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David Agus’s first encounter with Elizabeth Holmes at a health conference came as a shock. The Holmes he met in the green room was personable and pleasant. The Holmes he interviewed on stage was altogether different.
“The accent changed: this deep voice, very serious,” Agus, a medical oncologist, recalls by phone from Los Angeles. “It was as if I had met a person and then interviewed a separate person. That transition from the green room to the stage – I had never experienced something like that before.”
Holmes is not like you or me. She was still a teenager when she founded Theranos, touting technology capable of performing medical tests using only a few drops of blood. She cultivated a distinctive persona: blond hair, an unblinking gaze, a husky voice and a black turtleneck worn in homage to Apple co-founder Steve Jobs.
Holmes mesmerised investors and board members including Rupert Murdoch, Larry Ellison, Carlos Slim and former secretaries of state Henry Kissinger and George Shultz. She became America’s youngest self-made female billionaire. But it was all an illusion, a confidence trick built on a scam. Holmes’s shining career ended in disgrace and imprisonment.
Margaret O’Mara, a history professor at the University of Washington in Seattle and author of The Code: Silicon Valley and the Remaking of America, says: “You can’t make this stuff up. If some screenwriter had tried to manufacture this out of whole cloth people would be like, no, this is an unbelievable story. Yet it’s real. Who’s the real Elizabeth Holmes? That’s a question that still hasn’t been answered.”
Perhaps the answer lies in You Can See Everything, a reality-bending documentary, released in the US on Friday, in which Holmes goes eyeball-to-eyeball with the absurdist comedian Nathan Fielder, who directs along with Lance Oppenheim. It was filmed in the 34 days before she was due to report to federal prison camp Bryan in Texas to begin her 11-year sentence for wire fraud and conspiracy.
That fate seemed unthinkable in 2003 when, at the age of 19, Holmes dropped out of Stanford University and established Theranos, promising to revolutionise the multibillion-dollar blood-testing industry by using microfluidics to run hundreds of tests on just a few drops of blood.
She found a receptive audience among investors who wanted Silicon Valley to deliver more than Facebook friends. O’Mara explains: “She stands out in her ascent as a female entrepreneur at a time when men were dominating the scene and she was doing something that was in tech but seemed to be change-the-world-tech.
“The techlash wasn’t brewing yet but, where there was criticism of Silicon Valley, it was like: ‘Hey, you’ve got all these brilliant people and all you’re doing is building apps? Why don’t you do something a little more meaningful?’ And: ‘Hey, you’ve got all these brilliant people, but they all seem to be men.’”
O’Mara adds: “She was going against gendered expectations but also, to become the female Steve Jobs, she made herself less feminine and also made herself less young.”
Holmes ran the company with Ramesh “Sunny” Balwani, a businessman 19 years her senior, while keeping their romantic relationship a secret. Together they raised $945m. Theranos had published no peer-reviewed data but Holmes was a charismatic and persuasive presence in boardrooms.
Agus, a professor of medicine who is chief executive of the Ellison Medical Institute, comments: “You know how you go into a room and there could be 10 people at a table and everyone’s having a discussion? All of a sudden one person speaks and the entire room goes: ‘Yeah, I’ll go that direction.’ She had that ability.
“I saw how she was able to sway people. That characteristic is great if you’re a Steve Jobs. That characteristic is very difficult in health because we should be data-driven, not swayed by personalities.”
By 2014 Theranos was valued at $9bn. Holmes was named the youngest female self-made billionaire in the US with a net worth of $4.5bn by the time she was 30. She was celebrated on magazine covers and in power lists.
The New Yorker wrote: “Although she can quote Jane Austen by heart, she no longer devotes time to novels or friends, doesn’t date, doesn’t own a television, and hasn’t taken a vacation in ten years. Her refrigerator is all but empty, as she eats most of her meals at the office. She is a vegan, and several times a day she drinks a pulverized concoction of cucumber, parsley, kale, spinach, romaine lettuce, and celery.”
The heady atmosphere seduced elder statesmen such as Shultz, who had served as a bridge between Washington and Silicon Valley during the Ronald Reagan era. Despite no specialist expertise in laboratory diagnostics, he joined the Theranos board in 2011, when he was in his 90s. O’Mara says: “He was drawn in by the idea that here is a bright young person trying to do something more meaningful than building an app. But there wasn’t enough due diligence.”
