propagating these news:
1. Israel detains, every day, administratively a dozen Palestinian youth
2. Israel still keeps 400 Palestinian martyrs and refuse to deliver the bodies to their families
3. Israel detains 7,000 Palestinians without trial

USA, Russia and Turkey are doing their best to deviate Syria’s plan to the North (Afrin province), but Syria refuses to fall into that trap. The real battlefield is the re-conquest of the Golan Heights. Entering Galilee by Hezbollah is but the second phase in the next war.

Have you lived so long just to end up believing that all knowledge and wisdom are found in a single book? And you dare look me in the eyes and censure me?

Mind you that England fomented WWI when it realized, 7 years earlier, that Germany over ranked her in world export market, second to USA?

Before Bismark who united Germany, France was the nemesis of England for the simple reason that France could quickly dominate Europe with its vast population, administrative effectiveness, land and mind.

England was always willing to fund European political discord with France that it created in order to keep France short on liquid money.


BDS claims ‘massive victory’ after company reports $4m in losses

Versarin is a partner with Israel Aerospace Industries.

Supporters of the international Boycott, Divestment and Sanctions (BDS) movement are claiming a major victory following the news that an engineering company reported a loss of over $4 million on the back of a campaign exposing its alleged links with Israel Aerospace Industries.

The losses were revealed by the company’s chief executive officer during a bitter Twitter exchange with students from the University of Manchester (UoM) who brought to light a web of connection between UoM, Versarin, which is a commercial partner of UoM, and Israel Aerospace Industries. In their report released last month, campaigners alleged that Versarin made a deal with IAI in 2017.

Neill Ricketts, the chief executive officer of Versarin, who strongly rejected the conclusions of the report throughout the Twitter exchange, threatened to “sue individuals” for the loss of over $4 million which he believed was a consequence of “misinformation and mistruth”.

Activists taking parts in the 'Big Ride' blockade a UK-based Elbit Systems subsidiary. Image taken on August 8, 2016

Activists taking parts in the ‘Big Ride’ blockade, a UK-based Elbit Systems subsidiary [File photo]

Read: UK government seeks to overturn BDS victory in court

“My fear is honest private investors missing out as a result of misinformation and mistruth. I would sue the individuals for my loses which total £3m today. People should not be allowed to just lie and get away with it”. Neill Ricketts@neillricketts

Questioned as to how the company suffered the loss, Ricketts said: “The share price dropped on the back of fake news that caused some shareholders to sell.  As a result those that made up stories are liable for the losses incurred by the other shareholders.”

Ricketts, who was cited in the original report exuding over his company’s relations with the Israeli aerospace industry, reported the losses during a long and bitter Twitter exchange with UoM student and one of the authors of the report, Huda Ammori.

Read: Activists expose UK university’s links to Israel weapons manufacturer

The exchange began after Ammori responded to a tweet by Rickett from February in which he said: “Having a busy time in Israel with long hours and lots of meetings and presentations, did you know that despite not being in Europe they still can access European grants.” Neill Ricketts@neillricketts. 

Ammori replied: “More like, having a busy time creating links with Israel’s arms trade using my university @OfficialUoM as a research hub for your dodgy deals.” Ammori’s response to a three-month-old tweet by Ricketts appears to be a reaction to Israel’s brutal attack on Palestinians in Gaza.

Describing her joy over Versarin’s losses, which in all likelihood would not have been known to the wider public without Ricketts’ admission on Twitter, Ammori said that this was a “massive success” for BDS.

Speaking to MEMO she added that the loss was solely due to Versarin’s deal with Israeli companies and shareholders needed to think twice about working with a country like Israel that is responsible for the longest and most brutal occupation in modern history as well as carrying out dozens of massacres against Palestinians.

Update: A previous version of this report said that campaigners claimed that Versarin developed technology that was sold to Israel which was used by the Israeli military in the Gaza onslaught of 2014. This is not the case.

What Programming Language do you use? Would you switch based on Average Income?

 posted this August 21, 2013 “Average Income per Programming Language” (selected as one of top posts)

Update 8/21:  I’ve gotten a lot of feedback about issues with these rankings from comments, and have tried to address some of them here The data there has been updated to include confidence intervals.

A few weeks ago I described how I used Git commit metadata plus the Rapleaf API to build aggregate demographic profiles for popular GitHub organizations (blog post here, per-organization data available here).

