Restoring Missy’s Memories

Andrew Smith Lewis
Jul 20, 2017 · 9 min read

January 30, 2017. 13:00 hrs U.S. Army Pacific HQ, Fort Shafter, Hawaii.

I was very excited to finally have the opportunity to present Cerego to General Robert Brown. By this time, I was used to meeting with senior officers in the Army. I’d spent the last two years visiting a variety of installations to evangelize the promise of personalized learning across the whole spectrum of military training. That said, this was a big meeting for me; I’d been trying for six months to get in front of General Brown specifically, because he is a huge proponent of the “Human Dimension” aspect of training (a movement to balance the historical mantra of “stronger soldiers and better weapons” with the concept of cognitive superiority on and off the battlefield). Not to mention, he’s also one of only seven four-star generals in the U.S. Army.

The briefing went extremely well. General Brown not only immediately understood the value of accelerated learning but instantly recognized the inherent value of Cerego’s approach to data-driven talent assessment. I got what I needed that day (the support of leadership and eventually our first pilot project with the Army), but that’s not where this story ends.

Colonel Louis Zeisman arrives at Fort Bragg after a year in Iraq, 2009

Colonel Zeisman, one of the ten staffers with General Brown that day, was growing more and more agitated as I described the science behind Cerego and how the system works to track and build memory. He caught my attention as he was sitting right next to the General, and I couldn’t tell if his response was positive or negative — but the tension was building. Toward the end of our time, General Brown asked if anyone had any questions. Of course, Colonel Zeisman immediately asked permission to speak.

“As many of you know, my wife Missy suffered a double aneurysm a year and a half ago and has been recovering at Walter Reed ever since. While she is conscious of her surroundings, she’s lost the ability to recall the names of her family members and struggles with remembering about our life together. I don’t know how this would work, but is there any way I could get Cerego for her?”

This was not what I expected to hear.

My response was “Absolutely, let’s figure this out together,” and that’s where this story truly begins.

Over the next six months, I’ve learned a great deal about Missy and her recovery, as well as a little about Traumatic Brain Injury (TBI). Over 1.75 million people suffer some sort of TBI in the US every year, and 300,000 or so require extensive hospitalization, costing more than $56 billion. The injuries are quite varied; one specialist I’ve spoken with told me that “If you’ve seen one TBI, you’ve seen one TBI…”

Missy was in peak athletic form, training several days a week with her husband, and adjusting to their new assignment in Honolulu, Hawaii. On August 22, 2015, while working out in the gym, she felt ill and returned home to try and shake off a very bad headache. She got sicker and sicker, finally telling her husband, quite mysteriously to “call an ambulance, I’ve had an aneurysm.” Several hours later, Colonel Zeisman was told by a neurologist in a top hospital that his wife had two extensive bleeds in her brain and that he should go and “say goodbye” to his partner and mother of their two boys. Colonel Zeisman opted for a very risky surgery, and Missy pulled through the first of many challenging procedures.

Thus began a grueling ordeal with hospitals across the country, eight major operations, induced comas, months of hospitalization, and hours of daily physical therapy leading up to our meeting in General Brown’s office. At that moment, Missy was in one of the Army’s top hospitals, Walter Reed Army Medical Center, where she’d been for several months. Colonel Zeisman and his family were taking turns caring for Missy while she went through the long process of recovering her lost mobility and cognitive skills, including her memory.

Immediately following our meeting, Colonel Zeisman (whom I now call “Lou”) and I began crafting content for Missy to try out in Cerego. He collected images of family and friends, pets, places where they had lived and studied (Lou and Missy were college sweethearts), important dates — essentially the foundational knowledge about her life and the people around her.

He collected images of family and friends, pets, places where they had lived and studied (Lou and Missy were college sweethearts), important dates

Concept map of content that Missy is relearning via Cerego.

Over the course of the next four months, Missy became a power user of Cerego. Right after her first memory building session, Lou shot a video of Missy, asking her how she felt. “Worked out” was her response and like a determined athlete, she’s been diligently working out on Cerego ever since.

I like to say that “little and often” is the magic recipe for building lasting knowledge, and that’s the exact pattern that Missy has been following, checking in a few times a week, either on her iPad or iPhone, which is also where we’ve seen the greatest learning gains.

The mobile aspect of Cerego lets Missy train anytime, anywhere

Every few days Lou sends me an image of Missy on Cerego — in trucks, on beaches, at home. Recently she was back in the hospital for some tests and, yes she was on Cerego from her hospital bed.

