Welcome to Today In Space podcast - and another People of Space segment. This week we have an expert in space medicine & health. As we enter an age where more and more humans go into space, to the moon, mars, and beyond - and even just in zero g - a better understanding about the wide spectrum of humans in space environments is needed.
And that's why I'm excited to introduce Dr Saralyn Mark expert in space medicine, women’s health, endocrinology, and geriatrics. As President and CEO of SolaMed Solutions, LLC and its space subsidiary, she advises organizations and agencies including NASA, HHS, and the White House on health and space-related policies and programs. Dr. Mark is also President of iGIANT®, the only nonprofit accelerating gendered innovation/precision design in the world.
Join us as we dive into Space Health with Dr. Mark and talk about the past, present, and future of human health & spaceflight!
Learn more about SolaMed Solutions, LLC here: solamedsolutions.com
Timestamps:
01:00 Dr. Sarah Lynn Mark's Journey and Early Inspirations
02:34 The Evolution of Space Medicine and Space Programs
05:15 Challenges and Opportunities in Human Space Flight
08:01 The Role of NASA and the Private Sector in Space Exploration
18:06 Gender and Health Considerations in Space
33:04 The Future of Space Medicine and Commercial Space Exploration
47:16 The Impact of Space Medicine & Inclusivity on Earth
48:51 The Potential for Space Tourism and Commercial Space Exploration
Here's to building a fantastic future - and continued progress in Space (and humanity)!
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Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:03):
Steve, welcome to Today InSpace. We're back for another
people of Space segment, andthis week, we have an expert in
space medicine and health, as weenter an age where more and more
humans go into space, to theMoon, Mars and beyond, and even
just in zero G, a betterunderstanding of the wide
spectrum of humans in spaceenvironments is needed, and
(00:26):
that's why we're excited tointroduce Dr Sarah Lynn mark,
expert in space medicine,women's health, endocrinology
and geriatrics, as President andCEO of SOLOMIN solutions LLC and
at Space subsidiary, she advisesorganizations and agencies,
including NASA HHS and the WhiteHouse on health and space
related policies and programs,something we definitely want to
(00:48):
talk about a little bit about,because that's exciting. But Dr
Mark is also the president of Igiant, the only nonprofit
accelerating gender innovationprecision design in the world.
Dr Mark,
welcome to the show. Thank youso much for having me. I'm
delighted to be here with you.
Yes, it's great to have you.Let's dive in and just start
from the beginning. We lovedoing an origin story for the
(01:09):
folks that come on, you're doinga whole bunch of stuff, and some
really cool stuff, like, wheredid it all start? Is there,
like, a moment early on? Andwhat was, what was your journey
like?
You know, I think all ourjourneys start when we're
children, there's something thatjust gets planted in us. And if
you follow what's inside you, itjust eventually leads you to
where you need to be. For mygeneration, I'm the Paula
(01:30):
generation. I actually got tosee people walk on the moon, hop
on the moon, and I rememberbeing a little girl growing up
in Colorado and looking up atthe moon, you know, around the
time of the Apollo flights, youknow, the mountains and the
backdrop saying, I want to dothat too. I actually, I wanted
to be a doctor practicing on themall. How specific is that? But
that's cool. What's amazingabout it is that I didn't know
(01:55):
at the time, women couldn't beastronauts. They weren't allowed
into the program, into the mid1970s Yeah, so I was this little
girl thinking I could do that.And, you know, fortunately,
nobody discouraged me. Theyencouraged me to just follow my
dreams. And it really that's howit happens. You know, it's not
that you set out on a course andyou got to keep your blinders
(02:15):
on. It's just doing what youyou're passionate about. And I
was fortunate to be able to getto go to medical school, get to
do what I loved in medicine, andthen got to apply to be an
astronaut, got to connect it toNASA, and then sort of the rest
is history, and it's been anincredible journey all along.
Yeah,
that I've as I've been able todo this podcast and talk to
(02:36):
people who are in the industryand providing services for the
industry and for places likeNASA, like that really is the
kind of the story for mostfolks. It's you end up you want
to go as an astronaut, or you'rereally interested in space, you
make a connection, you provide aservice, then you're in, and
then you find people, and thenthings happen. Yeah,
(02:57):
right. And I think you know,you're hitting on something
that's really important, andthat's finding people, finding
your tribe. The gifts that Ihave now with solar solutions is
that many of the people thatI've worked with over the
decades I'm not working withagain, you know, we've come
together at NASA, and here weare, and it's almost like we go
right back into those roles, asif decades hadn't passed since
(03:19):
we had worked together. That'sreally a phenomenal thing,
because we know each other sowell that that catalytic energy
is going to allow us to do whatwe need to do, to help people go
into space from the commercialspace side. Now,
yeah, and so, I mean, I'm, I'm aspace shuttle Hubble baby,
right? So I was born the sameyear that Hubble was put up, and
(03:45):
the space shuttle was really,really the only thing that I
knew about space, the spaceprogram. And when we think about
how things are going to I mean,they're accelerating right now
in the space program. Thispodcast, we follow it along.
Anyone who's paying attentionhas seen how much growth we've
had in the last 10 years. Butthat thing, that that
(04:08):
cohesiveness and those thosepartnerships and team working
ability, I mean, that's whatwe're going to need for this
next level to keep people safeand healthy moving forward,
right?
Absolutely, I think we have thegoal to democratize space. We
always talk about it where, youknow, there's space for all. We
want to make it accessible. ButI think what we've done is we've
(04:30):
taken the extraordinary and madeit ordinary, and it's not it's
just people have worked sobrilliantly to make it work. And
so you need people on top oftheir game. People understand
risk assessment and alsounderstand, you know, the
challenges of doing this, and aswell as conveying, you know, the
aura and the excitement and thejoy of it. And I think, coming
(04:53):
from NASA, coming from the spaceprogram, coming from the
programs that you justdescribed, we can translate a
lot of that experience. Us intowhere we need to go into the
future.
I love that. I love that. Andone of the things we've touched
on before on the podcast, andit's really interest me about
the health aspect, and with allthese new astronauts going up,
(05:14):
you mentioned, obviously, thatthat NASA didn't, didn't allow
women originally, and eventoday, there's still such a
limited resource of humans, Iguess, to be weird about it, but
like we, we do have a ton ofdata on these humans, but we
don't really have, like, it wasfighter pilots and the right
stuff and and it was a lot ofmilitary personnel and stuff.
(05:37):
But now we're kind of expandinginto this new pool of of
genetics and people. What? Whatdoes that look like for you,
especially with your expertise?I absolutely
love it, and I am so excitedabout it, and you are absolutely
correct. Yes, started with themilitary mindset. It was
military fighter pilots who werein the program, and that was
(05:58):
part of the reason why womenwere not part of it is because
one of the prereqs was that youhad to be a fighter pilot,
military pilot. Women were not.So there was something called
the mercury 13 group female,hopefully one day astronauts who
had come in to test and they didsuperbly Well, incredibly well.
(06:19):
But they missed that one part,and that was, they weren't
fighter pilots, and so that tookthem out of the equation. I
think what we have now is thatwe want to open it up to
everybody, and that means peopleare going to come with a whole
host of medical conditions. Youknow, being human, you have
medical issues. Yeah. So otherthan excluding out, we're
including in, and we're tryingto figure out ways to do it. And
(06:39):
you touched upon somethingreally important that's taking
precision medicine to apersonalized approach. So we're
going to begin to understand,really the genetic structure of
what makes us tick. Now, whatare your risks from a genetic
component? I call it Astroomics, and it's a way where
(07:01):
people may have differentsensitivities and different
reactions to differentenvironments, and, you know,
begin to tailor protocols tomeet the needs of the individual
so that they can travel safely,and, not only that, enjoy what
they're doing.
Yeah, that's a big part of it,right? Absolutely,
absolutely. And I thinkeverybody going into space. They
(07:21):
love it. It's very rare to findsomeone come back and say, do
this again. In fact, most peoplesay, let me stay up there, and
sometimes on terra firma. But Ithink what we want to do is make
it an enjoyable experience. Andfor what I call people going up
(07:41):
space explorers, because that'swhat they're exploring new
terrain. And we need to ensurethat we can do it very safely,
as safe as possible. Because ifthere's any weak link, then the
whole mission fails 100%
and it puts a whole flavor tothe people that you put together
on a mission, right, right?
Yeah. You know, there's a lot ofeffort from the NASA side, when
(08:02):
they're assembling their crew,they look at skill sets. They
look how well people interactwith each other. They look at so
many different competencies andcapabilities, I think, for the
commercial space sector, thatmight happen, but it may not be.
You know, the the driver thatyou have individuals who one can
afford to go, who want to go,and can make it happen, and then
(08:24):
you have to do the effort totrain them as a team. They work
very effortlessly, because,again, everybody's
interdependent. You're up there,and it's a hostile environment,
even though we make it so muchfun that you are very dependent
on each other. Let's
talk into some of the thingsthat people are dealing with in
(08:46):
space, I guess, like, what, whattypes of environments in space
have you looked into? I think,like, the most common one today
is the space station, obviously.But could you give us a
breakdown of that and when whatto expect?
You know, people don't realizewe've had a human presence in
space for decades. And youmentioned it. It's the
(09:06):
International Space Station,this beautiful, bright object in
the sky. And we've had peoplefrom all over the world. We've
had multitude of crew and reallya huge diverse core of
individuals who've gone up. Andit's been what we call the
International Space Station, thelaboratory. So a lot of
experiments are being done, andit's given us a wonderful
(09:27):
example of how can you survivein microgravity, in an
environment that's got radiationexposure and other environmental
exposures. There's a lot to it.And again, because NASA and
because of NASA's partners aswell, they've just made it look
effortlessly, yeah, to do, andit's not. It's very, very
(09:48):
challenging. So we translatethose lessons into the new space
stations that are being designedand going to be built. And I
think that is so incredible,because these are going to be
the. Commercial Space Stations.They're going to transport
people like you and me up intospace. Yeah, and not only that,
to live, to work, to explore,and then eventually, you know,
(10:11):
onto the moon, to Mars and otherlong duration missions. So we're
at a kind of The Twilight yearof actually, I don't want to say
twice. I want to say the dawn.It's the dawn of a new age. And
you know, we've seen a lot ofour space companies do that with
our low Earth orbit flies, suborbital flights, and now we're
(10:34):
going to take it to the nextlevel. Yeah, it's
very exciting. And you know,when I first started this
podcast, 10 years ago or so, andI was still getting my degree in
aerospace engineering at thetime, and at that time, the the
idea of NASA having more thanjust having to deal with the
(10:58):
political whims of differentadministrations going back and
forth and kind of usingCongress, using, you know, NASA
as a football. We kind of livein this age for better and for
worse, it has its it has its upsand has its downs, with the
private sector adding fuelunderneath the public side of
things with NASA, that eventhough there's all this chaos,
(11:21):
and the budget cuts are onething that are, that are
proposed right now. But 10 yearsago, if those budget cuts had
been introduced, NASA would havevery little chance right now.
