You actually hit this nail quite on the head with the example. The "10x engineers" get a lot of their "10x"-ness from creativity - most I've met are cartoonists, painters, musicians, writers, cooks - artists in general that love software as a way of expressing themselves and earning good money. The beautiful bits of code you get after are usually there because the starting point is "create it" not "implement existing solution/pattern".
I used to do design/graphix/ux work... that always interested me. Programming pays better, and I have a talent for it. I have spent time learning patterns, etc, but not through a formal education. I tend to just see a good way forward... creating discoverable code along the way. I find a lot of the time, the formal patterns tend to just make things more complicated than they need to be.
Just my own take on things. I'm kind of lazy in a good way. I have spurts where I will do a crazy amount in a short time, and those where I'm closer to coasting. Like many/most creative types, it varies.
I imagine within the tech world there are tasks that are ill defined and a small subset of engineers can solve, but a typical engineer may not have the background to solve it.