Amazingly, we’ve had to continuously raise the bar as Missy keeps zooming past her learning goals. In the image below she’s past “level 3” of memory permanence which is a higher goal than most of our academic clients set for their college level learners.

Missy’s Memory Bank in Cerego showing her item by item progress

We are also able to monitor concept level difficulty to determine which items are the most challenging for Missy. Initially, she’d been struggling to keep her two sons’ birthdays in mind, something that our learning algorithms have been able to identify from her usage patterns.

The two “very hard” blue orbs are her son’s birthdays

The data coming from Missy’s relearning with Cerego has provided some remarkable insights into her recovery. For Lou, being able to understand her patterns and make adjustments to content based upon her engagement has been invaluable. However, the most promising aspect here isn’t the story the data tells; it’s the real world benefits that Lou and Missy are seeing from her efforts on Cerego. The first indication we got that we were on the right track came when after about four weeks on Cerego Lou called me up and told me that Missy went with him to register their youngest son Hudson for class. While filling out some forms, he casually asked out loud, “What’s Hudson’s birthday?” to which Missy immediately replied “August 21, 2000.” He then asked her several other questions, things that we would normally take for granted (like addresses and phone numbers) and Missy was able to help Lou complete her son’s application. Lou told me he felt strongly that there was no way Missy would have been able to answer those questions just a few weeks before.

However, the most promising aspect here isn’t the story the data tells; it’s the real world benefits that Lou and Missy are seeing from her efforts on Cerego.

I’m cautiously optimistic about the results Missy is seeing. I have tremendous faith, and empirical evidence that Cerego works for a wide range of users and subject areas. Though TBI is an area where while we have no expertise, I believe Cerego may come to play an important role in cognitive rehabilitation. Lou and Missy are helping us to understand what about Cerego works, at least in her case.

Missy’s journey on Cerego has been noticed by doctors at multiple medical facilities and we are now fielding inquiries from a variety of TBI centers and hospitals around the country. Lou tells me that every time Missy is in for tests or rehab someone asks about her progress and he happily shares her work on Cerego.

Cerego continues to support the Zeisman’s journey to restore Missy’s memories. Every few weeks we add additional items for Missy to learn — ranging from facts about the current government administration to the sequence for applying makeup.

I remember calling Lou up one morning after we got the “applying makeup” content in place for her. We were both so excited about Missy trying this out and then seeing if she could follow the steps outside of Cerego. It was 7:00 AM and I was in a Lyft on my way to the office, talking excitedly with Lou about the content. “Looking back on that briefing for General Brown, did you ever think that five months later you and I would be talking about putting on makeup?” We shared a good laugh about that. Caring for his wife and helping her regain her independence had become the main part of his life — no matter the challenge.

Over the years, I’ve learned thousands upon thousands of concepts on Cerego. My staff jokes that I’ve got the greatest memory for absolutely random content — they may be right. One of the most meaningful sets of content I’ve ever learned on Cerego is called “Missy’s Memories” — I can clearly picture in my own mind her friend Charlotte, her brother Brad, their dog Maxton, I know when they got married, where they first met, her son Hunter’s college, her mother’s home town. And while I have yet to meet Missy in person, I’ve had the privilege of talking with her multiple times. Every time we speak, we have these new shared memories — new for me, and restored for her and I feel as if I know her in a very unique and profound way.

When we purposefully designed Cerego to be content agnostic, we imagined learners building lasting memories for everything from aviation to medicine to zoology. Seeing Missy’s remarkable achievement has been tremendously rewarding and gives us hope that perhaps we can help many others who are struggling to reclaim this essential part of who we all are.

If you work in the areas of cognitive rehabilitation and TBI and this story resonates with you, please reach out. I’d appreciate hearing from you and am very interested in getting the right groups involved in helping us test whether this could be an effective, scalable solution for TBI and related injuries and illnesses.

Lastly, I’d like to thank my friend Colonel Lou Zeisman who agreed to share this very personal story with the world. I discussed this with Lou and he immediately said that we had to share their story. Lou believes that if Missy had started six months earlier on Cerego, her progress would be much further along. His dream, and now mine too, is that we make Cerego available far and wide to the families of people struggling to regain their lives and independence.

And most of all, sincere thanks to Missy, our true fighter.

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Andrew Smith Lewis

Written by

Chief Innovation Officer at CAIS, Co-Founder of Cerego

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