Why our ancestors sometimes lied on official records in the pre-digital age

I'm reading a memoir by MIT professor Sherry Turkle, The Empathy Diaries. I attended a talk she game some years ago at the MIT Media Lab and was fascinated - her research revolves around questions about how technology impacts people. In the book, she not only traces the evolution of her academic passions, but her personal influences. She shared some interesting facts about her mother, shown above. There were some discrepancies listed on official documents filed in New York City in the 1940s and 1950s:

"She had a drivers license that gave her incorrect height and also shaved a few years off her age, something she told me that certain ladies at the Department of Motor Vehicles would agree to do, understanding it was better if unmarried women over 23 were officially younger. When she married Charles Zimmerman in 1947, she took a year off her age on the marriage license declaring herself 28. Six years later when she married Milton Turkel, their marriage license had her at 29."

Both scenarios described by Turkle - asking a DMV clerk to fudge the birth year, or providing the wrong ages on marriage registrations - are almost impossible now.

But a long time ago, this was not unusual. We know not only because of Turkle's mother's experience, but because a few people on my own family tree also had discrepancies, particularly for marriage certificates and job applications.

In the pre-digital age, many people (including immigrants, cross-country migrants, adoptees, and poverty-stricken families) may not have had access to birth records. Government officials had to go by what they were told, and may not have been told the truth for various reasons, including very compelling reasons. In some cases, sympathetic clerks may have helped, as we learned from Turkle's book. 

We know this happened in other situations, too. Teenagers lying about their age to join the military was commonplace. An estimated 200,000 underage men and women enlisted during World War II. Not long after the war, enumerators for the 1950 federal census (released in April) could note in a dedicated field on the census form if they thought a respondent was not being truthful!

The moral of the story: Sometimes ancestors supplied incorrect information to officials, and they had good reasons to do so. Try to confirm dates and ages using other types of records that are less likely to be fudged, such as birth and death certificates.  

An email from 1995: Impact of VoIP and voice recognition?

I was going through some old photos and computer files this morning, and happened upon the following email. It's from sometime in 1995 (didn't preserve the headers) and was addressed to an op-ed or feature writer for the International Herald Tribune (then owned by the New York Times and Washington Post) who had written something about the Internet. My email to this person touched upon two then-emerging technologies, which didn't seem like a big deal at the time, but are now hugely important: 

I saw the article you wrote on the above in an issue of the International Herald Tribune. My question is this: Now that internet use is multiplying, and people are able to take advnatage of much cheaper LONG DISTANCE CALLS through a PC, a modem, and an internet provider, dont you think the phone companies are going to clamp down on this? I mean, five or ten years down the road people will be able to buy equipment, combo phone/modems with a chip inside that enables the general public to just dial across the world but only pay local rates plus a monthly internet fee. This will take a big chunk out of the phone companies business.

Can the phone cos start making providers pay for this, and pass on the cost to the consumer? Also, why havent they done this already? Who is actually paying for internet phone lines, and at what point will they say "enough is enough"?

One other question: VOICE RECOGNITION: what kind of impact do you see this technology having on the industry? What kind of timeframe? It seems like a major thing to me, but everyone I talk to, plus magazines, all mention two words: "science fiction" and then dismiss it as just that. True?

Voice over IP (VoIP) telephony thing quickly became a big thing, cutting down the cost of international phone calls and then leading to a host of new services (Skype, FaceTime, Google Voice, etc.). Domestic long-distance calls, which used to cost more than 30 cents per minute, are now free with most calling plans, and international calls which used to cost more than a dollar per minute to some countries, are now free or a few cents per minute at most. 

Voice recognition was slower to take off, but 2010 was widely used by automated support lines for banks and airlines. In the past 5 it has exploded, thanks to Siri, "OK Google" and Amazon Echo.

Healthcare: A promising vertical for Google Glass?

Last month, I spotted a very interesting blog post about Google Glass by John Halamka, M.D., the CIO of one of Boston's largest research hospitals. Google Glass, a virtual reality system embedded in a pair of eyeglasses, has been given a bad rap in the media by a series of minor controversies involving whether people are recording or photographing things that they shouldn't. But the usage of Glass that Halamka describes is one of the few examples that I've seen of the technology providing a measurable improvement over older technologies -- in this case, emergency room systems used to present patient information to doctors and other staff.

