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How Playing the Long Game Made Elizabeth Holmes a Billionaire (inc.com)
63 points by lxm on Sept 21, 2015 | hide | past | favorite | 80 comments


As amazing as her accomplishment is, I feel kind of sad for her.

"Holmes has taken a similar life-hack approach to every aspect of her existence outside of her lab test company, which is at best minimal, given that the 31-year-old works seven days a week. Holmes is a vegan because avoiding animal products allows her to function on less sleep. She says she "doesn't really hang out with anyone anymore," aside from her younger brother, who joined Theranos as a product manager four years ago. She didn't take a vacation during the entire decade of her 20s and doesn't date. "I literally designed my whole life for this,".

She has no life but work. Not even friends or dating. She literally worked away her 20s which is one of the most exciting times of life.

While it's fine to sacrifice for a while to get your business started, it doesn't sound like she has any plans to enjoy any part of her life outside of her work.

I hope other entrepreneurs don't take her plan to heart and give up everything that makes life enjoyable. It should be a balance. Work hard but also enjoy the things that makes life worth living.


As amazing as you think your empathy is, I suspect your comment comes from a sense of feeling superior because you are applying your value system in a place where it has no use at all.


Yeah, you're probably right, but I'd go so far as to place all empathy as coming from a place of superiority. Some poor guy can feel sorry for a rich dude because the poor guy knows his friends really like him and aren't just out for his money. The childless couple can feel sorry for how the couple with children has no free time, and the couple with kids can feel sorry for how the childless couple doesn't experience the joy of having a family, and so on, and so on.

That said, I sure feel sorry for someone with no friends, romantic partners, or human engagement on anything outside their work. It may be rewarding, but it doesn't sound very fun.

AND, if it's fun for them, then great! Different strokes and all. I hope they're as satisfied at the end of their days as I suspect I will be, looking back on life.


> I sure feel sorry for someone with no friends, romantic partners, or human engagement on anything outside their work.

That would actually describe most of my life, including the parts where I wasn't being paid to work. However, the reason I didn't have those things is because, outside of work, all I think about is work. I don't want friends who don't want to talk about work, because it is the most important thing in my life. I don't want a romantic partner who doesn't want to work with me because my work is the top priority. I don't want human engagement outside of work because it is time I could put into my work.

The bottom line is this: the best way for me to make the world a better, more enjoyable place for both myself and for others is for me to be successful at my work. Anything that detracts from that becomes stressful and frustrating to deal with, and ultimately feels pointless.


That's great!

How do you actually know you're making the world a better place for others, when all you talk about and think about is work?

See, what gets me about that attitude is, that kind of closed-off attitude is what I took into my first few startups. It's a tunnel-vision kinda thing, where I was pushing my ideas out into the world, but not engaging as a person with people (who, I assure you, are not all so focused on work). It never worked well, because people all want a lot of different things, and rarely does that all just line up with what I want.

But talking to people about their interests, listening and engaging with them on the human level? There's gold there, both in the friendships and the business that comes out of it.


The word 'work' just has connotations that it needn't have. For instance, I would consider "raising children" and "nurturing relationships" to be work, and I think if people are going to do them at all, then they should have an obligation to do them well, and they should be paid for their efforts.

>How do you actually know you're making the world a better place for others, when all you talk about and think about is work?

Because the work I do is general enough that it doesn't apply specifically to me or my culture. If I were to summarize, I would say my work is "to ensure by any means that the best possible decisions are made by as many people as possible in every situation in which I'm involved." Right now, there's a major technological aspect to that, since the capability of machines to advance human decision-making and communication is ripe for some real improvement. (Specifically in machine ethics.) These are things I will work on regardless of whether or not I am employed to do them. I only try to communicate it clearly enough and be successful enough at it that I can survive to do it with minimal obstruction.

So even though people want a lot of different things, they all want to be more capable at getting them, and that's what I am driving toward.


How do you actually know you're making the world a better place for others, when all you talk about and think about is work?

How do you know s/he's not?

And who asked you? These attitudes toward work-life balance are something we must decide for ourselves, and then live with.


Who asked me? This is a web forum, the whole point is to say stuff, respond to stuff, and so on.

