How to Astronaut

by Terry Virts

  Each subsequent crew would leave a module behind, gradually building a human presence on Mars, in much the same way that we slowly built the ISS, piece by piece.

  There are several other heavy-lift rockets potentially on the horizon. Elon Musk’s SpaceX has flown the Falcon Heavy rocket several times and recently sent its first live crew to the ISS, after it famously launched “Starman” in his Tesla toward Mars. SpaceX is also developing a much bigger rocket that was initially called BFR (Big Falcon Rocket or Big F*!ng Rocket, depending on who you ask) and recently renamed Starship, with a first-stage booster rocket called Super Heavy. Jeff Bezos’s Blue Origin is developing New Armstrong, another massive rocket. All of these promise a lift capability approaching that of the SLS for much less than half the cost. We will see if they actually fly; it’s very easy to make promises in the rocket business but an entirely different thing to deliver. There are also several other medium-lift options, notably Elon’s Musk’s Falcon 9 and Jeff Bezos’s New Glenn, as well as United Launch Alliance’s Vulcan and Northrop Grumman’s OmegA. A Mars mission would likely include a series of launches, using different rockets to assemble a Mars transfer vehicle in less than a year. The crew would then launch, rendezvous with it, and head off for the red planet.

  Launch concerns aside, I believe two greater problems we need to address are minimizing the crew’s exposure to radiation as well as the equipment’s exposure to failure, both of which are helped by a fast-boat, one-year mission. The nuclear-powered spaceship would accelerate for the first half of the flight at a very slow but constant rate. Then the whole spaceship would turn around and decelerate for the second half. There would be a heat shield to help slow the craft down when it arrived at Mars, using atmospheric braking, and then the transfer module would remain in orbit while the crew went down to the surface for a month or so. They would descend and land next to a surface module that was waiting for them. Because they are unmanned, those prepositioned supplies could be sent via a slow-boat approach, saving money on launch costs and in-space nuclear propulsion. Each subsequent crew would leave a module behind, gradually building a human presence on Mars, in much the same way that we slowly built the ISS, piece by piece. The crew would return to Earth in the same transfer vehicle that took them to Mars, and they would use the heat shield again when arriving home.

  The nuclear power plant, engine, and habitat module could be used again and again, perhaps for decades, cycling back and forth between Earth and Mars. The planets align for launch opportunities every twenty-six months, so a single transfer vehicle could theoretically support four missions per decade, each one building on the last one, until we had an infrastructure of surface logistics modules, an operational nuclear reactor on the surface of Mars, and a reusable and refuelable lander, transferring crews to and from Martian orbit to the surface.

  In this manner, crews would be exposed to the harsh radiation environment of space for only one year instead of three, and they would require only one year’s worth of supplies, saving a tremendous amount of money and cancer treatment. The technology that enables this plan is nuclear-powered in-space electric propulsion. There are significant technical challenges to fielding such a reactor, but they can be overcome—this is not unobtainium.

  In addition to the electrical power problem, there are other systems that must be developed: landers, transfer vehicles, better and more reliable life-support equipment, etc. Those problems are real but are also solvable. The overarching challenge is finding and maintaining the political will to make in-space nuclear power happen. As I have said many times, the problem isn’t the rocket science, it’s the political science. I firmly believe that this nuclear option doesn’t simply make a Mars mission more attractive, it actually enables such a mission. Conversely, without a way to get there fast I don’t believe a three-year mission is possible. It’s either electric propulsion or we don’t go anywhere in the solar system beyond the Moon. The choice is that stark.

  I would choose to go to Mars and other planets, not because it is easy, but because it is hard. (That sure does have a familiar ring to it.)

  The Human Body Beyond Earth

  The Physical Toll of Long-Term Spaceflight

  One of the most fascinating parts of leaving Earth was observing what it was like to adapt to weightlessness. I was constantly amazed at how quickly and completely humans were able to survive and thrive in that very alien environment. Our bodies were designed, adapted, and evolved to live in Earth’s gravity. Then, roughly eight and a half minutes into your rocket ride, the engines shut down, someone turns the gravity switch off, and you are floating, completely removed from the only home humans have ever had. Though the process of adapting to weightlessness is fascinating, it’s not all fun and games, and there are some serious medical issues that astronauts face. And some funny ones, too.

  The first issue that everyone has to deal with to one extent or another is SAS (Space Adaptation Syndrome), the NASA acronym for feeling sick. Just about every colleague of mine has reported feeling some type of dizziness, headache, or downright nausea, especially on their first flight. For me personally there were two main impacts—a strong dizziness and a headache. I could hardly rotate my head for the first day or two in space; quickly looking left or right or up or down was extremely painful and felt like it would have instantly made me barf.