And so we, we've had 10 years ofkind of like rocket fuel for the
commercial sector. And while itwould be great to be five years
(11:42):
ahead in progress right now,when this is happening, we at
least have that. So yeah, thesethese private stations are
exciting, and if the cost ofeverything can go down, we'll
just be able to do more withwhat we have. And I think that's
been a I mean, that was thespace shuttle's problem,
ultimately, was just the expenseof it, and it had been in, I
(12:05):
mean, almost four decades ofoperation. I mean, it's crazy to
think about. But yeah, how doyou see the the public and the
private space sector and like,where they are today, and maybe
some ways that you think theycould get together more that
they don't. Well,
you're getting on somethingimportant, and that's
partnerships. And fortunately,we've had the private sector, so
(12:29):
when we didn't have transport tothe station, we didn't have to
be completely dependent on theRussians. We had SpaceX, and
that was really a game changer,yeah, really a game changer to,
you know, provide anotheropportunity to get to the
station and not be dependent onanother country. And as you talk
about the political wins, Imean, that's certainly, it's
been a very, very successfulpartnership, but it does come
(12:53):
with some of those politicalovertones at times. You know, I
always see NASA as the crownjewel in the government, and
it's a political, non partisan,inspirational, mm, inspires
people not only to dream aboutgoing into space, but
encouraging people such as us togo into medicine, to go into
engineering, yeah, people gointo the arts that we need to
(13:17):
really, you know, be able tonurture it and not put it At a
political whim. So I don't thinkwe ever give enough to the
agency. Imagine if you gave evenmore. And you know, I, I had the
the privilege to meet AlanShepard, the first, yeah, he was
doing a book event at theSmithsonian. I hadn't even moved
to Washington yet. I was stillin my medical training, and I
(13:39):
came up with him just have himsign this book. And he asked me
what my discipline was. And Itold him, I'm the doc, but I
want to go into space. And heencouraged me to do it. And then
I read in his book, he said, youknow, the comfort level he felt
being strapped basically, to,you know, a vehicle that was
built by the lowest bidder. Yes.So that's what people don't
(14:01):
realize, is that when you're ingovernment, you're trying to
keep costs down because it's thetaxpayer money, but still do it
safely. So I think we have toget that story back into our
public conscience. We need toexpand the funding and ensure
that there's long livelihood. Imean, the worst thing that can
(14:23):
happen in the space program isyou course correct every four
years that think about how longit takes to develop a vehicle or
to develop a program or developa space suit, and then you're
changing the plans every fouryears. You're never going to go
anywhere. Yep. So there's, therehas to be that continuity. I
mean, we were so fortunate inthe 60s that, you know, Nixon
(14:47):
picked up after what Johnsonpicked up after what Kennedy had
put forth. Otherwise we'd stillsay, I think we could get to the
moon. Mm, hmm. Imagine, imagine,
yeah, and just in, like, think.Of the alternative world,
alternative universe, of like,what someone that didn't grow up
at that time, every time youtalk to someone who was was
(15:08):
young or just alive back thenand witnessed it. I mean, it's
it changed the culture. Itbecame, we put men on the moon.
Why can't we do this? You know,it was like this impossible
thing was possible
that became the standard aperson on the moon, we certainly
can do it. Or we used to say,it's not rocket science. Yeah,
(15:31):
we used to say, and I have abrother who actually, you know,
is a rocket engineer. So it's, Isaw what he went through, to go
through school and to do what heis doing. It's brutal. It's
really difficult. Medicine washard, and it is, and certainly
the time commitment. But youknow what he endured to go
(15:51):
through his schooling andexperiences? And we need all of
that. We need all those skillsets. Yeah,
yeah, absolutely, yeah. I'vebeen, you know, from my
perspective, having gone foraerospace engineering, I I'm
kind of like filtered to seekind of the engineering side of
things and how the lowest bidderoption can in some ways create
(16:16):
an environment where feedbackand descent and just the
scientific process, thecommunication can kind of get
blocked up. And it's not really,it's almost shamed for that
conversation to happen. Um, butthat's the engineering side. You
know? I think I, you know if, ifthe public side is the lowest
(16:38):
bidder, the private side is theleast paid employee, right? Like
there's it, there's always abalance of it. And you hope
that, because of the amazingstuff that they're doing, that
even though maybe you know thatthe the Apollo program was just
such a perfect unity for thecountry, and I know from some of
(17:02):
the people that I went to schoolwith that are working in these
programs like the private sectoroffers this, I don't want to
wait 10 years to launchsomething into space, yeah, you
know. And so it does attracttalent in that way.
It really does. I mean, thinkabout who the engineers are at
Blue Origin, or SpaceX orSierra, any other companies you
(17:26):
know, they have incrediblepedigree. Some of them have come
from the agency. And I think theother thing we have to keep in
mind is there's a different riskbenefit equation. When you're in
the government, you really tryto keep things to the lowest
risk as possible, because wedon't want to be brought before
Congress, or, as they said, youknow, above the front page, you
(17:47):
know, above the fold, about whathas happened. So the private
sector, in a sense, conveys anability to be a little more risk
taking a little more advancedadventuresome. But with that
said, I'm going to keep comingback to medicine. We are
careful, yes, and by beingcareful doesn't mean we have to
be slow or a showstopper. Wejust have to do it right. And
(18:09):
that's why, for me, creatingsolar med solutions into that
space obsidian, where we'regoing to focus on commercial
space medicine, bring in thebest of the best to develop the
concept of operations and thepolicies and the requirements
and the delivery of care and theeducational aspect of it, and to
be able to advise on a wholevariety of issues, anything from
ethics to telemedicine to someof the logistics of it, and
(18:34):
allows me to feel morecomfortable that we're going to
do the best that we can to keeppeople healthy in space and Not
only as they train, but whenthey're up there, and for when
they come back. Because when yougo into space, your body adapts.
It adapts to that environment.And some of it's not necessarily
good for when you come back tothe so we need to make sure we
get people back in their shape,into the best shape they can.
(18:56):
And then keep in mind we'regoing to have all ages and all
experiences and all issues, andI think it's just phenomenal.
It's gonna be so exciting to beable to work in that quote,
unquote space. Yeah,
absolutely. So you talk aboutpersonalized protocols in, like,
the future of of human spaceflight, what's, what are some
(19:17):
protocols, or maybe mindset thatyou go about, because it's
obviously individualized. Whatare some of those things that
you think about or that youoffer as a strategy for these
companies that are starting tosend people up there,
right? Well, keep in mind,there's something called Human
Factors. Let me give you acouple examples. That's sex,
(19:40):
gender, race, ethnicity, age,different ways that people
interact with theirenvironments. There's a lot that
goes into it. So we're not justthis one size fits all approach,
and it makes it easy if youcould take that approach, but it
just doesn't work, andespecially when you go into the
space environment where. Smalldifferences have profound
(20:02):
impact. So what you need to dois understand who's going up,
what makes them tick, what risksare they potentially going to
face? So for example, if you hada very thin woman who has a
history of bone mass loss hereon the planet, what risk for
losing bone mass in space, she'salready coming in at a deficit.
(20:25):
So, you know, how do you developa protocol to protect what bone
mass she has? And then what isgoing to what are going to be
your counter measures? And thenhow are you going to help her
rehabilitate? So when she comesback to the planet and is
exposed to gravity again, shedoesn't break her bones, right?
So that's example. I think, youknow, we have a world of
biomarkers. Some people are veryfast bone resorts, just ideas.
(20:47):
So if you know that, then youcan be a little bit more
aggressive in what you need todo to take care of there are
people who metabolize drugsdifferently here on Earth,
right? The precision medicinefor that. We do that. I mean, we
we're hearing, for example, withPresident Biden, that he has is,
(21:08):
is hormone sensitive, so changethe protocol that he may get. So
imagine, you know, we translatethat kind of knowledge into, you
know, how do people respond? Arethere certain therapeutics we
need to give them, and there'scertain nutritional aspects that
they need. There are people whodump calcium into their urine.
There are ways we can slow thatdown. So there's so many
(21:30):
different aspects. Every singlesystem of the body adapts from
cardiovascular to neurovestibular, sensorineural,
reproductive behavior,everything, everything, you
know, we look at the individualas an entire being, and then be
able to develop the protocolsand using the most cutting edge
(21:50):
technology so that we providethe safest experience for them.
That's
my mind was just racing with howboth exciting. This is how it
must be for you as as as adoctor, and like dealing with
humans, and also like you, youneed to move with speed, but
(22:12):
also be thorough at the sametime. And it must be such a I
mean, there's so many things youmentioned, obviously, with with
women, with your expertise, andthe fact that there is so little
there's that's such a a groundto be, to be discovered, right?
Like incredible.
