Alex Gibney’s new HBO documentary viscerally captures Elizabeth Holmes and Theranos

Theranos founder Elizabeth Holmes is, in so many ways, a documentarian’s dream. There’s her carefully choreographed wardrobe of black turtlenecks and black slacks–a not-so-subtle nod to her idol, Steve Jobs; her seeming inability to blink her eyes, ever; and, of course, her voice, which is an eerie baritone that is reportedly an affect, intended to give her more gravitas in a tech world where female CEOs and inventors are few and far between. 

Alex Gibney’s new film about Holmes and her company, The Inventor: Out For Blood in Silicon Valley, which debuts on HBO on Monday, makes ample use of Holmes’s almost cartoon-like physical characteristics and unwavering self-control as it follows Theranos’s dramatic rise and fall from a tech darling valued at $9 billion that promised to make blood tests a simple, affordable process that would save lives, into one of Silicon Valley’s most egregious cases of fraud and deception. (Theranos is now worth nothing). Holmes looks like a robotic Barbie doll as she strides through Theranos’s white, antiseptic hallways. Even when she’s trying to let her hair down–as in one scene, when she boogies to an MC Hammer song during a company party (she also romps inside a bouncy house)–the effect is so unnatural that it’s painful to watch. She has no idea how to deviate from her script. 

But at its heart, The Inventor is an investigation into what drives Holmes, and what makes an idealistic young woman, who dropped out of Stanford with the dream of changing the world, defiantly refuse to back down when the dream proved dangerously flawed. The invention that Theranos was based on, a black printer-like box called The Edison that promised to run multitudes of tests on a mere drop of blood, was never close to being able to do such things. Yet the more red flags that went up, the more Holmes dug in, rolling out Theranos testing centers in Arizona and making the rounds for more funding. When she was accused of wrongdoing in a lengthy Wall Street Journal expose, she only fought back harder.  

Gibney has chronicled fraud stories before–in docs like Enron: The Smartest Guys in the Room and The Armstrong Lie, about cyclist Lance Armstrong–but he says what interested him in Holmes was the opportunity to study “the psychology of fraud.”

“So much about this story speaks to really good intentions,” he says. “It’s hard to knock somebody who’s trying to come up with a way for transparent, low-priced, uninvasive blood testing that’s going to help people live longer. 

“So to look at that good mission and then to see how it was corrupted and, also, weirdly, to try to understand how somebody could deceive others and whether or not they were deceiving themselves in order to better deceive others. So it was thinking about those issues that made me want to begin on this film.” 

Fast Company recently spoke with Gibney and his producing partners, Erin Edeiken and Jessie Deeter, about the depths of Holmes’s deception–both to herself and others; how gender factored into their thinking as filmmakers; and similarities and differences between Holmes and Steve Jobs. 

Fast Company: How did your perception of Holmes change as you worked on the film? Did she become more or less sympathetic to you as a character? 

Alex Gibney: “I think over time she became less sympathetic. It was interesting, inside our team–three producers on the film are women–and I think they were much more willing initially to cut her some slack until we really dug into the details of the story. For example when we got galleys of John Carreyrou’s book (Bad Blood: Secrets and Lies in a Silicon Valley Start-up), and when we began to see and hear some of the audio tapes that we had collected with her literally lying on tape. Then the perception changed, and I think it darkened. 

“I think the team all agreed that she started off with good intentions, even if part of the intent was a sort of personal grandiosity. But by the end, we all agreed she was fully corrupted. Because in her struggle to make the company great and fulfill her dream, she crossed a real, ethical line when she went live with patient tests in Arizona. That was a breach that went way too far. And her unwillingness to hear any criticism internally. And the kind of ruthlessness with which she operated in order to shut down whistleblowers and go after people or dismiss them in a very ruthless way.”

Gibney points to Ian Gibbons, who was Theranos’s chief scientist, and who committed suicide just before he was supposed to testify as a plaintiff in a patent lawsuit involving Theranos. Gibbons was aware of the technological flaws in Theranos’s product but feared telling the truth under oath.

“That moment when his widow talks about the fact that Elizabeth didn’t even give her a phone call (after Gibbons’s death). This is one of the founding scientists of Theranos, after he’d committed suicide. Suddenly you see the charm and guileless nature of Elizabeth turning into something far more ruthless and calculating.” 

FC: Holmes is very open about her adulation of Steve Jobs, someone whom you’ve spent time thinking about and studying through your documentary about him. How do you compare the two as leaders and visionaries, but also as people who are incredibly strong-minded and, to various degrees, flawed? 

Gibney: “She was very much trying to emulate Jobs in all sorts of ways. The siloing (at Theranos) in some ways was very Apple-like. The attention to design, very Apple-like. Dropping out of college, very Jobsian. All those things were very self-conscious and deliberate. She hired Patrick O’Neill from Chiat/Day because he had been on the Apple account. She was hiring all sorts of people from Apple. 

“She really did think she was going to have a device that was going to be Apple-like in terms of its reach in every home in America. But it was really interesting in that, maybe if she’d stayed at Stanford until graduation, she would have heard that speech that Steve Jobs gave in which he said some things that might have led her to understand Jobs a little better. 

