Driving through Southwest Michigan in February is the kind of road trip that makes a person want to nap. Sloping, landfilled hills and bare trees are the most exotic things one sees. A few weeks ago, I pulled into a BP gas station somewhere around Kalamazoo to shake off the doldrums and grabbed a squat bottle of 5-Hour Energy from the small convenience store. It was an appropriate choice: I was headed to a research center funded by the eccentric creator of 5-Hour Energy.
I chugged all 2 ounces at the register. 5-Hour Energy shots are meant to be gulped, swallowed whole, their vaguely medicinal citrus tang traveling from lip to throat in seconds. They are lighter than a fat can of Monster, more convenient than waiting for coffee to brew. They contain just four calories, an adorable number. Jerry Seinfeld called them “meth lab Hawaiian punch Jell-O shots” in a stand-up bit. (“Five hours? That’s a weird amount of time!”) When a product is ubiquitous enough to land a Seinfeld whinge, it cannot possibly get more mainstream. The grabbable bottles and primo product placement — always right by the register at the convenience store by the highway or by the checkout at Wal-Mart or Target — have made the drink a staple for weary travelers looking for a legal upper. Red Bull might have flashier promos and more name recognition, but 5-Hour is a quiet titan of its industry.
According to IRI, a Chicago-based market-research firm, in the past year 5-Hour Energy has sold more than 271 million bottles, generated $1 billion in revenue, and accounted for 91 percent of the dollar share of the market, based on checkout data from U.S. supermarkets, drugstores, mass-market retailers, gas/convenience stores, military commissaries, and select club and dollar retail chains. The brand is so dominant among energy shots, it’s a near monopoly.
5-Hour Energy has made its creator, 64-year-old, Michigan-based, India-born entrepreneur Manoj Bhargava, tremendously wealthy. “I’m probably the wealthiest Indian in America,” Bhargava, in a typical flourish, told a Forbes reporter in 2012. That year, he climbed onto the Forbes list of the 400 wealthiest people in the U.S. (no. 311) for the first time, and joined Mark Zuckerberg and Richard Branson as signees on Warren Buffett and Bill and Melinda Gates’s Giving Pledge, vowing to earmark the vast majority of his money for philanthropy.
The Giving Pledge is the Hall of Fame for rich people who want to look virtuous. Bhargava entered an exclusive strata of mega-wealth by taking this pledge, one in which philanthropy is the primary status symbol. Bhargava is not as well known as many of the other names on that list, but his approach to giving invites a closer look. Bhargava wants to use the profits from his disposable pump-me-up canisters to tackle large-scale problems, including scarcities of clean water and renewable energy supplies. He is practiced at spreading the word about his mission. When there are headlines about Bhargava, they’re usually glowing. In Fortune: “This billionaire wants to solve California’s water problem.” In National Geographic: “Creator of 5-Hour Energy Wants to Power the World’s Homes — With Bikes.” Bhargava is canny at promoting his narrative, which is: reclusive, wealthy man does good.
“I do as much work behind the scenes as I can. I rarely accept invitations to speak at events, I don’t do many media interviews, and I minimize the need to appear on TV. Everything I’m doing is utility. My goal is to get stuff done and make people’s lives better. If I could, I’d just do it all low profile,” he told me via email.
“I realized after the success of 5-Hour that I had two choices: Keep the money and make myself and my family miserable, or give most of it away and help to alleviate human suffering. That was an easy decision,” he said. Bhargava has already successfully sold an energy drink; now he wants to sell himself as another sort of vital tonic, an antidote to greed and a salve for the poor. His ambitions are as grandiose as his bottles are ubiquitous.
Bhargava is rarely interviewed, and when he is, anecdotes about his life tend toward the vague. His origin story reads more like apocrypha than biography. He was born in Lucknow, India, a densely populated city in Uttar Pradesh, nestled on the banks of the Gomti River, closer to Nepal than Pakistan. It is an old city. According to one Hindu legend, the foundation was laid by Lord Rama’s brother, Lakshmana; it is now lined with wide boulevards. His Lucknow childhood was prosperous, and he attended private schools and lived in a farmhouse framed by gardens. (I was originally supposed to meet Bhargava in Michigan, but was later told he was traveling to India. He answered some of my questions over email, with a spokesperson as intermediary.) His book-publisher father had his eye on attending Wharton business school, and so he, his wife, and their two sons and one daughter immigrated to West Philadelphia when Bhargava was a teenager, crowding into a two-bedroom apartment. Bhargava snagged a scholarship to tony boarding academy The Hill School in 1970. He shares alumni status with filmmaker Oliver Stone, novelist Tobias Wolff, and former secretary of state James Baker III. After graduating from The Hill School, he was admitted to Princeton, but he attended only a year before dropping out. “I thought I got what I needed to get out of Princeton in one year,” he told The Daily Princetonian.
