It was November 2014, and I was working on a feature story about a buzzed-about blood-testing company in Silicon Valley that promised to “disrupt” the lab industry with new technology. The company, Theranos, claimed its revolutionary finger-prick test would be a cheap and less painful way to screen for hundreds of diseases with just a few drops of blood. Old-fashioned venous blood draws, where the patient watches as vial after vial of blood is collected, would quickly become obsolete, Theranos promised.
The interviews took a month to arrange. The public relations officer wanted to know, did I “plan on sourcing other people?” and implied that CEO Elizabeth Holmes might not be available to me if I did talk to other sources. I rejected that condition, but finally the company’s public relations contacts agreed to let me visit its site at the Walgreens in Palo Alto, Calif. — one of the first such setups in the country — followed by a sit-down interview with Holmes at her office.
I arrived at the Walgreens on the morning of Nov. 4 and was met by two Theranos press representatives who would supervise my visit. I took out my recording equipment (the story was for NPR) and began approaching patients who were waiting in line to check in for testing. Some didn’t want to talk to a reporter, but others were open and gracious, sharing with me the reasons they had decided to give Theranos a try. One couple offered to let me come with them into the small testing room, set up to feel like a relaxing spa.
A pattern quickly emerged — none of the patients I talked to that day could get a finger-prick test, as promised. Instead, they received a regular venous blood draw, the same as I’d received on numerous occasions at my doctor’s office, though the phlebotomist said the needle was slightly smaller.
I asked the phlebotomist: Was this standard? Did most patients get the venous draw? She told me they “did more finger sticks than venous draws,” but couldn’t give me a number. One of the PR people approached me — I was not authorized to talk to the phlebotomist, he said — and asked me to erase the audio I had recorded. I declined.
I asked him: Why were none of the patients getting a finger prick? Just bad luck and timing, he said. This wasn’t how it usually was, he promised. And wouldn’t I just rather get a finger prick myself and report on the experience, as so many other journalists had agreed to do?
I said no. I needed an actual patient to make a compelling radio story. So, I continued waiting for other patients.
Soon, the two Theranos representatives approached me again — with a third on the phone, who said she wanted to talk to me. They were getting complaints about my asking patients questions, she told me. The main Theranos office had gotten several calls from people who had been in the Walgreens that morning, she claimed, complaining that a reporter was bothering them.
I hadn’t pressured anyone. The patients I’d interviewed had all been perfectly friendly and willing. I’ve also been a health reporter for 10 years, and never have I been told I was pushing patients to do something that made them uncomfortable.
Something seemed very wrong.
Soon, one of the Theranos representatives approached me again, clearly nervous. They appeared worried. Unless I found a patient getting a finger prick, he said, they would likely have to cancel my interview with Holmes.
It was clearly a threat to try to steer me away from where the story was taking me: Theranos seemed to be doing very few, if any, of its revolutionary tests on actual patients. I asked the press representatives to get the other one on the phone again; I didn’t like being threatened and I wanted to hash it out with her.
Meanwhile, I sat down with another couple, who had driven 45 minutes to experience the vaunted finger prick. Would they too be steered to a traditional blood test?
As I was interviewing them — but before we knew which test they could get — a sudden and jolting BEEP BEEP BEEP reverberated through the drugstore. “Fire alarm!” someone called out, and we evacuated to the street.
I’d never been in a drugstore when the fire alarm went off. There was no smoke and no fire.
I decided to cancel the feature. I had pitched it as a consumer-focused story about how often “less is more” in health care. I clearly no longer had that story. I made a few more calls to various experts on lab testing to try to figure out what was happening: Was Theranos for real? I was given an interview with a lawyer at Theranos, who promised me that “significantly more than 50 percent of the tests are done with a finger prick,” though she would say no more.
Now that Theranos has been implicated in massive fraud, that encounter serves as a reminder of the skepticism both journalists and health care consumers need to have in an age when public relations, marketing and advertising try to guide the story and our treatment.
Theranos generated huge hype and laudatory coverage in places like The New Yorker, Wired and Fortune by selling a compelling idea — even as its PR people couldn’t show me an actual patient who had benefited. Sometimes, in health care, an idea that seems too good to be true, isn’t. We all — patients and journalists — have to do our due diligence.
The PR tactics Theranos employed blocked journalists from providing the kind of scrutiny that might have revealed the fantasy the company was weaving for investors sooner.
And 11 months after my experience at that Walgreens, John Carreyrou of The Wall Street Journal published the first of his groundbreaking investigations surrounding Theranos, blowing the lid off of the company’s fraudulent claims. Of the 240 types of blood tests the company said it did, only 15 used finger-pricking.
Now comes the news that Theranos has accepted a settlement in the fraud case with the Securities and Exchange Commission. Which has me thinking.
Had someone pulled the fire alarm? I’ve been suspicious since the moment it happened.
Last week, I wrote to Theranos to ask. No surprise: no response.
This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.