Dr. Halamka is one of those rare CIOs who truly embraces the cutting edge of information technology -- ten years ago he had an RFID chip containing his medical information embedded in his arm. He is very interested in promoting discussions around new technologies and what they can do to improve healthcare. Working with Emergency Room staff at Beth Israel Deaconess Hospital, he developed a prototype system for doctors to retrieve certain types of information through Google Glass. In a blog post titled Wearable Computing at BIDMC (since removed from the Web), he described how it worked, as well as some of the issues around usage of the technology:

When a clinician walks into an emergency department room, he or she looks at bar code (a QR or Quick Response code) placed on the wall.  Google Glass immediately recognizes the room and then the ED Dashboard sends information about the patient in that room to the glasses, appearing in the clinician’s field of vision. The clinician can speak with the patient, examine the patient, and perform procedures while seeing problems, vital signs, lab results and other data.

Beyond the technical challenges of bringing wearable computers to BIDMC, we had other concerns—protecting security, evaluating patient reaction, and ensuring clinician usability.

Here’s what we’ve learned thus far:

Patients have been intrigued by Google Glass, but no one has expressed a concern about them. Boston is home to many techies and a few patients asked detailed questions about the technology. Our initial pilots were done with the bright orange frames—about as subtle as a neon hunter's vest, so it was hard to miss.

Staff has definitely noticed them and responded with a mixture of intrigue and skepticism. Those who tried them on briefly did seem impressed.

We have fully integrated with the ED Dashboard using a custom application to ensure secure communication and the same privacy safeguards as our existing web interface. We replaced all the Google components on the devices so that no data travels over Google servers. All data stays within the BIDMC firewall.

We have designed a custom user interface to take advantage of the Glass’ unique features such as gestures (single tap, double tap, 1 and 2 finger swipes, etc.), scrolling by looking up/down, camera to use QR codes, and voice commands. Information displays also needed to be simplified and re-organized.

We implemented real-time voice dictation of pages to staff members to facilitate communication among clinicians.

Google Glass does not appear to be a replacement for desktop or iPad—it is a new medium best suited for retrieval of limited or summarized information. Real-time updates and notifications is where Google Glass really differentiates itself. Paired with location services, the device can truly deliver actionable information to clinicians in real time.

Here’s a real BIDMC experience described by Dr. Steve Horng

"Over the past 3 months, I have been using Google Glass clinically while working in the Emergency Department. This user experience has been fundamentally different than our previous experiences with Tablets and Smartphones. As a wearable device that is always on and ready, it has remarkably streamlined clinical workflows that involve information gathering.

For example, I was paged emergently to one of our resuscitation bays to take care of a patient who was having a massive brain bleed. One of the management priorities for brain bleeds is to quickly control blood pressure to slow down progression of the bleed. All he could tell us was that he had severe allergic reactions to blood pressure medications, but couldn’t remember their names, but that it was all in the computer. Unfortunately, this scenario is not unusual. Patients in extremis are often overwhelmed and unable to provide information as they normally would. We must often assess and mitigate life threats before having fully reviewed a patient’s previous history. Google glass enabled me to view this patient’s allergy information and current medication regimen without having to excuse myself to login to a computer, or even loose eye contact. It turned out that he was also on blood thinners that needed to be emergently reversed. By having this information readily available at the bedside, we were able to quickly start both antihypertensive therapy and reversal medications for his blood thinners, treatments that if delayed could lead to permanent disability and even death. I believe the ability to access and confirm clinical information at the bedside is one of the strongest features of Google Glass. "

We have been live clinically with Google Glass for a limited set of four emergency physicians serving as beta users since 12/17/13. Since then, we have been working on improving stability and adding features to improve usability. Some of these modifications include the addition of an external battery pack, increasing the wireless transmission power, pairing the headset with our clinical iPhones, using head tilt to control vertical scrolling, revamping our QRcode reader to improve application stability, adding an android status bar to show wireless connection strength and battery power.

In addition to our four beta users, we've also had impromptu testing with at least 10 other staff members since 1/24/14 to get feedback to refine the user experience.

As a device being used in clinical care, we needed to rigorously test our setup to ensure that the application is not only reliable and intuitive, but improved the workflow of clinicians rather than impede it.

I believe wearable computing will replace tablet-based computing for many clinicians who need their hands free and instant access to information.

Dr. Halamka indicated that the pilot was a success, and said a full roll-out was anticipated in the coming weeks.

It should be interesting to see if this learning experiences of this experiment can be applied to other medical settings, not just at BIDMC but also other hospitals and clinics. Of course, besides improving the interface and other aspects of the data being delivered to caregivers, developers need to consider how the technology may impact other aspects of running a hospital and interacting with patients. VR may be a large chasm for patients and some staff to cross, and there is also the issue of whether the usage of such technologies requires FDA input.

23andMe's CEO letter and the FDA crisis

I just received this email from the 23andMe's CEO:

Dear 23andMe Customers,

I wanted to reach out to you about the FDA letter that was sent to 23andMe last Friday.

