Dan Huot (Host): Houston we have a podcast. Welcome to the official podcast of the NASA Johnson Space Center. This is Episode 93 Space Medicine. I’m Dan Huot and I’ll be your host today. If you’re new to the show, we bring in the experts here at NASA to talk about all the different parts of our space agency. Recently though I got a chance to get out of the studio and head up to Comicpalooza in Houston where we headed up a live recording of the podcast in front of a live audience of a couple hundred of our closest friends to discuss the science fiction and science fact of space medicine. Joining the esteemed panel was Gates McFadden, most famously known for her portrayal as Dr. Beverly Crusher, Chief Medical Officer aboard the USS Enterprise on the TV show Star Trek Next Generation. She shared her insight into how space medicine worked in the far off future of Star Trek and how she prepared for the role and assumed the character of a space doctor. And, joining her on the panel were some actual space doctors including Serena Auñón-Chancellor, a NASA astronaut and former flight surgeon who flew in space last year and also doctor’s Kris Lehnhardt and Richard Jennings. We go into detail on who they are at the very beginning of this panel. This is the first time we’ve recorded a podcast from outside of our home here at NASA. And, this is the biggest live audience we’ve had yet. So, with no further delay, let’s jump right ahead to another live recording of Houston We Have a Podcast, again, with Serena Auñón-Chancellor, Richard Jennings, Kris Lehnhardt and Gates McFadden, enjoy.

Host: Well, we’ll jump right in. Thanks everybody for being here. This is our panel on space medicine, all things space awesomeness and also our first live recording outside the Johnson Space Center for Houston We Have a Podcast. So, thanks for being here today. All right, if you’re unfamiliar with us, we do podcasts on all things human space flight. We get to talk to some really incredible people, actors, scientists, astronaut, engineers, the people doing amazing things that inspire us and are really pushing, you know, humanity into the next generation. And so, today though, we’re going to be focusing on space medicine. What happens to humans when you go into space? How do we keep you healthy? How do we prevent you from getting sick? How do we really keep you going when you’re up there for extremely long periods of time? And, I’m going to go down the line real quick, introduce my esteemed panel, and then we will jump right in. I’m going to go to my notes because all of these people are insanely accomplished [laughter] and I want to make sure I don’t leave anything out. So, starting off, right to my left we are joined today by Gates McFadden, everybody’s going to recognize her.

Gates McFadden: Thank you thank you.

Host: And, Gates obviously famous for her portrayal of Dr. Beverly Crusher, which I must say one of the coolest name in Sci Fi history [laughter], hands down. She was the Chief Medical Officer aboard the USS Enterprise D and E under the Command of Captain Jean-Luc Picard in the show Star Trek Next Generation. So, that show aired from 1987 to 1994. Gates though has directing choreography and puppeteering experience in film, films like Labyrinth and the Muppets Take Manhattan. And, was in a number of other pictures like the Hunt for Red October, personal favorite of mine, and When Nature Calls. And then, she’s taught at several universities including the University of Southern California, Harvard, the American Academy of Dramatic Arts and the University of Pittsburgh. So again, let’s hear it for Gates.

And then next to her, she’s kind of easy to pick out. She’s the astronaut amongst the group. This is Serena Auñón-Chancellor and she is a NASA astronaut and medical doctor. She’s been on the International Space Station. She recently completed a long duration stage. She was flying above all of us for about six months while she was up there in orbit. She was there from June to December 2018. So, recently acclimated back here on earth. She’s has a background though in internal medicine and she as a flight surgeon before she was an astronaut and conducted a whole bunch of experiments onboard the Space Station including once impacting diseases here on earth and doing some cancer research on the station. So, Serena, thanks for coming out today.

All right and then we have Kris Lehnhardt. And this is a mouthful. He is the Element Scientist for Exploration Medical Capability in NASA’s Human Research Program.

Gates McFadden: That’s like techno-babble.

Host: All right, and so, he also is at the Senior Faculty with Baylor College of Medicine and the Center for Space Medicine and Department of Emergency Medicine. He’s board certified I emergency medicine not just here in the USA but also in Canada and he works clinically in the Emergency Department Ben Taub Hospital here in Houston. Some of his main research interests are in medical care an extreme environments, so places like space, people in the military, and out in the wilderness. And then, he’s also a pilot because again, like I said, you guys can’t just have one job, can you? You have to do like 40 different things. Also a pilot, he’s a Reservist in the Royal Canadian Air Force and advanced open water scuba diver. So, let’s hear it for Kris here with us.

