Elizabeth Holmes founded her revolutionary blood diagnostics company, Theranos, when she was 19. It’s now worth more than $9 billion, and poised to change health care. ... In the fall of 2003, Elizabeth Holmes, a 19-year-old sophomore at Stanford, plopped herself down in the office of her chemical engineering professor, Channing Robertson, and said, “Let’s start a company.” ... Robertson, who had seen thousands of undergraduates over his 33-year teaching career, had known Holmes just more than a year. “I knew she was different,” Robertson told me in an interview. “The novelty of how she would view a complex technical problem–it was unique in my experience.” ... Holmes had then just spent the summer working in a lab at the Genome Institute in Singapore, a post she had been able to fill thanks to having learned Mandarin in her spare hours as a Houston teenager. Upon returning to Palo Alto, she showed Robertson a patent application she had just written. As a freshman, Holmes had taken Robertson’s seminar on advanced drug-delivery devices–things like patches, pills, and even a contact-lens-like film that secreted glaucoma medication–but now she had invented one the likes of which Robertson had never conceived. It was a wearable patch that, in addition to administering a drug, would monitor variables in the patient’s blood to see if the therapy was having the desired effect, and adjust the dosage accordingly. ... “I remember her saying, ‘And we could put a cellphone chip on it, and it could telemeter out to the doctor or the patient what was going on,’ ” Robertson recounts. “And I kind of kicked myself. I’d consulted in this area for 30 years, but I’d never said, here we make all these gizmos that measure, and all these systems that deliver, but I never brought the two together.” ... Still, he balked at seeing her start a company before finishing her degree. “I said, ‘Why do you want to do this?’ And she said, ‘Because systems like this could completely revolutionize how effective health care is delivered. And this is what I want to do. I don’t want to make an incremental change in some technology in my life. I want to create a whole new technology, and one that is aimed at helping humanity at all levels regardless of geography or ethnicity or age or gender.’ ” ... “Consumerizing this health care experience is a huge element of our mission,” Holmes says at our first meeting in April, “which is access to actionable information at the time it matters.” In our conversations over the next two months, she comes back to that phrase frequently. It is the theme that unifies what had seemed to me, at first, a succession of diverse, disparate aspects of her vision. ... Though she has now raised more than $400 million, she says she has retained control over more than 50% of the stock.

Elizabeth Holmes rarely slips out of character. When she responds to questions in an interview or on a conference stage, she leans forward, leg crossed ankle over knee in a half-lotus manspread power pose. She lowers her voice an octave or two, as if she’s plumbing the depths of the human vocal cord. Although she hates it being remarked upon, her clothing, a disciplined all-black ensemble of flat shoes, slacks, turtleneck, and blazer buttoned at the waist, is impossible not to notice. She adopted this uniform, as she calls it, in 2003, when she founded Theranos, a company seeking to revolutionize the medical diagnostics industry by doing tests using only a few drops of blood. ... “I wanted the focus to be on my work,” she says slowly and deliberately. “I don’t want to go into a meeting and have people looking at what I’m wearing. I want them listening to what I’m saying. And I want them to be looking at what we do.” ... She was only too willing to let that propel her through the business media’s star chamber, though she refused to let photographers use a wind machine to blow her hair. ... After several years of Holmes telling the largely unchallenged story of how Theranos intends to change the world, a blast of cold air came ... Most blood work in the U.S. is run on analyzer machines made by companies such as Siemens, Roche Diagnostics, and Olympus. The labs that buy these machines don’t need the FDA’s OK to use them, but the manufacturers need it to sell them. ... FDA clearance alone may not be enough to convince physicians that the tests can be used for all patients, according to John Ioannidis, a professor of medicine at Stanford who’s best known for his criticism of the way scientific research is conducted, in particular for a 2005 paper titled “Why Most Published Research Findings Are False.”

There are a lot of directions in which to point fingers. There is Holmes, of course, who seemed to have repeatedly misrepresented her company. There are also the people who funded her, those who praised her, and the largely older, all-white, and entirely male board of directors, few of whom have any real experience in the medical field, that supposedly oversaw her. ... But if you peel back all of the layers of this tale, at the center you will find one of the more insidious culprits: the Silicon Valley tech press. They embraced Holmes and her start-up with a surprising paucity of questions about the technology she had supposedly developed. They praised her as “the next Steve Jobs,” over and over (the black turtleneck didn’t hurt), until it was no longer a question, but seemingly a fact. ... The system here has been molded to effectively prevent reporters from asking tough questions. It’s a game of access, and if you don’t play it carefully, you may pay sorely. Outlets that write negatively about gadgets often don’t get pre-release versions of the next gadget.

In a searing investigation into the once lauded biotech start-up Theranos, Nick Bilton discovers that its precocious founder defied medical experts—even her own chief scientist—about the veracity of its now discredited blood-testing technology. She built a corporation based on secrecy in the hope that she could still pull it off. Then, it all fell apart. ... At Theranos, Holmes preferred that the temperature be maintained in the mid-60s, which facilitated her preferred daily uniform of a black turtleneck with a puffy black vest—a homogeneity that she had borrowed from her idol, the late Steve Jobs. ... Holmes had learned a lot from Jobs. Like Apple, Theranos was secretive, even internally. Just as Jobs had famously insisted at 1 Infinite Loop, 10 minutes away, that departments were generally siloed, Holmes largely forbade her employees from communicating with one another about what they were working on—a culture that resulted in a rare form of executive omniscience. At Theranos, Holmes was founder, C.E.O., and chairwoman. There wasn’t a decision—from the number of American flags framed in the company’s hallway (they are ubiquitous) to the compensation of each new hire—that didn’t cross her desk. ... And like Jobs, crucially, Holmes also paid indefatigable attention to her company’s story, its “narrative.” ... In a technology sector populated by innumerable food-delivery apps, her quixotic ambition was applauded. ... she is often surrounded by her security detail, which sometimes numbers as many as four men, who (for safety reasons) refer to the young C.E.O. as “Eagle 1”—and headed to the airport. (She has been known to fly alone on a $6.5 million Gulfstream G150.) ... it is impossible to get a precise result from the tip of a finger for most of the tests that Theranos would claim to conduct accurately. When a finger is pricked, the probe breaks up cells, allowing debris, among other things, to escape into the interstitial fluid. While it is feasible to test for pathogens this way, a pinprick is too unreliable for obtaining more nuanced readings. Furthermore, there isn’t that much reliable data that you can reap from such a small amount of blood.