What Bhargava did next is hard to pin down. He told The Wall Street Journal that he worked as a cab driver and manual laborer after abandoning college, wandering between India and the United States for 12 years as he searched for his calling. Bhargava says he traveled to India for long stretches, where he volunteered at the New Delhi–based Hanslok Ashram, a Hindu monastery, and he has been described as a monk. He moved back to the United States permanently around 1990. At some point, he got married to a woman named Sadhna. He lives in Michigan, and they have a 20-something son, Shaan, who studied at Michigan State University and now works at one of the philanthropic organizations Bhargava cofounded. By the time Bhargava returned to the U.S., his family had moved to Indiana and started a plastics company; Bhargava came back to get into the plastic game himself. As a prodigal family entrepreneur, he was a success, running an Indiana-based plastics company called Prime PVC Inc., which he sold in 2007 for an undisclosed amount.
While he was wandering around monasteries, Bhargava became close friends with Mahipal Rawat (whose name is now Bhole Ji Maharaj), a son of Hanslok’s founders. Mahipal’s daughter, Shivani, is Bhargava’s goddaughter. She is also a film producer on the rise; the 31-year-old produced Trumbo and Captain Fantastic through her New York–based production startup, ShivHans Pictures. In a recent Variety piece, Dan Fogelman wondered if Shivani is the “next Megan Ellison” — and, just like Ellison, who rose to prominence as a financier by leveraging her tech billionaire father’s connections and money, Rawat has her own super-rich patriarch patron. Her godfather funded three of her films, and he remains the primary financial backer of ShivHans Pictures. (Yes, Bryan Cranston’s sole Oscar nomination is a side effect, of sorts, of 5-Hour Energy.) The ties aren’t technically familial, but they’re close. “He considers my father his teacher and my father considers him a younger brother,” Shivani told me via email.
Bhargava cofounded a development fund in India, the Hans Foundation, with Shivani’s sister, Sweta Rawat. He travels to India frequently in connection with this work, spending about eight to 10 weeks in the country each year, he said. The foundation, named after the Rawats’ ashram-owning grandfather, is also where Bhargava’s son works. “It focuses on employment for women, which is something I support and encourage,” Shivani said. “There is a village rural development program in my ancestral home state of Uttarakhand, which is rejuvenating employment for the region.” When the Business Standard, an Indian newspaper, spoke to Sweta, she provided perhaps the most unscripted anecdote about her fundraising partner. She told the reporter that Bhargava had dressed up like Drake at a recent birthday party.
Before he demonstrated an interest in Canadian rappers and regional Indian employment revitalization, Bhargava went searching for the keys to artificial rejuvenation, a way into the wellness elixir business. His first swing at selling this type of product was less about providing energy and more about trying to fix the effects of boozing. 5-Hour Energy was preceded by Chaser, and its intriguingly specific follow-up, Chaser for Wine Headaches.
Chaser’s hook was alluring: It was meant to alleviate hangovers. But Bhargava ran into problems with the Food and Drug Administration over the promises he made about the product. A 2001 letter from the agency informed Bhargava that the claim that it “helps prevent hangovers” suggested that it was being used as a drug, and thus would need to be regulated like a drug if his company continued to make the claim. The company added the following boilerplate disclaimer: “These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.” It did not mention that some of its claims, including the claim that the product alleviated hangovers, had, in fact, been evaluated by the FDA and determined inappropriate to use for an unregulated supplement. The FDA sent another letter to Bhargava about the wine hangover product, noting that even using the term “wine headaches” suggested he was selling a cure for a specific ailment. In 2002, Bhargava applied for a patent for a charcoal-based product intended to help with hangover symptoms, and the next year, the company blasted out PR missives about how clinical trials backed up its claims. But despite the company’s efforts to market Chaser as a legitimate curative, the product never broke through, and Bhargava discontinued the line.