And then, finally, down on the end, Richard Jennings whose a Clinical Professor in Space Medicine at UTMB and he’s a Flight Surgeon for Space Adventures and he’s a member of the Safety Advisory Panel to Space X, a couple of people might have heard of them, and a Medical Consultant to Virgin Galactic. And, he also served as a NASA flight surgeon, so something Serena’s also done. So, he was there from 1987 to 1995 and continued to provide care until 2013. While he was at NASA he was the chief of the Flight Medicine Clinic and Chief Medical Operations for the Space Shuttle Program and he served as the director for the UTMB NASA JC Aerospace Medicine Program as well. And, as a Lead Flight Surgeon for Space Adventures, he’s actually supported five missions on the Russian Soyuz Spacecraft over in Kazakhstan in Russia. That’s a pretty interesting place. And, if you can corner him afterwards, ask him a bunch of questions, I guarantee you he’s got some really cool stories about that. He was also a President of the Aerospace Medical Association and currently serves on the board of the Aerospace Medical Association Foundation. So, once again, let’s hear it for Richard and for our entire panel for being here today.

Okay. And, that was the, that was the abridged version of everybody’s biographies, just a really let it sink in. So, before we really get into the nitty gritty of space medicine and medical technology and stuff like that, I want to start off with something that’s, it’s really pertinent to a place like this, at Comipalooza, and that’s inspiration. A lot of people, one of the great things, if you work at NASA or you know somebody that does, they’re extremely passionate about what they do and the same is true for actors and artists, they’re extremely passionate and they’re always driven. So, I want to know, what kind of took each of you down that road? What was the guitar in the pawn shop window moment? And starting off with Gates, what really kind of drew you to be an actor, director, choreographer and, kind of, more importantly, what drew you to something like Start Trek?

Gates McFadden: Well, to be honest, I was pushed when I was young to be a performer. I always, personally, would play in the dirt pile making cities. I was like really into the relationship of people and space. Not necessarily the final frontier but just kind of the dirt pile frontier. But, as I got older and I was performing more and more and I was learning about theater and I majored in, at the university, I graduated from Brandeis University. And then, I met a man, I took a workshop at Harvard and he changed my life. So I would say he was the catalyst. He was someone who actually came to NASA. He was invited to NASA. And, he was unknown, pretty much, in the United States. But, he was very into analysis of movement. He had started in sports medicine and then he went into theater and he was friends with some of the most famous French artists of that period. But, he believed that artists had a responsibility to help change the world for the better. And, we actually studied things like architecture, we had to understand music and had to compose music. It was sort of like, really he synthesized a lot of ideas that I had had, because I liked more than one thing. I liked the whole process of creating something. And so, when I came back to the United States, I was much, all my friends had gone to New York to try to get an agent and make it. And, I was less thinking about my career but thinking about how could I effect change in the world or how could I be part of, participate in it? And so, I started doing, you know, literally started doing some street theater, doing different things. And then, I started getting teaching positions because I knew how to teach his techniques which were very much in demand. And so, I would say, that was the catalyst that got me thinking about the world. And, it was complete chance that Star Trek happened. I was not, really, I had done a lot of theater in New York City as an actor. I performed many, many, many plays and loved it because I loved transformation. So when Star Trek came up, I had actually already auditioned for a play I wanted to do with Linda Hunt and a director name Des McAnuff. So, believe it or not, this is real, I turned down Star Trek to go do this play for $400 a week. But you know what? I loved doing the play and I had no comprehension about the Star Trek Universe. I am so humbled now because I have learned more from the people I meet who have watched Star Trek. And yes, of course, I learned watching the show and I loved when my character would be involved in the Hippocratic oath working against the prime directive. I love that conflict. I thought that’s really what we need to look at things like that, you know, the ethics of things, all sorts of things. And so, I think, that’s for me, that’s really how I started to appreciate more and more how crucial Star Trek has been for so many people and for me. Because now, I feel such a bond in a community to people who really walk the walk, people like, I was telling them, Jim Wetherbee who commanded several Space Shuttle missions, became a friend. And, we emailed from the Space Station. I actually was like, you know, and I asked him. I said, why are you—you’re doing it, I’m just pretending. And he said, “Yes, but you’re the inspiration. And I like to think I have a lot of Jean-Luc Picard in me.” And, I went oh okay I get it, okay. So, I’m Dr. Crusher, I get it. And that kind of hope and inspiration, because our show was so positive. It wasn’t dystopian. It had a really, you know, we can work together as a community. I think that has been so important in my life right now to be a role model to young people both as a single parent, in the show, and also as a medical commander. And so, anyway, it’s a lot of talk, sorry I talked so long. But, that, for me, since I can’t really walk the walk like they do, I’m honored to be part of this panel.

