Juan Rodriguez was born in Colombia. He worked hard, married and had two children. In his early 60s, Juan (not his real name) retired. His retirement was not a healthy one. By 70 he was experiencing the kind of mild cognitive impairment associated with Alzheimer’s disease. And as each year passed Juan increasingly struggled with verbal fluency and short-term memory loss. At 72 he was diagnosed with dementia and from that point his decline was swift. He passed away aged 74.
It’s a sad story and all too common, given the prevalence and severity of Alzheimer’s in modern society. But Rodriguez was an extraordinarily lucky man. He carried the PSEN1-E280A mutation, one of the more serious Alzheimer’s precursors. It’s a gene mutation common among a group of Colombians who all trace their origins back to the Basque region of Spain. Carriers of the mutation start to experience cognitive decline in their 40s and develop severe dementia by the time they turn 50. Yet none of this happened to Rodriguez. He enjoyed two decades of dementia free life that his prognosis would have suggested impossible. Why?
The intriguing answer to that question is Juan had a double mutation. First, because he carried PSEN1-E280A in his genetic code and was therefore incredibly vulnerable to Alzheimer’s. But second because he also carried a mutation in his production of Reelin – a protein that plays a pivotal role in regulating brain function. That mutation formed a protective barrier in Juan’s brain preventing the harmful proteins that usually form Alzheimer’s pathological connections. Juan’s second mutation trumped his first and granted him more than two decades of extended life as a result.
By studying a few abnormal humans, scientists discover unexpected insights that might eventually shed more generally useful light on the rest of the population.
The story of Juan Rodriguez was published in Nature on Monday (15 May). He was identified by a team of scientists led by Harvard Medical School investigators studying a large group of Colombians susceptible to early onset Alzheimer’s and who – in some cases – appear able to avoid its severity for unexpectedly long periods of time. The hope was that by following these special patients the secret of their longevity could be understood and eventually replicated to progress the global cure for Alzheimer’s.
“Extraordinary cases like this one illustrate how individuals and extended families with Alzheimer’s disease can help advance our understanding of the disease and open new avenues for discovery,” Yakeel Quiroz, an associate professor of psychology and member of the research team, explained to the New York Times this week.
“The insights we are gaining from this case may guide us on where in the brain we need to look to delay and stop disease progression.”
It’s an amazing discovery and one that could eventually improve the fortunes of the millions of people expected to suffer from Alzheimer’s in the decades ahead. But it’s interesting to note where this great insight originates. Not from initial work in the lab or grand theory construction or the latest application of AI. It comes from Mother Nature and a cluster of unusual Colombians. By studying a few abnormal humans, scientists discover unexpected insights that might eventually shed more generally useful light on the rest of the population.
It’s not as unusual an avenue for scientists as you might think. It was a similar story with Stephen Crohn, ‘the man who could not catch AIDS’. Despite losing his partner and most of his friends to the disease in the early 1908s, Crohn remained uninfected. He became convinced of his immunity to the disease. And sure enough, when scientists tried to infect a sample of his blood with the HIV virus, even at concentrations thousands of times greater than normal exposure, Crohn’s blood remained impervious to it all. He was indeed immune to HIV.
Like Rodriguez, scientists eventually identified the mutant root of his immunity. Crohn had a genetic abnormality – known as delta 32 – that made the receptors of his white blood cells impossible for HIV to latch onto. And research on his ‘defective’ blood cells eventually led to the development of Maraviroc – a vital drug that limited the HIV infection and saved thousands of lives in the process. Crohn died (tragically from suicide, not AIDS) in 2014 and was widely hailed as a medical hero for his bravery and commitment to finding a cure for the disease that killed almost all of his peers.
The value of extreme outliers
Market research is a tiny, pointless pursuit when contextualised against proper scientific endeavours like these. For all our talk of purpose and societal impact, we are a pimple on a pimple on the backside of disciplines like medical research. My PhD earns me the right to call myself Dr on my credit card. My appreciation for the pointlessness of my contribution to society ensures I would do no such thing. But there is a striking lesson to be learned from these gigantically important clinical studies when imported back into our own relatively minor endeavours to understand brands, consumers and the relationships between them.
