Dorothy Crenshaw August 31, 2021 | 07:00:42
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Lessons Of Theranos: Sex, Lies, And PR

Like many in tech PR, I’m fascinated by the Theranos story because of what it says about Silicon Valley, public relations, and the press. Now that the trial of its disgraced founder Elizabeth Holmes has started, media and pundits have updated their hot takes on her spectacular rise and fall. Theranos claimed to have devised a technology that offered ultra-sophisticated diagnostic testing based on a single pinprick of blood. The implications – and potential PR angles – were irresistible. It would revolutionize diagnostic testing, making it easier, cheaper, and more accessible. It would disrupt the legacy companies in the field. It would be a boon for needle-phobics. Most appealing to the media, it was started and run by a woman. And Holmes wasn’t just any woman; she was young and blond, a Stanford dropout with a fascinating backstory who channeled Steve Jobs. Is it any wonder that Theranos was valued at $10 billion at its pinnacle?

Fake it ’til you break it?

Its breathtaking success and subsequent crash tells us a lot about the sexism that persists in startup circles, how investors see women in tech, and how females try to cope with the perception.

Still, I was surprised to read that in the years following the collapse of Theranos, female entrepreneurs in life sciences and biotech say they’re constantly compared to Holmes. The Theranos case, according to a piece in The New York Times, has left female founders facing “the additional hurdle of fighting assumptions that they were like Ms. Holmes… something their male counterparts have generally not had to contend with.” One female founder of a health testing company said that she was linked to Holmes so frequently that her advisors suggested she dye her naturally blond hair a darker color, presumably to stop the damaging comparison.

Wow. Even more remarkably, some women founders have weighed in with a degree of sympathy toward Holmes. Entrepreneur Beth Esponnette posted on Medium that, while she fully recognized that Holmes was wrong, “I still believe that she thought she was doing the right thing taking the universal advice of Silicon Valley: ‘Fake it till you make it.'” Esponnette claims that in her own struggle to get funding, she was encouraged by investors to overpromise and exaggerate even to the point of lying.

Can confidence turn to criminality?

I take Esponette’s point that female founders are seen and treated differently than male counterparts. I doubt the next brash young male techpreneur has to worry he’ll be compared to Adam Neumann, the WeWork founder who dazzled investors and media, only to leave in disgrace (albeit with a $1.7 billion parachute.)

Yet her view that women in Silicon Valley are held to unique and inappropriate standards is a double-edged one. It’s clear that Holmes was lionized in part because she was female. Anyone who works in PR with high-growth technology businesses knows that the media are eager to cover women founders. There are so few of them, and what’s different naturally makes news. Holmes would have been the first self-made woman billionaire in tech, and everyone was rooting for her. Of course her sex was a factor. For me, “fake it til you make it” is about projecting confidence, not an excuse to engage in criminal fraud.

Journalists missed red flags

Of course, the Theranos debacle also tells us something about journalism. As someone who has spent a career in tech PR, where we try to build up business leaders and tech entrepreneurs in the media, it feels weird to criticize press who took a good pitch and ran with it. But there’s no denying the Theranos story is about the credulity of tech journalists. They were thirsty for a female Steve Jobs, so most didn’t sufficiently question Holmes’s claims. What’s more, reporters often work in packs, especially in sector bubbles like Silicon Valley. Media coverage begets more media coverage. Even as reporters compete fiercely for the story, they’re influenced by what colleagues and competitors write. As soon as Holmes’s PR team cracked one top-tier business publication, the rest clamored to cover her with fresh angles and updated quotes. Few questioned the culture of secrecy or the absence of peer-reviewed research on the Theranos technology. No one asked why there wasn’t a single physician (except Senator Bill Frist) on its board. It took a couple of sharp professors and John Carreyrou, with his investigative background and outside-the-bubble pedigree, to bring down the house.

A PR-first culture can’t work in healthcare

Finally, even if you attribute Holmes’s dishonesty to the self-aggrandizing ethos of Silicon Valley, that ethos doesn’t translate outside the tech industry. It’s one thing to promote “vaporware” by exaggerating a product’s readiness or overpromising on features. But in medical diagnostics, the stakes are too high. The consequences for mistakes can be fatal. It’s the main reason why I can’t ultimately swallow the “fake it til you make it” mantra as an excuse here.

The tragedy of Elizabeth Holmes is that we’re still clamoring to make her a symbol – of sexism, of journalistic laziness, investor gullibility, or even imposter syndrome and the pressure to succeed. She may be all those things, but in the end, a lie is a lie and a fraud is a fraud. Even in tech, a great PR campaign will only take you so far.

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