Creativity, Chaos and Cures

How Dr. Emil Kakkis makes room for the divergent thinking that leads to scientific breakthrough

Creativity, Chaos and Cures: In Conversation with Dr. Emil Kakkas

BY ELIZABETH YUKO

Science has a reputation for being rigid and formulaic — but the approach Emil Kakkis, M.D., Ph.D. takes is anything but.

Kakkis is the founder and CEO of Ultragenyx, a company that develops treatments and finds cures for rare diseases impacting children. He views creative and divergent thinking — the neurodivergent trait of thinking so far outside of the box that you explode the box — as crucial to finding solutions for complex medical problems.

“It involves starting with a blank piece of paper and a terrible disease, and figuring out an answer — creating from scratch an approach to fix the problem in these rare genetic diseases,” Kakkis says.

 In fact, the thrill of discovery is what drew Kakkis to a career in science in the first place. “When I first started doing research, I was excited about the idea of learning something that was unknown,” he says. “To have that moment where you discover something, and where that discovery then leads to other ideas — I found this stimulating. I found myself staying in the lab for hours, searching for answers and coming up with new ideas.”

His own disruptive thinking led him to design new models that challenged traditional beliefs and established paradigms in everything from clinical developmental protocols to therapy access for patients – earning him multiple leadership and achievement awards.

So where, exactly, do these new ideas come from? Kakkis’s superstrength of pattern recognition and non-linear thinking. “Many are somewhat accidental: a random association between two things that are completely unrelated,” Kakkis explains. “It’s good to have the stimulation of a lot of different things in your life that help you pick up those ideas.” 

Other times, his ideas are the product of curiosity and challenging the status quo. “This leads you down a path of breaking the rules and discovering something that was unknown,” he says.

“Creation always starts with disruption, just like farming involves digging the dirt first.”

Freedom From Fear

Though creative and divergent thinking comes naturally for Kakkis, that’s not the case for everyone. Fortunately, he’s found a way to foster this trait among his employees.

“The number one thing for allowing more creativity into your business or life is the reduction of fear or the release from fear,” he explains. “Because I find most people — out of fear for things going wrong — put rules and barricades in to stop creativity. They want to avoid chaos, and that fear causes them to limit their ability to succeed and do great things.

To prevent this from happening at Ultragenyx, Kakkis stresses the need for people to get comfortable letting go of fear and allowing themselves to try something new — accepting that it might not work. 

“One of my jobs as CEO is to be the risk taker,” he says. “What I mean by that is when someone comes to me and says ‘I don't want to try that — it could go wrong,’ I tell them, ‘No, I'll take the risk [and] the responsibility. Go ahead and try it.’ You'd be amazed how this allows people to go do something amazing that they can be proud of.”

But Kakkis recognizes that not everyone reacts to fear in the same way. While it may deter some people from taking chances and making mistakes, it stimulates others — including himself — to think and work harder. 

“Some people get paralyzed by [fear], but some people get energized,” he says. “Once you've tried doing things that are very challenging [and] difficult, and succeeded, you get that feeling you want to do that again.” 

Fostering Creativity And Open-Mindedness

Kakkis is a firm believer that arts can bolster creative thinking, a philosophy he puts into practice at Ultragenyx. The company encourages employees to “do art or other activities” as a way to re-energize and flex the right side of their brain, “because I think in the pharma industry, there's a lot of left-brained people,” he says. “And the truth is to be really successful, you need to be able to work both sides of your brain, the creative side as well as the analytical side.”

In addition to encouraging his employees to embrace and be energized by fear, Kakkis also fosters open-mindedness by having them participate in a training module called the Dynamic Development Model. The module is made up of 3 components: Ready to Learn, Ready to Invent, and Ready to Hedge.

According to Kakkis, being “Ready to Learn” means having the humility to accept that you don’t know everything and opening your mind to discovering things that are wrong. “What we like to tell people is that every rare disease has at least one major well-accepted fact that's actually wrong,” he says. “When you discover what that fact is, you open the door to finding a treatment.”

The “Ready to Invent” component emphasizes that they’re attempting to create entirely new treatments for rare diseases. This means being ready to think up new ways to measure disease or understand how to treat it. “Something different has to happen,” Kakkis explains.

“Don't get stuck just doing what's always been done. Open your mind to seeing things in a new way.”

Finally, being “Ready to Hedge” means coming up with a number of different ideas, including some that will allow you to pivot and change course, if need be. “I liken this to playing chess,” Kakkis says. “When you're playing chess, you're working a number of pieces all at the same time. It's very creative to have several strategies running at once. If you don't know the rules of chess, it looks chaotic. But when you do, then there's a brilliance in it.” 

Making Way For Disruptive Thinkers

Drug development involves several dozen people working together as a team. “I look at a great team as a mosaic of types that fit together and complement each other,” Kakkis says. 

First, there are “the stabilizer organizer types” who often serve as team leaders and keep everything on track and moving forward. 

Then, there are people who run parts of the operation. “They're very rules-based,” Kakkis explains. “They like running a clinical trial, which has certain rules.”

Finally, there are the people who come up with new ideas – the creative and divergent thinkers. “Their contribution is to creatively think of solutions, talk to patients, and find out how to measure this disease, or how to design a trial,” he says.

It’s the team leader’s job to recognize disruptive thinkers and make room for their ideas. “The hardest thing about being a team leader is to know when there's one person in the team who has the right answer and everyone else is wrong,” Kakkis says. “And that's where you celebrate people who are divergent or different because they may come up with an answer no one else could come up with.” 

Encouraging The Next Generation Of Creative Thinkers

So how do we ensure that we’re fostering the next generation of status-quo smashers, creative problem-solvers, and divergent thinkers who will tackle our world’s pressing problems?

Kakkis wants to start nurturing these qualities young. “I felt like kids who were creative in high school — who were going to have great lives — were getting ignored, [weren’t] supported, and maybe felt like they were outsiders in their own environment,” he says.

To address this problem, he founded the Bay Area Creative Foundation, an organization that seeks to encourage and support young people by providing awards programs that promote and honor their creativity, giving them the same level of recognition as others get for sports or traditional academics. 

Each year, the foundation invites San Francisco Bay Area high school students to submit original artworks and performances across a range of creative disciplines — including visual art, film, music, dance, photography, and writing — for the Creative Youth Awards. The competition is structured so that the top third of applicants win something. “We don't have a first, second, [or] third [place], because we're not trying to create a lot of people who lose,” Kakkis explains. “We're trying to recognize the top group of people as a group. It is definitely about celebrating youth creativity.”

Ultimately, Kakkis wants to ensure that children, as well as future generations, grow up to value creativity and prioritize expanding their abilities. “We can't raise robots,” he says. “We have to raise creative talent who can find the answers to all the problems we have.”

BIO: Elizabeth Yuko, PhD, is a bioethicist and journalist. Her work has appeared in outlets including The New York Times, The Atlantic, The Washington Post, Rolling Stone, Architectural Digest, Bloomberg CityLab and CNN, among others. 

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