What Does It Take to Be a Doctor and an Astronaut?

The growing field of aerospace medicine puts physicians on track for jobs at NASA — and trips to space — a fascinating combo of childhood dream and hardcore medical practice.
https://www.medscape.com/viewarticle/...

-- TRANSCRIPT --
The "what I wanna be when I grow up" dream checklist:
Rock star
Secret agent
Pro athlete
Astronaut

(And perhaps more recently "social media influencer," but I digress.)

Nicolas Nelson, an MD candidate (MS4) at Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, Pennsylvania, always leaned in the astronaut direction.

He grew up in Southern California and often went camping with his family in the Mojave Desert, where the night sky was darker and the stars shone brighter. Nelson remembers looking up and listening as his grandfather talked to him about the vastness of space.

"That's what hooked me into wanting to be a doctor in the first place — thinking how tiny our lives are and wanting to help people live their best lives," he recalls.

And while "doctor" may also be on a lot of kids' career wish lists, what kind of educational, motivational, and talent mix does one have to muster to become an MD and an astronaut?

It starts with something like this:

As Nelson pursued a path to become a radiation oncologist, he never stopped looking up at the stars. He came across the book Space Physiology and Medicine and was intrigued by the idea that he could potentially merge his two interests.

He reached out via email to one of the book's authors, Arnauld Nicogossian, who pointed Nelson in the direction of the Aerospace Medicine Association, the leading professional organization for those working in the fields of aerospace medicine and human performance.

"That's when I realized that aerospace medicine is a legitimate discipline," Nelson says.

A Specialty With a Colorful History
"Aerospace medicine is a small field, but in fact it's been around since the 1950s," explains Natacha Chough, MD, MPH.

Chough is a flight surgeon at NASA's Johnson Space Center, though "the term 'flight surgeon' is a total misnomer," she says, "just like the Surgeon General of the US is not an actual surgeon nor a general."

Chough is a ground physician who cares for astronauts before, during, and after their spaceflights. She likens her position to being a member of a group of doctors assigned to a professional sports team. NASA has around 30 flight surgeons, she says, and two are usually assigned to each mission — a primary and a deputy.

Most flight surgeons never leave the planet. Chough has completed four missions and has been assigned a fifth. "There's no requirement for a doctor to be in space," she says. "We train astronauts to be an extension of us in space."

This includes teaching them how to draw blood, put in stitches, start IVs, and perform CPR in zero gravity.

From the ground, Chough monitors the astronauts' schedule to ensure an appropriate work-life balance to avoid fatigue and burnout, which can be particularly dangerous in an inhospitable environment like space. She also has a standing telemedicine appointment each week with the astronauts and sits in mission control, particularly when a spacewalk is scheduled.

"That's a really high-stakes day for the entire ground control team," she says, "but particularly for us, because going outside into the vacuum of space is the most dangerous thing we ask astronauts to do."

Become a Physician on a Mission
As she entered college, Chough already knew she wanted to work at NASA and planned on becoming an aerospace engineer. But after an unpleasant encounter with calculus, she switched her major to biology.

"I didn't know how that was going to get me to NASA, but I'd figure it out," she recalls.

Chough attended a NASA summer internship on life sciences and discovered that they also hired physicians. After serving in the Peace Corps as a health educator, she went to medical school.

Knowing she would need a strong, broad foundation in order to pursue aerospace medicine, Chough specialized in emergency medicine (this is a common thread, as you'll see). After completing her residency at Stanford, she enrolled in the University of Texas Medical Branch Aerospace Medicine program in Galveston, Texas — an additional 2-year residency.

"During that training, I was like, 'I can't believe I'm getting paid to do this,'" she says. Physicians in the program get a lot of the same training that astronauts do, including parabolic flight training (simulated zero G in the vaunted "vomit comet"), which Chough describes as being "like Christmas Day."

Transcript in its entirety can be found by clicking here:
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