Doctor Astronaut with Jay Buckey Jr., M.D.

[00:00:00] As much as we may try, it is impossible to pack for every medical situation in space. For example, sanity is just as important to the well-being of a astronaut as physical well-being. The two are unsurprisingly often intertwined.

[00:00:17] And it should be no surprise that floating in a tin can thousands of miles from home has a psychological toll on a crew. While there are many tests and methods to diagnose and assist mental health here on earth, space, as always, is a whole different playing field.

[00:00:35] Between astronauts' unreporting symptoms in an attempt to stay airborne and a lack of research on how the environment of space actually affects the neurocognitive functions in psychology, the field of neuropsychology among astronauts in the void is growing and evolving.

[00:00:53] So just how are we approaching this concern for deep space travel? Today, we look at the engineering, psychological and scientific avenues of this problem. As always, I'm Nick Saba and I'm Dominic Tanzillo. Welcome to Spherical Cows!

[00:01:28] To discuss the innovations in this field, we are joined by Dr. Jay Bucky. Not only is Dr. Bucky a professor of medicine at Dartmouth's Geisel School of Medicine and an adjunct professor at the Thayer School of Engineering, but he also serves as the director

[00:01:44] of the Space Innovation Lab at the University as well. And he was previously a NASA Columbia Space Shuttle astronaut and payload specialist. We're very excited that this is the first astronaut we have on our show. Thank you so much for joining us. Good to be here.

[00:02:01] So after flying on the Space Shuttle missions for Neuralab, it seems that you've made it your life's work investigating and overcoming the barriers of long duration space flight. One could even say that you've written the book on the subject. That's available on Kindle as well.

[00:02:16] So now among the many health problems presented by deep space and long duration space flight, are there any that you believe are the most interesting or critical areas or in tractable problems that we need to overcome and study before we send people to Mars?

[00:02:34] Yeah, so I think one problem I think perhaps is maybe we don't talk about enough is the radiation problem. And here on Earth when we talk about radiation, we tend to think about radiation in terms

[00:02:50] of cancer so that we think of radiation curall, causing a risk of cancer and that's what prevents people from being in high radiation environments. But the nature of the radiation in interplanetary space is a little bit different and there you're worried more about the collective cosmic radiation.

[00:03:11] And so like the radiation we worry about here with X-rays and medical imaging and things like that it's like high energy light. It's like a photon radiation, sort of like getting a bad sunburn.

[00:03:25] Whereas a galactic cosmic rays, the nucleus of an atom traveling at a really high speeds. So it's a difference between a sunburn and a gunshot wound. These things come if they deposit energy in the body, they deposit a lot of it and sort of attract through the body.

[00:03:49] And so they tend to kill cells. So and where that's most important of course is in the brain and nervous system. Where those cells may not be as easy to replace. So whereas on Earth we tend to think about radiation in terms of the risk of cancer in

[00:04:06] interplanetary space you need to think of radiation in terms of the loss of cells and the central nervous system over time. Gotcha and correct me if I'm wrong but the story that astronauts always talked about where they're sleeping in their

[00:04:19] bunks and they see those bright white flashes from radiated particles. I think flashing across their corny is that's an example of this kind of radiation that you're talking about. That is probably what that's from yes. Okay. Awesome.

[00:04:33] And did you ever experience that when you were not on the show? Yeah, I had a couple of life flashes that I saw. Yeah.

[00:04:39] And then in lower th orbit though you're still not that it's not it's it's only when you get out of the magnetic field of the earth. The magnetosphere of the earth that you really started and experienced the full flux of galactic cosmic radiation. Gotcha.

[00:04:56] So your specialty is in kind of neuro cognitive development in the sense of you're looking at how this radiation affects neurological development, correct? Well, you know actually I wish that we're doing more research on radiation. I mean the question was what area do I think of very important?

[00:05:15] Yes. And I think the radiation is an important one it doesn't have to be one that I'm working then right now. But we do do a lot of work with neuro cognitive problems but that happens more in other areas outside of space.

[00:05:31] Well, if I may ask about that I was looking at that research and it's very interesting in our course and they can I present the necessity for these autonomous diagnosing tools, you know.

[00:05:42] That as you move further away from earth transmission times two and from earth get longer and longer so much so that you know you lose first the ability to do a live call and then even text chats would be, you know,

[00:05:55] very delayed and difficult to undergo and so having autonomous tools are helpful. And it seems that your lab is looking at how in particular auditory tests can help determine neuro cognitive functioning and the progression of diseases here on earth and both us the

[00:06:11] are cases that then potentially in space and so we would just love to hear a little bit more about where you see that tool fitting in for a long duration space flight.

