Total Recall: How the E-Memory Revolution Will Change Everything (14 page)

Your personal health record combined with biometric lifelogging can be integrated with your complete e-memory. As with everything else in Total Recall, the more integration, the better. You should be able to find all sorts of informative correlations between your health data and seemingly miscellaneous other facets of your life.

Imagine if your e-memory presented you a chart revealing a high correlation between your entertaining a certain difficult relative and a trifecta of weight gain, poor sleep, and self-imposed social isolation for a week following each of his or her visits. You’d think,
Wow, I had no idea it was so bad.
Knowing this, and assuming you couldn’t avoid the person by dint of filial duty, you might at the least take pains to manage your exercise, eating, and socializing in the wake of those visits.

Or what if you could see in plain-as-day graphical form that 80 percent of the time when you order a red-meat entree at a restaurant, you become on average 30 percent less productive at work and half as likely to go to the gym the day after? Armed with such knowledge, you might cut back on red meat or redouble your vigilance against lame rationalizations for not exercising.

Or what if your e-memory gave you a chart showing a connection between moderate exercise and improved sleep? That will be more effective than generic advice or nagging to motivate you to get out and walk more because your own (digitized) experience will be telling you this.

In July 2008, a year after my second bypass, I felt some slight angina pains while walking to work in the mornings. This could mean that my arteries were getting clogged again, which would be extremely bad news. So I decided to log my weight, diet, exercise, and heart rate to see if I could glean any patterns. Would eating a dip or two of ice cream have repercussions? Were the tingles in my chest related to times or distance that I walked?

I carried a small GPS tracker on my way to work, measuring the distance walked and elevations encountered—remember, I live in San Francisco. I wore a Polar heart monitor and pedometer for a record of my heart rate and footsteps. The monitor makes suggestions for my weekly workouts based on height, activity level, and my weight. With GPS and a pedometer, it can download workouts from the Internet and keep track of all my exercise.

I used my BodyBugg to look up how many calories I’d burned in the past two days, or since breakfast, or in the past ninety minutes. I compared my average burn rates on weekends versus work-days. In the evenings I checked whether I’d burned more calories than I’d consumed that day, which I could use to justify a little ice cream.

I even made a point of wearing my SenseCam during meals to see if it could give me pictorial reminders of the food I ate, as opposed to what I remembered eating. How many shrimp did I really consume? What was on that snack table in the coffee room?

I learned that the angina was related to my food intake. By increasing my exercise and reducing fat even more, I was pain-free again after six weeks. Ice cream and even low-fat cheese are verboten, just as I had given up butter and foie gras in ’83 after my first bypass. I am becoming convinced that one can eliminate plaque with a regimen of diet and exercise, just as physicians like Dean Ornish claim. If only there were a way to easily measure that buildup.

The benefits of health lifelogging are irresistible: increased self-reflection and self-knowledge, less room for denial or half-conscious fudging on your diet-tracking or time spent at the gym, improving your health habits, helping you cope with or cut down on stress by identifying its causes, alerting you when you get swept away by negative passions, and saving your life by identifying incipient strokes, heart attacks, panic attacks, and other acute episodes.

ENTER THE PROACTIVE ADVISOR

Farther down this road, we will see the advent of the e-Nurse. Timothy Bickmore of Northeastern University has developed a virtual health coach called Laura. Laura is a computer-generated character who nods and raises her eyebrows as she engages in conversations with patients.

Laura has increased the physical activity of elderly patients by 100 percent, and is used to help schizophrenics stick to their medications. While e-Nurses can never be as good as real nurses in many ways, it turns out that patients are sometimes more comfortable asking questions of a virtual health provider, rather than taking up the time or asking potentially embarrassing questions of a real person. Besides communicating with patients using an animated character, e-Nursing can take place via text messaging, cell phones, chat sessions, or any electronically mediated form of communication.

With all this in mind, you should expect to hear stories like these soon:

Sara gets an e-mail from her family’s e-Nurse, recommending that she take her son, Alex, in for a checkup. The e-Nurse has noticed that Alex’s weight, wirelessly submitted from his bathroom scale each day, is tracking lower than expected. The e-Nurse suggests that this could be a side effect of Alex’s asthma medication. Alex also puffs into a meter each day, which has likewise been wirelessly transmitting his breathing flow, and his breathing has been excellent for several months. The doctor reviews the situation and suggests taking Alex off his medication.

Her sister, Gwen, has been sharing her moods and sense of well-being with her e-Nurse. The e-Nurse begins asking questions about her diet each day. After a few months, the e-Nurse suggests a link to wheat. Gwen is tested and discovers that she does indeed have a wheat allergy. Going off wheat radically improves her moods and energy levels.

Their father, John, lies down in his bed, and a wireless unit underneath the mattress communicates with his pacemaker, downloading the story of his heart for the day. Almost every month, his medication is slightly adjusted based on pacemaker data. Several times, a trend of his weight combined with heart activity leads to messages from his e-Nurse. The e-Nurse remarks that these episodes seem to follow times the RFID sensor in the fridge has tracked chocolate ice-cream purchases. John has believed he could get away with a “little bit” of his favorite dessert, and is chagrined to learn he cannot.

Our health care has been built on limited, spotty data. It reminds me of the guy building a house mostly by “eyeballing” it, with only rare use of his tape measure, level, or square. Health care with Total Recall is like a house that is built right.

A HEALTHIER WORLD

Tremendous collective benefit will be gained from pooling personal health data. A population’s worth of personal health records will be invaluable in large epidemiological studies.

