Humans Verses Space: The Next Battleground w/ Shawna Pandya #33

Hello, everybody. This is David Goldsmith, and welcome to the Age of Infinite. There are many different types of podcasts out there talking about different direction that the world will meet potentially going. Ours is not to be thinking about the 4th industrial revolution and the speed of, 5 g. It's to not to talk about just biotechnologies. We are to talk about a bigger picture, the age of infinite, infinite possibilities, and infinite resources.

And through our podcast, we hope to be able to show you a new definition of the future. The podcast is brought to you by the Project Moon Hut Foundation where we look to establish a box with a roof and a door on the moon, a moon hut. We were named by NASA, and it is through the accelerated development of an Earth and space based ecosystem. Then to use the endeavors, the paradigm shifting, those innovations, and to turn them back on Earth to improve how we live on Earth for all species.

Today, we have an amazing topic. It is humans versus space, the next battleground. And with us, we have Shauna Panda. Did I say that right? Actually, I'd I'd never asked you how do you say your last name. Is that how it's pronounced? Pandya. Pandya. Okay. I I should have asked, but I didn't. I apologize. So No worries. Shauna is a physician. She's the director of Internet the International Institute of Aeronautical Sciences. She's a medical adviser. She's also a martial artist.

When we first met, we talked a little bit about that. She's a a diver. List goes on and on and on, and I believe you're going to learn a lot from listening in on the conversation. So, Shauna, do you happen to have an outline for us? Absolutely. Are you ready for them? I am ready. K. I have 6 bullet points. First one, space is trying to kill you. Okay. Tried to kill you, number 2. The next battlegrounds Number with an s. Battlegrounds. Okay. 3. The toolkit for human spaceflight.

Let's engineer the space out of this. Far out questions. And the last. Coming back to Earth. Well, I'm excited. Let's start with this first one, which is really a killer title. Space is trying to kill you. So what do you mean by this? Help me. Sure. So you you you heard that I'm a physician, and I have a massive interest in space. So, I often get asked space medicine, like, what is the correlation? And it's what we know through decades of human spaceflight is exactly that.

Space is trying to kill you. So that's the first premise. So how is space trying to kill us? So when we talk about the various hazards of the space flight environment, it's helpful to know, and have a framework of how we think of the hazards of space flight. So borrowing from our friends at NASA, the human research program has broken this down into what we call the big five.

So these are isolation and confinement, distance from Earth, altered gravity environments, radiation, and then hostile environments. I missed 1. Hostile and radiation. And what was the third one? Probably altered gravity environments or distance from Earth. Okay. I k. Understand them all. Yes. Go ahead. So that's the second layer of the framework. So space is trying to kill us. Well, how? Those are the big five categories. So now let's get into the nitty gritty.

So starting with radiation, we know that the higher up we go in altitude I'd like to just quickly why why did you Mhmm. Start with radiation instead of the way in which you gave them to me? Because I've gotta believe the only reason you did that is there's an emphasis on this one in your in your own mind's eye. That's a good question. I think it's as we tie into the next topic, you'll see that certain of these initial hazards become more hazardous. Okay. So so it was exactly what I'm thinking.

You brought it up because you feel this is a bigger point than the others, and so you wanna emphasize it first. But you could understand there's a rationale. You gave me the list, and then what you did is you picked 1 in the middle. Yeah. And the other thing is in in my mind, you have to give each and every one of these topics the respect they deserve. You cannot underestimate any one of these components, because if you do, then you're failing the first drill of space.

It's half contingencies for everything. Okay. So I'm I'm fine with you starting radiation. It you could just understand. You started there and then you went someplace else. So so tell tell me about radiation. What is where do you and how do you look at radiation? Yeah. So what we need to know about radiation is that the higher up we go while still in low Earth orbit, the more radiation we are exposed to.

And then as we go beyond low Earth orbit, we are outside of the protective confines of the Van Allen Belts, and now it's not just trapped, radiation that within the within these belts. We're we're exposed to increasingly high energy ionized ionizing radiation, when we go outside of the Van Allen belt.

So now we have to contend with, ionizing ray ionizing radiation from 2 extra sources, GCRs or galactic cosmic rays, as well as SPEs or solar particle events, or what you may more familiarly know as solar flares. What's the difference in terms of to humans? That's a great question. And so the these two types of radiation that I mentioned are ionizing, ionizing energy, ionizing radiation.