[00:06:21] Yeah so all the research we do right now has to do with how the brain's ability to process sound can provide a mark marker overall brain health and so, you know there's kind of two parts of

[00:06:38] here you can break it down this way simply one is you know detecting the sounds and turning the sound into nerve signals that your brain can interpret and then the other part of it is

[00:06:48] your brain making sense out of the sound and you can really see your brain of work in this part of it at a cocktail party, you know if you're at a cocktail party there's all this noise around you

[00:07:02] but you can focus on the one person that you're talking to you can understand what they're saying you can suppress all the other stuff even though the person who's talking is actually at a lower level

[00:07:12] than the noise it's all around you and that ability to focus that ability to understand that speech and background noise is something that your brain really does and so we've been looking at whether that ability of the brain to process, you know, speech

[00:07:28] and background and all these sort of do this what's called central auditory processing can also be a measure of overall brain health and people who have diseases that affect the brain like HIV

[00:07:39] or the Zika virus infection or a pedicum cushion there are a lot of different areas that conditions that can affect the brain we're looking at see if we could use these central auditory tests

[00:07:52] to detect problems or declines in brain function and the reason we like that is because these tests are easy to do and easy to train people or do and they don't really depend a lot of having

[00:08:03] a lot of education or being able to solve math problems or anything like that but um but that's something that it grew that that work that we're doing grew out of a space project that we had

[00:08:15] which is really focused on hearing loss in space when it comes to autonomy the thing that we've been most interested in is is in the psychological aspects of space life because right up there with

[00:08:29] radiation the psychological challenges of being in an isolated and confined environment for a long period time are really significant problems you know people can do it I mean we've had people live together and small isolated environments for long periods of time and do that very successfully

[00:08:50] but it can also go very long and there are things like interpersonal conflict depression stress things that come up that people have to deal with on their own in the environment that they're in because in a isolated confined environment you just can't leave the environment or

[00:09:09] go talk to somebody else you know you you you have to kind of work it out yourself and so one of the things that we have developed are online tools that help people be better at conflict

[00:09:22] resolution stress management and also we have a program for training people how to improve their mood if they're affected by depression and part of that when I saw is that you frequently collaborate and work with the Dartmouth interactive media lab it's where it appears that you are

[00:09:42] utilizing virtual reality as a potential mechanism and way for people to hopefully combat some of those stressors and also potentially immerse themselves in different environments on the space capsule or space station for example you're probably not getting a lot of variety and

[00:10:01] being able to put yourself in a different environment would probably be a big boom yes so so the tools I talked about these psychological training treatment tools are interactive media based so they're

[00:10:12] very much focused on videos and audios to try to give you a sense of real interaction with a person but then what came after that is we also realize that people who live you know are in isolated

[00:10:29] confined environments don't have any experience of nature and and people really like experiences of nature you know we seek them out people will spend thousands of dollars to go on as a farer people

[00:10:42] like going to park being outdoors going on hike and there's a thought that being exposed in nature is is restorative that there's a theory called attention restoration theory that just being out in nature it's sort of it's it's ability to capture our attention just very easily and the

[00:11:02] fact we're very engaged and interested in what's around us that this is restorative and so one of the things we start to do was to see if we could provide people immersive experiences of

[00:11:14] nature by giving put it giving them VR experiences what they could be in an immersive natural environment while they were actually an isolated and finding environment and we haven't been able to do

[00:11:26] a big study with them but some of the smaller studies we've done where we were in the high seas habitat I don't know if you're familiar with high seas but it was a habitat or in

[00:11:37] Hawaii that in an area that looks very much like the surface of Mars but it was six people living in this habitat and they could only go out you know if they put on a space suit

[00:11:48] and they did enjoy having that experience of being able to put on those headsets and kind of to leave the environment for a while and be at least these natural settings and I mean that makes sense right your brain is wired to exist essentially in nature so

[00:12:05] that's almost like a scratching post for a cat right like it's something to keep your brain active and keep going that's a nice analogy yeah yeah it's a good way of putting it yes I mean

[00:12:21] that's the basic idea right it's sort of something that's just built into us which kind of reflects our evolutionary history and I'm not sure if people have recently made this analogy to you

[00:12:33] but with the recent past half a year metaverse has been quite talked about about how companies are increasingly encouraging employees and people to enter into virtual spaces for additional social interactions that could even be helpful in combating a lot of the isolation and confinement

[00:12:53] people experiencing on the prolonged lockdowns and so that kind of work I think is especially interesting to see how it's fitting in not just on a space mission but also here on Earth.