I was also interested in slicing the data somewhat differently, breaking down demographics per programming language instead of per organization.

Stereotypes about developers of various languages abound, but I was curious how these lined up with reality.

The easiest place to start was age, income, and gender breakdowns per language. Given the data I’d already collected, this wasn’t too challenging:

  • For each repository I used GitHub’s estimate of a repostory’s language composition.  For example, GitHub estimates this project at 75% Java.
  • For each language, I aggregated incomes for all developers who have contributed to a project which is at least 50% that language (by the above measure).
  • I filtered for languages with > 100 available income data points.

Here are the results for income, sorted from lowest average household income to highest:

Language Average Household Income ($) Data Points
Puppet 87,589.29 112
Haskell 89,973.82 191
PHP 94,031.19 978
CoffeeScript 94,890.80 435
VimL 94,967.11 532
Shell 96,930.54 979
Lua 96,930.69 101
Erlang 97,306.55 168
Clojure 97,500.00 269
Python 97,578.87 2314
JavaScript 97,598.75 3443
Emacs Lisp 97,774.65 355
C# 97,823.31 665
Ruby 98,238.74 3242
C++ 99,147.93 845
CSS 99,881.40 527
Perl 100,295.45 990
C 100,766.51 2120
Go 101,158.01 231
Scala 101,460.91 243
ColdFusion 101,536.70 109
Objective-C 101,801.60 562
Groovy 102,650.86 116
Java 103,179.39 1402
XSLT 106,199.19 123
ActionScript 108,119.47 113

Here’s the same data in chart form:

Language vs Income

Most of the language rankings were roughly in line with my expectations, to the extent I had any:

  • Haskell is a very academic language, and academia is not known for generous salaries
  • PHP is a very accessible language, and it makes sense that casual / younger / lower paid programmers can easily contribute
  • On the high end of the spectrum, Java and ActionScript are used heavily in enterprise software, and enterprise software is certainly known to pay well

On the other hand, I’m unfamiliar with some of the other languages on the high/low ends like XSLT, Puppet, and CoffeeScript.  Any ideas on why these languages ranked higher or lower than average?

Caveats before making too many conclusions from the data here:

  • These are all open-source projects, which may not accurately represent compensation among closed-source developers
  • Rapleaf data does not have total income coverage, and the sample may be biased
  • I have not corrected for any other skew (age, gender, etc)
  • I haven’t crawled all repositories on GitHub, so the users for whom I have data may not be a representative sample

That said, even though the absolute numbers may be biased, I think this is a good starting point when comparing relative compensation between languages.

Let me know any thoughts or suggestions about the methodology or the results.  I’ll follow up soon

Blood, sweat and tears in biotech — the Theranos story

Eric Topol, May 14, 2018

Bad Blood: Secrets and Lies in a Silicon Valley Startup John Carreyrou Knopf (2018)

Few scandals have so gripped both the health-care and technology industries as the seismic rise and fall of blood-testing company Theranos.

In Bad Blood, acclaimed investigative journalist John Carreyrou, who broke the story in 2015, presents comprehensive evidence of the fraud perpetrated by Theranos chief executive Elizabeth Holmes.

Specifically, Holmes and the company’s former president Ramesh ‘Sunny’ Balwani raised more than US$700 million through “elaborate, years-long fraud in which they exaggerated or made false statements about the company’s technology, business, and financial performance”, as the US Securities and Exchange Commission put it in March this year.

By the time Carreyrou’s Wall Street Journal story and a long chain of follow-ups had led to regulators closing down Theranos’s labs in 2016, nearly 1 million lab tests had been run in California and Arizona.

A significant proportion of these were erroneous; all had to be voided. An untold number of people were harmed by the erroneous results: some underwent unnecessary procedures, received misdiagnoses of serious conditions and experienced emotional turmoil.

Carreyrou presents the scientific, human, legal and social sides of the story in full. Although some of it was previously reported in his extensive coverage, he unveils many dark secrets of Theranos that have not previously been laid bare.

The company’s alluring goal, which changed as it evolved, was to quickly analyse a drop of blood for hundreds of different assays, at a fraction of prevailing costs. Collected in ‘nanotainers’ and allegedly tested in a diagnostic ‘miniLab’ the size of a microwave oven, the method was publicized as revolutionizing an industry that hadn’t changed for decades.

