The treatment, along with her doctor. He was a neurosurgeon at new york presbyterian. I am pleased to have both of them at this table for the first time. I must say, that alexander is a good friend of mine. Welcome. Guest thank you very much. Charlie tell me about you. Guest i have had this since i was three it has been an issue in my career. I am in the Financial Services world and i need to have people trust me and feel confident about me in terms of doing business and having the hand tremor, which was very visible, really caused problems for me. Inside me and it affected my confidence. Charlie what did you do . You lived with it for a long time. Guest i did. I lived with it for a long time. I tried various medications that either did not work or there was one that actually lowered my Blood Pressure and i have lower Blood Pressure to begin with. So i went along trying to handle the daily tasks that are Second Nature for everybody else, picking up a cup of coffee, picking up sushi with chopsticks. It was a great embarrassment for me. I never wanted to talk about it before. Charlie what causes it . We dont know. The term essential tremors means a tremor when you move, and action tremor. You go to pick up a glass and you shake it and spill it all over yourself. Charlie how is it different from parkinsons disease . Guest it is different. We know there are cells in the opening of the brain that lead to various symptoms. In parkinsons disease, you have multiple symptoms and the tremors are different. Parkinsons tremors are where ing are sitting there, tremor n away. The essential tremor is isolated and it makes it difficult perform daily activities, but otherwise you are fairly normal. Charlie the treatment that she took and you administered, was developed where . Guest in israel. It is based on operation for you. You make a small hole in the skull and you go into the middle of a circuit that regulates coordination, which is where the problem is. We normally put in electrode in there that is attached to a battery and it has been effective. What they found in israel is that they could generate the ultrasound waves going through the skull are lowenergy. They could create a helmet that has a thousand sources that all converge on the one spot. All of the beams of Ultrasound Energy are relatively safe as they go through the brain come but they add up their energy at the spot so you can actually essentially, burn or take out that abnormally functioning spot and free up the rest of the brain to function normally. Charlie are there risks . Guest it is a new procedure, even though it is fda approved. Even when you do anything inside the brain, there is a risk of bleeding. But so far it has been relatively safe. Charlie so far. Guest so far. It is a new procedure. We do not know if it will last as long as the traditional procedures because it has been a around for a short time. There is evidence that the effects could last for a year. But it is so new that we cannot say even 10 years, even though i am hopeful. These are some of the issues we are addressing and there are uniqueness to each patient, based on the shape of their head and the thickness of their skull. Charlie do you have to go back for more treatments . Guest they only do one side at a time. I would love to be able to do both sides. It is great for demonstration purposes, because this is my tremor. This is my hand now. Charlie and what has it done for your spirit and your confidence, since you no longer have to live with this . Guest it has been amazing. As i said before, there are things that are Second Nature to everyone else, when each time i do it for the first time our second or third time, i am just amazed and a chuckle inside. I am drinking my coffee by myself. From a confidence perspective and as i mentioned before, the issues related to business, that has been a great difference for me as well. Finally, i mentioned, i never wanted to talk about it. I was embarrassed. Able to tell people about this, and how often in ones life the somebody have the ability to potentially change other peoples lives. I am so grateful and honored to have that opportunity. Charlie take a look at this. We have a clip of your hand before the surgery. Guest holding my cup with two hands. Sometimes holding the wine glass by the stem, and the glass itself. Charlie this is you going to the highintensity ultrasound treatment. Right now she is inside the mri machine. You can see the bottom half of her face. Her head is held in place because the ultrasound must be so precise that you do not want the head to move. So it is in place. What you saw a minute ago was the helmet that has those ultrasound beams. Here we are working on the plane of the consul to deliver the ultrasound. Charlie you said it was noninvasive. Guest correct. Charlie take a look at the essential tremor test before and after. Guest this is what we do during the procedure, you are drawing Straight Lines. At the end, this is her writing upside down, most of us might not even do that well on the other side upside down. She is drawing a circle upside down and doing a Straight Line upside down. You can see the improvement. Charlie is this a platform for the future . Guest i do. Charlie meaning . Guest i think that what we can do now is take all of the skills and knowledge that we have learned as surgeons and apply it to much less invasive type of technologies and this is what people want. So the idea that we can take out a certain part of the brain might be good for the essential tremor, for things like epilepsy. But what we can also do, what we have been experimenting with, is in a different way to open up the blood vessels that lead to a certain area so we can just through a simple intravenous injection deliver things like gene therapy, which we have worked on for several decades. This way we can expand the diseases, like alzheimers disease and depression, if we use this to deliver advanced therapies, rather than take out part of the brain. Charlie are there any downsides . Guest not really. For the first couple weeks i was wobbly and unbalanced. That has since subsided entirely. The other