How outsiders become game changers

Gino Cattani and Simone Ferriani write for HBR:

Take the case of Katalin Karikó, who defied all odds to pioneer the mRNA technology that ultimately gave the world Covid-19 vaccines in record time. Daughter of a butcher and raised in a small adobe house in the former Eastern bloc with no running water or refrigerator, Karikó started working with RNA as a student in Hungary but moved to the United States in her late twenties. For decades, she faced rejection after rejection, the scorn of colleagues, and even the threat of deportation. Yet today, Karikó’s foundational work on mRNA is at the heart of the vaccines developed by BioNTech/Pfizer and Moderna, and many researchers are now calling for Karikó to win the Nobel Prize.

(emphasis mine)

This is a fascinating write up on the outsider complex – required for “disruption” and “innovation”. I’d quote a couple of instances from the write up and share in my experiences.

Being less tied to the norms and standards to which insiders conform, outsiders recognize solutions that escape incumbents’ attention. Yet, the paradox is that the same social position that gives outsiders the perspective to pursue imaginative projects also constrains their ability to obtain support and recognition for their innovations. How do the innovations of outsiders like Karikó gain traction?

My career graph has been the relentless pursuit for research. There are numerous domains in radiation oncology that need a relook. For example, quantification of symptoms. Despite many obstacles, I could bootstrap two applications and an algorithm to determine outcomes. However, the dice is always loaded against the outsiders. It was a chance acceptance in one major international conference in North America which gave credence to my ideas and I pursued them. Through my extensive workflows and extensive blogging, I can easily spot patterns and “join-the-dots”. I hypothesized the platform concept because I had some prior work experience in EMR and digital health integration. I can visualize the regulatory obstacles and understand the policy shifts happening in the consumer domain.

Here’s another interesting blurb:

What we found surprised us: The most successful artists were not those at the extreme periphery of the network, the “renegades from the human race” — to borrow a label famously coined by Don Valentine, the pioneering venture capitalist who created Sequoia Capital, to describe Steve Jobs, when he first met him in the late 1970s. But neither were they “network kings” at the heart of their industry. The outsiders were not outliers: This study showed that the probability of creative success was highest in a border zone between the center and the periphery, by artists who belong to the system but have not lost touch with its fringes.

This is true. I work in a resource constrained system with specific primary business objectives. Sometimes, it is a combination of circumstances and luck that push an individual to make choices different from peers. Nevertheless, it gave me incredible insights into the “process of cogitating out of box” for seemingly straightforward problems.

Another interesting insight:

Steve Jobs’s early career is a case in point. The VC industry repeatedly refused to support his project, but Jobs kept searching for a receptive audience. Finally, he met Mike Markkula, a wealthy young engineer who saw potential where the VC establishment saw only roadblocks. He made the first investment in Apple Computer. Why did Markkula support Jobs? Because his passion for technology and relatively young age gave him a stronger affinity with Jobs and his partner Steve Wozniak than most members of Silicon Valley’s investment community had. And with Markkula behind him, Jobs had the credibility he needed to attract more talent and money.

I have long written and pondered the healthcare intersecting with machine learning/artificial intelligence. While AI and ML are mutually exclusive, they are used interchangeably. I am not born with Jobs’ insight. What I have, however, is the incredible ability to gather insight in integrative domains.

For example, in my quest for a personal knowledge graph, I wish to rely on the browser first approach. The internet is littered with examples of “taking effective notes”, but each requires a significant manual input and steep learning curve. Software developers usually code their product to serve a niche class, unless there is a specific demand for workflow from their user base. Despite the limitations imposed with the current systems, I have been able to develop a patchwork of solutions to address various needs on any platform. I still don’t have a perfect solution, but the need arose from my dissatisfaction with the conventional tools. I bring that mindset to healthcare.

On a positive note:

Most established organizations and industries tend to reproduce the power and privilege structure of incumbent groups, reducing outsiders’ chances of making their ideas heard and proving their worth. But our research suggests that outsiders should not be daunted: The very traits that make outsiders so disadvantaged within established occupational structures and professional categories are often precisely those required for the pursuit of exceptional entrepreneurial achievements in art, science, and business.

It is also about the “chance” and “good luck” to meet someone who will engage with cold emails. Most recipients refuse to acknowledge or even engage with the ideas. I agree everyone has constraints on their time, but there have been exceptional individuals in my career who took out time and guided me through the process. It fanned and fuelled my interest in Neuro-Oncology, specifically- which represents a formidable challenge. In the conference I mentioned above, I met some scientists in person and pitched in a clinician’s perspective on tackling brain stem gliomas with clinical literature. It didn’t gain any traction but it wasn’t my loss. We are still at the same crossroads because my practical ideas were not tested in the lab. (I had proposed novel fractionation/radiology and genomics cocktail). (Addendum: I had also proposed to monitor patients remotely through mobile applications and quantify their symptoms).

Persistence is the key while keeping a strong focus on the goals. Creativity stems from internal-external restrictions because the existing order is too dismissive, sometimes. I intend to build my own lab where all sorts of “crazy ideas” will be theorised because no idea is “stupid”. It’s the failure in the execution of the idea, per se.