[00:13:06] Yeah I don't know about that. A question that I have that might be a little bit far field currently I'm doing some work in and about hyperberics and I wanted to ask about a lot

[00:13:19] of the maybe questions about because I know you've done some work in that area as well about the potential to customize the atmosphere's for a long duration space flight mission there are different ways that people are thought about tinkering with the percentage of

[00:13:37] oxygen so you know dialing those percentages up or down whether that be on a space ship itself or also in the space suits we're always trying to maintain very specific amounts of oxygenation to combat both decompressive stress and then also to make sure that astronauts are well

[00:13:57] oxygenated do you have any insights that one talks about making these customized artificial atmospheres for example increasing trace amounts of hydrogen gas not so that it becomes an explosive hazard but to act as for example a reductive element in the air and combat the

[00:14:16] oxidative stress from long duration exposures in the pure oxygen space suits. Well I mean I will say this so the the biggest you know the concern with habitats is like so right now we're at sea level right and we have an atmosphere that's

[00:14:39] 21% oxygen and the remainder is nitrogen and nitrogen is inert so we have all this nitrogen dissolved in our body so so anytime we go into a lower pressure environment that nitrogen wants to

[00:14:55] come out on the body so for example if we were to go from where we are right now it's sea level up to 30,000 feet or whatever and we did that right away that lower pressure on the outside

[00:15:11] so there'd be a very low pressure on the outside but a high pressure of nitrogen on the inside that would lead to a creation of bubbles and for the potential of decompression sickness of these bubbles would be for warming. So anyway we're saturated with nitrogen here on our

[00:15:26] um so that the that's the problem on the space station so the space stations at sea level atmosphere of pressure so everybody's saturated with nitrogen but if I want to go into a space suit

[00:15:37] that is at a very just a fraction of you know that the atmosphere of pressure so let's say it's hate to you PSI but that's what I grew up with. So let's say it's 14.7 PSI right

[00:15:51] people are going to go into a space that is 4.3 PSI so that's just like taking us from sea level from going at the 30,000 feet so they can't do that right away because if they did that they'd

[00:16:03] get decompression sickness so there always has to be a process in between in order for them to get the nitrogen out of the body um now you can see that that would be impractical if you're going

[00:16:14] to have a habitat in another surface if you made the habitat at sea level atmosphere pressure every time anybody want to go outside or do anything they're going to have to go through this

[00:16:24] process of getting all the nitrogen out of their body and then they come back in and then well the nitrogen back go on and then they go out of the equipment nitrogen off so it's a real pain

[00:16:33] how they solved this back in the day back in the Skylare program and then the Apollo program they kept the spacecraft that it was at 5 PSI 100% oxygen so um you didn't have to do anything

[00:16:46] you don't have to do any creepy thing or anything you just got in the suit and you went out you know because there was no that the nitrogen was out of the equation um there is some concern

[00:16:57] that doing that however is not as safe as having some inert gas in the environment so this thought there should be some inert gas and I saw and there have been workshops you know on findings

[00:17:13] sort of the optimal atmosphere you know how much nitrogen can you put in the atmosphere they'll keep the fire risk low but it also make going in and out of the habitat and into the space suit

[00:17:23] easy to do and keep the risk of decompression sickness low and I think it's around a PSI have to go just looking to see yeah that APSI right is that what some people are thinking about and if you

[00:17:37] did an APSI um atmosphere that was about 32% oxygen or 100 you didn't know 100% oxygen that would you know that would be something where you could kind of strike a balance between having to you know getting having the risk of decompression sickness but also keeping things simple so

[00:18:00] you're not constantly being nitrogenated or getting written nitrogen all the time got you where the benefits outweigh the cost exactly so I wanted to I have two quick questions I want to

[00:18:14] pivot back and we know you have some engineering experience uh we also know that you've talked about kind of these different issues radiation and pressure oxygen um what are some of these engineering solutions that could be created improved or added in order to help not just physical health

[00:18:35] of astronauts but also their mental health and cognitive neuro cognitive development as well yeah so technology so I mean we obviously like the idea of the interactive training and um and the idea there is that's based on the idea that people can train themselves to be better

[00:18:56] at things like concrete for the resolution and stress management um I mean we all we all know from our own lives it's some people are better certain things and others right but we also we can all train and be better so that that's the underlying notion there

[00:19:12] the other technology that I think would be great to see more work on is uh that there's some controversy about is the idea of active radiation shielding so um so what you know there's always

[00:19:26] galactic radiation flying around space how come we don't worry about it here on earth and well we don't worry about it here on earth because two things one is the way this amagnetic field around the earth the tends to deflect this radiation and then also the atmosphere

[00:19:40] does also help to reduce it because it creates a certain amount of interactions with the galactic cosmic rays before they end up hitting the ground so um so that's why our life evolved without worrying about galactic cosmic radiation all the time so if

[00:19:57] the magnetic field in the earth is such a great thing for keeping um you know galactic cosmic radiation at a reasonable level well why couldn't we put a magnetic field around this

[00:20:06] base grab and and this is an idea that's certainly not new you can go back there's a popular science article from the early sixties by Warner von Bromann that was uh the show is a