As for whether the original poster is or isn't making the world a better place for others, you're right, I don't know. After how they described their work in the sibling post to yours (something about making decision-making better), I'm still not sure how what they're doing is any good.

As for why I'm skeptical that they're getting it right (i.e. solving a problem people have) without going out and talking to people about it, my experience tells me that that's pretty tough to get right.

Customer feedback is gold, and putting on your "I only talk about work" blinders is a good way to get something done, but whether it's the right thing, well, how do you know?

Look, I get it, it's fun to geek out and try and "solve problems" and treat life as an engineering exercise, but if you want to do it right, don't just sit at home and think "this is the problem," meet people where they are, and see how your vision and ideas fit with that, and on and on and on.


How does anyone know they're getting something right? Going out and talking to people is largely not the way to do it. Most people don't know anything about how to solve important problems.

You think you can cure cancer by going around making friends with people? Or discover a new algorithm? Or understand how to structure an organization?

I mean, if you just want to make money and be popular, then fine. Go talk to everybody. But if you want to solve an actual problem, that isn't going to help you find a solution unless you're always talking about the problem.

Which is work. I'm 100% ok with talking to people about problems. It's just the other pointless stuff that I don't do. Like talk about music, sports, beer, tv, family, or sex.


Yes, I do think you can cure cancer by going around making friends with people--especially smart people who are doing other interesting things. I don't think a single-mindedness about problem solving ever works as well as staying focused, but having a broader perspective.

As for not talking about music, sports, beer, tv, family, or sex, hey, if that works for you, that's great. When you spell out all the things you're missing out on (especially family and sex), I'm doubly glad we have different approaches to life.


> That said, I sure feel sorry for someone with no friends, romantic partners, or human engagement on anything outside their work.

All three of those things are really available throughout life and are not that hard to accumulate once one sets his/her mind to it. In fact, she'll probably have access to higher caliber of candidates who'd know her background and find her intellectually stimulating in those capacities.

Whereas the opportunity to move humanity forward in a major way, with a matching set of skills (and energy of a young person) is more of a once in a lifetime opportunity.


It's debatable whether that kind of monomania is really necessary. Steve Jobs still found time to have a family. Zuckerberg and his pediatrician wife just had their first kid. pg and Jessica have what, two kids now?

Anyway, studies show a lack of interpersonal relationships will actually shorten your lifespan, so OP's comment is hardly misplaced. http://www.slate.com/articles/health_and_science/medical_exa...


As amazing as you think your empathy is, I suspect your comment comes from a sense of feeling superior

Had you raised it as a question, this might have been a fine point, but putting it uncharitably makes it mean, and throwing in a personal swipe breaks the HN guidelines outright. Please don't do that.


Not at all. I've myself been burnt out from focusing too much on work. It sucks to be out of balance. If you feel that work is all that matters and you don't need anything else to be happy then good for you. I have a feeling that others might feel different.


Wow, I think you could not be more spot on.


Surprised to see such a non-imaginative viewpoint on HN.

Over what I feel like the last couple of decades, we've been taught that work == bad, life == good. You work because you have to, you trade time for money, you suffer from 9 to 5, you anxiously watch the clock, and then you go home and enjoy "life."

I think this is sad. There's nothing wrong at all with productive work, and putting best years of your life into doing something creative like building your life's business.


Work is good, sure, but there's more to life than it


The point is that we've grown to mentally associate the word "work" with "doing chores for my boss because I have to." It's a dirty word, the way we use it.

What about redefining this word to mean, for some individuals at least, "I'm pursuing my dream"?


It's not just a mental association. It's reality for nearly everyone on the planet. For the vast majority, work is something you're paid for that you would otherwise not be doing. That's why they call what you get in return "compensation". It's to compensate you for the time you spend doing what you otherwise wouldn't.

If you get up in the morning to "pursue your dream" you're among a lucky fraction of a percent of the population.


Why? What do you think work is, if not worth living to do?


Traveling to new places, having sex, exploring a new cuisine, going to a concert, hiking in nature, all of those things and a billion more you're surely familiar with, and you won't find them universally as part of this one particular job.

Work is fine, but doing nothing but work which is what Elizabeth's life seemingly alludes to, means you're missing out on all of the above. If you truly love life that way, so be it, to each their own, but for the vast majority of people life's desires are much less lopsided and there's a much bigger desire for a different balance. And that doesn't mean you have to hate your job. I like my work, I also like going home. Liking just working is like eating just bread n cheese and nothing else. I quite like it but I'm quite happy to eat other things, too.