It is absolutely critical that our consumers get high quality genetic data that they can trust. We have worked extensively with our lab partner to make sure that the results we return are accurate. We stand behind the data that we return to customers - but we recognize that the FDA needs to be convinced of the quality of our data as well.

23andMe has been working with the FDA to navigate the correct regulatory path for direct-to-consumer genetic tests. This is new territory, not just for 23andMe, but for the FDA as well. The FDA is an important partner for 23andMe and we will be working hard to move forward with them.

I apologize for the limited response to the questions many of you have raised regarding the letter and its implications for the service. We don't have the answers to all of those questions yet, but as we learn more we will update you.

I am committed to providing each of you with a trusted consumer product rooted in high quality data that adheres to the best scientific standards. All of us at 23andMe believe that genetic information can lead to healthier lives.

Thank you for your loyalty to 23andMe. Please refer to our 23andMe blog for updates on this process.

Anne Wojcicki
Co-founder and CEO, 23andMe

I am a 23andMe customer. I was attracted to the genetic testing service because the results can be used for genealogical research, but have since grown to appreciate the health insights. In fact, family members have ordered kits based on the reports that they saw were available. We have already received the results for one relative, but two others are awaiting testing.

The other valuable service provided by 23andMe is the community. There are a lot of online discussions about genealogical and health results, and even more importantly, it's possible to reach out to people who share some common genes that indicate relative status.

I think the FDA should be concerned about the accuracy of the testing, and the potential for false positives. But remember that 23andMe is also focused on data quality. In addition, 23andMe is very careful to provide peer-reviewed research and other vetted data to users of its service, when it comes into providing health insights. It also states that health-related concerns should be discussed with doctors and other health professionals.

In other words, 23andMe is not a DIY diagnosis service. It shows risks based on genetic profiles and public research, and advises people to seek out professional medical advice.

Bad data, and a pool problem

We put so much trust into online databases. Oftentimes, the trust is misplaced. I learned this the hard way when I used some expiring American Airlines miles to book a vacation in New York. I trusted the online database used by aavacations.com to display accurate data about the New York Marriott Downtown. Instead, I found out that some crucial information about the hotel (see the circled part below) was incorrect.

I contacted the hotel and American Airlines, but aside from cancelling the reservation, nothing could be done. My family was out of luck.

In the grand scheme of things, whether or not a hotel database displays accurate information about certain hotel in a certain city matters little. But when you consider that hundreds of millions of people make decisions based on what they see in online databases every day, the scale of the problem becomes apparent. Even if only 10% of listings in a travel or ecommerce website have incorrect data, that represents a lot of frustration, misspent dollars, and lost business.

Why Ancestry.com is not enough

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"The real killer for me was that every search gave me zillions of irrelevant hits. That, together with a paucity of Scottish data, means that it is never going to be worth my while trying to use it."

This quote comes from an email sent to me by Ray Hennessy, an experienced genealogist in Scotland who maintains the What's In A Name website. He made this comment after reading my Ancestry.com review, and discussing with me some of the difficulties I have encountered building my own Lamont family tree (I am using his comment with permission).

When I heard this, I was not at all surprised. I've been working on my family tree off and on for the past 15 years, and am very familiar with the limitations of using databases (online and offline) to build out a family tree.

Lamont is a Scottish surname, and we confirmed the Scottish connection through family sources and public documents, including obituaries and birth records. I began using online sources for research in the 1990s, and tried Ancestry.com for the first time in 2008. I revisited Ancestry again late last year after receiving a trial offer that urged me to explore a new batch of U.S. military records that they had posted. The online military records were a huge waste of time. Despite easy access, I've had much more productive sessions in phone or face-to-face interviews with relatives, examining letters and photographs from family members, and visiting local government offices.

Ancestry.com and other online databases such as Rootsweb have been of limited use. The "zillions of irrelevant hits" problem is only part of the story. Other problems include an emphasis on censuses and other lists (ship registers, military rosters, etc.) as opposed to photographs, local histories, and trend data relating to health/immigration/economy. The databases also fail to provide mechanisms to connect or correlate names, despite statistical and algorithm-driven methods to piece together likely connections. Sometimes, family trees submitted by other people help connect the dots, but often the trees are poorly documented or contain significant errors.

But there's another issue at work here, too: A database is only as good as the data that's put into it. If you can exclude the irrelevant hits, an 1870 census record might be a starting point, but the best stuff is to be found in church registers, county historians' offices and the humble town clerk -- sources which are almost never digitized or shared online.

Image: Portion of a handwritten family tree kept on file in the Clinton County, NY, Historian's Office.