I feel so fortunate that I wasable to have 18 years at NASA to
(22:36):
look at some of these issues. Wehosted, we chair two decadal
reviews to assess how the bodyadapts to space, looking at it
from a sex, gender lens, everysingle system. And it's so
fascinating. And then how do youtranslate those findings from
what you see in microgravity inspace to earth as a
endocrinologist and as ageriatrician, working in the
(23:00):
space program was just ideal,because, in a sense, it's almost
like a platform for acceleratedaging, and only that, you almost
kind of get to reverse what'shappening in space. It's, in a
sense, like reverse aging. Yeah,a lot of lessons that you can
share with the public here
so and so talking space economy.Because I think the next you
(23:23):
talked about the dawn of thisnext, like human space era, the
space economy comes up a lot,and I think at least my
perspective on it is, and I'mnot an economist, but it feels
like the space economy is reallymore of a an earth economy with
space based applications. It'snot like it's a self sustaining
(23:46):
like, you know, rockets aregoing up into space more often,
and there's more stuff onstation, but it's people aren't
starting entire budgets on spaceseparately. Or at least, I
haven't seen it, and I wouldlove to see that. So like, How
far along is some of this stufffor funding of space health on
(24:08):
the station? Like, what's what'sthat like navigating, just in
general, for for your, for yourindustry?
Well, you know, keep in mind,from the dawn of the space
program, flight medicine. Spacemedicine was there. And again,
there was so much to learn. Iremember having an afternoon
(24:29):
with Senator John Glenn. He hadjust come back from the United
station, I think it was STS 97and he said, You know, when we
went up, we didn't know what wasgoing to happen to the eyeballs.
We didn't know if they weregoing to pop it out. Just no
idea. And it was so fascinating,because you were truly going
into the unknown. So from thevery, very beginning, I mean,
(24:50):
the Think about when NeilArmstrong walked on the moon,
how fast his heartbeat wasgoing. You know, the first
indication of sinus tachycardiaon. Other, you know, Oh, wow. I
didn't know that whole body, youknow, think about, when you're
excited about something, howfast your heart is beating. Now,
imagine you're going to walk onthe moon. Oh, my God, on that.
(25:10):
And, you know, the history ofhumanity. So it's really, really
exciting. I mean, that wasagain, the beginning, in a
sense, of telemedicine, whichthink about, you know, during
the pandemic, that's what kepteverybody afloat. We utilized
our telehealth capabilities.And, you know, we're able to do
that all over the world, youknow, especially in very remote
areas. So there's incredibleapplications. So when I look at
(25:34):
the space program, I see it in acouple lens, what actually is up
there, what it takes to get upthere, and then the terrestrial
application of it, that techtransfer component. And so it's
really a very rich ecosystem. Iknow right now, a lot of people,
you know, talk about the newspace economy and the billions
(25:55):
and trillions that are goinginto it. We've been doing this
for decades, and it's just onlygoing to accelerate. And
especially, you know, thinkabout aviation going into going
on a plane in the 1960s and 70s.I mean, people actually dressed
up for it. It was getting a TVdinner was like the most
incredible
thing, sit at a bar. Yeah.
(26:17):
So this is where we're kind ofat right now. So 1020, years
from now, you know, let's sayyou need to go from New York to
Tokyo or to Australia. Imaginehaving a faster route, taking it
into space and moving your wayover the, you know, across the
planet. So think about thesespace ports that are popping up
(26:40):
everywhere. I find it reallyexciting, and I believe we're
going to utilize it. We justhave to have the commitment to
do it and not get diverted anddetoured by other crazy stuff
that happens. Yeah, well said,
well said, Could you describesome of the things, some of the
differences that you've seenbetween how women and men
(27:03):
experience or or, yeah, whenthey're in space, what happens
to their bodies?
Sure, and we have some wonderfuldecadal reviews. If you look at
the journal of women's health,we published that in 2014 all
findings from our six workgroups. I also highlighted
several of it in my book stellarmedicine, a journey through the
(27:24):
University of women's health.Little bit of a plug there. Plug
it. It's a part memoir, partguidebook, and it explores the
psychosocial and politicalenvironments which shape our
decisions. And that showseverything today. We see that,
and that's been going on formaternity. It's nothing new.
It's just we see it 24/7, now,um, but with the body, every
(27:46):
single system, and as Imentioned, it happens
dramatically. So, for example,cardiovascular system, when
women tend to return from space,they're at higher risk for
fading. We call that syncope.When you go into space, think
about it, all the fluid fromyour legs go up to your face,
you know, the moon faces, youknow, yes, cellulite gets
(28:08):
better. You get a little tall.Wrinkles disappear. But when you
come back to Earth, it all kindof resets back to the way you
are. But your receptors in yourbody say, Hey, we're volume
overload. So you start todiurese, since you're in a
sense, volume depleted when youcome back. So we try to volume
load pressure garments. Butwomen at our higher risk when
(28:29):
men feel stressed, testosterone,the male hormone, causes
friction in the blood vessels.So women, when they're stressed,
they tend to more vasodilate,and their heart rates go up.
You're at a risk if you'realready volume depleted, and
even if you're increasing yourheart rate, you still don't have
enough cardiac output, and yourbrain doesn't get enough blood,
(28:52):
so you may be at risk forfading. Oh, wow. You know, we're
way there ways we can managethat, but being attuned to that,
I think, is incrediblyimportant. I mean, just think
about on Earth, men and womenhave heart attacks, right? But
the presentation for women isbit different compared. So
that's atypical. It's not likethe male standards, the gold
standards, just different,right? So, you know, we're,
(29:13):
we're clued into that, andthere's one way just to
remember, like clots and bloodvessels and coronary artery
disease, men exposed, womenerode, and so the breaks down
into the vessel, whereas menjust kind of release all that
gunk into it and plot off. It'sreally fascinating. And again,
(29:34):
Understanding these differencesallow us to provide better
therapeutics and screening.Another really interesting area
is, is the the neuro vestibularand sensory nerve systems. We
used to call it visualimpairment in a cranial
pressure. And now you know spaceassisted neuro ocular syndrome,
(29:54):
and we see fluid pressure buildup in the eye. And what we found
is that men tend. Be moresymptomatic, they both seem to
develop it, but men tend to bemore symptomatic, and that can
cause blurred vision. And thereasons for it not quite known.
It may again be that women areused to accommodate volume
changes, like what you seethrough your menstrual cycles
(30:16):
and your pregnancy, and youknow, the different phases your
reproductive cycle, so the bodycan accommodate different
volume. It's just fascinating.You know, I mentioned, I talked
to you about bone mass. Womenare at higher risk for
developing fractures compared tomen. They don't build as much
bone density compared to men.Again, a hormonal connection
(30:36):
there. When you go into space,you begin losing bone mass very
quickly if you do nothing.That's why, with our astronauts,
they're exercising two, two anda half hours a day. It's
crazy. It's
tough, you know, going on, butyou have to maintain that bone
and muscle mass. We also look atdietary interventions so that
(30:57):
they're not leaching, you know,calcium into the bone.
Pharmaceuticals, maybe anotherway, and there's in even looking
at vibration and other ways tostimulate bone cells. So I mean
every single system, and thenthe psychological parameters are
really interesting too. We knowmen and women on earth respond
differently. Women are morelikely to be diagnosed with
(31:18):
depression. Unfortunately, onlyabout a quarter appropriately
treated and taken care of. Butwhat we see is that men and
women do equally well. It's justthey have different ways of of
interacting with theirenvironments and being attuned
to those differences. So it'sfascinating. And then there's a
lot of individual, individualvariability. So you know, we
(31:41):
have to keep that in mind. And Ithink that's where we just come
down to human factors andindividual we understand from a
population from a precisionapproach. Now let's take it to
the personalized approach, andthat's what supplement solutions
can do brilliantly. That's
amazing. It's
fascinating. Yeah, yeah, it'ssuch
(32:01):
a cool job. So I love yourthoughts. None of the political
stuff, but the Boeing Starlinerastronauts, Sonny Williams,
Butch wiltmore. It seems likesuch a great case study of like
emergent, I would emergency,like health, like, I know
(32:24):
there's planning for thismission could get extended for
whatever reason, but that feltlike it was an Apollo 13 esque,
like moment for space healthand, okay, you know, I don't
think the amount of time theywere going To be up there was
ever really set in stone. Itkind of always kept changing, at
least from the outside. What wasit like for you following that
(32:47):
on the outside? Well,
first of all, these are very,very well trained astronauts,
yes. And remember, they weretest pilots for a new vehicle,
and that's why you're quote,unquote, testing it. You know,
you've gone through what youcan, but then eventually you
have to put humans in there. Youhave to have a crew to see how
well, you know, you interactwith it, and it interacts with
(33:08):
you. So there are a lot of plansin place, you know, I It's
funny, I come from the place ofsomething is half empty, and I'm
very happy with that. Peopleare, you know, it's half full.
And people ask, you know, whyare you living in that
environment? And I just say, ifI can plan for everything I can
think of, it alleviates mystress. I'm prepared, and I'm
(33:29):
fine with that. If I come intosomething completely blind, I'm
not thinking about contingencyin different plans. It makes me
very anxious. So, yeah, it'sjust, you know, and I think if
you were to ask a lot of peoplewho've worked in the space
program, they probably have avery similar perspective. So,
oh, you know, something's gonewrong. Okay, this is Plan B.
We'll take that versus, no, Ican't. I haven't trained for
(33:53):
that. So they're very open,very, you know, able to adapt,
and very resilient. I think whatit showed was how well they were
trained and how well the crewthey were with was trying to
absorb them and bring them in.You know, NASA has an incredible
medical team, a great team offlight surgeons and medical
officers and people who knewthem well, so to keep them as
(34:15):
healthy as possible. Yeah, I'veoften thought, and I don't know
how popular this is, but thatthe crew that needs to go to
Mars actually should be olderindividuals. And the reason for
that is, I like that it's andthink about it. You know, first
of all, radiation exposure, thedevelopment of cancer, tends to
have a bit of a latency period.So little less concerning if
(34:38):
you're older and, you know, youhave it 20 years later, versus
you're in your 20s and 30s andearly 40s, and you're
experiencing this in quote,unquote, your crime. Two, I
think the psychosocial componentof it, you have nothing more to
prove you're doing it becauseyou want to leave the ground for
the next generation. Yeah,right. Um, three, you're just
(34:59):
well trained. You. Out a wholelife of experiences that you can
bring with you. And then four, Ithink it takes ageism out of our
society. Because, you know, sucha good job having people live
longer. If you go to cemeteriesaround the turn of the century,
you know, people died at 40s,50s. Yeah, it's actually
(35:20):
interesting. You're in theBoston area. You got your trove
of that to
learn history. We've got someold ones. Oh my gosh. You know,
you
see what's happened, and ittells a story. And now, you
know, it's just not unusual. Imean, look at President Carter
died around 100 and he had, youknow, metastatic melanoma, you
know brain cancer. And just wehave the technologies to keep
(35:42):
people alive, I just think itwould be phenomenal. And then
probably we could get AARP tounderwrite the flight. That'd be
amazing. Now, that's a goodsponsorship, right there. Yeah,
you get a discount for yourmission.