Most of those people would even go so far as to liken a love for work and nothing but work, at all, as a sign of some kind of addiction. Can it be genuine love for a life spent just working? Well yes, absolutely, but knowing nothing else, I'd definitely be inclined to assume that a person who works, does nothing but work, is probably not fully aware of the richness that life outside of work offers, is scared or intimidated by it (it's easy to say no to love, or friends, or family, if it hurt you in the past, or say no to sports if you don't feel you fit in), or is somehow addicted to work in a way that's not completely free. Again, exceptions can exist, but those are reasonable assumptions when talking about such an extreme case of someone working and doing nothing but working for many years on end and no intention of stopping.


I think you're underestimating how much of that extra stuff is unavoidable in day-to-day life. But it's not hard to consider them all secondary to your goals, and there's no reason everyone should.


Yes for a normal hard working person, we're talking about Elizabeth who doesn't 'hang out' with anyone except her brother who is an employee of hers, chooses to wear turtlenecks everyday (she says she has over 150 turtlenecks and has worn them since she was 8, calls it her uniform, and they're all the same color of course, black, I'm not making this shit up) so there's no need to make any decisions in the morning, eats vegan so she can function on less sleep, had a solitary childhood. Nowhere does that appear she merely loves her work and does 'extra stuff' because it's 'unavoidable' and considers them 'secondary'. That's one thing. It looks like she doesn't do the extra stuff at all, purposely avoids them and that there's nothing secondary to work because it's all she lives for. She works 7 days a week and says she literally works from the moment she wakes up to the moment she goes to bed and designed her life so she doesn't have to dwell on 'extra stuff' like what to wear, and so she can sleep less, doesn't date at all and hasn't been on vacation in ten years, you really think there's nothing else to life than that? Ridiculous. That's totally different from your everyday 'I love my job, I work 80 hours a week with pleasure and have a family, go on vacation, do sports and meet new people for fun, go dancing etc besides work'. You're describing the latter in which case yes, it's completely fine to consider sports or hobbies as secondary to work if work is your nr 1 hobby, but for her there's no secondary. There's work and then there's sleep and that's it, and she's doing everything she can to reduce the latter and make more efficient the former, and no matter what you may say, she is totally missing out on a shit ton of things. Of course it's a personal choice and I'm in favour of her having the ability to make it, obviously. Life is a game of trade offs and the choices she makes are hers and I admire them a lot on some level, but let's not pretend there's no tradeoff here, life is clearly more than work, that's what Raverbashing said, you asked why, and I explained, it's as clear as day there's much more to life than the 7 day, 100% of her waking hours working work schedule, it's an objective fact you can't challenge.


I coud see how her work is extremely satisfying and provides her with plenty of rich stimulation. It's not like she's a sole proprietor.


for some there is, for some there isn't. i agree but i can totally understand that there are poeple who live to work.


Would you say that someone who runs onto a train track to save a child, and is killed in the process, has made a wrong decision? They've sacrificed not only their 20s, but their whole lives, for the sake of someone else.

Someone choosing to forgo personal pleasures to achieve something shouldn't be criticized for it, and should be celebrated if that thing benefits lots of other people. I don't know a lot about Theranos, but it seems like the idea is reduce blood testing costs tremendously -- if the CEO is sacrificing her personal life and dating life to bring better and cheaper healthcare to millions of people, that is an admirable sacrifice.


You are making the assumption that her decision to not date, or interact with any friends is beneficial to her mission.

I'm a believer that as a person sleeps less and interacts less with others at best they see diminishing returns and at worst their productivity overall declines.


Not really, I'm assuming that if someone decides to not date, that it's a legitimate decision for them, and if they decide not to date because they want to achieve something big for themselves and for the world, well, all the better.


Some people enjoy working. Some people don't want romantic partners. Most so called friendships really aren't the deep, meaningful, supportive experience depicted in popular media. Most so called friends are really "fair weather friends" -- people to do something shallow and fun with, not someone who has your back when it counts.