As he struggled with Chaser, Bhargava started looking for other, more marketable health tonics, and he found one with 5-Hour Energy. He now sells the wellness shots in six “regular” flavors, six “extra strength” flavors, and one decaffeinated version, plus two “regular” and two “extra strength” protein versions. It’s a growing, booming business, one that has withstood a variety of health crazes (the shots are free of both net carbs and gluten). The appeal is obvious and wide-ranging: It’s low-calorie, plus it offers healthy-sounding B vitamins and a cocktail of exotic-sounding boosters like niacin and phenylalanine. It’s a go-to for dieters and red-eyed commuters and redder-eyed partygoers alike.
While the product’s marketing highlights its combination of B vitamins and nutrients — phenylalanine, for instance, is hyped as an “essential amino acid that enhances alertness” — it is very clear what the little drink’s most potent weapon is. “The ‘energy’ is coming from the caffeine,” Minnesota State University professor Robert Pettit told me. The regular-strength doses provide around 200 mg of caffeine, which is less than a Starbucks grande, but still a sizable jolt. Pettit, who studies energy drinks, is skeptical about claims regarding special energy-boosting ingredients. “There is a shortage of research supporting any of the claims made by energy drink companies.” (This explains why the claims about phenylalanine come with an asterisk and a disclaimer about how the FDA hasn’t evaluated the claim.)
It is not clear who exactly came up with the recipe for 5-Hour Energy before it went on the market in 2004. Bhargava has told reporters that he got the idea for it at a trade show, but that the energy drink he tried there was 16 ounces and less palatable. There has been inter-energy-drink company squabbling about who owns trade secrets regarding 5-Hour Energy’s recipe. Living Essentials, which is the name of the company that Bhargava set up to sell 5-Hour and other products, has sued several companies, alleging that they had infringed upon 5-Hour’s formulas and recipes.
5-Hour has been involved in plenty of other controversies, many focused on whether or not it actually gives consumers five hours, or any hours, of energy. It was mentioned in 13 death reports from 2009 to 2012, according to death reports collected by the Food and Drug Administration, as well as 90 overall FDA filings on adverse effects during the same time frame, including reports of convulsions, renal failure, and one report of a miscarriage.
While these filings do not mean that 5-Hour was the cause of the deaths or the other maladies, its possible involvement alone and the sheer number of instances made headlines and prompted investigations from attorneys general. In 2014, Living Essentials and its parent company, Innovation Ventures, were sued by Oregon, Washington, and Vermont, which accused the companies of misleading advertising. Last year, it won the case in Oregon but was found guilty of violating the Consumer Protection Act on several allegations in the Washington suit, even though the suits used similar language. (The suit in Vermont is still pending, as is one from Hawaii.)
Bhargava’s strategy to head off other litigation isn’t something he often talks about, but he is a seasoned purchaser of lobbying power. The Center for Public Integrity called Bhargava “the political kingmaker nobody knows” in a 2015 investigation into his extensive record of political donations. Bhargava has more than 70 limited liability companies registered to the address of 5-Hour Energy headquarters, although some are no longer active. His investment firm, ETC Capital, is especially active; it has donated $539,600 to political organizations and officials from both parties. The CPI found that companies tied to 5-Hour Energy had given $5.3 million to elect state-level political candidates and to political groups since 2009, and that they had given more than $1.2 million to various attorneys general and their political organizations.
“He gives most heavily to Republicans but has donated to Democrats, too,” CPI’s Ben Wieder wrote. “Many of the donations appear to have ties back to Michigan, where his businesses are based. Nearly a quarter of the donations affiliated with Bhargava went to candidates for state attorney general, who have the power to investigate his business, and the organizations that support their election efforts.” The New York Times also featured 5-Hour Energy in a story about how companies lobby attorneys general, describing it as an expert strategy for wooing politicians with the most power to investigate its claims.
