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The Inventor examines the $9 billion Theranos scandal, and blames Silicon Valley

The Inventor examines the $9 billion Theranos scandal, and blames Silicon Valley

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Alex Gibney’s latest documentary considers how a $9 billion company emerged, then dissolved, over a few short years

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Photo: Drew Kelly / Sundance Institute

Welcome to Cheat Sheet, our brief breakdown-style reviews of festival films, VR previews, and other special event releases. This review comes from the 2019 Sundance Film Festival. It has been updated to coincide with the film’s HBO release.

Alex Gibney’s documentary The Inventor: Out for Blood in Silicon Valley starts with a compelling, startling hook: an opening tease about a private tech startup launched by a 19-year-old, once valued at $9 billion, and now worth absolutely nothing. Theranos was a health-care company built around a device called the Edison, a desktop-printer-sized blood tester that purported to quickly perform hundreds of scans on a micro-dose of blood. Founder Elizabeth Holmes was once widely celebrated by magazines like Forbes and Fortune, and her youth, her startling looks, and her confident promises to upend and “democratize” the health-care industry made her a talk-show darling and a popular public figure.

And then whistleblowers began to reveal that her startup, Theranos, was committing massive fraud, that the Edison didn’t work, that the company was feeding patients unreliable and potentially dangerous information about their health, and more. The Inventor tracks Theranos’ buildup and fallout, focusing particularly on Holmes — and on the difficulty of finding the truth about what she knew or didn’t know, or getting honest answers out of someone who built a fast-paced, massive, short-lived empire on bald-faced lies and apparently unshakable idealism.

What’s the genre?

Recent-history documentary. Gibney, the Oscar-winning director of the deeply depressing, admirably well researched 2008 documentary Taxi to the Dark Side (about the death of a falsely accused Afghani citizen under American torture), relies heavily on talking-head interviews with former Theranos employees. He brings in figures from Chief Creative Officer Patrick O’Neill (who comes across as mildly chagrined about the whole mess) to the primary Theranos whistleblowers, intern Tyler Shultz and lab tech Erika Cheung. He talks to The Wall Street Journal’s John Carreyrou, who broke the Theranos story and later wrote a book about it: Bad Blood: Secrets and Lies in a Silicon Valley Startup. And he interviews central figures like Fortune’s Roger Parloff, a strong Theranos booster who eventually bitterly turned on Holmes as the company’s malfeasance emerged.

Gibney also uses CGI re-creations (including gaudy flythroughs of the Edison machine), internal company footage, and news and interview clips to tell the story. It’s a lively, varied assemblage of video that sometimes comes across as if it started life as a pro-Theranos “watch this company grow” documentary, then took a darker turn.

What’s it about?

To some degree, The Inventor is just about a single company and what went wrong with it. It primarily focuses on Holmes, with some side interest in software mogul Ramesh “Sunny” Balwani, Holmes’ boyfriend and Theranos’ president and COO. Gibney takes a particular interest in powerful enabling figures like former Secretaries of State Henry Kissinger and George Shultz, and recently resigned Secretary of Defense Jim Mattis, all of whom were deeply impressed by Holmes and helped boost her profile with investors and the media. Gibney smartly avoids exploring any sense that Holmes’ youth, attractiveness, and force of personality made it particularly easy for her to manipulate older men, but the implication is lurking in every clip of those men fulsomely praising her.

Big promises and big lies let Elizabeth Holmes manipulate investors and the media

And more broadly, Gibney touches on the idea that those same assets, plus a willingness to think improbably big and make accordingly sky-high promises, let Holmes generally manipulate investors and the media, who were quick to buy into her promises of industry disruption and technological revolution. Even lacking proof of Edison’s efficacy, companies and venture capitalists alike sank some $900 million into Theranos, in the hope of cashing in on the next big world-changing technology.

What’s it really about?