[00:20:19] to a royal spacecraft that had a magnetic field around it but of course back then the idea was um a little bit pine in the sky because the the energy to do that you know just didn't seem to

[00:20:32] aware where that come from you know and also creating a magnet of that strength you know with the technology to head at that time was it was really difficult to do but now with high temperature superconductors our ability to create magnetic fields um is really improved you know

[00:20:54] with MR scanners I mean in now there's uh you know there's some indication that perhaps you know fusion is going to be advanced because there are better high temperature superconductors which will allow you know for a cheaper and better technology to try to contain the reaction you

[00:21:14] know which is always done with these complex magnetic fields so we're getting a lot of experience in magnetic in using magnetic fields we're have more high temperature superconductors and so maybe this is the time to start maybe looking at active shielding a little bit more and more detail

[00:21:30] and that would be uh a good thing I think because I think that radiation is probably more of a engineering problem than a medical problem um so you know it's it's one thing to give people you

[00:21:48] know different things that might help with photon radiation you know like you can protect yourself from that fairly if the easily was shielding or you can take certain compounds that might minimize

[00:22:00] the damage that you get from it or it hands the DNA damage but there's not much you could do to prevent killing of cells you know you know it's like it's like giving vitamins to

[00:22:16] to treat a gunshot won't you know it's like yeah it's just it's just a different thing you know it just doesn't that work that way so I think that would be a technology that would be very

[00:22:27] interesting to see more work on that's actually that's fascinating I find a lot of your research fascinating and I love how it covers a bunch of different fields like the auditory tests and

[00:22:39] all of this important stuff I do want to try to pivot here in these last five minutes to kind of our question of the show which is do you have any advice for people that are interested in your field

[00:22:53] and I would love if you would kind of talk a little bit about your personal story and getting to where you are right now or getting to be in astronaut and then lending in the research sector how

[00:23:05] did you get there do you have any advice for someone that's trying to kind of follow your footsteps I don't know how to well I mean how I got I was a as an undergraduate I was in electrical engineering

[00:23:15] I was in electrical engineering major and and then I went to medical school and then I was doing training in internal medicine and it was really what I was doing training in internal medicine that

[00:23:29] I started looking ahead and say hey well where am I headed you know what am I looking towards doing and at that time I started realizing that I really like the space program but it was some of those

[00:23:40] real motivation for me when I was a kid and and I started really as well if I like it so much why am I not doing anything in the area right so and so that's when I started looking around

[00:23:54] for labs that were working with the space program we had projects going on and so I said I did some research set letters out and one of the people who got the letter knew someone at University of Texas Southwest Remedicle Center who had projects we're doing starting projects

[00:24:13] on the cardiovascular effects of weightlessness and they invited me there for a new view I went down and I reviewed and started off as a NASA space biology fellow no way at the University of Texas

[00:24:24] Southwest Remedicle Center and I have to say I mean I did that right after my internship at medicine and people thought I was nuts so but I mean the thing is is that I you know it is what

[00:24:38] I want it to do and I you know and I think as we all know you only go around once so you're out of you know if it is a passion of your age you should start looking at thinking well what is

[00:24:49] my passion what is my interest in how would I go about you know doing that so I started in the cardiovascular area and we did a lot of work measured central venitiprature in space which is the first

[00:25:03] invasive measurement made in the space program which had interesting results that we still talk about today and then I was an alternate payload specialist for the space lab life science

[00:25:14] is too flight I did a flying that mission but it was training and then I was a pilot specialist in fluent space in the neural admission which was a 16 day mission totally devoted to studying

[00:25:26] the brain and nervous system and how it you know adapt to weightlessness and then reattaps to being on there and so I think my background engineering helped and obviously background in medicine

[00:25:37] help background read research help but I think the main thing was that I just said hey I want to go to kind of just start looking for opportunity. That's awesome. Wonderful. Additionally

[00:25:52] is there any place that people can look to find you your resources your book for example anything that you'd like to tell audiences about? Well yeah I mean I guess the book is available on Amazon

[00:26:04] and other booksellers and it's called Space Physiology and it's basically goes through all it's a sort of a handbook about the space physiology covering all lot of the areas we talk about. We will post the link for that as well with the episode here. Are there any

[00:26:23] particular programs for students trying to pursue this path that you could highlight? Well I don't know but you know I will say there's been a tremendous great interest in a lot of schools forming medical students particularly I would be seeing a lot of medical schools forming

[00:26:43] space medicine interest groups so it's really growing. Absolutely Dominic and I are always fans of the growing interest in space so I think we're at time here Dr. Bucky I just wanted to say

[00:26:58] thank you so much for coming on and recording with us. Thank you great time and though all right we always like to tell the audience and remind them to stay oxygenated.