'The Inventor: Out for Blood in Silicon Valley': Film Review | Sundance 2019

An astonishing case of idealism morphing into egomania.

Oscar-winning documentary maker Alex Gibney weaves a cautionary tale of hubris and deception around Elizabeth Holmes, who built a $9 billion business out of her overreaching dream of a biomedicine revolution.

There's an unexpectedly emotional moment in Alex Gibney's riveting investigation for HBO, The Inventor: Out for Blood in Silicon Valley, when Fortune reporter Roger Parloff, who had written a 2014 cover profile on Elizabeth Holmes and her news-making startup Theranos, gets so choked up by the ethical violation of his subject's elaborate deception he can barely speak. A year and a half after that feature, Parloff published a mea culpa detailing how he had been misled into buying Holmes' promise of a complete revolution in blood diagnostic testing as a done deal. In reality, of course, it was an out-of-control sham, a hall of mirrors, and Parloff was far from the only smart person duped.

The collapse of Theranos — a company name combining the words "therapy" and "diagnosis" — was triggered by a front-page Wall Street Journal story written by John Carreyrou, who went on to publish the definitive book on the ignominious saga, Bad Blood: Secrets and Lies in a Silicon Valley Startup. The company went from being valued at $9 billion to zero, its principals charged with fraud and conspiracy in an ongoing case.

Using information from whistleblowers corroborated by various former employees, Carreyrou dismantled Holmes' claim that her company had developed proprietary technology capable of carrying out upwards of 200 tests from a single fingertip pin-prick blood sample. In truth, Theranos was performing only around a dozen tests using its own faulty technology while the majority apparently were being done with intravenously drawn blood samples on industry-standard equipment in alarmingly lax lab conditions.

This emerged well after the secretive company had gone live with a $400 million Walgreens deal in Arizona, promoted in a touchy-feely ad campaign shot by Errol Morris. Even after medics started spotting wild discrepancies in tests carried out on Theranos equipment in the drugstore chain's pharmacies, the work continued, and business exploded once a gift-card offer was introduced.

The possibility of drastically reduced diagnostic costs and potentially life-saving early disease detection had proved enticing to a phalanx of powerful investors, not to mention such notable board members as former Secretaries of State George Schultz and Henry Kissinger, and retired U.S. Marine Corps general James Mattis, until recently the Trump administration's Secretary of Defense. Subsequent investors included Betsy DeVos and Rupert Murdoch. Schultz's grandson, Tyler Schultz, and fellow Theranos lab worker Erika Cheung, who were among the key whistleblowers, provide illuminating insights here.

The indefatigable Gibney, whose prolific output has included deep probes into Scientology, WikiLeaks, corporate malfeasance at Enron and the conspiracy of silence in the Catholic Church, unpacks a complicated story in a briskly compelling narrative enlivened with sharp interviews, resourceful footage and terrific computer graphics.

The new film shows how much of the "Fake It Till You Make It" culture in Silicon Valley has remained unchanged since the Wild West days of the early dot-com boom chronicled in films like the 2001 documentary Startup.com. But Gibney is just as interested in the personal story as the case study, and while there's a distinct shortage of people interviewed who were actually close to Holmes, a fascinating portrait emerges of a nightmare millennial — like many of her generation, seemingly incapable of hearing the word "no." That factor is illustrated in vinegary comments from Holmes' former Stanford professor of medicine, Phyllis Gardner, who said she studied the proposal and explained why the technology would never work. Rather than recognizing any limits, Holmes reacted by dropping out at 19.

It's easy now with the hindsight of Theranos' fall to watch Holmes in interviews — notably a 2015 sit-down with Charlie Rose, but also from various seminars, company profiles and in-house motivational talks — and discern cracks in the frighteningly confident facade.

What's described as an intense, unblinking gaze now looks more like crazy eyes. New Yorker writer Ken Auletta, another distinguished journalist whose coverage helped boost Holmes' prominence, described her as "comically vague" when explaining the functions of Theranos' key piece of hardware, a compact black box given the illustrious name The Edison. Often, when Holmes is borrowing a mantra from Yoda or spewing out doublespeak in the guise of protecting trade secrets from industry competitors, she sounds disconcertingly like Mira Sorvino in Romy and Michele's High School Reunion. That might seem a misogynistic dig, but just try to unhear the similarity once it's in your head.

Gibney captures the fascinating dichotomy of someone described as unprepossessing in most social dynamics, but utterly persuasive when talking up her passion project. In that respect it makes sense that so many seasoned big-money investors and advisors signed on based on little more than an emotionally charged pitch pegged to the sorrow of losing her beloved uncle to cancer. Those heavyweight names in turn served to legitimize the claims of Holmes and Theranos president and COO Sunny Balwani (also Holmes' romantic partner, though the relationship was not disclosed to investors) once pressure for greater transparency began building.

The story gets ugly, particularly when legal heavies led by powerhouse litigator David Boies are brought in to intimidate defectors and snoops. And it's chilling that Holmes failed to contact the widow of an esteemed biochemist who committed suicide after falling out of favor and being fired from Theranos, then facing a patent dispute that would have been professionally devastating no matter how he testified. Yet Gibney leaves open the tiniest window of doubt on Holmes' integrity.

Rather than being strictly an exposé of snowballing, egomaniacal deception — though it is that — the film portrays a person of uncommon ambition and intelligence who appears to have started from a place of visionary idealism but gradually began drinking her own Kool-Aid, going into deep denial once it became obvious that her vaunted technology was unworkable.

Holmes clearly gets off on the guru mystique, positively glowing when comparisons to Steve Jobs are made, while at the same time pointing out that she'd been wearing black turtlenecks since she was 7. Bill Gates and even Archimedes are other names dropped in awed reverence of a woman once described as "the most important inventor of our times." The fact that Holmes was barely into her 20s when she soared highest only made the media and political establishment all the more eager to embrace a driven young female leader, despite her entrepreneurial skills far outweighing any concrete results.

If she remains to some degree a slightly creepy cipher, that doesn't make her any less complex as a subject or render Gibney's densely packed film any less gripping. And it certainly whets the appetite for Adam McKay's planned dramatic feature, with Jennifer Lawrence attached to play Holmes.

Production companies: HBO Documentary Films, Jigsaw Productions
Director-writer: Alex Gibney
Producers: Alex Gibney, Erin Edeiken, Jesse Deeter
Executive producers: Nancy Abraham, Sara Bernstein, Graydon Carter
Directors of photography: Lincoln Else, Antonio Rossi
Music: Will Bates
Editor: Andy Grieve
Venue: Sundance Film Festival (Documentary Premieres)

118 minutes