I thought her story was interesting because it does fit nicely with my understanding of why I did not have a successful career: Because I supported my husband's career and devotedly raised our two children. I don't regret that and I hope the world will eventually come up with answers better than "A woman can have a career OR a family." But given how many men have a career and not much of a relationship to their children, I don't feel like that is a thing society imposes on women only.

I feel like that is rooted in the reality that there are only so many hours in the day and both parenting and a serious career are big time sinks. Serious careers tend to consume your life. Most good parents have intentionally made choices that put family first, at the expense of "getting ahead." Middle class families -- a shrinking minority at this point -- are the ones that tend to be best for kids. At least according to one study, you see as much neglect and drug abuse in wealthy neighborhoods as you do in the ghetto.

Life is richer when we embrace diversity. Some people like putting all their time into their work. I hope her work winds up being a net benefit for the world, as she seems to envision. Some things cannot be accomplished without one person babysitting it 24/7 for years and years and years. Some of the things that need that kind of attention do make the world a better place.


I imagine she is fully aware of this but chooses to work anyway. I don't understand that level of obsession, but good for her.


What makes you think she doesn't enjoy her work?


Exploring the world outside of your core work is what gives you perspective. And perspective is very very important in building a business. Perspective and empathy, both of which cannot be "hacked" and can only be attained by truly living life and exploring the world.


I feel like you're suggesting two things in this post:

1. Holmes does not have perspective due to her focus on work.

2. Perspective is needed to build a successful business.

I think these are revealed to be inconsistent when we add in the following:

3. Holmes has already built a successful business.

Since (3) is known to be true, at least one of (1) or (2) has to be thrown out or weakened.

That said, I think DevX101 was focusing on her happiness and you were focusing on her success. We have no evidence that Holmes is happy. We only have evidence that she's been successful.


That sounds awfully prescriptive. You need to add "To me" to the beginning of that post.


There are a lot of assumptions implicit in that post. Maybe (certainly.) she just has different values than you? Someone who reads Marcus Aurelius as a teenager probably won't be particularly attracted to hedonism or conformity as a lifestyle choice.


Would it be hedonistic or would it make her less successful if she spent 1 hour/day hanging out with a significant other or her best friend? It would almost surely make her a better manager/leader, as leading involves other humans and gain a certain perspective on her business.

Also, what happens if thing don't work out? Her company is not public, may not get the next round of funding and then what? Or there may be a hostile take-over and she will be left with a decent amount of money, but no business. And nobody to talk to.


from all accounts, it makes her life extremely enjoyable. there have definitely been lots of times i was eager to get home from work and spend the rest of the evening/night hacking on my open source projects; if i were a more driven person i could well imagine being happy spending my entire life that way.


I wish I had my 20s back. Spent too much time in startups.


if i were younger, i'd agree... but now, i can only ask: why do you assume that you know better than her what life should be? why do you even care about life choices of someone you don't know? why does it matter so much that you had to comment about it? does it matter at all?


I take it she is taking the supplements to make up for a vegan diet?


It's hard to judge someone from a profile in a popular magazine. If you throw caution to the wind and attempt to judge her based on this particular article, you end up with an impression of someone who may not be, well, entirely stable and rational.

Still, more power to her. For everything that seems a bit "off," such as the idea of being able to sleep less on a vegan diet, or the idea of crediting an unspecified god as a source of personal strength, there's also something about Holmes and her approach to her life and work that comes across as unadulterated awesomeness.


I don't know if I would call this a flattering portrait of a founder. The article makes it sound like Holmes's Ahab-like focus borders on monomania, fitting into the well-known model of obsessed founder.

On a different note, though, one thing that jumped to me was this:

"Her parents let her use the money they'd saved for her education as her first seed round of funding."

I applaud this decision and wish more parents would consider this option. Note that based on her academic history this not a wild gamble by her parents but a good bet, well within acceptable risk levels. More parents need to ask their children: "Do you want me to spend ~$60k per year for an Ivy League undergrad (e.g. Stanford http://college-tuition.startclass.com/l/4518/Stanford-Univer...) or do you want me to invest part of that $240k in your company? Admittedly not for everyone, but when it works the payoff is huge.

The question becomes, I think, rhetorical for MS and PhD.