“I did a very critical film of Steve Jobs, but one thing I would say about Apple 2.0, when he comes back after the debacle at NeXT, was that he learned a lot from the failures at NeXT, and he applied those lessons. As the head of Toyota was known to say, ‘Mistakes are precious.’ Jobs learned from those mistakes and then made sure to surround himself with very skilled people who were willing to stand up to him. People like Jon Rubenstein (who led the iPod team), and the head of hardware, Avie Tevanian, and (chief design officer) Jony Ive. Those were people that had a kind of power and heft and talent and skill and experience to take that newly invented company to the promised land. But Elizabeth didn’t want to hear from anybody with criticism. She didn’t want to hear about mistakes. Mistakes weren’t precious to her, just the opposite. She learned the wrong lessons from Steve Jobs.” 

FC: Did you have any interaction with Holmes while you made the film? 

Jessie Deeter: “There was one, five-hour dinner I had with her. It was excruciating, a little bit. I thought what we were doing was having a casual dinner with Elizabeth, myself and her new PR person. This is still relatively early on in our reporting. I’d been told, ‘We’ll have a  dinner, then we’ll have a glass of wine, and it will be very casual.’ So then I’m like O.K., cool. And then I show up and I go to pull out my notebook and from the get-go, Elizabeth shut me down. Like, ‘What are you doing? You do not get to take notes. You don’t get to record anything.’ She then started in on the questions for me. What is our team doing, who has our team talked to? What is Alex doing? Yes, but if I’m meeting with her, how can I guarantee her, Elizabeth, of Alex’s editorial perspective? She went on and on and on and on. And then she said she’d been wanting to make her own film. Because she really did see herself as, if not Steve Jobs, then certainly his equivalent in the healthcare sphere. She was going to disrupt and do things entirely differently. And if we were so lucky, we’d be able to follow that, follow the reinvention of Theranos in her mind. So she was acting as if she was interviewing us, the editorial team, for the position.” 

FC: Do you think Theranos is emblematic of what’s going on in Silicon Valley at this moment in time, in terms of society’s deep distrust in tech companies? 

Gibney: “I do think to some extent it’s emblematic. The aspect of Fake It Till You Make It and Move Fast, Break Things. There’s an upside to those and there’s a real downside. And we’re seeing a lot of lying coming out of Silicon Valley now. Facebook would be key. When we see apologies [made by Facebook execs], they strike you much like the apology that Elizabeth gives at the end, when she trades in her black turtleneck, deep, red lipstick and mascara for a pale, blue blouse, no make-up and a small but evident crucifix around her neck. That apology: ‘Well, I was shocked! It was very upsetting to me!’ That has the vibe of Claude Rains in Casablanca and of the Mark Zuckerberg apologies. Not sincere.” 

FC: Gender inequality is a big, as well as sensitive, topic in Silicon Valley and other industries right now. How much did you think about the fact that Holmes is not just a CEO and founder, but a female CEO and founder, and did it affect the way you thought about and presented her? 

Gibney: “It’s part of the story. I think both myself and also my team were wrestling with these issues of, Is she being unfairly treated because she’s a woman? That was very much [Holmes’s] perspective, that men have the opportunity to sort of fake it till they make it. You know, Edison did. Why does the woman get picked on? 

“In pursuing this and grappling with that, you come across the notion that actually Elizabeth is not woman writ large, that is, a symbol of all women. Elizabeth is a woman who had ethical failings, and we have to be able to stand up and say that. Maybe one of her failings was needing to be so big. Needing to be the biggest. Why is that so important? Because you see in the film a number of ethical women who are doing good work and who are smart. Erika Cheung, one of the whistleblowers, is now off doing a kind of incubator company for small startups in Hong Kong. Very good stuff. But it’s not intended to be the world’s biggest company. It’s intended to do smart, good work. Phyllis Gardner, a very smart woman from the Stanford Medical School. To me those are my role models, not somebody who wants to be the biggest billionaire.” 

Erin Edeiken: “In my mind the issue of gender is something that we had to talk about. It’s not only because it’s a part of Elizabeth’s meteoric rise. Whether or not Elizabeth explicitly used that or not, it was a part of her life. Because she was a woman, people were interested. And because she was a woman inventor, something that is even more rare than being a woman CEO in that industry, people were especially interested in her. And rooting for her and wanting her to succeed in ways that I think maybe if she were a man maybe she would have been tested and questioned a little harder. 

“On the flip side of that was that when it all started to come tumbling down, she then turned the table on the issue of gender and said it was because she was a woman that she was being singled out for doing something that men in her industry did all the time. She does have a point in that there are people in startups and private companies that lie all the time and we address that in our film. But what she did in terms of the extremes of her lies has nothing to do with being a woman or not. This story is interesting and deserves special attention, because it was something involving real people and their health and it is a lie that goes beyond a certain boundary that maybe some of her colleagues in Silicon Valley are used to breaking all the time. There’s a difference between rolling out an app for an iPhone in a beta version and testing something that you know doesn’t work on real people.”