Lobbying does not completely immunize companies from legal troubles, of course. In 2013, a consolidated class-action complaint filed against 5-Hour Energy and Bhargava alleged that the company led “consumers to believe that the product’s healthy dose of B-vitamins and amino acids supply the increased energy. In reality, the jolt of alertness is actually the result of a concentrated dose of more than 200 milligrams of caffeine, more than an extra strength caffeine pill.” (It’s worth noting that 200 mg is not an abnormal dose for a caffeine pill.) The complaint lambasts the company for falsifying clinical studies and accuses Bhargava of using Living Essentials as his own bank. As of January 2017, 13 claims from that complaint are moving forward, including breach of warranty, false advertising, and consumer-protection claims. It’s not clear where the case will go. (A separate class-action case fell apart in 2012.)
On its official website, 5-Hour includes a “Myths” section. It doesn’t count aspartame among its ingredients. It does not contain vitamin C, nor does it have glycerin. The website carefully states that 5-Hour Energy will not cause someone to fail a drug test, but that it also will not help people pass them, either. (There are examples of mythmaking around 5-Hour Energy’s drug test powers, like this thread on a weed and occasional bodybuilding forum. I also found a Reddit post advising men to store urine inside a 5-Hour Energy and hide the can near their testicles in order to trick drug testers. The internet is a tapestry stitched by weirdos.)
The 5-Hour website does not include much biographical detail on Bhargava. “I like toiling in obscurity,” Bhargava told ABC News in a rare television interview in 2011. During the same interview, Bhargava showed a reporter how he keeps a bookcase full of the empty bottles of failed competitors in his office as motivation to keep imitators at bay. He showed the same bookcase to the reporter doing his Forbes profile the next year. It’s the go-to demonstration of competitiveness that gives his mellow persona a slight edge. But it’s no secret that Bhargava goes after competitors whom he sees as imitators, and that he often wins. In 2016, he was awarded what Crain’s Detroit Business reported may be the largest trademark infringement lawsuit award in Michigan history when a jury ordered the makers of a rival called 6 Hour Power to pay $10.6 million in damages.
Bhargava’s product is meant to rev people up, to increase focus, to spur them into a higher plane of activity. The man who sells the product is the peripatetic, can-do apotheosis of his own sales pitch, and the fact that he declines most interview requests and tightly controls his media narrative only enhances the impression he’s trying to give: that he’s too busy trying to save the world to explain himself.
When I asked Shivani Rawat if she had any favorite anecdotes about Bhargava that’d help me understand who he is as a person, she gave a canned answer that’d make her godfather proud. “The best way to know him is though the documentary at Billions in Change (billionsinchange.com). You will get a clear idea of who he is,” she wrote back.
Billions in Change, a 43-minute documentary about Bhargava, was released in 2015 and is available on YouTube. The film is as if An Inconvenient Truth were about Al Gore’s cleverness. Bhargava is the subject and hero, and the documentary is a glossy, effective infomercial for him. That’s not particularly strange, considering he self-produced the film. In it, he looks kempt and healthy, modestly outfitted in a gray puffy vest, with close-trimmed hair and a handsome, placid face.
“There are 7 billion of us in the world today,” Bhargava intones over the film’s opening shot. It shows him walking through a cavernous warehouse, equipment whirring in the background. He stands on a balcony and overlooks the space. “Awareness doesn’t reduce pollution, or grow food, or heal the sick. That takes doing.” The production team didn’t add a CGI halo into the frames, but it would’ve fit with the theme. He presides over the innovation like a TED Talk incarnate.
The film outlines his sweeping plans to introduce products (or “solutions”) that will make the world a better place. These products include a desalination and water purification machine called the Rain Maker, graphene cables, and a medical device meant to improve blood flow. On its website, Billions in Change is described as “a movement to save the world,” and the film yokes these disparate inventions together by framing them as different ways to solve serious problems affecting large swathes of humanity.
The warehouse space, which doubles as the set for most of the documentary, is home to Stage 2 Innovations, a private equity fund Bhargava founded. Through Stage 2, Bhargava channels money to the group’s four “investment focus” regions: pure water, clean energy, medical technology advancement, and the vague “benefiting mankind.”
All of these solutions are still, to put it generously, works in progress. Out of them, the project for which Manoj provides the most frequent updates on the Billions in Change website is the Hans Free Electric bike. It’s a recumbent machine that, when pedaled, generates electricity. One hour of pedaling is supposed to serve as the equivalent of a day’s supply of electricity for a rural household. Bhargava’s approach to “clean energy” in impoverished places has nothing to do with establishing an accessible grid. Instead, it is to sell people workout machines, albeit at a steep discount, that can generate small amounts of energy based on how hard they work on them. “It is like adding salt to the wounds of rural folk,” Leena Srivastava, executive director of operations for the India-based Energy and Resource Institute, told the Business Standard.