Location information can be essential in discovering health-related environmental factors. The great breakthrough in understanding cholera in the mid-nineteenth century came from associating it with certain water supplies. Who knows what great strides in epidemiology might be made based on correlations between health and location data? Add into the mix diet, exercise habits, social patterns, and literally hundreds of other dimensions of how people live, and you are assuredly looking at a tool for improving public health in the same league with the greatest modern-health achievements including germ theory, immunization, and antibiotics (not to mention plumbing).

You will soon be seeing massive health studies as never before, but they will no longer be high-maintenance, expensive endeavors Instead, medical scientists will be able to ask simply for ano nymized elements of people’s e-memories. Analyzing such data across thousands or even millions of individuals, they will be able to study correlations of a sort previously confined to speculation.

Some applications won’t be anything like what researchers have thought of as epidemiological study. Google is able to track the spread of the flu by noting when people enter words like
flu symptoms, aches, sore throat, cough,
and
fever
into the Google search engine. This simple act multiplied across millions of keyboards provides an early warning system for the spread of the flu about ten days before the Centers for Disease Control and Prevention has similar information collated from emergency rooms and health departments around the country.

Total Recall promises a revolution in personal and public health.

CHAPTER 6

LEARNING

When Deb Roy’s son was fifteen months old, a video camera in the hallway ceiling documented his first tentative steps.

As the boy starts to totter toward him, Deb asks, “Can you do it?”

The toddler staggers on. Amazed at this new, upright world, he whispers, “Wow.”

Deb watches in rapt attention. Then he, too, says softly, “Wow.”

The Roy family has this wonderful Total Recall moment thanks to their hallway camera, but family memories are really only a fringe benefit. For Deb, recording is all about learning—learning about the acquisition of language, in particular.

Deb Roy is the director of the Cognitive Machines group at the MIT Media Lab. In 2005, Roy and his wife, who is also a professor, had a son and decided to make all three of them into guinea pigs in a self-run experiment. They wired up their house so that virtually everything their son would hear and see from birth to age three would be recorded. Their equipment includes eleven omnidirectional, megapixel-resolution, color digital video cameras embedded in the ceilings of each room of the house—kitchen, dining room, living room, playroom, entrance, exercise room, three bedrooms, hallway, and bathroom. Fourteen ceiling-mounted microphones are placed for optimal coverage of CD-quality speech in all rooms. When there is no competing noise source, even whispered speech is clearly captured. A server sits in the basement storing all the recordings. They call it the Speechome.

The primary purpose was to get a complete record of their son’s language development—every cry, every coo, every “ga-gaga” and “da-da-da” ever uttered by the baby while at home, as well as every bit of language input to which the child is exposed. After three years they’ve collected 230,000 hours of raw data—a truly massive corpus. Compared to this corpus, previous studies are fragmentary at best. Who knows what key moments, previously unknown or overlooked, may be uncovered? The comprehensive nature of the Speechome record will enable observations that were completely impossible to make in the past. For the scientists studying language development, the Speechome approach expands their universe, just as the telescope has done for astronomers.

The size of the Speechome corpus will prove itself typical, if not indeed small, for future research projects. Total Recall will change how scientists learn. And each individual will come to have her own corpus of lifelong learning. Learning will change for all of us.

Technology is already changing what we take the time to learn. We no longer master the slide rule or even trust ourselves to evaluate a complex formula. Instead we turn to our calculators and spreadsheets, both of which we can get on cell phones these days. If you have children, you have probably heard the charge that spelling is an obsolete skill; who writes anything that matters without a spell checker? Even if those who vigorously defend spelling have to concede that it has become a less important skill—after all, as spelling and grammar checkers improve, the product of the poor speller has grown less and less distinct from that of the proficient speller.

Most of us are well along the path of outsourcing our brains to some form of e-memory. I no longer bother to learn telephone numbers; my cell phone remembers them for me. It knows eighteen hundred numbers, far more than I would ever hope to commit to memory, but quantity isn’t the issue; I can’t even be bothered to memorize the six numbers at my two homes and office. Likewise, there are many facts that need not be on the tip of the tongue as long as they are at your fingertip via your smartphone. The circumference of Earth, the speed of light, the year that Lincoln was assassinated, and Gauss’s electric flux law; each of these I once memorized in school. Now each takes about five seconds to look up on my smartphone. None seem quite so important to commit to memory anymore.

This is not to say you shouldn’t memorize facts or the correct spelling of words—it’s just that such memorization will never again be as important as it once was. And with Total Recall, the list of what is less important to memorize expands to cover everything you know.

Another way technology has already impacted learning is by changing the way we research things. When I was a student in the 1950s and had a paper to write, I’d walk to the library, hunt through the card catalogs and special abstract books, hike around the stacks grabbing items, and eventually sit in the library and make some notes in my notebook for the paper. The next generation had the luxury of photocopying articles, but following up a reference from a photocopied paper required another trip back to the library. All that hassle dampens one’s enthusiasm for extensive research.

Nowadays, I can look up anything I want to learn about in an instant. I visit the Web to find those extra references. The Internet allows me to drill down deeper than ever into any given subject. I don’t visit our library at Microsoft, and I never ask them for books. I just count on them to subscribe to the online collections that give me access to the professional journals and conference proceedings for my field. They also give me online access to market research, press clippings, and so forth. University Web pages are bursting with all kinds of intellectual treasure. Gone are the days of writing to other libraries to get material not found in my local library. I now call up the thesis of an obscure graduate student from the other side of the world as easily as I acquire a paper by a colleague down the hall. Out-of-print and out-of-copyright books are available by the thousand on sites like Project Gutenberg and Google Book Search. More and more books come straight to my Kindle e-book reader.

With the Web, our ability to research has been greatly amplified. Total Recall will take research productivity another notch higher. Your e-memories will provide quick access to the things you’ve already seen and the details of what you already know. You can step back from the vast world of information on the Web and focus on what you have found interesting in the past. You can collect and organize your own unique library.