In 2008, Theranos engineer Aaron Moore created a mock ad for a prototype of the company’s blood testing device. Intended as a prank to amuse his colleagues, his ad described the device as “mostly functional” and included “leeches” among its “blood collection accessories.”1
Now, with hindsight, we can interpret his spoof not just as a joke but as a desperate bid to raise a taboo subject: The company’s device didn’t work and the leadership team was hiding that fact. Moore’s actions spoke volumes about the undiscussables at Theranos.
Undiscussables exist because they help people avoid short-term conflicts, threats, and embarrassment. But they also short-circuit the inquiries and challenges essential to both improving performance and promoting team learning. Our consulting work with dozens of senior management teams has taught us that a team’s ability to discuss what is holding it back is what drives its effectiveness. We have observed this dynamic in a wide variety of settings and have drawn on this experience to propose a framework, a set of diagnostic questions, and some targeted solutions to help teams address their own undiscussables. This approach enables team leaders to identify the dominant undiscussables in their businesses and kick-start the necessary conversations to bring them to light.
At Theranos, CEO Elizabeth Holmes and her top team were unwilling even to acknowledge concerns that were obvious to many of their engineers. It was significant that Moore didn’t share his misgivings directly with his bosses but expressed them sarcastically and anonymously.
When Holmes was told about the prank ad, she launched an investigation to identify the culprit. Instead of triggering debate, her actions reinforced the message that problems with the company’s product were not to be discussed. Within months of being reprimanded, Moore resigned, frustrated and disillusioned.
The Theranos case illustrates what can happen when questioning voices are silenced and topics placed off-limits.
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