On the other hand, if you don't have rich parents then good luck trying to use your college loans/grants as seed capital, or to attract VC funding if you don't come from a socially privileged background. It's not impossible (obviously as quite a few HNers have done just that) but it's much more difficult than it sounds.


Indeed. I don't think my $0.00 in college money would have gotten me very far.


Then why not just dig into your trust fund and leverage your parents' business connections for funding? Stop making excuses.


Isn't this essentially how Gates financed the purchase of DOS?


Seriously chaps - we can do better than this.

- All credit to Holmes' accomplishments in business and technology, but...

- As amazing as her accomplishment is, ...

- I take it she is taking the supplements to make up for a vegan diet? ...

- I always wonder why articles like this don't make any mention of how Ms. Holmes is a billionaire, on paper ...

My daughter is only alive because someone in Belgium ticked a box in a blood test form in Belgium that the people in the UK missed. This shit is important.

What Holmes is doing is awesome, life changing work. Good on her.


I don't think anyone is necessarily saying what she has done isn't amazing, profound and admirable.

My comment was to the fact that she pretty much gave up everything to accomplish that. Was it necessary? Could she still have achieved what she did if she had friends or took even one day off a week? Maybe, maybe not.

My point was that it shouldn't be all or nothing to create a successful company. Many entrepreneurs, myself included have given up all of these things (at least temporarily) in the single minded pursuit of business success. I still work way more than I probably need to but also make time for other things.

Just because she is doing something lifesaving doesn't mean I shouldn't want her to also enjoy her own life. I would have said the same comment if she made the next WhatsApp instead. Good on her that she's saving lives. Also good on her if she wasn't and just accomplished something big.

To clarify (at least my own point), if you love what you do and don't need friends etc then that's great and I wish you all the best. Whatever makes you happy. If instead you like having friends, dating, a day off etc then don't feel you absolutely need to remove all of that to make a successful business.


I agree with you to the extent that I hope she doesn't burn out too soon.

> I don't think anyone is necessarily saying what she has done isn't amazing, profound and admirable.

Perhaps not but, (it seems to me) they're not showing anywhere near enough respect before coming up with some criticism.

Bare in mind Holmes is the most extreme case (i.e. the first female self made billionaire), and she knows this. In her words she's on a mission (see the youtube video). History is full of people e.g. monks, missionaries and leaders who devoted their lives to their work. They were no less happy for it. It's interesting in the article how much she relies on faith.

She's not just an entrepreneur. What she is doing is arguably more important than any of the self made billionaires (who are themselves extreme cases of entrepreneurs). Only Gates is doing something similar and he waited until he had billions in the bank first. Even Musk who I similar respect for made his millions first.

Further the point is she's not making the next WhatsApp. WhatsApp is a blip of nothingness compared to what Holmes is doing. She's going to improve the fundamentals of detecting life threatening illnesses which will continue an impact basically for the entire human existence. It will probably eventually impact every human (and any animal that is treated by a human) on earth.


I always wonder why articles like this don't make any mention of how Ms. Holmes is a billionaire, on paper. She obviously is set up to be an actual billionaire, however we all know there is a huge difference between private valuations and what someone is willing to pay for the entire company (or on the public markets).

Is this me being too critical?


These days, founders are taking massive amounts off the table in the large funding rounds you read about. I know of several cases where it has been upwards of 50% of the round (series D/E 100M+ deals). While she doesn't have a billion dollars of liquidity, I wouldn't be surprised if she had 50 million+ in the bank.


That's not how you keep 50% of a company. It's usually cash off the table or keeping your equity.


In this case they seem to have the revenue to justify a similar public market valuation.


All credit to Holmes' accomplishments in business and technology, but this story should be read alongside another recent one:

http://qz.com/455109/entrepreneurs-dont-have-a-special-gene-...


Although not poor, it seems her parents aren't really rich: https://en.wikipedia.org/wiki/Elizabeth_Holmes


They had enough for her to pay to attend university, which is certainly more than most. (Obviously, I'm referring to university of the price tag similar to Stanford.)


What precisely in the Wikipedia article you linked to made you suspect that her parents aren't rich? I saw, 'One of her ancestors was a founder of the Fleischmann's Yeast company', and immediately thought old money.


Is she backed by a wealthy family?


Take a look at her board of directors. Sometimes connections are worth more than money.

http://www.bloomberg.com/research/stocks/private/board.asp?p...