  Speaking of barfing, NASA has some very expensive emesis bags that are amazing. It’s a basic plastic bag with a big washcloth sewn into it with an integrated twist tie, so you simply open it up, barf, wipe yourself off, tie it up, throw it away, and get back to work. Some astronauts have reported suddenly throwing up without any warning several days into the mission, so I kept one of these sick-sacks in my pocket for the first week or so, just in case. In fine government procurement tradition, I was told that these cost $500 each, so NASA was a little stingy with them. When I flew on the Soyuz the Russians didn’t have anything like ours, so I requested two from NASA, just in case. It was a battle with astronaut office management to get approval, but I eventually won. I thought it was a no-brainer to let our crews fly with a decent barf bag. Better safe than sorry, especially when “sorry” includes making a floating cloud of vomit inside a hundred-billion-dollar laboratory for your five other buddies to avoid.

  It turned out that this pain was from the same phenomenon that was affecting my feet—my nerves had stretched at different rates than the rest of my body, and I felt it.

  I also had a serious headache on my first flight, as many astronauts do. I was downing ibuprofen left and right, but it just didn’t help. On the morning of flight day three, my crewmate “Stevie-Ray” Robinson asked me, “How are you feeling?” I told him I still had a bad headache, and then a few minutes later it was like someone flipped a switch and I was magically cured. I never had another problem with that headache/dizzy/SAS feeling for the rest of that two-week mission or on my next mission four years later. My brain was very confused for those first two days in space, but then it just magically figured out weightlessness.

  SAS ties in with another problem that some astronauts experience: insomnia. Thankfully, there was a solution that helped with both—Phenergan. It’s a common medication on Earth, used to prevent nausea for lots of reasons: morning sickness, motion sickness, post-chemo nausea, etc. NASA used a composite medication called Phen/Dex to help during our zero-g aircraft flights; the Phen would prevent nausea and the Dex would keep you awake. Hence, the real benefit of Phenergan for astronauts—without the Dex it helps us sleep, which is especially helpful on that first night or two when anxiety, nausea, and the need for sleep are all high.

  There are several ways to take this medication: as a pill, shot, or suppository. The doctors are big fans of the suppository method because apparently things get absorbed into the bloodstream very well down there. As a self-respecting fighter pilot, I turned that technique down. There was also the pill form. Though I never took any, I carried a few Phenergan tablets in a Ziploc in my pocket
, so I wouldn’t have to scavenge for them. The problem with this was twofold; first, pills are the slowest method to achieve the desired benefits, and second, if you barfed up the pill, well, that wasn’t very helpful. Which brings us to the third method—shot. In the butt. Which was what many of my colleagues chose.

  On that first night in space, after an incredibly exhausting first day, with the wakeup call only six hours away and sleeping bags velcroed all over Endeavour’s walls and ceilings and floors, we lined up for the shot. In training we had learned the technique—aim off to the side of the cheek so as to avoid a long and very painful nerve that goes through the buttocks. Our flight surgeons had marked an “X” on everyone’s butt with a Sharpie before launch to help us avoid the nerve. I’m not kidding. So we each dutifully floated by our Crew Medical Officer, Velcro-laden shorts hovering at the knees, and he jabbed the needle all the way to the base into our butts. Alcohol swab, Band-Aid, “Next!” All was well, and we all went off to sleep without incident. Fast-forward five days. I was rushing from the station back to the shuttle to get a checklist for a maintenance procedure. And my butt itched. I scratched it, but that didn’t help. So I reached down into my floating shorts to give my cheek a better scratch—and lo and behold, out came a Hello Kitty Band-Aid. I had forgotten and left it stuck to my butt the whole time! We all got a good laugh about that, and I had a memento of my Phenergan shot.

  A very significant effect of weightlessness is bone and muscle degradation. On Earth, everyone’s bones and muscles are constantly working against gravity, even when lying in bed or sitting on the couch watching Game of Thrones, but in space you never get that passive work. You are floating 24/7, which means that your bones and muscles need help to prevent serious atrophy. Which is why the various space agencies have developed a very effective exercise and vitamin D protocol over their decades of shared, long-duration space experience. In fact, I came back to Earth after 200 days in space having lost 0.0 percent of my overall bone density, and in good muscular shape. Of all of the medical problems space travelers face, bone and muscle atrophy is not one of them, thanks to the exercise and diet protocols developed and verified on the ISS.

  VIIP (NASA acronym for eyesight problems) has received a lot of attention in recent years. A few returning astronauts have experienced degradation of their eyesight. The cause of this has been debated, but a likely contributor to astronaut vision problems is the fluid shift that occurs in weightlessness. A lot of water that is normally in your lower body floats up in space, with much of it ending up in your head. Which leads to a puffy face, making many astronauts nearly unrecognizable compared to their Earthbound selves. It would be interesting to study how that affects facial recognition software. But back to eyes.

  A lot of our time in space was spent studying how fluid shift affected our eyesight, with its attendant increase in intraocular pressure (translation—our eyeballs were squashed). Like most astronauts, my short-distance vision worsened and my long-distance vision improved because the shape of my cornea and lens changed. My eye doc even sent up an anticipated prescription set of eyeglasses, assuming my vision would change once in space. He was right, though I never used the prescription glasses. The good news for me, as with the vast majority of astronauts, is that my vision returned to normal when I got back to Earth. The bad news is that for a few, their vision is permanently degraded. Though fluid shift is a prime suspect, other factors such as age, gender, and even elevated atmospheric carbon dioxide levels may be contributors. For now, the studies continue and, knock on wood, astronauts continue to return from spaceflight with functional vision.