In his biography, In the Nation’s Service, journalist Philip Taubman describes how people around Shultz worried that his enthusiasm had become entangled with personal affection for Holmes. Shultz spoke to her by phone almost daily and invited her to family Christmas dinners. Holmes encouraged his attention, leaning in close when they sat together.
Shultz even encouraged his grandson, Tyler Shultz, to take a summer internship at Theranos before joining the company full-time. Tyler eventually became convinced that Holmes was exaggerating what her technology could do. He took his concerns to the Wall Street Journal, whose investigation into the company was crucial to unravelling its web of deceit.
Holmes suspected Tyler was behind the disclosures. Her lawyers pursued him and he was placed under surveillance, leaving him afraid and looking to his grandfather for protection. But George Shultz declined to break with Holmes. According to Taubman, he tried unsuccessfully to mediate between the two rather than stand by his grandson. George Shultz died in 2021 at the age of 100.
Scientists also had their doubts about Holmes’s grand promises. Agus recalls: “The problem with blood is it clots and, when you do these small fluidics, it clogs. She wouldn’t give me an answer of why that wasn’t a problem for her. To me, that was the initial red flag. The emperor with no clothes was evident in that she was either ultra-secretive, or the way she was trying to explain things didn’t make sense.”
John Ioannidis, a professor of medicine and health research at Stanford University, happened to work in a building that had previously served as Theranos’s headquarters. In 2015, he published a Journal of the American Medical Association (Jama) commentary highlighting the striking absence of peer-reviewed evidence supporting Theranos’s claims.
He says: “They wanted me to recant and meet with Elizabeth Holmes, and maybe write together some new Jama piece saying that I had seen the light.” When Ioannidis urged them to publish validation data, Theranos cited 100-plus patent filings. “I looked at these patents and they were mostly nonsensical. One had a title close to ‘How to do clinical research’ – vague and non-specific. None of that covered the gap of what was being done.”
But in assessing Holmes’s motivations, Ioannidis offers a nuanced view. “I don’t think anyone can be in her mind. My most likely interpretation is that she believed she would start that wave – attract capital, funds, talent, expertise – and make this real.
“I don’t think she was purely a charlatan. She was power-driven, but in Silicon Valley so many people are power-driven. She saw that the way to do this was to get power first, and then attract the people and technology to materialise it.”
Holmes quit as chief executive in 2018 and the company collapsed that year. The trial of Holmes resulted in her 2022 sentencing to more than 11 years in prison for fraud and conspiracy. The scandal was chronicled in a book, multiple podcasts and the biographical mini-series The Dropout that starred Amanda Seyfried.
You Can See Everything offers an intimate, often bewildering glimpse into Holmes’s domestic life with her partner, Billy Evans, and their two young children during the 34 days before she reported to prison in May 2023.
Lavalier’s microphones capture Holmes’s every breath as she reads bedtime stories to the children, sometimes for 12 hours a day. Evans, meanwhile, is filmed naked in the shower and whisking eggs as he corrects her cooking. They fixate on past media profiles, arguing that journalists fabricated her persona.
The biggest revelation occurs off-camera. Even as she prepared to enter prison, Holmes and Evans were actively planning a new medical tech startup. In 2025, two years into her sentence, Evans sought $18.5m for Haemanthus – a company allegedly holding patents for a device claiming to scan blood, urine and saliva samples using lasers.
Fool me once, shame on you; fool me twice, shame on me? As Silicon Valley pours unprecedented sums into artificial intelligence, O’Mara believes the lessons of Theranos extend well beyond Holmes herself. “The cautionary tale is resonant to a broader Silicon Valley morality tale in putting so much faith and power in the hands of one young person or a small circle of people.
“The founder culture and obsession of Silicon Valley that helped Elizabeth Holmes become who she was is still alive and well and stronger than ever. We’ve never seen power and wealth more concentrated in so few hands. Not even in America’s Gilded Age have we seen this.”
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You Can See Everything is out in the US now, in Australia on 12 November and in the UK on 20 November
English (US) ·