[…]

Gates McFadden: Can I ask a question? A couple. I wanted to know if an astronaut has had some surgery that they have any piece of a metal screw or anything inside, are they, would they be prohibited from doing a mission? Or, the second part of that is what has been the most serious illness that has required some sort of intervention that has happened?

Richard Jennings: You’re talking about in space.

Gates McFadden: Yeah.

Richard Jennings: We had, the United States hasn’t really had much.

Gates McFadden: Okay.

Richard Jennings: We’ve been lucky. There’s a reason, it’s not lucky, truthfully, it is somewhat. Things can happen to people. But, for the most part, like, to give an example, let’s go back to the Apollo. They have a selection physical which is unbelievable. They have annual physicals. Then, for Apollo, they have physicals, fairly extensive, L minus 30 or F minus 30 they called it back then, 30 days before the mission, 15 days before the mission, 5 days before the mission, and they’re really looking at things. Like, we don’t carry dental equipment. But, they don’t allow any dental restorations for example.

Gates McFadden: They don’t okay.

Richard Jennings: And, three months before the flight, because new restorations are the ones most likely to cause problems. We have not had any. We, back to the Apollo program, on Apollo 15 one of the crew members had cardiac dysrhythmia.

Gates McFadden: Okay.

Richard Jennings: And, they thought it was due to potassium and it may have been. But, it turns out, this particular person had extensive coronary artery disease. This was before you could do calcium studies or—

Gates McFadden: Okay.

Richard Jennings: CT angiograms of coronary vessels. And he had extensive disease and, within two years of the flight he had a cardiac arrest due to a heart attack. The Russians have had some. They’ve had kidney stones, they’ve had some things happen. But, in general, we’ve been extremely lucky.

Gates McFadden: And what do they, like with the kidney stone, what happened, what did they do?

Richard Jennings: Well, you, for men you give them something to make their prostate smaller. You might hydrate them a little, use pain medication.

Gates McFadden: Pain medication.

Richard Jennings: Then you wait.

Gates McFadden: Yeah, yeah, but no one’s performed any real surgery.

Richard Jennings: Well, we do on animals some using a glove box. And, it’s been practiced in zero gravity and zero gravity airplanes. We’ve done laparoscopy, we’ve done cystoscopy, laparotomy, we’ve done all the things we can do but you did it in 22 second increments not in space.

Gates McFadden: Interesting.

Richard Jennings: Yeah.

Gates McFadden: Thank you.

Host: And so, Gates, kind of, we heard a little bit about what the very beginning of space medicine was like. In your world, that you played in.

Gates McFadden: Yeah Dr. Crusher was much more advanced.

Host: She was much more advanced.

Gates McFadden: I had quite a few degrees and yeah, right.

Host: Building on the legacy of people like Richard Jennings. But, what are some of the really kind of fantastical technologies that stood out for you that you got to interact with?

Gates McFadden: Well, I loved when, you know, we were replacing spines. And, first of all, the triquarter is just such an amazing machine. And, people have developed the triquarter now, it’s not out there, but Xprize actually had from all over the word, teams develop a triquarter. I mean, how fantastic is that? Because to be able to diagnose quickly and to be able to take the readings of everyone’s you know what’s going on in their body, you would know if someone had the heart arythmic thing. And so, I think there were so many fantastic things that that we were able to do in theoretical, you know, on the spaceship. One of the things that I really found I think about this quite a lot actually, is we had, so we had Data, all right. And he was android, so he’s the machine creature. But now, I know that, even in medicine, we put parts of the brain in that can make someone who’s had an arm amputated, it can make it so that they can function with a, you know, a new arm that’s there, a bionic arm. And, I think about things like privacy and how do you, what happens when..? We haven’t really done anything, I don’t know, I haven’t done it but, in, with the brain where there’s some sort of technology where they’re trying to deal with something like depression without, and I’m not talking schedules, but literally, you know, you have your own private thoughts. A computer doesn’t have their own private thoughts. And pretty soon, you know, it’s like what happens when the blend, do we ever get to that point? And, what are the ethical questions about that? And, I’m fascinated by that. I don’t know if I’m totally speaking, you know, asking something stupid, but, I’m interested.

[…]

Gates McFadden: Do you work with cryonics at all, I mean do you work with the idea of getting people like, theoretically, if you’re sick and you can’t really treat it but you can take their temperature down. Is that something that you all even talk about?