  Skin problems were some of the most pervasive (and gross) problems we had. Everyone on Earth develops calluses, mostly on feet, but also occasionally on hands, elbows, etc. Where there is a lot of constant pressure, skin hardens and develops calluses. When you get to space most of that contact and pressure stops, so the calluses slough off and disappear. Interestingly, though, while calluses on the bottom of your feet disappear, some astronauts grow them on the tops of their feet, where their feet are often wedged under metal handrails in order to hold their bodies still in weightlessness.

  On my tenth day in space one of my crewmates told me, “Hey Terry, float here and tap your foot on the floor.” That was a weird thing to do, but I tried it. Wow! Electric shocks shot through my legs into my body. I had never felt nor even heard of such a thing. For the rest of my time in space, I would occasionally tap my feet on a hard surface and . . . Zap! An electric, nerve-tingling sensation. A few weeks after my first flight I asked a fellow astronaut who is also a medical doctor about this and he said, “It’s rare, but occasionally folks have reported this. In fact, one astronaut returned from a flight a few years ago and still has the problem today—his leg is still numb.” How the heck did I spend a decade as an astronaut, talking to nearly everyone about their space experience, being trained as a Crew Medical Officer, working with NASA docs, and not hear about this?

  Apparently, this effect was due to nerves and muscles stretching at different rates as your body grew in weightlessness. My height increased by 2 inches without gravity pushing me down; I was finally 6 feet tall! Unfortunately, I was back to 5'10" a few hours after landing, but it was fun while it lasted. Although the added height was nice, the nerve pain was not. One problem that rookies tend to have when adapting to weightlessness is that they grab handrails and pull themselves too hard, and I was no exception. I was having to make a conscious effort to be more delicate as I pushed off and floated from point to point. After a week of learning how to move around, I began to have some serious chest pain—it felt as if I had torn my pectoralis (chest, or moob, muscle). If I pulled on a handrail to launch myself across the module at the wrong angle, there was a sudden and sharp pain, excruciating, if only for a second. It turned out that this pain was from the same phenomenon that was affecting my feet—my nerves had stretched at different rates than the rest of my body, and I felt it.

  This same sensation returned on my second, long-duration mission, and it wasn’t a lot of fun. On that flight I did quite a bit of weight lifting, and as I’d put my feet on the floor in order to push up during a squat or dead lift, that same electric, burning feeling returned. I was able to work through it, but it was definitely an unexpected physiological effect of spaceflight for me, and it continued for months.

  Although this was a nerve issue and not a symptom of a more serious muscle problem, the amount and intensity of our workouts on the station were a cause for concern for me. First of all, you can put a lot of force on the ARED machine, up to 600 pounds, and that’s potentially dangerous, especially when both you and the machine are floating. There is a specific technique to operating ARED safely and I took my time building up to higher weights; I didn’t want to get smashed unexpectedly, because there’s no hospital in space to help with broken bones. It’s also possible to overdo it on your muscles and tendons and joints. I was very careful to avoid this, because an injury would mean an extended length of time with no exercise, and I didn’t want to miss it. Fortunately, I was able to work out nearly every day of my 200-day mission.

  Despite my caution, one day while squatting I felt the dreaded tweak in my back. I stopped exercising immediately, but over the following twenty-four hours the pain continued to grow. I ended up going two weeks on a reduced exercise protocol to let it heal. Overall that wasn’t too bad; thankfully, I had stopped exercising as soon as I felt it or it could have taken much longer to heal. But it made me realize that you shouldn’t push it in space, because being unable to work out can really impact your overall health. Those exercise machines aren’t there just to make you look good at the beach; they’re there to combat the continuous, relentless, degenerative effects of zero g.

  All of the medical issues I’ve discussed so far are interesting and annoying but can be dealt with. However, there is one giant, overarching problem that makes flying humans in space a dangerous proposition. Ionizing radiation. Galactic co
smic radiation. Exotic radiation that doesn’t exist on Earth. In quantities that don’t exist on Earth. When you talk about sending humans out into the solar system (as I believe we should), radiation is the elephant sitting on your couch in the living room. It’s a problem that we haven’t yet figured out how to solve, nor do we understand its extent.

  I experienced radiation in a visceral way, by seeing “white flashes” when my eyes were closed, especially when the station was over the SAA (South Atlantic Anomaly), a weak point in Earth’s magnetic field and an area filled with a high level of cosmic radiation. The first time I saw this phenomenon was on my fifth night in space; when I closed my eyes for bed, I saw a brilliant white flash for just an instant, and I thought, “Cool—that’s what the Apollo guys were talking about!” Then I realized what was happening. If one particle was hitting my optic nerve, that meant there were a thousand other particles hitting other parts of my body, each one potentially damaging the DNA of my cells, which could potentially lead to cancer. Then it didn’t seem quite so cool. I eventually saw those white flashes tens, if not hundreds, of times. And every time I saw them and checked where we were over the Earth’s surface, we were over the South Atlantic Anomaly. It was an unexpected as well as ominous method of navigation, to be sure.