Often the best approach to understanding and identifying something is not to hypothesise and deductively work towards a conclusion. Sometimes it’s better to scan the extreme horizons of a population for outliers. Those who by luck, nature, or some other strange circumstance find themselves in a different subset from the main population. By studying this strange, obtuse minority we can derive answers that can then be more generally applied.
When it comes to understanding brands it is possible to completely give oneself over to quantitative data and deductive reasoning. To try and work out what makes a brand special by working through various scenarios in the office or testing the market to see what a brand stands for and how those proportions compare to other alternatives in the market. I see a lot of that. Brand managers staring at bar charts and PowerPoint decks trying to impute the best position for a brand or the assets that will generate the highest degree of distinctiveness.
There is nothing wrong with that. But there is a short cut. Or at least a second path to be also taken in parallel. The kind of unusual path even proper clinical researchers doing important medical analysis sometimes follow. Look for loyalists. The lovers. Advocates. The consumers that know your brand better than anyone in your internal team. Every brand of any standing has a few of them. And they offer a potential perspective that we often dismiss and overlook.
In the list of great resources for brand diagnosis, qualitative time with loyalists should be at the top of your list of activities. Not because they are representative of the broader market but because their very unrepresentativeness makes them a fantastically important resource.
They are nutters for the brand! Crazy for it! And they see and feel and think about it with such extreme commitment that they can, in some circumstances, allow marketers in on the secret of their passion and with it offer a potential route to attracting other consumers.
These new consumers won’t become as addled and infatuated as your super loyalists. But just as AIDS research sought an artificially replicable equivalent to Stephen Crohn’s mutated blood cells, marketers can use the insights from extreme consumers and brand loyalists to inspire and inform their efforts to recruit others.
I’ve done it my whole consulting career. Looked for the lunatic fringe at the far reaches of the consumption threshold.
When I worked on wine brands we would always include the input of the two or three restaurants that served 10 times the expected amount of our wine and ask the proprietors to tell us about our brand.
In a net promoter survey for a brand of women’s jeans, we invited as many ‘tens’ as possible to HQ and asked them to talk more about their extreme satisfaction and where it came from. It became probably one of the most fascinating focus groups of my career as 12 New York women got emotional about asses, the 1990s and feeling good again.
For a surgical glue, we found the dozen surgeons using more of the product than the rest of the country combined, and asked them to show us when, how and why they used our product. In each case we looked for people that would have been immediately discarded from most research on the grounds of bias and then listened to them.
And I’m not alone in my love for an outlier. When the mighty Clayton Christensen was hired by McDonalds to increase milkshake sales, he ignored the company’s deductive attempts to devise a better shake. Instead, his team stood outside cafes and apprehended early morning shake buyers. The kind that turned up at 8am, bought a shake, nothing else, and then drove off. And who did it almost every single day. Christensen and his team asked these consumers the same question: what ‘job’ is this milkshake doing for you?
Each consumer told a similar story. They had a long and boring drive ahead of them. They would eventually get hungry. Usually in the middle of nowhere. The shake was for then and the occasional boring moments along the way. Their shake would sit and stay cold for hours. It could be sipped, easily and without mess or distraction, for the whole boring drive. Its job was to be convenient company and eventually brunch. These consumers had ‘hired’ doughnuts and bananas for the same job in the past but found them to be miserable failures in comparison.
These strange, wonderful early-morning drivers explained the essence of a good shake and one of its prime jobs. Christensen reported back to McDonald’s that there were some obvious ways to improve milkshakes. Make them thicker so they took even longer to consume. Add pieces of fruit, not for health, but for some interesting unpredictable moments. Move the dispensing machine to the front of each café so consumers could come in, fill up and get on with their drive.
Your best source of ideas
Consumers are key to a brand’s success. Not just because they deliver sales and hopefully profit, but because once they have made a purchase they become marketing’s victory. The creation of a customer, as management expert Peter Drucker called it. And by studying that creation and how it was created, marketers can usually devise better strategy.
