The rise and fall of Theranos, Elizabeth Holmes' fraudulent blood-testing startup, can be traced back to one wildly ambitious idea: run a bunch of medical tests off of a single drop of blood. This was the elevator pitch that Holmes used when describing her company, which was once worth $9 billion, to investors and media.
But Holmes' pipe dream wouldn't have been possible without the machine that Theranos employees designed to execute the tests, called the Edison. Spoiler alert — if you haven't read reporter John Carreyou's book about Theranos, Bad Blood, listened to the podcast "The Dropout," or seen the trailer for the upcoming HBO documentary The Inventor — the Edison didn't work. It's complicated to explain exactly why it didn't work, and even consuming all the Theranos-related media out there wouldn't necessarily get to the bottom of it.
Even experts continue to be stumped. "I never figured out from the [Theranos] patents how they were claiming to do the assays," Norman A. Paradis, MD, a professor of medicine at Dartmouth College, who specializes in biomedical devices, tells Refinery29 via email. "That was the hint there was no breakthrough." But even if you're not an expert, and just want to understand why everyone is obsessed with talking about Holmes and Theranos, here's the background you need to know about the machine that started it all:
What did the Theranos Edison machine test for?
In theory, the Edison machine was supposed to run a handful of blood tests off of a single drop of blood — it sounds crazy because it is, and we know now that it couldn't do that. To get technical, the Edison was designed to perform "immunoassays," which look for the presence of an antibody or antigen in blood or fluid. Standard immunoassay tests can measure things like drug levels, hormone levels, and certain cancer markers. Theranos' testing "menu" offered more than 240 tests, and only a handful were done on the Edison. While the Theranos website has been wiped, an archived copy of their testing menu shows the various options and their prices — including everything from celiac to cocaine.
Why was it called the "Edison" machine?
The "Edison" device was named after Thomas Edison, the American inventor who was famously quoted saying, "I have not failed. I've just found 10,000 ways that won't work." Ominous, no? According to the book Bad Blood, Holmes said, "We tried everything else and it failed, so let’s call it the Edison," when naming the prototype in 2007. In a now foreboding 2015 commencement address at Pepperdine University, Holmes cited Edison's quote, saying, "We code-named our product the Edison, because we assumed we’d have to fail 10,000 times to get it to work the ten-thousandth-and-first. And we did."
How did it work — or why didn't it work?
Before the Edison was dubbed "the Edison," some Theranos employees affectionately called it the "gluebot," because it was based on a robot that dispensed glue. Inside the device (which, honestly looked like an old school PC tower, ironic given Holmes' obsession with making it look like an Apple product) a robotic arm was supposed to mimic what a chemist did in an IRL lab: take samples, dilute them, add antibodies and a reagent, and reveal a result.
But the Edison straight-up didn't work, and that's putting it very broadly. Pieces of the machine would fall off, doors wouldn't close, and the device couldn't properly regulate its temperature, Tyler Shultz, a former Theranos employee and one of the first whistleblowers, told 60 Minutes in 2018. And that's not for lack of trying; engineers worked tirelessly to figure out solutions, and were dismissed or fired by Holmes when they tried to raise concerns.
Despite the fact that tests weren't working with the machine, Holmes repeatedly lied to investors — including Walgreens, which had Edison systems in stores — or made up excuses as to why it wasn't working in the moment. In 2016, Theranos "voided" two years of blood tests because federal regulators said they were putting patients' health and safety at immediate risk.
Who should be self-testing their blood, anyways?
Nowadays, when you can order a home genetic test and view results online, the thought of having a home blood-testing machine might sound kind of clutch for those who have health conditions but can't regularly get to a doctor (like HIV, for example). But even when a testing device is 100% accurate and reliable, some experts are iffy on the benefits of self-testing. Due to human error taking samples, mistakes transferring the blood to the device, or trouble reading the results, the bottom line is self-testing has its cons.