CIO Straight Talk - Issue 2 - 21

he young cancer researcher’s boss looked at
him and said: “Do you realize what will
happen if you fail, if you kill these kids? Do you
know what the headline will be? ‘Scientists at
Government Institution Administer Poisonous Chemotherapy Cocktail to Three-YearOlds.’ People will call you a Nazi doctor.”
The researcher, his voice rising in exasperation, replied:
“Look, I've got a ward of 20 critically ill kids. Every single
one of them will be dead in six weeks. Why not try it?”
Malcolm Gladwell was describing this heated encounter –
between the late Gordon Zubrod, scientific director of the
National Cancer Institute in the 1960s, and Emil Freireich,
who with two colleagues discovered a cure for childhood
leukemia – as part of his keynote address at HCL’s 6th
Global Meet.
The theme of the Global Meet –– held November 13-15, in
Orlando, Florida –– was “I Have an Idea.” And as it turns
out, Freireich had a brillant one. His team’s combination of
four individually toxic agents to successfully treat a previously untreatable disease was one of the medical breakthroughs of the 20th century.
But Gladwell was telling the story to illustrate an idea he has:
Breakthrough thinking and innovation, whether in cancer
research or information technology, often comes from people
at the margins of an organization, an industry or a profession.
Gladwell, the author of such best-selling books as The
Tipping Point, Blink and Outliers, reminded listeners that, at
the time of Freireich’s conversation with Zubrod, leukemia
was one of the leading causes of death among children. (He
added that there were probably people in the Global Meet
audience who are “alive today because of that experiment 50
years ago.”)
Early chemotherapy drugs would arrest the progress of
leukemia, but only for several weeks, after which cancer
cells would become resistant to the medication. Because the
drugs were ultimately ineffective and their side effects were
so harsh, children with leukemia were basically left by
doctors to die. Now Freireich was proposing that four of
these ineffective leukemia drugs, each with terrible side
effects, be administered to young patients. Why?
He concluded that although each of those drugs was only
modestly effective, if at all, they were modestly effective in
different ways and might be highly effective in combination.
In a second insight, he concluded that although each of the
drugs was highly toxic, they were all highly toxic in different
ways, making their combined effect on the body no more
dangerous than their individual effect.
And how did Freireich come up with this idea?
He was smart and creative and capable, of course. But
Gladwell believes something else was at work, something
that plays a more important role than is generally acknowledged in stories of successful innovation. Freireich was an

outsider, someone on the fringes of the medical research
establishment.
On a personal level, he was just out of medical school, a
newcomer to the profession who had grown up poor in a
Chicago ghetto and had studied medicine at University of
Illinois, far from the prestigious medical schools of the East
and West coasts. He worked for an organization –– the
National Cancer Institute –– that often engaged in particularly speculative research. Furthermore, he was in a field,
cancer research, that at the time was conspicuous for its lack
of success in improving medical outcomes.
But because he was an outsider, he enjoyed several advantages as he searched for effective leukemia treatments.
He had the freedom to take risks that comes from the lack of
a stake in the system. Those risks were not so much the
medical risks to the children, who were likely to die anyway,
but the social risk of being ostracized by his peers for
defiance of the profession’s conventional wisdom.
He had the insight that comes from not being immersed in
that conventional wisdom. His inspiration that four useless
drugs might work in combination came from the field of
infectious disease, where researchers had recently learned
that treating tuberculosis with a combination of antibiotics
eliminated the problem of TB bacteria becoming resistant to
a single drug.
Finally, he had the motivation that comes from working on a
problem where nothing seems to work. Seeing all of those
kids dying, all those parents mourning made him desperate to
find a remedy.
In this edited interview with CIO Straight Talk editor Paul
Hemp, Gladwell elaborates on these advantages and talks
about how they might be leveraged in a business or other
organization.

Where did this idea come from?
I’m interested in this notion of the benefits of being
marginal, of how being pushed to the fringes, or starting out
at the fringes, can offer all sorts of unexpected benefits –
apparent disadvantages that are in fact advantages.

In your speech, you spoke about the freedom to take
social risks.
Being marginal – say, a member of a minority group – can
give you greater freedom in how you choose to tackle a
problem. Think of all the Korean grocery stores in New
York. If you are running an inner city grocery store and you
are a member of the predominant group of the inner city, you
have to hire your cousin; you have to look the other way
when your friend’s son comes in and tries to make off with
some candy; you can’t yell at anybody; you can’t refuse
someone credit – because you’ll see them at church the next
day. This makes it really hard to run a successful business.
But if you’re an outsider and a kid tries to steal a candy bar,