was, i had to relearn to use my hand, because i was so used to try to control charlie you had to trust your hand again. Guest right. I compare it to a batter swung in three bats in practice and then using one. My hand would jerk as i would try to reach for something six inches away and i would go a foot away. That subsided as well. Charlie he would recommend it to anybody . Guest absolutely. Charlie we do not know what causes it. We believe it is hereditary. Guest correct. We do know the area of the brain that is responsible. Charlie is it the same area of the brain responsible for parkinsons . No, it is different. The brain is composed of a variety of circuits and there are circuits that control movement that interact with one another but the particular circuit responsible for essential tremor is slightly different from the circuitry responsible for parkinsons. And our many circuits affecting parkinsons, depending on the symptoms. This is much more specific. Charlie what else do you think it might be applicable to . Way we are using it now might be applicable to essential tremor. I think it will be applicable to epilepsy. If we can use this to open the socalled blood brain barrier, you know, the blood vessels have a way of preventing things in our bloodstream to protect the brain. You dont want every virus to get into your brain, but that events us from getting important drugs, gene therapies, antibodies come all these new age therapies do not get in from the bloodstream well. We now have the ability with this and we approve and is in the laboratories, to be able to open up this barrier and allow these things to get from the blood into specific brain targets. Now you have the opportunity to deliver new chemotherapy is ies. We have the opportunity to deliver things, as i said, for other diseases like alzheimers. And many others. Charlie what else might cause tremors . Tremor is a very big diagnosis. There is essential tremor, which means it is isolated. Parkinsons disease is a very specific resting tremor. There are tremors that are the result of certain types of degenerative diseases. For example, there is a disease called hydrocephalus. That is a buildup of some spinal fluid in the brain. That can cause tremors and be confused with this or parkinsons disease. People with liver problems can get tremors because of the toxic buildup in their bloodstream. Charlie congratulations. Thank you. Charlie doctor. Thanks very much. Charlie we continue with a look at the troubled biotech company. She came out of stanford with a vision of trying to revolutionize medicine with blood testing that would be done on very small samples of blood, either a trick from the arm or finger. And the test would be done quickly, often just this painless pin prick, then you could diagnose conditions from that. It was pretty transformative. If it was achievable, i think it really meant a big change in medicine and in laboratory testing. The vision was a powerful one. Again, the people investing early knew they were facing a young lady who just graduated and might fail, as many entrepreneurs in Silicon Valley fail. We conclude with amy adams. She spoke with the New York Times about hurt two new films. I am much more relaxed than when i started. Im not sure if that is reflected in the work, or if the characters are more relaxed. But i feel more relaxed. And a love the stories i get to tell and i feel really grateful. I am in a great spot as far as gratitude goes. I think i am able to approach things from a different point of view, instead of feeling like i will get found out. I think every actor talks about that feeling of getting found out. Elizabeth holmes said out to revolutionize the blood Testing Industry when she founded theranos at the age of 19. By 2015, the biotech startup was valued at 9 billion, making her the youngest selfmade millionaire. In a few short months and began to unravel. Last fall, an investigative report published in the wall street journal revealed significant cracks in theranos. Since then, the company has come under federal criminal probes, including whether it misled investors. Elizabeth holmes has been banned from the blood Testing Industry for at least two years. Joining me now are John Carreyrou. I am pleased to have both at this table. If has been 13 months of reporting in the journal, but longer than that actually, looking into theranos. John, when did you first get an indication that something might be amiss . There was a new yorker piece in december of 2014, a long profile of Elizabeth Holmes. That piece both put on my radar. She had gotten a fair amount of press, but i had not paid much attention until i saw that story. In addition to putting her on my radar, just in general, they are decoupled passages that i thought were strange. I had done investigative reporting in health care for the last decade. Having a fair amount of experience, there were some passages that seemed off to me. I probably would not have done anything with that, but a couple of weeks later i got a tip. Host which passages . They were a couple of skeptical passages in the piece about the regulatory sort of no mans land, that this company was sort of charting, its path. Then, there was also a paragraph in which the writer asked her how the technology worked. And she sort of danced around the issue, but then gave a description that seemed almost childish, of you know, chemical experiments. And so, those passages caught my eye. To be fair, i might not have done anything with it if i had not gotten a tip two or three weeks later. Hos talt talk about that tip. John this was a person who had talked to a person who had talked to a recently departed employee. The message was, things were not as they seem at theranos. The nice this glowing coverage in the press, there were Serious Problems and that somebody ought to be looking into it. I pulled on that string and i got back to the primary source, the recently departed employee, and then build from there. I might add, it took 10 months from the time of that original tip to publishing the story. That is how long it took for john to unravel things. It is interesting. And