The Inventor: Out for Blood in Silicon Valley (Web Exclusive)
Reviewed by Bill Nichols
Produced by Jessie Deeter, Erin Edeiken, and Alex Gibney; directed by Alex Gibney; written by Alex Gibney; cinematography by Lincoln Else and Antonio Rossi; edited by Andy Grieve and Alexis Johnson; music by Will Bates. Color, 119 min. A Home Box Office release.
Elizabeth Holmes had a dream. She would found a company, Theranos, and build a little machine, which she named “Edison,” capable of testing for two hundred diseases from a single drop of blood, a procedure that could be easily done in every home. The dream turned into a nightmare when it became obvious that her idea defied the laws of physics, despite her prodigious efforts to have it be otherwise, and that she and her company lied to and deceived investors, health care providers, the media, and the general public in their quest to attain an impossible goal.
As exposés appeared, especially John Carreyrou’s book, Bad Blood: Secrets and Lies in a Silicon Valley Startup (Alfred Knopf, 2018), filmmaker Alex Gibney became interested in what had the scent of another tale of the obsessive pursuit of a goal by any means necessary—a theme that runs through Enron: The Smartest Guys in the Room (2005); The Armstrong Lie (2013), about Lance Armstrong’s regular use of performance enhancing drugs to win huge success at the Tour de France while vehemently denying any drug use at all; Going Clear: Scientology and the Prison of Belief (2015); and Steve Jobs: The Man in the Machine (2015), among others. Along the way Gibney came into possession of an extraordinary trove of footage shot by documentarian Errol Morris that Holmes had commissioned to promote a glowing picture of Theranos as a bright new star in the medical firmament.
This anonymous gift to Gibney undoubtedly came from either a Theranos or TWBA/Chiat/Day ad agency employee (the agency that represented Errol Morris) after Theranos began to implode. As reported by Jordan Ogihara in Hyperallergic, Errol Morris refused to speak to Alex Gibney about his work or to appear in Gibney’s film, but he did promote the story of Theranos as the creation of a Stanford dropout (Holmes) who would transform the medical blood testing industry. Holmes sold her dream not only to savvy venture capitalists but also to gullible yet powerful men with little to no background in medical technology or scientific method but who were eager to jump aboard the hot next thing led by a charismatic woman from Silicon Valley. They bought the story and ignored the facts. They succumbed to the seductive power of storytelling. It was the Greeks who taught us that rhetorical effectiveness increases if an audience’s pre-existing assumptions and expectations can be brought to bear. Holmes played up her role as visionary genius with a near magical product, an elixir for ills, that anyone would, of course, want to help make a reality. Unfortunately, Holmes was far more skilled at rhetoric than at scientific research.
Holmes did everything she could to keep the facts of failure secret as the company plunged ahead with promises and plans that, unlike those of most startups, put human lives at risk. Gibney laces interviews with Holmes throughout his film as she repeats the same visionary claims and scoffs at detractors as naysayers jealous of a woman too brave to fail. Walgreens even agreed to conduct blood tests using Holmes’s machinery but the tests were secretly done on other, reliable devices since consistent results were never possible with the Edison, an impossibly small, scientifically impractical testing device that some of Morris’s footage demonstrates failing completely in its assigned task.
Morris’s eagerness to heap yet more praise on Holmes as a Silicon Valley “genius” proves profoundly misplaced. As Emily Yoshida argues in her online review in Vulture, “Why the Errol Morris Shade in Alex Gibney’s The Inventor Is So Brutal” (https://www.vulture.com/2019/03/why-is-errol-morris-in-alex-gibneys-the-inventor.html), Gibney indirectly demonstrates that Morris’s reputation for the pursuit of truth and the exposure of self-deception was placed on hold as he fawned over the carefully concocted image Ms. Holmes created as a visionary disrupter of our healthcare industry. Gibney’s film makes it abundantly clear that Morris was as self-deceived as Holmes and, like her, his obsessive pursuit of a well-formed image for her and her company, took precedence over facts, truth, and a clear-eyed assessment of the risks of testing blood for illnesses on a machine whose results were consistently unreliable.
Gibney not only uses Morris’s footage to put Holmes on endless display as an expressionless, blinkless, see-no-flaw-that-can’t-be-willed-out-of-existence shill for her own company, but he also goes on to imitate Morris’s remarkable skill at creating subjective, fantastic images to capture the inner, emotional world appearances hide. These range from giant bubbles of blood floating across the screen, sometimes with Holmes’s face inside a bubble or other iconographically loaded inserts, to enormous pure-white dice bearing bright red dots that tumble toward us in slow motion. Like Morris’s documentaries, A Brief History of Time (1991) or Fast, Cheap and Out of Control (1997), The Inventor is extraordinarily resourceful in creating stunningly imaginative visuals to represent the halcyon world Elizabeth Holmes sought to conjure, and the darker nightmare lurking within it. There can be little doubt that The Inventor is a commentary on Morris’s filmmaking style of dramatic hyperbole as a source of enchantment and danger, when the passion for visual flair overrides the need for objective assessment. His insistence that truth is not relative, that it is real and unquestionable, is also called into sharp question when we witness him helping create a reality based on falsehoods rather than facts, facts that due diligence could have readily discovered. Morris bought into what one employee called the “carpet world” of orderly activity displayed for the casual visitor and ignored the “tile world,” a sequestered realm, consigned to the basement, where technicians struggled to make the Edison do what it was never able to do.