Stage 2 launched its pilot program to test 25 bikes in rural India in March 2016. After the pilot, the company decided to redesign the bike to be more lightweight and address complaints from the testers. For instance, women’s saris got stuck in the chain, so Stage 2 modified the design to include a protective barrier. One thing that hasn’t changed: The people living in poverty are the ones who are supposed to do the pedaling. If this sounds familiar, it may be because the first season of Black Mirror features an episode where people ride stationary bikes to generate capital for themselves. Last year, Bhargava told Fox News that people would pay for the bikes on a sliding scale based on their income — some would be free, but others would cost around $250.
When I asked Bhargava to explain his philanthropic philosophy to me, he clarified why it appears he’s attempting to profit off of many of the projects he classifies as altruistic. “Our business model is not non-profit, it’s not for-profit, it’s zero-profit,” he said, noting that he covers the research and development, testing, overhead, and all other costs to prepare products for market. “For wealthy countries, like the US, we’ll sell the products at a price the market can bear. For poor countries, we’ll sell the products at-cost or below-cost. And for some very disadvantaged areas, we’ll give them away. All money received from sales will go right back into the work we’re doing. It’s the only way to have a sustainable model where the maximum number of people benefits.”
“If I gave everything away, the bank account would be empty and relatively few people would ultimately be served. I’m not rich enough to take care of the world,” he said. “Our approach to philanthropy is how do we affect the maximum number of people. So simply put, we charge the rich and subsidize the poor. And if we can charge the rich even more, we do so.”
Bhargava has publicly promised to give away 99 percent of his fortune, but nobody knows how much he’s actually worth. While, as I mentioned earlier, Bhargava made it to number no. 311 on the Forbes 400 in 2012, that was his first and only appearance to date. On the websites for Stage 2 Innovations and Renew Group (a Singapore-based company whose board he sits on), Bhargava’s biographical blurbs claim he has pledged to give 90 percent of his fortune away to charity, a slightly lower figure than the 99 percent he pledged elsewhere. It isn’t clear when he changed the percentage, and it remains unclear how it’s being allocated.
Bhargava talked about where his money goes in an interview for a blog post on global consulting firm McKinsey’s website. He said that he works with between 350 and 400 charities, which operate school lunch programs, hospitals, and women-in-business programs. I have been able to track Bhargava moving money into the Hans Foundation, because its annual donor reports make it clear that he is the most prominent donor. In 2016, Bhargava’s Rural India Supporting Trust donated approximately $9.4 million.
I asked Bhargava how much of his money he’s given away, and how much has been earmarked for third-party charities versus in-house projects like his Stage 2 investment firm. “There’s a tendency for charitable organizations to judge themselves by how much they’ve spent on different causes. That’s a ridiculous way to measure because it says nothing about how effective you are,” he said. “If you spent a million dollars and all you did was give someone a glass of water, it doesn’t mean you did something really great. Unfortunately, intent alone doesn’t produce results. I usually don’t know how much money I’ve spent, because we judge ourselves by how much we accomplish. We look at success in terms of our projects and what we’ve done and then what we still need to do.”
Bhargava is practiced at talking about his philanthropic mission, but the ways in which he is implementing his do-gooder ideas range from strange to seemingly self-interested. In many cases, it appears these projects have been given a philanthropic gloss when they are at least partly a business venture. The Rain Maker, for example, is intended to provide more clean water to impoverished areas and Bhargava told Fortune in 2015 that he would give the device away for free in India. But he plans to sell it within the U.S., specifically in California’s drought-affected areas. In the same article, Bhargava also said he’d use the profits from U.S. sales to benefit the poor in India.
Billions in Change also showcases a medical device called Renew ECP as Bhargava’s entry into the health philanthropy space. He’s currently selling it. After Bhargava canceled our meeting, I got the go-ahead to meet the Renew research team. I arrived at the Farmington Hills, Michigan–based West Tech Park, a sprawling, mostly empty 278,000-square-foot corporate campus that one of Bhargava’s investment firms, ETC Capital, bought in 2010, according to Crain’s Detroit Business. The park houses nine low-slung cinder-block buildings. The dead grass, the sidewalks, and the walls of the buildings were all the same sallow color that day, like yellow gave up. I drove through the maze of beige until I finally spotted the building I was allowed to go inside. It looked exactly like all the other buildings, except it had a small sign on the door: Renew.