There are hints, especially toward the end of The Inventor, that it’s going to explore a wider problem and find larger messages in the Theranos mess. It hints that the Silicon Valley startup industry openly encourages companies to lie to investors, and that the lack of regulatory oversight makes it easy for charismatic liars to get away with outsized promises. And it implies that the entire structure of the VC world encourages a “fake it ’til you make it” attitude toward technology, with people like Holmes pretending they’ve developed groundbreaking devices, then using the resulting investments to try to bootstrap the technology they claim they’ve already created. It’s an inherently unstable model that sometimes works, and the rewards if it does can be tremendous. But The Inventor doesn’t dig particularly far into that idea, or spend much time contextualizing Theranos in terms of other Silicon Valley startups that have soared or folded. The film’s biggest weakness is the way Gibney feints at a larger purpose without really carrying it out.

Photo: Drew Kelly / Sundance Institute

Is it good?

For viewers not already intimately informed on the Theranos scandal, The Inventor’s first act may seem like a frustrating pile-on of trivia without enough substance to tell the story it teases. After that riveting opening, laying out the bare bones of Theranos’ rise and fall, Gibney backs off and spends a long time just on Holmes, exploring barely relevant things like her monochromatic wardrobe (and her insistence that in spite of her admiration of Steve Jobs, she didn’t steal his look — she’s liked black turtlenecks since childhood). Part of the approach is about considering Holmes’ surface, since it’s so difficult to get past that surface. Her stylized image was heavily used to sell Theranos to the public — the idea of a very young woman with a very big idea was core to the company’s model, and to its Apple-esque cult-of-personality approach to advertising. But by the end of the film, in spite of all the revelations about Theranos’ deceptions, she still seems more like a brand than a person.

The film picks up considerably when it moves past her and into the meat of the scandal — how Theranos promised its tiny “nanotainers” of blood, obtained from a finger-prick instead of a venous blood draw, would make testing easier on patients. How the company partnered with Walgreens, promising a menu of more than 200 easy over-the-counter finger-prick blood tests at Walgreens locations, then quietly worked around the limits of the Edison by taking venous blood samples and performing the blood tests offsite, with conventional machinery. How Theranos disguised its failures with a cloud of meaningless FDA filings and vague statements, then ruthlessly attacked the whistleblowers exposing what it was up to. At that point, The Inventor becomes a classic dramatic face-off between corporate malfeasance and a few determined fighters for the truth.

One of Gibney’s great strengths is laying out the facts with minimal editorializing

One of Gibney’s great strengths in The Inventor is in making all this information clear, simple, and easily accessible, without editorializing, or openly villainizing figures like Holmes. Viewers are left to interpret as they prefer — did she over-promise out of an honest desire to, as she put it, put health care information and choices back in patients’ hands? Or was there actual intent to defraud? Was there a meaningful turning point where she realized the Edison couldn’t do what she’d promised, but that she couldn’t admit it without gutting her company and ensuring she wouldn’t be able to move forward? The film puts forward an interesting theory, in the form of a long sidebar from behavioral economist Dan Ariely, who explains how guilt, idealism, and financial choices can interact in telling ways. But Gibney doesn’t have solid answers. He just tracks the process of Theranos’ outing and collapse, and leaves the rest open to interpretation.

But just as that approach feels admirable because it isn’t heavy-handed, forcing an agenda or hectoring the audience to take up a specific moral stance, it also feels a little empty. Ultimately, the audience is left wondering who Elizabeth Holmes really is, or who she ever was. Carreyrou’s book Bad Blood has been optioned to be adapted into a film by Adam McKay, director of the bitterly satirical recent-history films The Big Short and Vice. If that film comes to fruition, it’ll be interesting to see whether he takes an equally close but agnostic stance toward the company’s founders.

What should it be rated?

Possibly G, given the lack of violence, profanity, sexuality, or really anything beyond hubris, lies, and an awful lot of wasted money, energy, and hope.

How can I actually watch it?

The Inventor: Out for Blood in Silicon Valley is an HBO Docs production and is now available on HBO.