Oh, man, your Martian years,
and I guess the last part or sixpart would be, you're less
(36:04):
concerned about having to comeback, yeah, this might be your
final journey, in a sense, yeah.What an incredible way to do it,
you know, thank you would be,you know, laying the groundwork.
You're, you become the firstMartian see that your great,
great grandchildren wouldactually thrive there as best as
(36:25):
possible in that kind ofenvironment.
Yeah. The the the idea of itbeing similar to the colonists
that came over from America,just like getting on a ship and
going to New World,
world Plymouth. For I mean,think about it, yeah, yeah. And
it is usually hardships forpeople to do that. You know,
(36:47):
they had religious persecution,or, I guess, Australia, they
took the prisoners down toAustralia. It was generally
people wanting to get away fromsomething to create something
new. So now you're going towardssomething to create something
extraordinarily amazing for thenext generation, yeah,
(37:08):
yeah. And I think culturally, Ithink we are in this we have
been in this age. I have afeeling that it's changing. But
you know, respect for elders andfor experience really is kind of
at an all time low in theyounger generations. And I can
tell you, I mean as being 35 anelder millennial to them, an old
(37:34):
guy. You know, I do see at leastsome of the youngest generations
kind of flipping on that andseeing, seeing the experience
and actually wanting to talkabout it. So I think that from
an iconic thing would be reallypowerful. You know, I think when
I talk about this on thepodcast, I think space is the
(37:55):
setting for our next big moment,right? The like the space
conundrum of the first time, thethe Apollo era, right of of how
we got there, and how crazy theworld was, and has space
progress went up chaos andsociety went up, and we're smack
dab in that right now. And Ithink we're probably in the
(38:17):
Gemini era of that. So I thinkwe still have a long way to go
before that big moment, but I dothink that, like what's
happening now, could very wellset the groundwork for that
Walter Cronkite moment. For theyou know, whether those players
are in place yet is is one thingto be said, but what you're
(38:39):
describing is one of thosemoments that could be coming up.
I mean, in the next decade,which is wild, think about
it would be incredible. And thenthe other thing is, and we often
don't like to talk about it,but, you know, there's no risk
of pregnancy, and some of thoseissues that we wrestle
with interesting. Could you talkmore about that? Because that's
(39:00):
fascinating. Yeah,
I mean, it's, it's an importantarea. Reproductive Health is
very important. And you know,both for men and women on earth,
it's very politicized,especially for women's
reproductive health, where a lotof ethical issues, you know, can
you get pregnant in space? Andhow about, you know, if you're
(39:20):
on the Moon or Mars, where youhave 163, it's gravity. What's
the development of the fetus?And then, you know, the other
is, let's say you're able totake to term. You know, can that
individual come back to thisplanet? You know, when she when
it's developed in a differentyou know, perhaps by that time
you've created artificialgravity so you can train and
bring them back, but you know,you're also being bombarded by
(39:43):
radiation and otherenvironmental hazards. So it's
complicated. I had the goodfortune to create the, really,
one of the first policies in thegovernment on infertility
coverage, and I created it atNASA early on the turn of the
six. Injury, and it was aninfertility policy that still
(40:03):
stands in place, and it's formale and female astronauts.
Because, you know, we have thetechnology to do this. There
should be no genderdiscrimination that if one, you
know, wants to fly and they haveto be out of the queue, that
they can also have a family. Andagain, men and women are, you
know, it's 5050, equation, asense for infertility. Men and
(40:24):
women are impacted differently,especially in space.
Nonetheless, you have to thinkabout it. So, you know, we have
the technology to do that here.But let's say you're going to
colonize another planet, goingto the moon, you have to get
these issues. But for the firstmission, you don't want to think
about it. You sort about it. Youcertainly don't want to think
about an individual beingpregnant. And then, if there's
(40:47):
any complications, how do youmanage that? And then the other
thing, and we have to be carefulhow we talk about it. But yet, I
think it's important, because Iyou know, we've seen it down in
Antarctica and on ships, youknow, couples coming together,
yeah, and if we're going to makethis honeymoon destinations and,
(41:09):
you know, luxury expeditions andall that, we have to think about
these elements of what people donaturally. So, you know, how,
how do you handle that for 30day mission, but also for the
long duration mission, theexploration class missions to
Mars. So if you can take thatout of the equation, that part
(41:30):
of it, that's just one lessthing you have to worry about
and encounter.
Sure, yeah, so that's so that'sa protocol that exists today.
Well, the protocol, we have aninfertility policy at NASA.
There isn't a protocol. I mean,you know, astronauts are given
the option of the in on birthcontrol, one to control their
cycles. But again, it's not theissue for our professional
(41:53):
astronauts right now. But ifwe're going to make commercial
space exploration destinationYeah, our tourism world part of
what we want to do for enjoymentand fun. I think we have to be
clever, and we have to thinkabout these things. Yeah,
wow, that's, that's somethingI'd never really fully
(42:14):
considered. That's wild,
yeah? Because now that you'vegone down that path, you're
going to be thinking about it.It's actually something, I
think, important because, youknow, we we can't put taboo on
any aspect of our health. Needsto be able to discuss it. We
need to look at the ethicalissues, the medical issues, the
legal issues, so that we ensurepeople are healthy. And whatever
(42:38):
happens up there is healthmaintains that health
Absolutely,
and especially for like a Marsor or a lunar mission, just the
reality of the physics of thesituation, like, you know, if
some, if you need new suppliesor or more supplies, you're
You're rationing now for foranother person, that's, that's
(43:03):
not necessarily a curveball. Youwant to get unexpected, and it
would be, it would, it wouldactually be irresponsible not to
consider that. Yeah, yeah,
we'd be, I think it'd be aninteresting discussion. So we
have Dr Paul root while P as ourchief ethicist for smallmed
Solutions. And I think, youknow, if we were to hold sort of
(43:23):
a workshop or round table aboutsome of these issues, I think it
would behoove us just begindiscussing it in a very
sensitive, yeah, also proactiveapproach, what we need to think
about, because you cannot benaive. You just can't be No,
yeah, yeah. And then, andthat's, these are the kind of
things, the the blind spots, ifyou will, of the old fighter
(43:47):
pilot days that were neverreally fully considered that as
we look at a at an inclusivelook of we're sending everybody,
yeah, I would be totally downfor that conversation, yeah.
And then take it to the nextlevel. Elon Musk has talked
about, you know, Martiancolonies. How does that work?
(44:08):
And, yeah, do we provide, youknow, special gravity rooms so,
you know, you develop and thendo we have shielding, of course,
for radiation? I mean, there'sso much that goes into it, you
know, coming across the AtlanticOcean from England to Plymouth
Rock. You had to traverse theocean. But once you got here,
you know, you called your townthe same town that you came
(44:30):
from, and there's still landswater wasn't like you were
coming into a completely newworld, right? And to face, you
know, entirely new territory andand landscapes and hazards,
yeah,
yeah, the colony setup is goingto be very interesting. And I'm
(44:51):
sure the plans for whatever isgoing into that are happening
now, you know, like thosediscussions are happening. And I
think you. So, you know, as wethink about prepping for the
future, and as you're thisexpert that you know we we want
to make sure that your voice isgetting out there, the more we
can have those conversationsnow, the more repetitions we'll
(45:15):
have with those ideas, and thenthe better our solutions or
troubleshooting can be, right?Yeah. I
mean, it's really, it comes downto brainstorming. Mm and sylamed
summit has three pillars. It hasour people, our programs and our
partnerships, and we work acrossthree verticals, our advisory
group, our educational outreach,and then certainly the
(45:36):
operational and everything'svery integrated, tied together.
And I could really see, youknow, just bringing together
people from differentenvironments, coming and looking
at some challenging questionsand speaking their mind. You
know, there's no right, there'sno wrong. We just need to play
it out to see how things wouldwork, so that we're prepared. I
(45:59):
also come from the pandemicplanning ecosystem was the
civilian medical advisor to twosurgeons general, and then
certainly to the Chief MedicalOfficer at NASA and at HHS as
well. And you know, you look atdifferent scenarios so that when
you are faced with thesituation, you know how to
(46:19):
handle it. You can pivot assituations change, because you,
you table topped it, you're ableto maneuver.
That's, I love that you saidthat, yeah, there's, there's so
much to this that, you know, youjust scratched the surface of
it, and you realize, wow,there's, there's this whole
world. Dr, Mark, thank you somuch for for coming on. I wanted
(46:43):
to leave the floor to you at theend here for any kind of closing
thoughts or anything we didn'ttouch on that you'd like us to
touch on. It's been, it's been apleasure. Thank
you. It's been a joy to speakwith you as well. I just think,
for folks that are coming intothis, just follow your passion.
If you're an artist, followthat, maybe you'll be an artist
on the moon. You know, noteveryone's going to take the
(47:06):
same course, and we need to havea variety of disciplines. I go
back to the days of AlanShepard, when he asked me, what
my, you know, discipline was. Itjust indicated to me, you can
come from many walks of life,and need to bring that, you
know, to whatever you're goingto do. And then I think, from
the commercial space medicinepart of it, we're going to be in
an environment of inclusion. Sowe have to be creative. We're
(47:29):
going to have to devise as we goalong, but ensuring that
standards are met. And then wehave to ask, as as a pupil, what
risk are we willing to assumereally difficult discussion, but
we have to be attuned to it. AndI don't want to leave on that
note. I want to leave on theNote that we learned from every
(47:50):
experience. We learned fromevery experience, and are
certainly our space program ismarked by that where there's
been, you know, incrediblechallenges and incredible highs,
and we've learned from all ofit. So I'm just excited what
we're able to do, and I'm justso grateful to be able to work
with such brilliant people tohelp do this
(48:11):
absolutely. I mean, this isexploration, like, like you
mentioned, so so well, like,exploration doesn't come without
risk, and that doesn't mean thatyou need to just take on risk
for no reason. You can plan andadjust along the way. That's the
whole that's the whole thing,beautiful. All right, where can
folks find you? Really? Yes,
(48:33):
you can find me at solomedSolutions, and you can also find
me at my nonprofit. I giant, IG, I A N T and I look forward to
hearing from you awesome
Dr, Sarah and Mark, thank you somuch for being on the podcast.