So much higher energy so they have the potential to cause more damage, in different ways than the typical radiation exposures we would have within the, Van Allen belts. And so SPEs, those solar flares, have a low to medium energy, ionizing energy, and then the galactic cosmic rays background, radiation is higher energy. It's those highly charged particles. It's those, protons.

It's, it's higher energy and so what that means for translation into human hazards and human health is the way it affects DNA, the locations, and the pattern in which it affects DNA is much more complex. So is it a matter of DNA replication that's an issue, or is it just the fact that they're damaged, they can cause cancer, or they can cause anomalies that can happen in the future, when we're talking about the highly charged as compared to the low and medium? All of the above.

So this is why I say space is trying to kill you.

So what we know and we're kind of getting a little bit ahead of ourselves, but this is good recovering it, is that when we're exposed to these this highly these highly charged particles is that, yes, there's an increased cancer risk, there's an increased cataract risk, any type of epitheliized epithelialized surface whether it's the inside of our blood vessels, the linings of our guts, any mucosal surface like the inside of our mouth are more susceptible to cancers, and then we know there's a cardiovascular and cerebrovascular, effect as well.

So we're more likely to have cardiovascular disease, and cerebrovascular disease such as, a stroke. And, so I understand this, and I'm gonna bring it up right now because it keeps it's gonna pound me until it gets answered. We have had 570 approximately astronauts in the International Space Station or have gone beyond the International Space Station to the moon.

With those individuals, has the data came come back that the 24 who have seen the earth from afar, meaning they've gone farther than lower orbit, to those 24 have such a larger degree of, biological challenges as compared to those on the International Space Station, as compared to those on the on Earth that it would be a statistical anomaly enough to say it's causality? Not yet.

Or if it's been mentioned in the literature, I haven't seen it, and I am bringing to you the rate the latest citations on what we know about the hazards. For example, if you if you are motivated enough to read more beyond this, beyond our talk today, which my hope is that you are there's a great review in Nature Microgravity from 2 weeks ago that talks about red risks for the red planet and they they don't talk about data from Apollo.

And there's hundreds of pages of documentation, from the Apollo era called biomedical results from Apollo. So my I suspect, David, it's a very astute question but maybe the sample size is too small.

And we know, you know, it is acknowledged in the literature that we we know that the types of radiation are different, but we we aren't doing a good job of modeling the highly charged particles, the ionizing energy radiation of GCRs and SPEs, when we look at models for long duration space flight beyond low Earth orbit. The only the reason I bring it up, and it it's not that I wanna harp on it.

It's that if, when I started the space, the entry into space, which is only 6 years ago, I was invited to 2 events. 1 was a PhD level event. I don't know why I was there, but they won me there. There's a 50 top people in the space industry. Buzz Aldrin was there, many of the top people in the industry, and it was a global meeting. And the second one was in Washington DC, and it was the Pioneering National Space Summit. And it was a 100 of the top people in the United States space industry.

And, again, buzz was sales, 7 us 7 astronauts, the administrator, a large group of people who are highly, highly specialized. And then I and I had constantly heard about this Van Allen belt and the challenges of going to space and radiation. So I went to the Smithsonian Institute in Washington DC. I had it some time before, and I said, let me look at the space the space material, these rockets. And I walked around. I said, my lawnmower I don't have a lawnmower.

I people cut my lawn, but let's the lawnmowers I've had were better manufactured than the tools that were used in 1969 to go up. And so I said to myself, we talk about this radiation in the Van Allen belt and getting through it, and yet I don't see much protectiveness. No water barriers, no special technologies that protected these astronauts. And there you've got Buzz Aldrin and the the the individuals who've been to the moon who have more or less led a reasonably long lifespan.

So I I'm challenged with it because if it is that challenging, why haven't we seen it? And that's a very good point. You're you're absolutely right in that we need better data. There have been a few, astronauts who have died of cancer. And so what I haven't seen mentioned is that astronauts are dying of cancer, at a higher rate than, the general population.