The Inventor has the deceptive aura of idolizing the very person whom Errol Morris, like Bill Clinton, Joe Biden, George Shultz, Larry Ellison, Charlie Rose, Henry Kissinger, and many others, took at her word. Gibney overwhelms us with the glamorously composed shots of Holmes in various setups exercising her persuasive skills. (She did not agree to cooperate with Gibney; all these shots are from other sources, primarily Morris.) But Gibney slowly provides the evidence, largely from the whistle-blowing accounts by Theranos employees Tyler Schultz and Erika Chung, that demonstrates how her company’s mission bears less and less credibility until it is nothing but outright lies. Her machines and their results fail time after time, endangering unsuspecting patients in the process.
Holmes, however, continues to flatly deny the existence of any problems whatsoever. It took the repeated efforts by these two whistle-blowers, whose shift from giddy enthusiasm to disillusioned consternation Gibney skillfully chronicles, to initiate the collapse of this house of cards. Erika Chung and Tyler Schultz felt compelled to expose the dangerous lies when no one at Theranos, including Holmes, would listen to them. Chung conducted quality control tests on Edison’s performance only to find that it was highly erratic. When her concerns were dismissed internally, she was compelled to report them to the Centers for Medicare & Medicaid Services (CMS), a federal oversight agency. Likewise, Tyler Schultz realized that the machine’s blood test results were unreliable. Someone with a serious disease might be told their test came back negative when it should have been positive. Eventually, after massive efforts that risked alienating his grandfather entirely, he persuaded ex-Secretary of State George Shultz, a major Theranos supporter and member of the Board of Directors, that his faith in Elizabeth Holmes was utterly misplaced. Both left the company. Erika Chung later became the founder of Ethics in Entrepreneurship and is working to foster a climate of ethical corporate culture in Hong Kong. Tyler Schultz since founded Flux Biosciences, a company developing medical tests based on saliva, urine, and blood.
Errol Morris, like Gibney, often explores the darker underbelly in self-possessed figures such as Robert McNamara, Donald Rumsfeld, or Fred Leuchter, but he also pulls his punches when it comes to nailing them for their deceptions, self-delusions, and lies. He prefers to watch, question, and listen, but leaves it for us to find the evidence we need to arrive at our own judgment elsewhere. He prefers ambiguity to certainty and there is a rich complexity to be had in this. He began this pattern, however, in his innocuous films about human foibles like Gates of Heaven and Vernon, Florida. It becomes a far more worrisome tactic when dealing with powerful, public figures whose actions have serious consequences and cry out for rigorous assessment. Gibney, as he does in his other films on topics ranging from Enron to Lance Armstrong, does not make this mistake. Unlike filmmaker Agnès Varda, quoted in her New York Times obituary as saying, “I try to keep a certain level of quality of my films. I don’t do commercials, I don’t do films pre-prepared by other people…I do my own little thing,” Morris’s ad footage shot for Theranos reveals his blind spot, perhaps resulting from the potential for monetary profit.
Holmes and her sidekick C.O.O., Sunny Balwani, prove to be out for blood in a way Morris’s PR work fails to recognize—understandably, since he, like others, would have been dismissed on the spot. Anyone who questioned this pair’s master plan became suspect; anyone who suggested something can’t or shouldn’t be done was labeled a traitor. Even regulatory agencies that impeded their headlong, reckless pursuit of a dubious goal earn little more than a rousing, collective chant of “Fuck You!” from her assembled staff that is caught by Morris’s camera. Holmes’s relentlessly decries the brazen effrontery of the few men and women of integrity willing to speak out and then to demonize them. Seduce the media, threaten the dissenters, condemn the whistleblowers, fire the truth-tellers.
Roger Perloff of Fortune magazine puts it perfectly after he realizes he was yet another of the older white males duped by Holmes when he put her photo on the cover of the magazine and ran a feature story about her amazing vision. As he confesses to Gibney, “…what comes out of her mouth does not map onto reality as you or I understand it.”
Holmes seeks credit for a great dream: no more needles to draw tubes of blood for lab tests—but whether that is the crossroads where we find the most pressing issues facing healthcare today is a complete blind spot for Holmes. Why would we want a blood testing device in our homes and what would we, without medical guidance, do with the results? We entrust doctors to interpret lab results for very good reasons. And even if it worked, Holmes had no answers for more pressing issues like the need for affordable health insurance, low cost drugs, and accessible medical treatment for all.
Holmes professes a desire to make healthcare safer and more prevention-oriented but as Tyler Schultz aptly puts it, with faulty results there will be a lot more untreated disease in the world. What sort of visionary ideal willingly jeopardizes the very lives it is intended to save solely to be able to reach a goal created by the financial distress of burning through almost a billion dollars in startup funds? One former employee even declares that the whole concept of a drop of blood processed by such an extremely small machine, one that Holmes refused to enlarge, to test for hundreds of diseases was impossible from the start—but impossible only if we accept the laws of thermodynamics, which Holmes clearly chose not to do. No small irony resides in the lack of solid scientific knowledge to guide Theranos’s research and development. Those who possessed such knowledge were rare at Theranos, and we might recall that Holmes herself did not even possess an undergraduate degree of any kind. Those who saw the scientific impossibilities were, as Gibney makes painfully clear, driven out.
The film is utterly timely when belief trumps facts on a daily basis and at the highest levels. We will have to wait to see if Elizabeth Holmes and her accomplice, Sunny Balwani, get the jail time they deserve, but the verdict is already out on Theranos and those who fell for a vision and a story told by a woman who may be the closest thing to the classic Siren of Greek myth appearing in recent decades.—Bill Nichols
Bill Nichols is the author of a dozen books including Representing Reality: Issues and Concepts I Documentary (Bloomington: Indiana University Press, 1991), which launched the contemporary study of documentary, and the widely used textbook, Introduction to Documentary (Bloomington: Indiana University Press, 3rd edition, 2017).
Copyright © 2019 by Cineaste, Inc.
Cineaste, Vol. XLIV, No. 4