‘When Man steps into his rocket ship and leaves earth behind, he must be well equipped to survive in the hostile realm of outer space. To portray the complex problem of space medicine, we have designed a sort of common man. A man just like you and me. We will find out what will happen to him in a trip into space. In a way he’s going to be our space guinea pig. That makes him a brand new biological species. I think we should call him Homo sapiens extraterrestrialis.
Or, Space Man…’
Dr Heinz Hoffmann,
Walt Disney’s Man in Space
RISK ASSESSMENT
Wherever you’re planning to go in space, even if it’s just the few hundred kilometres to low earth orbit, bad things can happen. If it’s a cliché that there is nothing routine about going into space, it’s a cliché for a reason. Many minor and not so minor incidents have taken place over the years, many of which you won’t have heard about and have gone unreported, or have been hidden behind walls of political secrecy. Thanks to Ron Howard and Tom Hanks, you’ll be familiar with the Apollo 13 incident – an explosion en route to the moon that became one of NASA’s finest hours. Others not so: the Space Shuttle Columbia accident, caused by a piece of insulating foam coming loose on launch, striking and damaging the leading edge of the wing, which led to it disintegrating on reentry. And Challenger breaking up soon after launch, caused by a malfunctioning frozen rubber ‘O ring’ on one of the solid rocket boosters.
Further back was the Apollo 1 fire that killed astronauts Roger Chaffee, Ed White and Gus Grissom, an accident preceded by the similarly grisly death of cosmonaut Valentin Bondarenko – one of the first group of cosmonauts – in 1961, only weeks before Yuri Gagarin’s historic first flight. The cosmonauts would train in the sensory deprivation isolation room known as the Chamber of Silence. Bondarenko was coming to the end of his ten-day training stint living in the chamber and was cleaning the patch of skin where the ECG medical sensor had been attached with an alcohol cotton swab. Tossing the swab away, it landed on the small electric cooking hotplate, which immediately ignited the oxygenated surroundings, engulfing him in flames. The pressurized environment meant the two doors, like submarine hatches, couldn’t be opened immediately. Several minutes later he was pulled out of the chamber, still conscious but his body almost completely burned. Only the soles of his feet remained unburned, where doctors tried to administer intravenous lines to give him painkilling treatment. He survived in the utmost agony for a few hours. His death was only reported in the 1980s. A crater on the moon is now named after him. In 1967, Vladimir Komarov was killed when his Soyuz spacecraft parachute failed to open, and four years later Soyuz 11’s explosive decompression on re-entry killed the crew Georgy Dobrovolsky, Vladislav Volkov, and Viktor Patsayev. Recently Virgin Galactic’s SpaceShipTwo crashed over the Mojave Desert, killing the co-pilot Michael Alsbury.
Bad things will continue to happen as we push further into space. But the fact that there hasn’t been a single fatality on board any space station during the last forty years is a tribute to how far we’ve come.
STAYING HEALTHY – A NOTE FROM YOUR DOCTOR
If you’re going on an extended adventure anywhere, it’s always wise to seek medical advice. Luckily for you, I’ve consulted a doctor on your behalf. Here are some thoughts on the problems of staying healthy in space from medical doctor, cosmonaut and ISS Commander Dr Oleg Kotov.
Cosmonaut and ISS Commander
June 2017, Moscow, Russia
What is the most difficult thing in space from the point of medicine? It is not possible to have a fully staffed polyclinic* with all the necessary equipment on the spacecraft. How to solve this problem, especially for flights beyond the Earth’s orbit to the moon and Mars?
Firstly – the selection and the medical screening of astronauts should be more thorough.
Secondly – it is necessary to determine the list of the most probable illnesses and diseases that can arise in flight and to provide the necessary medicines and equipment for their treatment. And hope that no one will become sick with an illness that is not on the list.
Thirdly – we need to learn to conduct surgical operations in weightlessness (which we have not yet begun to do).
And in the fourth place, the most important thing is to prepare an astronaut doctor and medically train one more member of the crew, a paramedic for all possible medical scenarios. Of course there are opportunities for telemedicine and consultations with doctors on Earth – but as the distance from our planet will keep increasing, this thread will become thinner and thinner.
Another pressing problem is weightlessness. Until artificial gravity is created in one form or another, we will constantly struggle with the adverse effects of weightlessness on the human body. Special suits, many hours of exercise, medication and other tricks help overcome the effects of weightlessness, but not completely. This problem is yet to be solved and must be solved by science.
Radiation – in the conditions of long flights to the moon and Mars outside the Earth’s radiation belts, with the subsequent long stays on their surface, the development of a means of protection from the effects of radiation on humans and technical systems is one of the most important tasks.
Not entirely medical, but a problem close to it in spirit: the psychological compatibility of the crew, and social and psychological support**. When immediate return to earth becomes impossible, the crew will need to have as much information as they need to support decision making. These decisions will affect the success of the entire mission and even the lives of people on the ship. The role of the crew commander will be especially important in those circumstances. The compatibility of the team members and their unity should be nurtured long before the start.
The problem faced by crews in long duration flights in the earth’s orbit is of microbial and fungal contamination of hermetic volumes. Despite the observance of all quarantine procedures and special measures, a significant number of species of microbes and fungi become passengers on spacecrafts and stations. They settle on panels, cable harnesses, equipment, in garbage bags, dirty linen bags, etc. All existing methods of combating this phenomenon have shown their inefficiency. We need to develop a method for disinfection of space objects, taking into account that within these objects people are working and living.
* This is a Russian term for a clinic, where outpatients are treated. It is usually a multi-storey building with general and very specialized medical personnel. I haven’t come across this term being used in UK.
** Russian crew also receive ‘information support’, I guess the closest term would be the ‘psychological support through information’. This could be updates in specified areas and news close to the interests of the crew member.