Pleasure. All right, folks, bewell. Spread science. Spread
love and spread science. Staycurious, and we'll see you on
(48:55):
the next episode of Today InSpace. See ya.
Steve, welcome to Today InSpace. We're back for another
people of Space segment, andthis week, we have an expert in
space medicine and health, as weenter an age where more and more
humans go into space, to theMoon, Mars and beyond, and even
just in zero G, a betterunderstanding of the wide
spectrum of humans in spaceenvironments is needed, and
(00:26):
that's why we're excited tointroduce Dr Sarah Lynn mark,
expert in space medicine,women's health, endocrinology
and geriatrics, as President andCEO of SOLOMIN solutions LLC and
at Space subsidiary, she advisesorganizations and agencies,
including NASA HHS and the WhiteHouse on health and space
related policies and programs,something we definitely want to
(00:48):
talk about a little bit about,because that's exciting. But Dr
Mark is also the president of Igiant, the only nonprofit
accelerating gender innovationprecision design in the world.
Dr Mark,
welcome to the show. Thank youso much for having me. I'm
delighted to be here with you.
Yes, it's great to have you.Let's dive in and just start
from the beginning. We lovedoing an origin story for the
(01:09):
folks that come on, you're doinga whole bunch of stuff, and some
really cool stuff, like, wheredid it all start? Is there,
like, a moment early on? Andwhat was, what was your journey
like?
You know, I think all ourjourneys start when we're
children, there's something thatjust gets planted in us. And if
you follow what's inside you, itjust eventually leads you to
where you need to be. For mygeneration, I'm the Paula
(01:30):
generation. I actually got tosee people walk on the moon, hop
on the moon, and I rememberbeing a little girl growing up
in Colorado and looking up atthe moon, you know, around the
time of the Apollo flights, youknow, the mountains and the
backdrop saying, I want to dothat too. I actually, I wanted
to be a doctor practicing on themall. How specific is that? But
that's cool. What's amazingabout it is that I didn't know
(01:55):
at the time, women couldn't beastronauts. They weren't allowed
into the program, into the mid1970s Yeah, so I was this little
girl thinking I could do that.And, you know, fortunately,
nobody discouraged me. Theyencouraged me to just follow my
dreams. And it really that's howit happens. You know, it's not
that you set out on a course andyou got to keep your blinders
(02:15):
on. It's just doing what youyou're passionate about. And I
was fortunate to be able to getto go to medical school, get to
do what I loved in medicine, andthen got to apply to be an
astronaut, got to connect it toNASA, and then sort of the rest
is history, and it's been anincredible journey all along.
Yeah,
that I've as I've been able todo this podcast and talk to
(02:36):
people who are in the industryand providing services for the
industry and for places likeNASA, like that really is the
kind of the story for mostfolks. It's you end up you want
to go as an astronaut, or you'rereally interested in space, you
make a connection, you provide aservice, then you're in, and
then you find people, and thenthings happen. Yeah,
(02:57):
right. And I think you know,you're hitting on something
that's really important, andthat's finding people, finding
your tribe. The gifts that Ihave now with solar solutions is
that many of the people thatI've worked with over the
decades I'm not working withagain, you know, we've come
together at NASA, and here weare, and it's almost like we go
right back into those roles, asif decades hadn't passed since
(03:19):
we had worked together. That'sreally a phenomenal thing,
because we know each other sowell that that catalytic energy
is going to allow us to do whatwe need to do, to help people go
into space from the commercialspace side. Now,
yeah, and so, I mean, I'm, I'm aspace shuttle Hubble baby,
right? So I was born the sameyear that Hubble was put up, and
(03:45):
the space shuttle was really,really the only thing that I
knew about space, the spaceprogram. And when we think about
how things are going to I mean,they're accelerating right now
in the space program. Thispodcast, we follow it along.
Anyone who's paying attentionhas seen how much growth we've
had in the last 10 years. Butthat thing, that that
(04:08):
cohesiveness and those thosepartnerships and team working
ability, I mean, that's whatwe're going to need for this
next level to keep people safeand healthy moving forward,
right?
Absolutely, I think we have thegoal to democratize space. We
always talk about it where, youknow, there's space for all. We
want to make it accessible. ButI think what we've done is we've
(04:30):
taken the extraordinary and madeit ordinary, and it's not it's
just people have worked sobrilliantly to make it work. And
so you need people on top oftheir game. People understand
risk assessment and alsounderstand, you know, the
challenges of doing this, and aswell as conveying, you know, the
aura and the excitement and thejoy of it. And I think, coming
(04:53):
from NASA, coming from the spaceprogram, coming from the
programs that you justdescribed, we can translate a
lot of that experience. Us intowhere we need to go into the
future.
I love that. I love that. Andone of the things we've touched
on before on the podcast, andit's really interest me about
the health aspect, and with allthese new astronauts going up,
(05:14):
you mentioned, obviously, thatthat NASA didn't, didn't allow
women originally, and eventoday, there's still such a
limited resource of humans, Iguess, to be weird about it, but
like we, we do have a ton ofdata on these humans, but we
don't really have, like, it wasfighter pilots and the right
stuff and and it was a lot ofmilitary personnel and stuff.
(05:37):
But now we're kind of expandinginto this new pool of of
genetics and people. What? Whatdoes that look like for you,
especially with your expertise?I absolutely
love it, and I am so excitedabout it, and you are absolutely
correct. Yes, started with themilitary mindset. It was
military fighter pilots who werein the program, and that was
(05:58):
part of the reason why womenwere not part of it is because
one of the prereqs was that youhad to be a fighter pilot,
military pilot. Women were not.So there was something called
the mercury 13 group female,hopefully one day astronauts who
had come in to test and they didsuperbly Well, incredibly well.
(06:19):
But they missed that one part,and that was, they weren't
fighter pilots, and so that tookthem out of the equation. I
think what we have now is thatwe want to open it up to
everybody, and that means peopleare going to come with a whole
host of medical conditions. Youknow, being human, you have
medical issues. Yeah. So otherthan excluding out, we're
including in, and we're tryingto figure out ways to do it. And
(06:39):
you touched upon somethingreally important that's taking
precision medicine to apersonalized approach. So we're
going to begin to understand,really the genetic structure of
what makes us tick. Now, whatare your risks from a genetic
component? I call it Astroomics, and it's a way where
(07:01):
people may have differentsensitivities and different
reactions to differentenvironments, and, you know,
begin to tailor protocols tomeet the needs of the individual
so that they can travel safely,and, not only that, enjoy what
they're doing.
Yeah, that's a big part of it,right? Absolutely,
absolutely. And I thinkeverybody going into space. They
(07:21):
love it. It's very rare to findsomeone come back and say, do
this again. In fact, most peoplesay, let me stay up there, and
sometimes on terra firma. But Ithink what we want to do is make
it an enjoyable experience. Andfor what I call people going up
(07:41):
space explorers, because that'swhat they're exploring new
terrain. And we need to ensurethat we can do it very safely,
as safe as possible. Because ifthere's any weak link, then the
whole mission fails 100%
and it puts a whole flavor tothe people that you put together
on a mission, right, right?
Yeah. You know, there's a lot ofeffort from the NASA side, when
(08:02):
they're assembling their crew,they look at skill sets. They
look how well people interactwith each other. They look at so
many different competencies andcapabilities, I think, for the
commercial space sector, thatmight happen, but it may not be.
You know, the the driver thatyou have individuals who one can
afford to go, who want to go,and can make it happen, and then
(08:24):
you have to do the effort totrain them as a team. They work
very effortlessly, because,again, everybody's
interdependent. You're up there,and it's a hostile environment,
even though we make it so muchfun that you are very dependent
on each other. Let's
talk into some of the thingsthat people are dealing with in
(08:46):
space, I guess, like, what, whattypes of environments in space
have you looked into? I think,like, the most common one today
is the space station, obviously.But could you give us a
breakdown of that and when whatto expect?
You know, people don't realizewe've had a human presence in
space for decades. And youmentioned it. It's the
(09:06):
International Space Station,this beautiful, bright object in
the sky. And we've had peoplefrom all over the world. We've
had multitude of crew and reallya huge diverse core of
individuals who've gone up. Andit's been what we call the
International Space Station, thelaboratory. So a lot of
experiments are being done, andit's given us a wonderful
(09:27):
example of how can you survivein microgravity, in an
environment that's got radiationexposure and other environmental
exposures. There's a lot to it.And again, because NASA and
because of NASA's partners aswell, they've just made it look
effortlessly, yeah, to do, andit's not. It's very, very
(09:48):
challenging. So we translatethose lessons into the new space
stations that are being designedand going to be built. And I
think that is so incredible,because these are going to be
the. Commercial Space Stations.They're going to transport
people like you and me up intospace. Yeah, and not only that,
to live, to work, to explore,and then eventually, you know,
(10:11):
onto the moon, to Mars and otherlong duration missions. So we're
at a kind of The Twilight yearof actually, I don't want to say
twice. I want to say the dawn.It's the dawn of a new age. And
you know, we've seen a lot ofour space companies do that with
our low Earth orbit flies, suborbital flights, and now we're
(10:34):
going to take it to the nextlevel. Yeah, it's
very exciting. And you know,when I first started this
podcast, 10 years ago or so, andI was still getting my degree in
aerospace engineering at thetime, and at that time, the the
idea of NASA having more thanjust having to deal with the
(10:58):
political whims of differentadministrations going back and
forth and kind of usingCongress, using, you know, NASA
as a football. We kind of livein this age for better and for
worse, it has its it has its upsand has its downs, with the
private sector adding fuelunderneath the public side of
things with NASA, that eventhough there's all this chaos,
(11:21):
and the budget cuts are onething that are, that are
proposed right now. But 10 yearsago, if those budget cuts had
been introduced, NASA would havevery little chance right now.
