Figuring out treatment options for a patient can be tedious, but caring for one who is in a spacecraft hundreds of miles above Earth for months at a time poses a unique and daunting set of challenges.
“Really, what we are trying to do is help protect the health of the men and women who are willingly going into space doing work on behalf of all mankind,” said Dr. Joseph Dervay, a flight surgeon for the Johnson Space Center in Houston.
Dervay spoke of his 18 years of working in space medicine at a lecture Monday evening for pre-health students at Baylor University. The department regularly invites medical professionals like pharmacists, researchers and family health physicians to share their career paths with students.
Pre-health students make up about a third of Baylor’s undergraduate enrollment.
“We want them to be exposed to all the different medical fields out there,” said Rizalia Klausmeyer, associate director of the pre-health studies department. “But this one is out there. This one, no one would have thought about.”
Dervay completed his medical training while serving in the Navy, where he rose to the rank of captain and spent a combined 29 years of active-duty and reserve service.
He has served as the lead deputy crew surgeon for 11 space shuttle missions and three missions to the International Space Station, and also supported 45 other space missions.
NASA physicians collaborate on treatment and diagnostic options to counter the medical and physiological changes astronauts undergo as a result of a space mission. For example, Dervay said, astronauts lose 10 to 15 percent of the bone density in their hips, heels and lower spine while in space, a change that also can cause kidney stones.
A solution is a daily exercise regimen in which the astronauts run on specially engineered treadmills and weight equipment for up to two hours to build muscle and counter the effects of the bone loss.
“It takes 90 minutes to orbit the Earth at 17,500 mph (in a space shuttle), so we have people who can say they literally ran around the world,” Dervay joked to the crowd. “We’ve also had one lady, a Navy captain, who ran the Boston Marathon while people were doing it on the ground, she was running it in space, which was pretty cool, I think.”
Each astronaut undergoes a private medical consultation with the team once a week while they are in orbit. The medical team also works extensively with astronauts ahead of a trip into space to prepare them for medical events during the six-month journeys.
Each is given a medical kit that includes various medicines and medical supplies to treat common issues like space motion sickness or perform procedures like CPR, drawing blood or intubation.
“When you’re doing a procedure in orbit, everything you touch has to go somewhere because if it doesn’t, that needle is going to rotate in air, and where do you think it’s going to end up? Square in your eye,” Dervay said. “There’s checklists for everything, so that we can train the astronauts how to do everything efficiently and effectively.”
Dervay shared how a team of astronauts and physicians created an eye irrigation system using scuba goggles to clear the eye of normal debris that may float around the space shuttle.
NASA physicians also have several ongoing research projects to find ways to better shield the body from the long-term effects of a zero-gravity environment.
One concern is the potential for exposure to radiation once astronauts are outside of the protective barrier of the lower-orbit shield. Space suits are designed with protective layers to ward off radiation, but the medical team has been searching for a preventative pharmaceutical solution.
“We’re looking at the kind of chemicals that can help repair DNA, so things that are going on in laboratories right now for cancer patients, we’re looking at things we might be able to use as chemical protectants before we’re going to send you away (to space) for three years,” Dervay said.
In recent years, MRIs conducted on astronauts have shown some swelling in the back of the eye. Dervay said though astronauts have not yet complained of any vision issues, researchers are examining what is causing the transformation before it leads to problems.
“Imagine that you’re the one who’s going to Mars and your vision is changing after several months,” Dervay said. “We have redundant systems for engineering and computers systems (in space), but you’ve only got one set of eyeballs. We don’t have a redundant system for that, so we’ve got to really figure this one out.”
Dervay also shared some of his own personal highlights since working at NASA, such as meeting Neil Armstrong, the first astronaut to walk on the moon, and doing a physical assessment on President Barack Obama and the first lady before they were cleared to greet a crew preparing to launch into space.
He said the U.S. space program has faced challenges with the end of the shuttle program in 2011 and has had to rely on Russian Soyuz capsules to get to the International Space Station. But Dervay said he is hopeful that commercial spacecraft designers will engineer new U.S. vehicles for getting into space by 2017.
“The benefits of what we get out of the space program — engineering, medical, life science — is incredible, so hopefully our country will have the will to get back on track, and we all look forward to the day that we get that,” Dervay said.