Did you consider you're putting the horse before the cart? I mean to say....did you consider she has these connections because she comes from money? Sometimes they come hand in hand.


You need more than money to get Henry Kissinger on your board of directors at the age of 31.


Sure, but money and the connections derived from it certainly helps you get to that point.


Her parents both worked for Government


Sure, but so what?

'One of her ancestors was a founder of the Fleischmann's Yeast company', and her great-great-grandfather was 'dean of University of Cincinnati College of Medicine,[11] where a hospital is named after him.'


Wealth is usually gone by the second or third generation. Her parents seemed to be employees who had to put in their 9-5, not any kind of tycoons. They did afford a prep school and Stanford though, I guess that's more than most.


Shrug. Its totally possible the old wealth is gone, its totally possible its not. I should state, I don't think any less of this persons and their accomplishments. Just a bit of a nitpick on details.


I don't really recognize anyone very important besides Kissinger.


Theranos has some pretty big red flags. No peer reviewed studies showing accuracy levels, stacking the board people known politicians to give it an air of legitimacy (and get legislation passed), ridiculous levels of secrecy.

I really hope they are what they say they are but if I were investing I wouldn't give them money without a serious 3rd party audit.


They're a CLIA certified lab so they don't need to publish public peer reviewed studies. They're also slowly submitting their tests to FDA, which isn't required for their kinda lab (something Quest & others actively are fighting).

Quest and others don't really have peer-reviewed studies for their tests.


How the Sexes Fundraise

15 Percent of U.S. venture funding goes to startup teams that include a woman, and only 2.7 percent of venture funding goes to female CEOs.

3x Male founders are that much more likely to find equity financing through angels than their female counterparts.

14 Percent of men tap business acquaintances, versus 5 percent of women.

2 Percent of women are likely to leverage networks of close friends, as opposed to 9 percent of men.

I like seeing these stats included, but I wish there was more context than just gender. I was one of the top three students of my graduating HS class and some people expected me to be a millionaire by age 30, but I did the full time wife and mom thing instead. I have done a fair bit of reading over the years to try to understand why I never got the two career couple lifestyle I had been "told" by society/media was my due. The exact mechanics of how and why women do this differently is far more interesting and useful information than dry stats.


>"You hear a lot about young entrepreneurs who come in with a certain confidence," Fonstad says. "Holmes had 10 times that."

I hear this kind of thing a lot and wonder what specifically they are describing. Is it swagger? Is it how she responded to questions? Is it the traction they had that they could point to? Some combination of all of these?

Seems like a critical thing and never really described what people mean by "confidence." After all one person's confidence is another persons arrogance, so I'd be interested to see how she had 10x confidence without crossing that line.


Holmes is a vegan because avoiding animal products allows her to function on less sleep.

Just gonna drop that one in there? I'd love to see evidence of this. (As a happy non-vegan, I kind of hope it's not true.)



Thanks for the reference. Hard to tell if veganism is the cause, though. For example, lots of paleo people consume "living foods," including fermented vegetables. Do they see similar benefits? I'd wager yes. Plus, the study doesn't substantiate the claim of vegans needing less sleep. It points to a better "quality of sleep," with no indication of quantity, and even then only in fibromyalgic subjects. So it appears that my initial skepticism was justified.


Does anyone here agree with me that it's weird that every article about Theranos is actually an article about Elizabeth Holmes? It seems most other high profile startups inspire a mix of articles, some about the founder, some not.


Stanford did a "View From The Top" with her: https://www.youtube.com/watch?v=hLTAFbKbC8w


I don't know anything about the technology in this space, but I sat in on a conversation recently where a bunch of people that work at diagnostic start-ups expressed skepticism about the claims that Theranos makes.

There are two possibilities: 1) these start-up people just don't understand what Theranos is doing, and they can only judge Theranos from their own perspective, which isn't up to the task; 2) Theranos is overhyped, and these scientists know something investors don't know.


Fantastic read, very inspiring. Being able to devote yourself to that sort of goal, and then actually achieve it is impressive, and humbling (to me).


This line doesn't really make sense:

"You'd have to look really hard not to see Steve Jobs in Elizabeth Holmes."

How can you look hard to not see something?


> self-made billionaire

lolwut




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