And so we, we've had 10 years ofkind of like rocket fuel for the
commercial sector. And while itwould be great to be five years
(11:42):
ahead in progress right now,when this is happening, we at
least have that. So yeah, thesethese private stations are
exciting, and if the cost ofeverything can go down, we'll
just be able to do more withwhat we have. And I think that's
been a I mean, that was thespace shuttle's problem,
ultimately, was just the expenseof it, and it had been in, I
(12:05):
mean, almost four decades ofoperation. I mean, it's crazy to
think about. But yeah, how doyou see the the public and the
private space sector and like,where they are today, and maybe
some ways that you think theycould get together more that
they don't. Well,
you're getting on somethingimportant, and that's
partnerships. And fortunately,we've had the private sector, so
(12:29):
when we didn't have transport tothe station, we didn't have to
be completely dependent on theRussians. We had SpaceX, and
that was really a game changer,yeah, really a game changer to,
you know, provide anotheropportunity to get to the
station and not be dependent onanother country. And as you talk
about the political wins, Imean, that's certainly, it's
been a very, very successfulpartnership, but it does come
(12:53):
with some of those politicalovertones at times. You know, I
always see NASA as the crownjewel in the government, and
it's a political, non partisan,inspirational, mm, inspires
people not only to dream aboutgoing into space, but
encouraging people such as us togo into medicine, to go into
engineering, yeah, people gointo the arts that we need to
(13:17):
really, you know, be able tonurture it and not put it At a
political whim. So I don't thinkwe ever give enough to the
agency. Imagine if you gave evenmore. And you know, I, I had the
the privilege to meet AlanShepard, the first, yeah, he was
doing a book event at theSmithsonian. I hadn't even moved
to Washington yet. I was stillin my medical training, and I
(13:39):
came up with him just have himsign this book. And he asked me
what my discipline was. And Itold him, I'm the doc, but I
want to go into space. And heencouraged me to do it. And then
I read in his book, he said, youknow, the comfort level he felt
being strapped basically, to,you know, a vehicle that was
built by the lowest bidder. Yes.So that's what people don't
(14:01):
realize, is that when you're ingovernment, you're trying to
keep costs down because it's thetaxpayer money, but still do it
safely. So I think we have toget that story back into our
public conscience. We need toexpand the funding and ensure
that there's long livelihood. Imean, the worst thing that can
(14:23):
happen in the space program isyou course correct every four
years that think about how longit takes to develop a vehicle or
to develop a program or developa space suit, and then you're
changing the plans every fouryears. You're never going to go
anywhere. Yep. So there's, therehas to be that continuity. I
mean, we were so fortunate inthe 60s that, you know, Nixon
(14:47):
picked up after what Johnsonpicked up after what Kennedy had
put forth. Otherwise we'd stillsay, I think we could get to the
moon. Mm, hmm. Imagine, imagine,
yeah, and just in, like, think.Of the alternative world,
alternative universe, of like,what someone that didn't grow up
at that time, every time youtalk to someone who was was
(15:08):
young or just alive back thenand witnessed it. I mean, it's
it changed the culture. Itbecame, we put men on the moon.
Why can't we do this? You know,it was like this impossible
thing was possible
that became the standard aperson on the moon, we certainly
can do it. Or we used to say,it's not rocket science. Yeah,
(15:31):
we used to say, and I have abrother who actually, you know,
is a rocket engineer. So it's, Isaw what he went through, to go
through school and to do what heis doing. It's brutal. It's
really difficult. Medicine washard, and it is, and certainly
the time commitment. But youknow what he endured to go
(15:51):
through his schooling andexperiences? And we need all of
that. We need all those skillsets. Yeah,
yeah, absolutely, yeah. I'vebeen, you know, from my
perspective, having gone foraerospace engineering, I I'm
kind of like filtered to seekind of the engineering side of
things and how the lowest bidderoption can in some ways create
(16:16):
an environment where feedbackand descent and just the
scientific process, thecommunication can kind of get
blocked up. And it's not really,it's almost shamed for that
conversation to happen. Um, butthat's the engineering side. You
know? I think I, you know if, ifthe public side is the lowest
(16:38):
bidder, the private side is theleast paid employee, right? Like
there's it, there's always abalance of it. And you hope
that, because of the amazingstuff that they're doing, that
even though maybe you know thatthe the Apollo program was just
such a perfect unity for thecountry, and I know from some of
(17:02):
the people that I went to schoolwith that are working in these
programs like the private sectoroffers this, I don't want to
wait 10 years to launchsomething into space, yeah, you
know. And so it does attracttalent in that way.
It really does. I mean, thinkabout who the engineers are at
Blue Origin, or SpaceX orSierra, any other companies you
(17:26):
know, they have incrediblepedigree. Some of them have come
from the agency. And I think theother thing we have to keep in
mind is there's a different riskbenefit equation. When you're in
the government, you really tryto keep things to the lowest
risk as possible, because wedon't want to be brought before
Congress, or, as they said, youknow, above the front page, you
(17:47):
know, above the fold, about whathas happened. So the private
sector, in a sense, conveys anability to be a little more risk
taking a little more advancedadventuresome. But with that
said, I'm going to keep comingback to medicine. We are
careful, yes, and by beingcareful doesn't mean we have to
be slow or a showstopper. Wejust have to do it right. And
(18:09):
that's why, for me, creatingsolar med solutions into that
space obsidian, where we'regoing to focus on commercial
space medicine, bring in thebest of the best to develop the
concept of operations and thepolicies and the requirements
and the delivery of care and theeducational aspect of it, and to
be able to advise on a wholevariety of issues, anything from
ethics to telemedicine to someof the logistics of it, and
(18:34):
allows me to feel morecomfortable that we're going to
do the best that we can to keeppeople healthy in space and Not
only as they train, but whenthey're up there, and for when
they come back. Because when yougo into space, your body adapts.
It adapts to that environment.And some of it's not necessarily
good for when you come back tothe so we need to make sure we
get people back in their shape,into the best shape they can.
(18:56):
And then keep in mind we'regoing to have all ages and all
experiences and all issues, andI think it's just phenomenal.
It's gonna be so exciting to beable to work in that quote,
unquote space. Yeah,
absolutely. So you talk aboutpersonalized protocols in, like,
the future of of human spaceflight, what's, what are some
(19:17):
protocols, or maybe mindset thatyou go about, because it's
obviously individualized. Whatare some of those things that
you think about or that youoffer as a strategy for these
companies that are starting tosend people up there,
right? Well, keep in mind,there's something called Human
Factors. Let me give you acouple examples. That's sex,
(19:40):
gender, race, ethnicity, age,different ways that people
interact with theirenvironments. There's a lot that
goes into it. So we're not justthis one size fits all approach,
and it makes it easy if youcould take that approach, but it
just doesn't work, andespecially when you go into the
space environment where. Smalldifferences have profound
(20:02):
impact. So what you need to dois understand who's going up,
what makes them tick, what risksare they potentially going to
face? So for example, if you hada very thin woman who has a
history of bone mass loss hereon the planet, what risk for
losing bone mass in space, she'salready coming in at a deficit.
(20:25):
So, you know, how do you developa protocol to protect what bone
mass she has? And then what isgoing to what are going to be
your counter measures? And thenhow are you going to help her
rehabilitate? So when she comesback to the planet and is
exposed to gravity again, shedoesn't break her bones, right?
So that's example. I think, youknow, we have a world of
biomarkers. Some people are veryfast bone resorts, just ideas.
(20:47):
So if you know that, then youcan be a little bit more
aggressive in what you need todo to take care of there are
people who metabolize drugsdifferently here on Earth,
right? The precision medicinefor that. We do that. I mean, we
we're hearing, for example, withPresident Biden, that he has is,
(21:08):
is hormone sensitive, so changethe protocol that he may get. So
imagine, you know, we translatethat kind of knowledge into, you
know, how do people respond? Arethere certain therapeutics we
need to give them, and there'scertain nutritional aspects that
they need. There are people whodump calcium into their urine.
There are ways we can slow thatdown. So there's so many
(21:30):
different aspects. Every singlesystem of the body adapts from
cardiovascular to neurovestibular, sensorineural,
reproductive behavior,everything, everything, you
know, we look at the individualas an entire being, and then be
able to develop the protocolsand using the most cutting edge
(21:50):
technology so that we providethe safest experience for them.
That's
my mind was just racing with howboth exciting. This is how it
must be for you as as as adoctor, and like dealing with
humans, and also like you, youneed to move with speed, but
(22:12):
also be thorough at the sametime. And it must be such a I
mean, there's so many things youmentioned, obviously, with with
women, with your expertise, andthe fact that there is so little
there's that's such a a groundto be, to be discovered, right?
Like incredible.
I feel so fortunate that I wasable to have 18 years at NASA to
(22:36):
look at some of these issues. Wehosted, we chair two decadal
reviews to assess how the bodyadapts to space, looking at it
from a sex, gender lens, everysingle system. And it's so
fascinating. And then how do youtranslate those findings from
what you see in microgravity inspace to earth as a
endocrinologist and as ageriatrician, working in the
(23:00):
space program was just ideal,because, in a sense, it's almost
like a platform for acceleratedaging, and only that, you almost
kind of get to reverse what'shappening in space. It's, in a
sense, like reverse aging. Yeah,a lot of lessons that you can
share with the public here
so and so talking space economy.Because I think the next you
(23:23):
talked about the dawn of thisnext, like human space era, the
space economy comes up a lot,and I think at least my
perspective on it is, and I'mnot an economist, but it feels
like the space economy is reallymore of a an earth economy with
space based applications. It'snot like it's a self sustaining
(23:46):
like, you know, rockets aregoing up into space more often,
and there's more stuff onstation, but it's people aren't
starting entire budgets on spaceseparately. Or at least, I
haven't seen it, and I wouldlove to see that. So like, How
far along is some of this stufffor funding of space health on
(24:08):
the station? Like, what's what'sthat like navigating, just in
general, for for your, for yourindustry?