Kris Lehnhardt: So, there is actually a NASA project that is looking at advanced concepts. And, one of the concepts that they’re looking at is something like that, they call it TORPOR. And, basically it’s the idea of, can I slow down someone’s metabolism and essentially preserve them for longer because we’ve done that? And so, those are concepts that we still look at and we’re very interested in, in the future. But, we can’t even do that on the ground very well right now. So, NASA doesn’t like to fly things into space that we haven’t tested ad nauseum on the ground. And so, that one’s still many years away.

Gates McFadden: Thank you.

Host: And so, one of my favorite things about Star Trek and a lot of science fiction is actually the myriad of alien disease and things like that we end up running out to on the final frontier. Because, I mean, right now NASA, we’re mostly worried about people bringing stuff from Earth, with them, you know? That’s why we do the quarantine and stuff, things like that. Gates, what are some of the really memorable, you know, viruses or plagues that you guys had to combat that, you know, really stand out in your mind.

Gates McFadden: Well, of course there was the Naked Now, that makes you just kind of nicely drunk, I guess, that one was always very fun. But, its, and also what that actually brings up is, so if everyone has, is affected by this virus, how does the medical team, in spite of the effects of this virus, figure out, with the computer, what’s going on and how to solve it, and how to diagnose it, and then how to treat it? I mean, there were a lot of things like that. And, then, of course, there were invasive things that would take over your mind, and do all that. That’s why I think it’s fascinating, the psychological aspect of all of it, and how do you deal? I always have admired the astronauts, because, obviously, they’re going to be top notch people who are driven, who know how to do their program. And, it’s like the people who fly those fighter jets, you know exactly what you’re supposed to do so you’re not in terror. You’re like, I do this, then I do this, then I have to check this, and I work out now, and I do this. And that’s fantastic. But, just to be aware of, psychologically, all the things that you, that could be happening. When you said, when you can’t see Earth anymore, that was fascinating. Can you talk more about that? Because, to me, that’s the reason, I personally want to go into space, is so that I can actually look at Earth and get a new perspective. But once that’s not there, what’s that like? How do you deal with that?

[…]

Gates McFadden: And I think, see, I think that’s the part, and if I can?

Serena Auñón-Chancellor: Yes.

Gates McFadden: Like, again, it’s with Star Trek, because to be creative, you’re using parts of your brain, and you are imagining things. And just to engage the imagination, so that it’s not only scientific. I mean, obviously, you have to be imagining in order to be scientific. You wouldn’t even come up with the idea that you want to prove. But, I think, sometimes it’s getting away from it, totally, being out of your comfort zone, that you really can discover something about yourself. And discovering something about myself makes me much more engaged in the world. Like, oh, I didn’t realize I would be like that if I were doing this, or whatever. You learn about yourself. You’re interested in yourself, and less worried about being interesting. You’re interested, you know, in—

Serena Auñón-Chancellor: Yeah, and I think, one of the things we also did, just because the station is a very sterile environment, right? There are no smells of earth, there’s no wind, there’s no rain, you had the same people that you’re with. And, so, the one way we could make station more human on the inside was music. And I didn’t realize how important music, I mean, I listened to music down here, in my car, or wherever, but up there, we had music all the time. And depending on which module you were in, you could be listening to Queen or to Mozart, it just depended on who was working in that module at that time. But that, for me, made the Space Station so much more human, and it just felt like we belonged there, and this was ours.

Host: Well, so, so far we’ve only had to really worry about a limited number of people in space at any given time. Like, you only have 6 people, typically, 7 sometimes, on board the space station. In the future, we’re going to be in situations like Dr. Crusher was, where you have entire star ships worth of people, and entire colonies worth of people, especially as we have commercial companies starting to fly people into space. What do you guys see, kind of, over the horizon, and even, kind of, longer term in the world of space medicine?

Richard Jennings: Well, I’m really excited about commercial space flight, and the commercial crew program. I know how to count seats, and there’s a few more seats in those vehicles than just for the astronauts. And, so, we’ll be flying some other people. And there’ll eventually be free flyers in low Earth orbit, and colonization of Mars. Hopefully we’ll become a multiplanetary species. I’m excited about it. Up until now, all the people have been selected, pretty much, by agencies, bureaucracies, that sort of thing. And commercial space flight can be much more agile. Finally, it’ll have some nontraditional people flying up. We’ve had 8 that flew to the International Space Station through Space Adventures. And you have computer experts, you have artists, all different kinds of people, and that’s great. We need different people flying in space. One of the other things is that, back to going to the long duration flights, we’re going to have to learn how to take care of medical conditions that do develop, like Gates was talking about. We don’t have much experience in that. Well, where can we get it? Commercial space flight. Just like I said, you give up your youth and your health to be able to afford one of those flights, and it’s a little bit self-serving, for me, because I always have to get these guys approved to fly, but we ought to require that they have something wrong with them. Where else can we learn, unless we do that? And, so, I’m very excited. I’m excited that the numbers are going to increase, that we’ll have nontraditional crew members flying. I think the biggest issue will not be medical. It gets back to what you were just discussing, is the psychological aspect. And that’s why, I do think, a nice 6 month training program is a good deal. And if there are going to be problems, they’ll tend to come out. Most anybody can be on their best behavior for a couple of weeks, but if you put them in a stressful situations, teamwork, over 6 months, if there’s a problem, you’re going to find out about it. But I’m terribly excited about commercial space flight.