But for example, astronaut Piers Sellers, unfortunately, he was an American British, astronaut, passed away from pancreatic pancreatic cancer not too long ago. How old was he? That's a great question. I wanna say sixties. He was, he was born in 55 and died in 2016. So, 45 plus 16, 61. Yeah. So he's that's that he's right within the the, lifestyle range of when an individual would get it if they were to discover it as a male, condition.

So, yeah, it's it's I hear this and I'm still it's almost like I'm searching for an answer to say radiation here is challenging. Radiation is very difficult. It can. It can. It can. And I think that we're still in that are you would you agree that we're in the hypothesis stage still as to what damages we do?

Yeah. Yeah. Good good for you because you're you're very astutely noting that we the the theory doesn't fit the evidence to date, but also the sample sizes of people who've gone beyond low earth orbit are small, 24 people, and they're all of a very homogeneous demographic, middle aged white males, mostly, and, well, all Americans. So, sounds very, very, very profiled as to a certain group.

Okay. Okay. So the so when you're talking about this, I'm assuming we're taking this data, the ionizing radiation, and comparing it to what we know and the radiation that's on earth, and we know that radiation on earth, from example, from too much x-ray exposure or too much too much of a type of, radiation, a nuclear will cause damage, and we're extrapolating that to space. Yeah. Exactly. And then you're you're right. We need to do a better job of saying, okay.

Well, if we will if we hypothesize that these high highly charged particles, the GCRs, are the ones that are are the ones that pose pose the greatest risk to human health, then that's what we need to set up our studies to to look at. You know, it's you can't cap compare the apples and oranges of, low non ionizing energy versus the higher energy, of GCRs and SPEs.

Is there anything going on right now that you know of in terms of find discovering that in to a level which would be conclude that they expect to be conclusive enough to go beyond the Van Allen belt and live? There is there yes. There is a lot of data. There's the, NASA Human Research Space Radiation Lab. There's computer models.

There's, a simulation of how these work in synergy with, the altered gravity environment, the stress of the human, sorry, the stress of the operational schedule, up in space. I am certain that there are animal experiments in my review. I did not, dig too much into the weeds about what's going on with animal studies.

I wonder what the Chinese, and I know the Russians have worked very hand in hand with the Americans, but I wonder what they have, especially the Russians in terms of data on these type of things. I don't know if that's shared to the same degree as other information. Okay. I stopped you. I stopped you in the middle of this. Keep on going.

Give me give me more because I'm trying to I'm really trying to figure out how we can achieve this Mearth, moon and earth space economy, and one of the challenges always brought up is radiation, And how do we protect from it? And how do we live within it? And, I'm looking for more answers. Yeah. And that's exactly it.

This is, what you're gonna find either to your delight if you wanna dig more into this, as we go on or to your frustration because what you're all about the questions is a lot of these are to be determined further studies are needed giant question mark. And so that will be a running theme but it just means that we have more solutions to engineer, and by the end of this, more benefit for problems on earth. Okay. So, more with and anything more with radiation?

The last note I'll say is that we need to know when we talk about we'll put it this way. What is the radiation prescription? What is the maximum limit for what duration, for what type of radiation. Right? So this will this kind of starts tying into the next battlegrounds as we talk about going beyond low earth low earth orbit. What is the absolute limit? Because we know the numbers.

We know that we can be exposed, to up from 10 to 4 to 10 times more milligrays, on, on the moon and beyond the Van Allen belts that we would see on the ISS. But also, again, you're comparing apples and oranges. So stay tuned to be determined. But the bottom line is we need to figure out the first We have to yes.

I we have to address that, and I know the data keeps on coming back that there's actually more of certain substances than we've ever we've imagined, and that we we really don't have a clue as to how how much or how intense this would be until potentially we're actually in that environment. So okay, so what's the next one that you've picked off your NASA list? So let's go with isolation and confinement. Okay. So yeah.

So, you know, when we talk about isolation and confinement, we talk about not having your usual creature comforts. And so starting with the International Space Station, you are shuttered in a tin can hurtling through space at 17,500 miles an hour with 6 other people on average for months at a time. You know, you have your twice weekly conferences with the psychologist, your weekly conferences with the flight surgeon, and mission control is within immediate, there's no time delay.

They're within immediate comms. K. So so the question is, how do you be that guy or gal who thrives in this environment? The guy who's not voted off the hab or the spacecraft. And so that comes down to to crew dynamics and personality. And I'll leave it at that because this is kind of a teaser for when we talk about the next battlegrounds about how much this more of an issue this becomes. So I I I know you wanna leave it, but I need to ask something. For sure.