Well, you know, keep in mind,from the dawn of the space
program, flight medicine. Spacemedicine was there. And again,
there was so much to learn. Iremember having an afternoon
(24:29):
with Senator John Glenn. He hadjust come back from the United
station, I think it was STS 97and he said, You know, when we
went up, we didn't know what wasgoing to happen to the eyeballs.
We didn't know if they weregoing to pop it out. Just no
idea. And it was so fascinating,because you were truly going
into the unknown. So from thevery, very beginning, I mean,
(24:50):
the Think about when NeilArmstrong walked on the moon,
how fast his heartbeat wasgoing. You know, the first
indication of sinus tachycardiaon. Other, you know, Oh, wow. I
didn't know that whole body, youknow, think about, when you're
excited about something, howfast your heart is beating. Now,
imagine you're going to walk onthe moon. Oh, my God, on that.
(25:10):
And, you know, the history ofhumanity. So it's really, really
exciting. I mean, that wasagain, the beginning, in a
sense, of telemedicine, whichthink about, you know, during
the pandemic, that's what kepteverybody afloat. We utilized
our telehealth capabilities.And, you know, we're able to do
that all over the world, youknow, especially in very remote
areas. So there's incredibleapplications. So when I look at
(25:34):
the space program, I see it in acouple lens, what actually is up
there, what it takes to get upthere, and then the terrestrial
application of it, that techtransfer component. And so it's
really a very rich ecosystem. Iknow right now, a lot of people,
you know, talk about the newspace economy and the billions
(25:55):
and trillions that are goinginto it. We've been doing this
for decades, and it's just onlygoing to accelerate. And
especially, you know, thinkabout aviation going into going
on a plane in the 1960s and 70s.I mean, people actually dressed
up for it. It was getting a TVdinner was like the most
incredible
thing, sit at a bar. Yeah.
(26:17):
So this is where we're kind ofat right now. So 1020, years
from now, you know, let's sayyou need to go from New York to
Tokyo or to Australia. Imaginehaving a faster route, taking it
into space and moving your wayover the, you know, across the
planet. So think about thesespace ports that are popping up
(26:40):
everywhere. I find it reallyexciting, and I believe we're
going to utilize it. We justhave to have the commitment to
do it and not get diverted anddetoured by other crazy stuff
that happens. Yeah, well said,
well said, Could you describesome of the things, some of the
differences that you've seenbetween how women and men
(27:03):
experience or or, yeah, whenthey're in space, what happens
to their bodies?
Sure, and we have some wonderfuldecadal reviews. If you look at
the journal of women's health,we published that in 2014 all
findings from our six workgroups. I also highlighted
several of it in my book stellarmedicine, a journey through the
(27:24):
University of women's health.Little bit of a plug there. Plug
it. It's a part memoir, partguidebook, and it explores the
psychosocial and politicalenvironments which shape our
decisions. And that showseverything today. We see that,
and that's been going on formaternity. It's nothing new.
It's just we see it 24/7, now,um, but with the body, every
(27:46):
single system, and as Imentioned, it happens
dramatically. So, for example,cardiovascular system, when
women tend to return from space,they're at higher risk for
fading. We call that syncope.When you go into space, think
about it, all the fluid fromyour legs go up to your face,
you know, the moon faces, youknow, yes, cellulite gets
(28:08):
better. You get a little tall.Wrinkles disappear. But when you
come back to Earth, it all kindof resets back to the way you
are. But your receptors in yourbody say, Hey, we're volume
overload. So you start todiurese, since you're in a
sense, volume depleted when youcome back. So we try to volume
load pressure garments. Butwomen at our higher risk when
(28:29):
men feel stressed, testosterone,the male hormone, causes
friction in the blood vessels.So women, when they're stressed,
they tend to more vasodilate,and their heart rates go up.
You're at a risk if you'realready volume depleted, and
even if you're increasing yourheart rate, you still don't have
enough cardiac output, and yourbrain doesn't get enough blood,
(28:52):
so you may be at risk forfading. Oh, wow. You know, we're
way there ways we can managethat, but being attuned to that,
I think, is incrediblyimportant. I mean, just think
about on Earth, men and womenhave heart attacks, right? But
the presentation for women isbit different compared. So
that's atypical. It's not likethe male standards, the gold
standards, just different,right? So, you know, we're,
(29:13):
we're clued into that, andthere's one way just to
remember, like clots and bloodvessels and coronary artery
disease, men exposed, womenerode, and so the breaks down
into the vessel, whereas menjust kind of release all that
gunk into it and plot off. It'sreally fascinating. And again,
(29:34):
Understanding these differencesallow us to provide better
therapeutics and screening.Another really interesting area
is, is the the neuro vestibularand sensory nerve systems. We
used to call it visualimpairment in a cranial
pressure. And now you know spaceassisted neuro ocular syndrome,
(29:54):
and we see fluid pressure buildup in the eye. And what we found
is that men tend. Be moresymptomatic, they both seem to
develop it, but men tend to bemore symptomatic, and that can
cause blurred vision. And thereasons for it not quite known.
It may again be that women areused to accommodate volume
changes, like what you seethrough your menstrual cycles
(30:16):
and your pregnancy, and youknow, the different phases your
reproductive cycle, so the bodycan accommodate different
volume. It's just fascinating.You know, I mentioned, I talked
to you about bone mass. Womenare at higher risk for
developing fractures compared tomen. They don't build as much
bone density compared to men.Again, a hormonal connection
(30:36):
there. When you go into space,you begin losing bone mass very
quickly if you do nothing.That's why, with our astronauts,
they're exercising two, two anda half hours a day. It's
crazy. It's
tough, you know, going on, butyou have to maintain that bone
and muscle mass. We also look atdietary interventions so that
(30:57):
they're not leaching, you know,calcium into the bone.
Pharmaceuticals, maybe anotherway, and there's in even looking
at vibration and other ways tostimulate bone cells. So I mean
every single system, and thenthe psychological parameters are
really interesting too. We knowmen and women on earth respond
differently. Women are morelikely to be diagnosed with
(31:18):
depression. Unfortunately, onlyabout a quarter appropriately
treated and taken care of. Butwhat we see is that men and
women do equally well. It's justthey have different ways of of
interacting with theirenvironments and being attuned
to those differences. So it'sfascinating. And then there's a
lot of individual, individualvariability. So you know, we
(31:41):
have to keep that in mind. And Ithink that's where we just come
down to human factors andindividual we understand from a
population from a precisionapproach. Now let's take it to
the personalized approach, andthat's what supplement solutions
can do brilliantly. That's
amazing. It's
fascinating. Yeah, yeah, it'ssuch
(32:01):
a cool job. So I love yourthoughts. None of the political
stuff, but the Boeing Starlinerastronauts, Sonny Williams,
Butch wiltmore. It seems likesuch a great case study of like
emergent, I would emergency,like health, like, I know
(32:24):
there's planning for thismission could get extended for
whatever reason, but that feltlike it was an Apollo 13 esque,
like moment for space healthand, okay, you know, I don't
think the amount of time theywere going To be up there was
ever really set in stone. Itkind of always kept changing, at
least from the outside. What wasit like for you following that
(32:47):
on the outside? Well,
first of all, these are very,very well trained astronauts,
yes. And remember, they weretest pilots for a new vehicle,
and that's why you're quote,unquote, testing it. You know,
you've gone through what youcan, but then eventually you
have to put humans in there. Youhave to have a crew to see how
well, you know, you interactwith it, and it interacts with
(33:08):
you. So there are a lot of plansin place, you know, I It's
funny, I come from the place ofsomething is half empty, and I'm
very happy with that. Peopleare, you know, it's half full.
And people ask, you know, whyare you living in that
environment? And I just say, ifI can plan for everything I can
think of, it alleviates mystress. I'm prepared, and I'm
(33:29):
fine with that. If I come intosomething completely blind, I'm
not thinking about contingencyin different plans. It makes me
very anxious. So, yeah, it'sjust, you know, and I think if
you were to ask a lot of peoplewho've worked in the space
program, they probably have avery similar perspective. So,
oh, you know, something's gonewrong. Okay, this is Plan B.
We'll take that versus, no, Ican't. I haven't trained for
(33:53):
that. So they're very open,very, you know, able to adapt,
and very resilient. I think whatit showed was how well they were
trained and how well the crewthey were with was trying to
absorb them and bring them in.You know, NASA has an incredible
medical team, a great team offlight surgeons and medical
officers and people who knewthem well, so to keep them as
(34:15):
healthy as possible. Yeah, I'veoften thought, and I don't know
how popular this is, but thatthe crew that needs to go to
Mars actually should be olderindividuals. And the reason for
that is, I like that it's andthink about it. You know, first
of all, radiation exposure, thedevelopment of cancer, tends to
have a bit of a latency period.So little less concerning if
(34:38):
you're older and, you know, youhave it 20 years later, versus
you're in your 20s and 30s andearly 40s, and you're
experiencing this in quote,unquote, your crime. Two, I
think the psychosocial componentof it, you have nothing more to
prove you're doing it becauseyou want to leave the ground for
the next generation. Yeah,right. Um, three, you're just
(34:59):
well trained. You. Out a wholelife of experiences that you can
bring with you. And then four, Ithink it takes ageism out of our
society. Because, you know, sucha good job having people live
longer. If you go to cemeteriesaround the turn of the century,
you know, people died at 40s,50s. Yeah, it's actually
(35:20):
interesting. You're in theBoston area. You got your trove
of that to
learn history. We've got someold ones. Oh my gosh. You know,
you
see what's happened, and ittells a story. And now, you
know, it's just not unusual. Imean, look at President Carter
died around 100 and he had, youknow, metastatic melanoma, you
know brain cancer. And just wehave the technologies to keep
(35:42):
people alive, I just think itwould be phenomenal. And then
probably we could get AARP tounderwrite the flight. That'd be
amazing. Now, that's a goodsponsorship, right there. Yeah,
you get a discount for yourmission.
Oh, man, your Martian years,
and I guess the last part or sixpart would be, you're less
(36:04):
concerned about having to comeback, yeah, this might be your
final journey, in a sense, yeah.What an incredible way to do it,
you know, thank you would be,you know, laying the groundwork.