The dirty secret of most marketing work is that we marketers rarely come up with anything using just our own intelligence and ability. Anything good, that is. We cheat and consult consumers. If you know where to look, your next great product, winning ad campaign or category entry point has already been created. Just not by you, but someone out there in the market. The biggest marketing teams number in the hundreds. Most markets are made up of millions. Do the maths. Guess where the best ideas are located.
With loyalists and advocates we encounter an even more flagrant and rewarding resource. They provide an even more concentrated source of insight into our brands. Find out why these consumers love the brand so much, why they forgive us our sins so readily, why they would pay double or triple what we currently charge if we asked them, and then distil this down into a marketing strategy and execute it to bring others into the brand. If general consumers offer us a key to understanding our brand, loyalists provide us with a much bigger, more obvious version.
Often these drivers of love and loyalty look nothing like the purported strategy the marketing team in charge of the brand want to execute. The distance between the real reasons consumers buy a brand and the ones that marketers promote in their plans has always stunned me. If you had to choose between an hour with the brand manager or a rabid loyalist to learn about a brand, there is only one right answer.
I still encounter brand managers who have never talked to loyalists as part of their diagnosis.
And I’m as bad as the rest of them. When we launched the Mini MBA in Marketing, I remember having this vision of the ‘virtual classroom’, which was shiny, all-encompassing and immersive. Then, I listened to loyalists who had taken the class and loved it. They had cats. Kids. More cats. Holidays. Partners. A messy kitchen. No time to learn. But the course had been convenient enough to fit into the tiny spaces of their busy lives and allowed them to learn and evolve.
The Mini MBA was not about being all-encompassing and flashy. It was about being convenient and easy. Our virtual classroom isn’t something out of Star Trek. It’s a thousand different places, each more chaotic and messy than the next, and each with a marketer in the middle of it learning nonetheless. I would never have planned that positioning in a thousand years. My loyalists taught it to me. And we’ve used it ever since.
Despite all this massive potential, I still encounter brand managers who have never talked to loyalists as part of their diagnosis. Part of the problem is our obsession with big data and representative samples. Both are important parts of the marketing puzzle. But there is also a time and a place, usually in the early stages, for small samples of outliers and learning from extremes.
Yes, you often need to recruit a representative sample of consumers with the appropriate confidence level and confidence interval – every good marketer knows how to do that. But other kinds of sampling exist too. Purposive sampling challenges a researcher to seek out specific consumers that exhibit specific traits, which often fly in the face of general representation. Such sampling can also be very fruitful.
The other problem is the emphasis marketers now place on penetration. For a decade, we have been harangued into accepting that a brand can only grow if it focuses on acquiring new consumers and avoids engaging with loyalists at all costs. Heavy users: bad! Light users: good! True, most of the time. But the argument against outliers only works when applied to business growth. It’s not such great advice when it comes to insight and diagnosis. That’s a place where heavy users can light the way for the rest of the market. A focus on heavy users may not be how brands grow, but it can provide a big insight into how you can make that growth and penetration happen.
Of course, at some point you need to return from the far reaches of the periphery and test your new insights on a broader, more typical slice of the market. But in the early stages of brand diagnosis, listening to and learning from loyalists is right up there with secondary data and founder research for powerful insights into what the brand offers and why consumers will buy it.
“These are the kinds of insights we cannot gain without patients,” Joseph Arboleda-Velasquez, associate professor of opthalmology at Massachusetts Eye and Ear – and another member of the research team looking for a cure for Alzheimer’s – explained to the New York Times this week. “They are showing us what’s important when it comes to protection and challenging many of the field’s assumptions about Alzheimer’s disease and its progression.”
If some of the world’s leading clinical researchers can learn from outliers and extremes, surely marketers – minnows in comparison – can do the same?
Mark Ritson teaches brand diagnosis as part of his award-winning Mini MBA in Brand Management. The next course runs in September.