Holmes, who idolized Apple entrepreneur Steve Jobs, called it “the iPod of health care”.

As a child in the 1990s in the United States, Holmes declared that she wanted to be a billionaire when she grew up. By age 30, she had achieved her goal.

Highly intelligent, she had been accepted in 2002 to study chemical engineering at Stanford University in California as a President’s Scholar, a prestigious programme that comes with a grant. She dropped out in her second year to start Real-Time Cures, the Palo Alto-based company that became Theranos and operated for 15 years.

Carreyrou explores Holmes’s talents and liabilities.

Driven, and with an exceptional gift for selling ideas, she built up a board of high-level political figures, such as former secretaries of state George Shultz and Henry Kissinger, former secretary of defence William Perry, Marine Corps general (now secretary of defence) James ‘Mad Dog’ Mattis, and former senator Sam Nunn.

Investors included media magnate Rupert Murdoch; partners numbered supermarket giant Safeway and pharmacy chain Walgreens.

Channing Robertson, a professor of Holmes’s at Stanford, was a board member and adviser to the company.

In 2015, Holmes was recognized by then-president Barack Obama as a US ambassador for global entrepreneurship. The same year, vice-president Joe Biden sang her praises at a launch of the miniLab (which Carreyrou uncovers as completely fake; the lab was not operational at the time).

All the while, as Carreyrou reports, Holmes was lying about the nanotainer, contracts with the pharmaceutical industry and assay validation. She made false statements to the US Federal Drug Administration (FDA) and to the US government agency that regulates blood-testing labs, the Centers for Medicare and Medicaid Services.

And she claimed that Theranos was being used on the battlefield in Afghanistan, saving soldiers’ lives.

Holmes described the miniLab as “the most important thing humanity has ever built”.

But at best, the lab could do immuno-assays using micro-fluidics. The tiny blood sample had to be diluted extensively (for which there are no reference standards or precedents), leading to artefacts and spurious results.

Later inspections by the FDA demonstrated poor quality control of multiple lab tests using Theranos equipment, and several examples of failed proficiency testing.

The rest of the hundreds of routine assays the lab was supposed to deliver would require cytometry, general chemistry and DNA amplification. These were done using routine commercially available lab equipment, or were hived off to other facilities. That was the well-kept secret inside the toxic work environment that Bad Blood exposes.

Carreyrou describes firings and legal threats to and serious intimidation of employees, as well as industrial espionage involving spying on employees’ social-media accounts. The book even goes into the suicide of a former leader of the company’s chemistry group.

I met Holmes twice and conducted a video interview with her in 2013, for the medical-information website Medscape. At the time, I gave a fingerstick nanotainer blood sample and within 30 minutes received my results for many routine tests — allegedly showing, for instance, normal glucose and lipid levels in accordance with previous testing.

Little did I know that they were run on a standard Siemens machine (I was not allowed to see the lab area) in the back room of Theranos, and had nothing to do with the miniLab.

Like so many others, I had confirmation bias, wanting this young, ambitious woman with a great idea to succeed. The following year, in an interview with The New Yorker, I expressed my deep concern about the lack of any Theranos transparency or peer-reviewed research.

Near the end of Bad Blood, Carreyrou describes how, in 2015, litigator David Boies — then Theranos’s legal counsel — attempted to prevent The Wall Street Journal from publishing Carreyrou’s reportage. For instance, Boies accused the paper of publishing Theranos trade secrets and making false and defamatory statements.

Despite the $125 million invested in Theranos by Murdoch, the newspaper’s owner, the pieces were published. We also learn about Carreyrou’s tipster, a pathologist and blogger, along with so many employees who were rightfully afraid of hurting patients with fraudulent lab results.

The combination of these brave whistle-blowers, and a tenacious journalist who interviewed 150 people (including 60 former employees) makes for a veritable page-turner.

My only criticism is the book’s lack of reflection about lessons learnt from this debacle.

How did a company rise to a valuation of $9 billion in a network of so many influential people, even as people were endangered? In my view, letting this technology loose (despite grand claims) without a single publication by independent scientists, never mind replication, was a recipe for jeopardy.

Had the medical community and regulators held the company accountable, this could have been pre-empted. There have been other examples of Silicon Valley companies that rose meteorically, but none has put patients’ health at risk. Hopefully, the evidence in Bad Blood will stop it happening again.




May 2018
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