Renew is a medical research center studying the effects of a treatment called external counterpulsation therapy, or ECP, which Bhargava sees as a potential umbrella nostrum. “It enhances blood flow, which is the basis of almost all health,” Bhargava told the Detroit Free Press in 2016. “Your brain, for dementia and Alzheimer’s, skin, heart, every organ, muscles, joints, diabetes, all that is affected by blood flow.”
ECP became commonly used in China in the 1960s and became popular in the United States in the past decade. It is most commonly referred to as EECP in the U.S., although the Renew team still refers to it as ECP (so I will too, for clarity). The most high-profile incident involving this kind of therapy happened when a prominent New Jersey cardiologist pleaded guilty to a $19 million insurance fraud scheme centered around unnecessary treatments of ECP on Medicare and Medicaid patients.
Bhargava told me he uses his device for athletic recovery. “I use the ECP about three times a week for about 20–30 minutes on the days as I play tennis,” he told me by email. “If I use it before I go to the court, I find that I play better tennis. If I use it after, my recovery is much better.”
“I probably first encountered ECP in 2011 or 2012,” Bhargava said. “But much earlier than that I had learned in my study of Chinese and Indian medicine that good circulation is the basis of good health.”
The machine is approved by the FDA for the treatment of chronic angina, a symptom of heart disease, which manifests with chest pain. But the Renew team is hoping that its research will contribute evidence to get the machine approved for a wider array of use cases. They see it as a wide-ranging therapeutic tool. Specifically, they are testing for evidence that the machine can be used for general wellness and to treat memory loss, diabetic nerve pain, type 2 diabetes, chronic pain, athletic recovery, and sexual dysfunction. So far, most of the people who have signed up for the study represent the “memory loss” category.
Bhargava sits on the board of Renew Group Private Limited, a Singapore-based company that manufactures the devices. Although they share a name, the two companies are entirely separate entities. This means that Bhargava also created a company to manufacture the medical equipment he sells to his research lab.
At Renew’s research center, I was greeted by Dr. Julie Finn, a physician who has taken control of the project in addition to her local practice, as well as two research coordinators, Amy Siecinski and Beth Chriss, who have experience working with ECP machines in a hospital setting. The only other person present was an affable PR minder for Bhargava’s companies. There were no patients in the center while I was there. The trio of women who run the shop were polite and kind.
We sat in a roomy lounge area, watched a few promotional videos for the device, and chatted for a bit about the history of their project, which began last May. I’d rewatched Billions in Change before driving to the campus, and I’d expected a similar scene to the one I saw in the documentary, a large space buzzing with people, but the Renew team works in isolation. Their workspace is essentially a small, empty medical spa within the office park.
We walked over to a room divided into cubicles, with one or two machines in each. In keeping with the fancy dentist’s office vibe, the cubbies had potted bamboo and ceiling tiles with illustrations of clouds.
The Renew machine looks like a doctor’s exam table with huge leg blood pressure cuffs protruding from the top. To receive the treatment, the patient lays down on the table, her legs and hips ensconced in the triad of cuffs. The attending nurse or doctor clips a pulse oximeter to the patient’s finger. The doctor or nurse can adjust the intensity of the pulses from the cuffs — low intensity produces gentle presses and higher intensity issues squeezes firm enough to make the patient’s legs shift visibly on the bed. The doctor or nurse monitors heart rate and pulse during the treatment. The machine is designed to compress the patient’s lower body in sync with its natural heartbeat, inflating while the heart rests to improve oxygenated blood flow.
I had been expecting a demo on a mannequin, but Beth volunteered her body as tribute and casually strapped herself into the device, wrapping the cuffs around her calves, thighs, and hips. Patients come in for around 30 minutes and they’re supposed to do 35 sessions. The machine made a womp-womp noise, like the mechanical heart imitator it is. She laid on her back and seemed to have no trouble chatting as the machine thumped; I could see her vitals on a monitor hooked up to the side of the table. Amy told me that it’s best when someone is relaxed enough to have a lower pulse.