You're, you become the firstMartian see that your great,
great grandchildren wouldactually thrive there as best as
(36:25):
possible in that kind ofenvironment.
Yeah. The the the idea of itbeing similar to the colonists
that came over from America,just like getting on a ship and
going to New World,
world Plymouth. For I mean,think about it, yeah, yeah. And
it is usually hardships forpeople to do that. You know,
(36:47):
they had religious persecution,or, I guess, Australia, they
took the prisoners down toAustralia. It was generally
people wanting to get away fromsomething to create something
new. So now you're going towardssomething to create something
extraordinarily amazing for thenext generation, yeah,
(37:08):
yeah. And I think culturally, Ithink we are in this we have
been in this age. I have afeeling that it's changing. But
you know, respect for elders andfor experience really is kind of
at an all time low in theyounger generations. And I can
tell you, I mean as being 35 anelder millennial to them, an old
(37:34):
guy. You know, I do see at leastsome of the youngest generations
kind of flipping on that andseeing, seeing the experience
and actually wanting to talkabout it. So I think that from
an iconic thing would be reallypowerful. You know, I think when
I talk about this on thepodcast, I think space is the
(37:55):
setting for our next big moment,right? The like the space
conundrum of the first time, thethe Apollo era, right of of how
we got there, and how crazy theworld was, and has space
progress went up chaos andsociety went up, and we're smack
dab in that right now. And Ithink we're probably in the
(38:17):
Gemini era of that. So I thinkwe still have a long way to go
before that big moment, but I dothink that, like what's
happening now, could very wellset the groundwork for that
Walter Cronkite moment. For theyou know, whether those players
are in place yet is is one thingto be said, but what you're
(38:39):
describing is one of thosemoments that could be coming up.
I mean, in the next decade,which is wild, think about
it would be incredible. And thenthe other thing is, and we often
don't like to talk about it,but, you know, there's no risk
of pregnancy, and some of thoseissues that we wrestle
with interesting. Could you talkmore about that? Because that's
(39:00):
fascinating. Yeah,
I mean, it's, it's an importantarea. Reproductive Health is
very important. And you know,both for men and women on earth,
it's very politicized,especially for women's
reproductive health, where a lotof ethical issues, you know, can
you get pregnant in space? Andhow about, you know, if you're
(39:20):
on the Moon or Mars, where youhave 163, it's gravity. What's
the development of the fetus?And then, you know, the other
is, let's say you're able totake to term. You know, can that
individual come back to thisplanet? You know, when she when
it's developed in a differentyou know, perhaps by that time
you've created artificialgravity so you can train and
bring them back, but you know,you're also being bombarded by
(39:43):
radiation and otherenvironmental hazards. So it's
complicated. I had the goodfortune to create the, really,
one of the first policies in thegovernment on infertility
coverage, and I created it atNASA early on the turn of the
six. Injury, and it was aninfertility policy that still
(40:03):
stands in place, and it's formale and female astronauts.
Because, you know, we have thetechnology to do this. There
should be no genderdiscrimination that if one, you
know, wants to fly and they haveto be out of the queue, that
they can also have a family. Andagain, men and women are, you
know, it's 5050, equation, asense for infertility. Men and
(40:24):
women are impacted differently,especially in space.
Nonetheless, you have to thinkabout it. So, you know, we have
the technology to do that here.But let's say you're going to
colonize another planet, goingto the moon, you have to get
these issues. But for the firstmission, you don't want to think
about it. You sort about it. Youcertainly don't want to think
about an individual beingpregnant. And then, if there's
(40:47):
any complications, how do youmanage that? And then the other
thing, and we have to be carefulhow we talk about it. But yet, I
think it's important, because Iyou know, we've seen it down in
Antarctica and on ships, youknow, couples coming together,
yeah, and if we're going to makethis honeymoon destinations and,
(41:09):
you know, luxury expeditions andall that, we have to think about
these elements of what people donaturally. So, you know, how,
how do you handle that for 30day mission, but also for the
long duration mission, theexploration class missions to
Mars. So if you can take thatout of the equation, that part
(41:30):
of it, that's just one lessthing you have to worry about
and encounter.
Sure, yeah, so that's so that'sa protocol that exists today.
Well, the protocol, we have aninfertility policy at NASA.
There isn't a protocol. I mean,you know, astronauts are given
the option of the in on birthcontrol, one to control their
cycles. But again, it's not theissue for our professional
(41:53):
astronauts right now. But ifwe're going to make commercial
space exploration destinationYeah, our tourism world part of
what we want to do for enjoymentand fun. I think we have to be
clever, and we have to thinkabout these things. Yeah,
wow, that's, that's somethingI'd never really fully
(42:14):
considered. That's wild,
yeah? Because now that you'vegone down that path, you're
going to be thinking about it.It's actually something, I
think, important because, youknow, we we can't put taboo on
any aspect of our health. Needsto be able to discuss it. We
need to look at the ethicalissues, the medical issues, the
legal issues, so that we ensurepeople are healthy. And whatever
(42:38):
happens up there is healthmaintains that health
Absolutely,
and especially for like a Marsor or a lunar mission, just the
reality of the physics of thesituation, like, you know, if
some, if you need new suppliesor or more supplies, you're
You're rationing now for foranother person, that's, that's
(43:03):
not necessarily a curveball. Youwant to get unexpected, and it
would be, it would, it wouldactually be irresponsible not to
consider that. Yeah, yeah,
we'd be, I think it'd be aninteresting discussion. So we
have Dr Paul root while P as ourchief ethicist for smallmed
Solutions. And I think, youknow, if we were to hold sort of
(43:23):
a workshop or round table aboutsome of these issues, I think it
would behoove us just begindiscussing it in a very
sensitive, yeah, also proactiveapproach, what we need to think
about, because you cannot benaive. You just can't be No,
yeah, yeah. And then, andthat's, these are the kind of
things, the the blind spots, ifyou will, of the old fighter
(43:47):
pilot days that were neverreally fully considered that as
we look at a at an inclusivelook of we're sending everybody,
yeah, I would be totally downfor that conversation, yeah.
And then take it to the nextlevel. Elon Musk has talked
about, you know, Martiancolonies. How does that work?
(44:08):
And, yeah, do we provide, youknow, special gravity rooms so,
you know, you develop and thendo we have shielding, of course,
for radiation? I mean, there'sso much that goes into it, you
know, coming across the AtlanticOcean from England to Plymouth
Rock. You had to traverse theocean. But once you got here,
you know, you called your townthe same town that you came
(44:30):
from, and there's still landswater wasn't like you were
coming into a completely newworld, right? And to face, you
know, entirely new territory andand landscapes and hazards,
yeah,
yeah, the colony setup is goingto be very interesting. And I'm
(44:51):
sure the plans for whatever isgoing into that are happening
now, you know, like thosediscussions are happening. And I
think you. So, you know, as wethink about prepping for the
future, and as you're thisexpert that you know we we want
to make sure that your voice isgetting out there, the more we
can have those conversationsnow, the more repetitions we'll
(45:15):
have with those ideas, and thenthe better our solutions or
troubleshooting can be, right?Yeah. I
mean, it's really, it comes downto brainstorming. Mm and sylamed
summit has three pillars. It hasour people, our programs and our
partnerships, and we work acrossthree verticals, our advisory
group, our educational outreach,and then certainly the
(45:36):
operational and everything'svery integrated, tied together.
And I could really see, youknow, just bringing together
people from differentenvironments, coming and looking
at some challenging questionsand speaking their mind. You
know, there's no right, there'sno wrong. We just need to play
it out to see how things wouldwork, so that we're prepared. I
(45:59):
also come from the pandemicplanning ecosystem was the
civilian medical advisor to twosurgeons general, and then
certainly to the Chief MedicalOfficer at NASA and at HHS as
well. And you know, you look atdifferent scenarios so that when
you are faced with thesituation, you know how to
(46:19):
handle it. You can pivot assituations change, because you,
you table topped it, you're ableto maneuver.
That's, I love that you saidthat, yeah, there's, there's so
much to this that, you know, youjust scratched the surface of
it, and you realize, wow,there's, there's this whole
world. Dr, Mark, thank you somuch for for coming on. I wanted
(46:43):
to leave the floor to you at theend here for any kind of closing
thoughts or anything we didn'ttouch on that you'd like us to
touch on. It's been, it's been apleasure. Thank
you. It's been a joy to speakwith you as well. I just think,
for folks that are coming intothis, just follow your passion.
If you're an artist, followthat, maybe you'll be an artist
on the moon. You know, noteveryone's going to take the
(47:06):
same course, and we need to havea variety of disciplines. I go
back to the days of AlanShepard, when he asked me, what
my, you know, discipline was. Itjust indicated to me, you can
come from many walks of life,and need to bring that, you
know, to whatever you're goingto do. And then I think, from
the commercial space medicinepart of it, we're going to be in
an environment of inclusion. Sowe have to be creative. We're
(47:29):
going to have to devise as we goalong, but ensuring that
standards are met. And then wehave to ask, as as a pupil, what
risk are we willing to assumereally difficult discussion, but
we have to be attuned to it. AndI don't want to leave on that
note. I want to leave on theNote that we learned from every
(47:50):
experience. We learned fromevery experience, and are
certainly our space program ismarked by that where there's
been, you know, incrediblechallenges and incredible highs,
and we've learned from all ofit. So I'm just excited what
we're able to do, and I'm justso grateful to be able to work
with such brilliant people tohelp do this
(48:11):
absolutely. I mean, this isexploration, like, like you
mentioned, so so well, like,exploration doesn't come without
risk, and that doesn't mean thatyou need to just take on risk
for no reason. You can plan andadjust along the way. That's the
whole that's the whole thing,beautiful. All right, where can
folks find you? Really? Yes,
(48:33):
you can find me at solomedSolutions, and you can also find
me at my nonprofit. I giant, IG, I A N T and I look forward to
hearing from you awesome
Dr, Sarah and Mark, thank you somuch for being on the podcast.
Pleasure. All right, folks, bewell. Spread science. Spread
love and spread science. Staycurious, and we'll see you on
(48:55):
the next episode of Today InSpace. See ya.
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