Fingertip with a drop of blood being drawn into a microcuvette slide held by a blue-gloved hand

A Few Drops of Blood

Wouldn’t it be amazing if all of our disease and medical health testing could be done with just a finger prick of blood? Elizabeth Holmes and I share that dream.

She said her company could do it with a small robotic lab-in-a-box. Now she’s facing criminal charges because the blood testing company she founded took some shortcuts.

Elizabeth Holmes and I Have a Dream

It’s a dream of being able to run medical tests from a single finger prick of blood. Holms initially had a dream of diagnosing and treating disease with a patch on the skin. That didn’t work out (neither the diagnosis nor treatment parts).

She founded a company called Real-Time Cures, which became Theranos. (The renaming presumably happened when the idea of providing “cures” to accompany the testing was abandoned).

For Me It’s Personal

Six vials of blood in a rack held in blue-gloved hands.
Six vials of blood drawn for testing as part of a typical blood donation.

I’m familiar with finger pricks and also the needle in my arm. I don’t especially like either one.

Every time I donate blood it starts with a mini-physical. After the questionnaire they check my blood pressure and pulse. Then they take a finger prick of blood. That tiny amount of blood is for a quick check of my hematocrit level (to make sure I have enough iron in my blood).

When the actual blood donation begins, the phlebotomist fills six tubes with blood for testing. Only after that does the bag that holds a unit of blood begin to fill. It would sure be nice if all of my donated blood went to someone who needs it. Of course it would also be fine if they just left the extra in my veins.

One of those tests is for cytomegalovirus. CMV is one of those many viruses that can lead to the “flu-like symptoms” we’re all very conscious of these days. Healthy people exposed to it may have no symptoms at all, but it can cause serious problems for babies. My blood is CMV negative, which means a baby can receive it. An inaccurate test could lead to a false positive, indicating my blood couldn’t be given to a baby who needs it. A false negative could indicate that a unit of blood from an individual exposed to CMV was safe to give to a baby. That could lead to potentially serious problems.

Note that the photos in this post are from the routine testing process when I give blood. That’s a finger-prick quick-test for iron levels, and six tubes of blood sent to a central lab for testing. They do not illustrate Theranos technology.

If it Sounds Too Good To Be True

I’d heard and read amazing things about this revolutionary Theranos technology. They offered a menu (an actual printed menu!) of hundreds of blood tests they could run using a tiny amount of blood from a finger-stick. They promised fast results with greater accuracy. All of this was offered at lower cost than the “venous draw” (needle in the arm) blood tests that we’ve all experienced.

Holmes spoke of a childhood fear of needles as an inspiration for developing this technology. Companies including Walgreens opened Theranos “Wellness Centers” in their stores. Some of these centers resembled a spa more than a lab and the level of customer service was not what you would expect. Some customers were disappointed to find a needle in the arm was used, but Theranos used a small butterfly needle and even then their process drew much less blood than conventional testing.

Walgreens closed the Wellness Centers in 2016 when it became clear that the results were less accurate than conventional testing, not more accurate.

Holmes was charged with eleven counts of wire fraud and conspiracy to commit wire fraud.

Bad Blood

Author John Carreyrou‘s investigative reporting in the Wall Street Journal documented that things at Theranos were not as they seemed. His book, Bad Blood: Secrets and Lies in a Silicon Valley Startup, went into much greater detail and reads like a novel. It’s really a page Turner. To this day, when I see a byline that even looks like his (such as aerospace writer Mark Carreau) I flash-back to Bad Blood.

It’s a compelling true-crime story and I recommend it if you want to learn more about Theranos, Elizabeth Holmes, and her partner “Sunny” Balwani. It’s also a story about dreaming big, and maybe having trouble separating the dream from reality.

Have you ever visited a Theranos Wellness Center, or wished that this kind of quick, accurate, inexpensive blood testing was really available?

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