“There’s really no downside to it,” Finn told me, though she specified that there are a number of medical conditions that would preclude someone from using the machine, including severe pulmonary disease, bleeding disorders, a pacemaker, or uncontrolled arrhythmia. (She screens patients for these conditions before they sign up for the study.) Finn also noted that the machine requires medical supervision, and it’s too cumbersome and expensive to become an at-home treatment device.
The women who run Bhargava’s ECP research center run it as a side project; they have other primary jobs. They do not spend time with Bhargava. Although Billions in Change made it seem like Renew was a major undertaking, its three-person squad is still at the beginning of its trial. They have 50 test subjects right now and want to have 700 in total, 100 for each potential use case. They assess patients by simply asking them if they think the procedure worked, and the subjective nature of this assessment means it’s more of a loose experiment in seeing how people feel than anything remotely scientific. They sent me a few preliminary studies showing how other researchers were investigating the issue, including one on 18 people in Florida that suggested this kind of therapy can be helpful for people with diabetes and another promising study on 13 people with erectile dysfunction in Germany. However, all of the studies were very small.
Most hospitals and clinics offering this treatment use it primarily for chronic angina. Dr. Michael Dangovian, a cardiologist who practices in Sterling Heights, Michigan, owns one of Bhargava’s Renew machines, in addition to older ECP devices. Dangovian is optimistic about the device’s potential as a general wellness treatment. “I personally use it all the time,” he told me over the phone. Dangovian called his patients’ improvements “astounding,” although most of them come in for heart-related treatments.
“I don’t have a whole ton of people who are doing it for general wellness, but I’ll say that this technology makes more sense than anything I’ve seen out there.”
I did find another center extolling the virtues of the machine for a wide-ranging variety of illnesses, including memory loss, erectile dysfunction, and Parkinson’s disease. It’s the Whitaker Wellness Institute, an alternative medical center run by the controversial doctor Julian Whitaker, an opponent of vaccinations who believes psychiatry is fraudulent. Whitaker has also claimed that Dr. Stanislaw Burzynski made “what [he considers] to be the most powerful cancer therapy ever discovered.” Burzynski is also controversial, for his unproven cancer treatments; the Texas Medical Board recommended imposing a four-year probationary period (and tabled an initial recommendation to suspend his license) and other sanctions on him for failure to adhere to treatment standards.
Meanwhile, Dr. Gordon F. Tomaselli, a professor and cardiologist at Johns Hopkins University, does not think this type of treatment has a wide range of applications, apart from the treatment of specific forms of angina. “I know of no good data that demonstrates any efficacy in any of the general well-being or health areas,” he said.
“For the most part, it probably won’t do any harm, but I’d be very surprised if it does any good,” Tomaselli told me. “And the real question on this is, should people be spending money on this and not on different things that might improve their own cardiovascular health.”
Dr. Nisha Chandra, who is also a cardiologist at Johns Hopkins Bayview Medical Center, is skeptical about using this kind of device for the wide variety of ailments Renew is studying, particularly memory loss. She stressed the need for clinical studies. “When it comes to memory loss, there are very sophisticated tests for memory that need to be done. It’s not ‘Do you think you are less forgetful?’ There is psycho-cognitive testing that needs to be done.”
I asked what she’d say to patients who wanted to enroll in this sort of treatment. “I would tell them there’s no data to support it, and if they have that much money to throw away, why don’t we get on an exercise plan and lose weight and do all those other good things,” she said. “There’s nothing to support it.”
When I talked to Dr. Anoshia Raza, a cardiologist and lead author of a recent paper on the history of the treatment, she was cautiously optimistic, noting that the treatment had originally been used in intensive care units and only later developed its reputation as an angina helper. “It’s funny how these things work, you can always find more uses,” she said.
There’s no consensus on whether this kind of treatment has a future as a wellness tool. But it is clear that the way Bhargava is approaching the treatment is unusual. He created a company to manufacture and sell the devices, so he must believe it has a chance of catching on enough to sell units. The research center seemed like a diverting side project for the women who ran it, but it’s a plainly unrigorous study. I found it fascinating that the only question they cared about asking was whether the participating patient felt like the treatment cured their condition. It seemed like the study was testing whether the treatment was commercially palatable as a medical spa procedure, not whether it worked as one.