CIO Straight Talk //

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CIO Straight Talk - Issue 2

Table of Contents for the Digital Edition of CIO Straight Talk - Issue 2

CIO Straight Talk - Issue 2
Contents
So What Do CIOs Want
Innovation at the Periphery
The CIO as Thought Leader
Career Move: From Managing Technology to Managing Change
Every CIO is in the Information Business
Analytics and Decision Making
Putting IT at the Center of the Customer Experience
Pick n Pay Focuses on Delivering Value to Customers
Bringing "Lean" to IT
Whither the Cloud in a Stormy IT Enviroment?
Management by Driving a Stake in the Ground
From Data Processing to Orchestrating Knowledge
Extreme Collaboration
Enterprise Mobility: Delivering the Connected Customer Experience
CIO Straight Talk - Issue 2 - CIO Straight Talk - Issue 2
CIO Straight Talk - Issue 2 - Cover2
CIO Straight Talk - Issue 2 - 3
CIO Straight Talk - Issue 2 - Contents
CIO Straight Talk - Issue 2 - 5
CIO Straight Talk - Issue 2 - So What Do CIOs Want
CIO Straight Talk - Issue 2 - 7
CIO Straight Talk - Issue 2 - 8
CIO Straight Talk - Issue 2 - 9
CIO Straight Talk - Issue 2 - 10
CIO Straight Talk - Issue 2 - 11
CIO Straight Talk - Issue 2 - 12
CIO Straight Talk - Issue 2 - 13
CIO Straight Talk - Issue 2 - 14
CIO Straight Talk - Issue 2 - 15
CIO Straight Talk - Issue 2 - 16
CIO Straight Talk - Issue 2 - 17
CIO Straight Talk - Issue 2 - Innovation at the Periphery
CIO Straight Talk - Issue 2 - 19
CIO Straight Talk - Issue 2 - 20
CIO Straight Talk - Issue 2 - 21
CIO Straight Talk - Issue 2 - The CIO as Thought Leader
CIO Straight Talk - Issue 2 - 23
CIO Straight Talk - Issue 2 - 24
CIO Straight Talk - Issue 2 - 25
CIO Straight Talk - Issue 2 - Career Move: From Managing Technology to Managing Change
CIO Straight Talk - Issue 2 - 27
CIO Straight Talk - Issue 2 - 28
CIO Straight Talk - Issue 2 - 29
CIO Straight Talk - Issue 2 - Every CIO is in the Information Business
CIO Straight Talk - Issue 2 - 31
CIO Straight Talk - Issue 2 - 32
CIO Straight Talk - Issue 2 - 33
CIO Straight Talk - Issue 2 - Analytics and Decision Making
CIO Straight Talk - Issue 2 - 35
CIO Straight Talk - Issue 2 - 36
CIO Straight Talk - Issue 2 - 37
CIO Straight Talk - Issue 2 - 38
CIO Straight Talk - Issue 2 - 39
CIO Straight Talk - Issue 2 - Putting IT at the Center of the Customer Experience
CIO Straight Talk - Issue 2 - 41
CIO Straight Talk - Issue 2 - 42
CIO Straight Talk - Issue 2 - Pick n Pay Focuses on Delivering Value to Customers
CIO Straight Talk - Issue 2 - 44
CIO Straight Talk - Issue 2 - 45
CIO Straight Talk - Issue 2 - 46
CIO Straight Talk - Issue 2 - Bringing "Lean" to IT
CIO Straight Talk - Issue 2 - 48
CIO Straight Talk - Issue 2 - 49
CIO Straight Talk - Issue 2 - 50
CIO Straight Talk - Issue 2 - Whither the Cloud in a Stormy IT Enviroment?
CIO Straight Talk - Issue 2 - 52
CIO Straight Talk - Issue 2 - 53
CIO Straight Talk - Issue 2 - 54
CIO Straight Talk - Issue 2 - 55
CIO Straight Talk - Issue 2 - Management by Driving a Stake in the Ground
CIO Straight Talk - Issue 2 - 57
CIO Straight Talk - Issue 2 - 58
CIO Straight Talk - Issue 2 - From Data Processing to Orchestrating Knowledge
CIO Straight Talk - Issue 2 - 60
CIO Straight Talk - Issue 2 - 61
CIO Straight Talk - Issue 2 - Extreme Collaboration
CIO Straight Talk - Issue 2 - 63
CIO Straight Talk - Issue 2 - 64
CIO Straight Talk - Issue 2 - 65
CIO Straight Talk - Issue 2 - Enterprise Mobility: Delivering the Connected Customer Experience
CIO Straight Talk - Issue 2 - 67
CIO Straight Talk - Issue 2 - 68
CIO Straight Talk - Issue 2 - 69
CIO Straight Talk - Issue 2 - 70
CIO Straight Talk - Issue 2 - 71
CIO Straight Talk - Issue 2 - 72
CIO Straight Talk - Issue 2 - 73
CIO Straight Talk - Issue 2 - 74
CIO Straight Talk - Issue 2 - Cover3
CIO Straight Talk - Issue 2 - Cover4
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