john mentioned this expertise in health care. He knows health and science really well. I think also what helped you, john, was the fact that you were looking at this with an outsiders lens. This was not somebody who is part of Silicon Valley and the ecosystem there. I think it allowed you to have a skepticism and a freedom to be able to write about it that sometimes you cannot when you are in the midst of Silicon Valley. Host there are so many layers to this story that it would be difficult to cover talking for a day about all of it. But just about 10 days or so ago you came out on the article of tyler scholz, the grandson of george scholz. He was a whistleblower and he left the country. He created big controversy within his own family as well. He was one of the first people you spoke to about what was allegedly going on. John he was not the first person i spoke with and he was not the first source. He perhaps was not the most important source. He was an important source and an important corroborating source. I learned of his existence from the first source. And i figured i would try to reach out to him. So, i looked him up on linkedin and used this great function on clintonn linkedin, the inmailing function. I did not hear anything back for three weeks. And suddenly, almost a month later, i am at my desk in the middle of the afternoon and my phone rings and i pick it up and it is tyler. A burner phone. John a burner phone. Host and he said, he was gone from the company at that point. He had been gone from the Company Almost a year at that point, 11 months. Is your tracking this down then, when you approached your editors about what to do, and wh at help you needed, how did the team then coalesce . John i described the early goings as seeing if there was anything to this. Really, you know, lets see if really there is a story here at all and try to understand the issues. I dont think we were necessarily convinced we had a story for quite some time, for many weeks. Gradually, i think, as i got people to talk to me and mostly off the record, unfortunately, because all these people were former employees that had signed nondisclosure agreements, there was no reason i would get them on the record. I had to do a lot of cooperating. As we got to a certain level, the Critical Mass of information coming from these ex employees, convinced that this was something that touched on public health. Said he wasscholz feeling pressure from his family and was followed by private investigators. Were you follow that any point . I know that you came under immense pressure from the company and others, but maybe you can talk about that process. John i do not know if i was followed. If i was to find out that i was, it would not surprise me. Tyler and i met again in may on the stanford campus. And the message was passed on to tyler via his grandfather that within a few days of the meeting, that the company was aware we had met again. Let me tell you about the pressure that john faced. The journal was based twice with a lawsuit from theranos. Johns sources were threatened with litigation. Theranos executives sought to have them recant and write statements that john had misquoted them. In fact, there was one moment after one of his stories, i think it was the cafeteria at theranos, where Elizabeth Holmes was talking about story that john had done. There was a lot of anger in the room and a suddenly a chant started. Carreyrou. E f you they were attacks john was facing with frequency. To his credit, he brushed them off. But they were personal elements to this that john had to face. Host nevermind the fact that your owner of the newspaper was an investor in theranos. I have to tell you, it is a point of pride for us. Journalists taken point of pride. There was some slickly no interference of any kind at any point. The editors handled the story from the getgo. I have to tell you that john and i had a lot of support from the editor in chief to the great lawyers, to the page one editors, this was a team editor. There was an enormous amount of support and never was anything but just keep going. Host Rupert Murdoch is not the only bigname investor in theranos. Elizabeth holmes was able to secure some enormous contributions from some enormously popular and influential people at a very young age. Yes, there are really two categories of investors. There are the people that came in early after she had just dropped out of stanford as a 19yearold or 20yearold, people like tim draper, the venture capitalist. The first million. And Larry Ellison came in in the first three years. Don lucas who had groomed ellison. All of those people were there at the beginning. And they knew what they were getting into and that this was essentially a kid with a great idea. And they knew that the company could either succeed or fail. Then there is another category of investors, the people who came in and ponied up most of the money, stretching from early 2014 to 2015. When you look at when the money was raised, that is when it was raised. At just the wrong time. 330 million was raised between 2014 and 2015. Host just before the last chunk of it was raised in march of 2015, two months after i started looking into the company. Host how was it based on your reporting that somebody at that age, Elizabeth Holmes founded the company at the age of 19, was able to raise plenty of than in her mid20s, more money poured in when she was 29 years old. What was it that she was able to say and to do based on what youve been able to find, to get that cash . John she came out of stanford with a vision to revolutionize medicine with blood testing that would be done on a very small samples of blood, either pricked from the arm, then the finger. The tests would be done quickly off of just a painless prick. And then you could diagnose a bunch of conditions from that. It was pretty transformative, if it was achievable. And if the company could do it. It meant big changes in medicine and in laboratory Testing Industry. So the vision was a powerful one that a lot of people bought into. But again, the people investing they werewq dealing with a young lady that mig