Gates McFadden: One of the, I went to Gene Roddenberry, my first year, I said, can I base a lot of my character on Dr. Oliver Sacks, who was this amazing neurologist. I had read all of his books up to, and he, you know, even now that he’s passed, he still has books that’ll come out. The most amazing things, because it’s all about neurology in the brain, and it’s such a burgeoning field, right now, as is radiology, which is enormous. But, it’s fascinating, just on earth, all the things the brain does. And when we go up in space, and all that we don’t know, and when it changes your entire perspective of the, of the universe, right? Your, my perspective would be completely changed. I’m not looking up like that, I’m looking around, and I’m either seeing nothing, or seeing the Earth small. That has to be profound. That certainly is something that would drive me, should I have the money, ever, to go up into space. I think that would be amazing.

Host: Well, Gates, I’m happy to pool my money with yours, and we can go together.

Gates McFadden: Alright!

Audience Member: Okay. My daughter is 13 years old. Your show is her favorite show. And you’re the one who made her want to be an astronaut. So, my question is, for a 13 year old girl going to high school, and everything, from a small town, what advice would you have for her going forward on a career path line?

Gates McFadden: Is she talking to me?

Serena Auñón-Chancellor: Both of us I think.

Gates McFadden: Me, both, or which one?

Audience Member: All of you.

Gates McFadden: I will say that I meet, every time I do a convention, I meet so many extraordinary, young women. I mean, really, the kids that come up to the table who are interested and know the show, they are sensational. I am a person who happens to believe that if these children grow up, and they become the people who are, you know, taking care of me in the old age, we’re going to be fine. Because they are interested in all sort of things, and I do feel that there’s too much pressure, I think, dealing with anxiety and having to do everything. That’s the one thing I noticed, more from being a teacher for 35 years on the university level. There’s way too much pressure on kids to know what they want to do so young. I mean, if you peak when you’re, you know, 7, what are you going to do for the rest of your life? So, I think that, I would advise not to push, expose children to a lot of different things, and see what they are drawn to. And then, if they’re drawn to it, then okay, then you can, sort of, guide a little bit more. But I feel having to make decisions of what they’re going to do, in their preschool years, is, it’s ridiculous. Because I have, some of the best people I’ve ever taught didn’t know what they were doing, and then they suddenly got passionate, and wow. It’s because they wanted it. You know? So, I think it’s both. It’s listening to advice, people say hey, you’re really good at this, listening to advice, and speaking up and asking questions. But I think it’s also, sometimes, for the parents to just, parents, just love them, you know, just love them. Yeah, great. Great.

Audience Member: So, hi. My name’s Natalie, and my question was for the people that are medical doctors. So, what do you do when you didn’t want to study at all? Personally, right now, I’m still in my premed years. I haven’t taken the MCAT yet, and I’m taking organic chemistry soon. So.

Gates McFadden: I mean, I think there’s even, I’m not speaking, now, for any astronaut thing, but I have a son who’s a violinist, and he, I mean, when, at certain points it was like, you have 100 pages of music you have to learn. And, I mean, it’s 9 hours of practice. And he, for years, he almost over practiced. And as he’s gotten older, and better and better, he’s learned that it’s better to just take a step back, do something totally different, even if it’s a type 20 minutes, and then you go back to it, and you actually plan how, you get more organized. That he actually is now, spends more time just creating, this is what I have to do in order to get to that concert. And he always plans in the breaks, and when he’s, you know, and he actually condenses, now, his practice time, and he sounds better, which is really fabulous. I wish I had known that.

Audience Member: I married up, didn’t I? Gates, I can’t think of a single character anywhere in the Star Trek universe with a higher sense of personal integrity than Doctor Beverly Crusher, so I thank you for that portrayal.

Gates McFadden: Thank you, very much.

Audience Member: I married up, didn’t I? Gates, I can’t think of a single character anywhere in the Star Trek universe with a higher sense of personal integrity than Doctor Beverly Crusher, so I thank you for that portrayal.

Gates McFadden: Thank you, very much.