Inside Elizabeth Holmes's Family Tree & Legacy Before Theranos

On the premier episode of The Dropout, the ABC News–produced podcast about Elizabeth Holmes and the Theranos fraud, we meet Don Lucas Sr., one of the first investors to back the blood-testing company. In a clip from an oral-history interview from 2009, Lucas explained that he assumed his initial conversation with Holmes would be a short one — she had no formal background in business, and for this reason he found it quite "presumptuous" of Holmes to think she could be president of a biotech company.

But, as he tells it, he quickly changed his tune when he became aware of some important distinctions about her: "Her great-grandfather was an entrepreneur, very successful. And it turned out later that the hospital [near] where [her family] lives is named after her great-uncle." In Lucas's mind, she had the two necessary qualifications to start Theranos — a family with history in both business and medicine.

As it turns out, key to understanding Holmes's story is her family tree, the generational wealth from which she descends, and the pressure that was placed on her to succeed as a result of it. As former family friend Joseph Fuisz told reporter Rebecca Jarvis in the same podcast episode, "This was a family that took nice things really seriously."

Elizabeth was born in Washington, D.C., in 1984, the daughter of Christian Holmes IV and
Noel Anne Daoust, both of whom came from powerful circles. Elizabeth's mother, Noel, worked as a foreign policy and defense aide on Capitol Hill, and her father worked for government agencies after serving for a time as a vice president at Enron. After Enron's demise, Christian allegedly asked for help from Joseph Fuisz's father, Richard, who let the Holmes family live in one of their homes. (Years later, Elizabeth Holmes would sue Richard Fuisz over a patent dispute.) Holmes's family moved frequently when she was growing up, which made it difficult for her to retain friendships. One such time, when Elizabeth was nine and her father's new job in Texas uprooted the family, she knew her dad felt guilty and allegedly wrote him this letter: "What I really want out of life is to discover something new, something that mankind didn’t know was possible to do.”

Richard Fuisz told Forbes that Noel and Christian put pressure on Elizabeth from the time she was young — and claimed that Noel pushed her daughter to follow in Richard's footsteps as a physician and to learn Mandarin, largely "to improve their position in the world." As the story goes, Elizabeth's ability to speak the language fluently got her into Stanford summer classes on the spot, despite her still being a high school student. And it was a friend of Christian's who introduced her to Don Lucas to begin with.

The great-uncle referenced by Don Lucas was actually Christian Holmes IV's great-grandfather (so, Elizabeth's great-great), a famous surgeon after whom Cincinnati’s General Hospital was named. This doctor, Christian Rasmus Holmes, married the heiress to the Fleischmann yeast empire, cementing the already established Holmes name as one of wealth and status — a history Elizabeth allegedly referenced a lot in order to establish Theranos's credibility in the absence of hard science.

According to Joseph Fuisz, Elizabeth's father especially took great pride in the family's lineage. Fuisz told Jarvis on The Dropout that "her father had a real sense of entitlement in terms of the traditional importance of his family, that it sort of eroded over the years. The seeds of Elizabeth's grandiose fantasy for her business connect to this paradise lost family mythology."

And it's clearly a legacy that heavily influenced Holmes, who was expected to live up to her family name. "I grew up with those stories about greatness,” Holmes told The New Yorker in 2014, “and about people deciding not to spend their lives on something purposeful, and what happens to them when they make that choice — the impact on character and quality of life.”