Bhargava’s plan to change the world is muddled, based on questionable science, and framed in a way that will maximize his own profits. After all, consider the product that made him rich. It’s liquid caffeine with vitamins mixed in, but it’s promoted like a curative elixir. He is a master of packaging little pick-me-ups, but understanding what people want to buy when they need to feel a little better does not correspond to understanding what the world needs to be healed.
Bhargava’s efforts to bring good into the world are not necessarily malevolent, but they are blinkered. Expecting poor people to do additional manual labor to get basic utilities is a uniquely cruel and impractical energy solution. Manufacturing and selling blood-circulating machines and then running a small and unscientific study on their efficacy is more of a whimsical business venture than anything resembling philanthropy. In the same vein, equating a homebrew R&D warehouse with a philanthropic mission, even when it primarily houses projects for profit, is not so much a stretch of the imagination as much as a deliberate misrepresentation, one that flatters Bhargava. The Billions in Change story line obscures how much Bhargava stands to profit if any of his moonshots suddenly take off.
Bhargava’s brand of philanthropy unapologetically tangles his own business interests up in his mission to help people, and he portrays the entanglement as simple common sense. It’s what The Economist has described as “philanthrocapitalism,” where donors behave like investors, develop their own organizational infrastructure, and fixate on maximizing the return on their investment. This is a rising, popular mode of giving for many of the world’s wealthiest people, like the Gates Foundation and the Chan Zuckerberg Initiative are philanthrocapitalist operations, for example. Billionaire crusades are often lauded and celebrated, and a 2008 book called Philanthrocapitalism argues that ultrawealthy donors like Gates, Bill Clinton, George Soros, Angelina Jolie, and Bono are poised to be the greatest forces for social change in the world. (Its subtitle is How the Rich Can Save the World, just so nobody misses the point.)
Bhargava’s philanthrocapitalism is captivating not because it is unique in its form, but because it is so odd in its specifics. Its seams are showing. His background as the purveyor of wellness-industry concoctions seems to have influenced his fixation on rejuvenating and energizing “solutions” that are almost self-consciously quirky ambitions. Bill Gates declaring that the global health community needs to focus on vaccinations is a better-conceived mission than Manoj Bhargava releasing a documentary on YouTube about how the world will improve via controversial blood-pumping gadgets and stationary bikes that he happens to manufacture. But the system that bestowed these men with the means and confidence to make that sort of proclamation is the same.
The idea of billionaire philanthropy as the route to global salvation is cockeyed, even when it isn’t zoomed in on suggesting people exercise to see in the dark. Some philanthropic work yields specific positive results, such as the Gates Foundation’s work on malaria. The reason that plutocrats with philanthropic zeal have risen to such a vaunted position is because our other institutions of power have failed to provide adequate help to people in need. The reason people like Bill Gates and Manoj Bhargava are so easy to hail as icons of generosity is because the other dominant mode of using wealth is ostentatiously interested only in accumulation. Philanthropy, even when laced so tightly with self-interest and imperial attitudes, looks good in comparison with bald acquisitiveness.
Yet this model of giving is predicated on inequality; it is one of the few occasionally positive symptoms of a broken economic system. The world’s progress does not depend on how magnanimous its ultrawealthy have decided to be, it depends on recognizing and eliminating the conditions that caused wealth to be distributed so unevenly. Little Orphan Annie is a kid’s movie, not a deep salvation parable. Bhargava has the means to act on his missionary impulses, but that fact should be interrogated before it is applauded. He has a surplus of money, not morality. And he’s an instructive example of how pledges to give money away can get morphed into opportunities to siphon money into a bewildering array of weird science projects as long as a person is rich enough to always find someone to say yes.
There is a commercial for an older and even more famous drink that reminds me of Bhargava’s blend of profit-driven calculation, quirkiness, and feel-good messaging: Coca-Cola’s 1971 “Hilltop” ad, where clear-eyed young people gather peacefully for a sponsored sing-along about harmony and authenticity in the hills of Italy. Mad Men portrayed the ad as the masterful culmination of Don Draper’s vision, a commercial that nestles a message to buy sugar water inside a hippie hymnal about global friendship, so corny it works. It looks like the purest and most disingenuous thing in the world at the same time. Just like a 5-Hour shot, it’s easy to swallow, but the aftertaste is funny.
An earlier version of this story misstated Shivani Rawat’s age. She is 31, not 30.