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- Sood, Shefali
Based on the 2021 podcast of the same title produced by Rebecca Jarvis, The Dropout is an 8-episode miniseries starring Amanda Seyfried as the infamous biotechnology fraudster Elizabeth Holmes and Naveen Andrews as her much older boyfriend-turned-accomplice, Ramesh “Sunny” Balwani. The miniseries documents the real-life story of Elizabeth Holmes and her evolution from an ambitious, dedicated and somewhat awkward teenager into a ruthless, immoral and still quite awkward CEO of Theranos, a company she founded after dropping out of Stanford her sophomore year. She claimed to develop technology to run hundreds of diagnostic medical tests on a single drop of a patient’s blood. She defrauded hundreds of doctors, investors, pharmaceutical companies and even Walgreens along the way and put hundreds of patients who received faulty Theranos blood test results at risk. This year, Holmes was found guilty on four counts of fraud by a federal grand jury.
The miniseries begins in Holmes’ childhood and utilizes footage from her federal deposition and media interviews to document her evolution from having an innocent desire to invent something to help people to a grifter who put others in danger without a second thought. In her teenage years, Holmes idolizes Steve Jobs. Instead of boyband posters in her room, she has photos of him with Apple products. She spends a summer in China in a language immersion program, where she meets a man 30 years her senior, Sunny Balwani, and strikes up an uncomfortable friendship after learning of his success in business. She is shown to be somewhat of an outcast in school, practicing being excited for a party in a mirror and speaking almost every day with Balwani instead of her peers. Her conversations with Balwani mostly are about her ideas to help people and her desire to be a billionaire. This goal of helping others pushes her to study biomedical engineering at Stanford. She proudly proclaims to family friend Dr. Richard Fuisz, a physician-turned-inventor, that she is in the top 10% of applicants. At Stanford, she is incredibly focused on her goal to invent, and with an unrelenting fervor, she enrolls in graduate level classes and pitches ideas to professors. She is a teacher’s pet; however, when she pitches her idea for a medical drug delivery patch to Dr. Phyliss Gardner, a highly accomplished physician and researcher, her world crashes. Dr. Gardner immediately shoots down her idea and tells her to focus on her schoolwork before trying to invent the next big thing. Holmes can’t take no for an answer and quotes Yoda from Star Wars: “Do or do not. There is no try.” Dr. Gardner responds that in medicine and science, some things are impossible and recognizing that is also part of the scientific process.
This all changes soon after pitching an idea for a blood test using a single drop of blood to Dr. Channing Robertson, an influential chemical engineer at Stanford. He backs her idea and gives her capital for a company. She encourages her parents to let her drop out of Stanford, citing Steve Jobs, Michael Dell and other influential tech leaders as examples, and uses her tuition money to establish Theranos.
Theranos, a combination of the words therapy and diagnosis, takes off, with significant roadblocks, fueled only by Holmes' dreams. Holmes neither has the scientific background nor the leadership skills to lead the company. She does little in the chemistry labs and her lack of engineering, chemistry and medical knowledge prevents her from being able to pitch the idea successfully to healthcare venture capitalists. The blood testing device requires technology that would take years to build and require significant scientific collaboration that does not exist at Theranos. She needs data for investors that the devices are complete and work, so enrolls the faulty, not yet completed devices in a trial testing the blood of cancer patients. This leads to a tense encounter between lead engineer Edmond Ku and Holmes outside a cancer clinic. Ku states that he is an engineer, not a healthcare provider, and he is uncomfortable looking these patients in the eye and testing their blood on a machine he knows does not work. He is clearly very upset; but Holmes forces him to go inside and collect the samples. The clinical trial goes nowhere.
After almost running the company into the ground, she convinces the Board to let her stay CEO if she brings on Balwani, with whom she is in a romantic relationship, as chief operating officer. Balwani offers advice on how to be a CEO of a tech company and encourages her to change her management style. The departments at Theranos become siloed to a point that scientists have no idea what is happening in the executive, marketing and media departments and vice versa. All information comes from Holmes. She spends no more time in the lab and has no meetings with lab personnel, but her name is on every patent. She markets herself as a young female tech CEO in a landscape dominated by men in sweatshirts. Her charisma and newfound business acumen allows her to secure a deal with Walgreens in which Theranos’ devices will be in Walgreens Wellness Centers for use by patients. She does not tell any of the scientists working on the device and does not consult any physicians. She shares no data with Walgreens about the design of the device, its accuracy or validity, citing trade secrets. When her lead chemist, the celebrated Dr. Ian Gibbons, catches wind of this plan, he confronts Holmes, who fires him on the spot for not having the same vision. Amidst pressure from the scientists, she rehires him the next day, but prevents him from working in the lab ever again. The toxic environment created by Holmes eventually causes Dr. Gibbons to commit suicide.
The Theranos devices for the Walgreens agreement fail quality control checks and cannot be used. Holmes and Balwani create a plan in which they use Siemens devices with Theranos logos to run the single drop blood patient samples which have been diluted to provide enough sample to be read by the Siemens machine. This leads to wildly inaccurate results being sent to patients. Examples include a high estrogen reading in a woman with a history of ovarian cancer, suggesting remission; a high thyroid hormone level in a pregnant woman already on thyroid medication, almost prompting her doctor to alter her dosage, which would be fatal for the fetus; and a high troponin level in a man with cardiovascular disease indicating he may be having a myocardial infarction. The lab technicians are aware of these inaccurate results. Eventually two techs, Erika Cheung and Tyler Schultz, the grandson of former Secretary of State George Schultz a and a Board member at Theranos, leak what is happening to a journalist, John Carreyrou at the Wall Street Journal, despite immense legal and physical threats from Holmes and Balwani. Eventually, using evidence from Cheung, Schultz, former scientists at Theranos, and physician-advocates among others, Carreyrou writes an article in the Journal exposing Theranos and Holmes for what they are --frauds. This spirals into the Centers for Medicare and Medicaid Services shutting down Theranos labs indefinitely and leads to thousands of lawsuits regarding Theranos products. Holmes loses all credibility and is arrested on federal charges of fraud and conspiracy to commit fraud.
In the last scene, Holmes visits the office with her new dog to speak with a former Theranos lawyer, who can no longer find a job as a result of the scandal. She boasts about her new boyfriend. The lawyer confronts her, “you hurt people.” Holmes denies this vehemently saying she just ‘failed to deliver’ as CEO and runs frantically out of the office where she breaks down while waiting for her Uber.