I've, I've never asked and I did not know the twice a week psycho psychological connection and the once flight surgeon. Have you been privy? Have you seen? Do you know what actually goes on in these sessions? I don't. And this is this this is a testament to realizing that as high profile, as public as human spaceflight is, at the end of the day, patient confidentiality is patient confidentiality.

So we know there's there's data from the lifetime health surveillance of astronauts, the LHSA, but that data is highly anonymized because in such a small sample size that's only 12% female, we it's, you know, there's a huge push to anonymize and protect that medical data. The so even though it's, it's now cleansed for visibility, are there certain types of challenges is there any data on the certain types of challenges that are faced more often than others?

Yes. Yeah. So then, you're getting into what is the history of medical events from decades of human spaceflight. So that anonymized data is definitely published. And so, to quickly answer that question, we know that, suprafacial injuries and traumas, figure highly. We have seen potentially scary things like cardiac arrhythmias that have been noted in flight, but have actually been of no clinical consequence and have been in passing.

We've seen headaches and backaches, particular likely due to the adaptation to the altered gravity environment. We've seen sleeplessness and fatigue. And then, you know, psychiatric issues have come up, but maybe not as frequent frequently as one would expect. The the topic of being away from home.

I wonder how much the preparation has to do with the ability for an individual to understand that be capable of under and and being able to live through it as compared to the shorter and shorter timeframe over the time spans that or education, the experiences that the training the word I was looking for, the training that would go into somebody and say 10 years might be a much shorter time frame.

So we might end up with more challenges in space because of less time acclimating individuals and selecting them to be a part of a mission? It starts at selection. So even before you ever get accepted to the astronaut corps, they wanna see that you've had that experience and that you haven't, you know, gone crazy, experienced depression, been affected to the point where you can't function.

So for example, on the 2016 CSA, Canadian Space Agency astronaut selection, you know, the the application asked about what is your experience working in remote environments? And, you know, the people who made the top 72, who made the top 30 were the ones who had spent time on working on remote ships in the middle of the ocean, who had spent time on Arctic and Antarctic deployments.

So, you really want this this person who approaches this this isolated confined environment with a salutogenic sorry, salutogenic approach. And so that's a positive psychology term for someone who takes this adversity and rises to the occasion. And this comes down to resilience. And we know from the data, of not just space flight, but austere environments, there are people who view, you know, 6 months of darkness in the Antarctic, for example, a a challenge to rise to the occasion.

And so it's it's partially at selection you're looking for these people, but you also want people who have the experience of thriving in these environments. Do you know if there's been any major conflict on the end on the station? Not typically, not openly discussed, but there is data from previous I think it was Skylab where, the operational schedule was so heavy that the commander ended up and the crew ended up rebelling against mission control and simply turned off comms. Oh, wow.

Yeah. Well, I mean, they never flew again. So, you know, it was that active, active rebellion. But, you know, looking back at the data, I say I wonder if that was too harsh because Yeah. As the commander, I've also been I we'll talk about analog environments a little bit later on, but I've been in situations where the operational schedule that was given to us was too heavy, and I've said, no. You know, we need to stray from the schedule.

So, you know, may you as the commander in that situation are doing what's best for your crew in the moment and in the long term. So they can they might not be working today, but you're doing that so they can work. Yeah. You're you're you're protecting your crew at the same time. You're giving them that breathing room. You're you're supporting their challenges so that they can unlock. There are many reasons for it.

So, yeah, that that seems harsh at the time, yet it was at the time that it happened that makes, an understanding. So in terms of isolation and confinement, it is a challenge, yet we've not been we've not really run into a challenge that's because the sample size again going back is too small, and these individuals are all weeded out to fit that behavioral capability. Exactly. Exactly.

And so as we as once we finish covering these or if you wanna talk a bit now, we're gonna talk about the evolution of these hazards, and how we need to start thinking about them differently. I think we should hit the others, and then we can come back to the evolution of them, so that this is good. I mean, I'm I I know this is these are issues. I just have never been gone into them. So what's the next one you wanna hit on your list? Let's talk about distance from earth.

So this kind of ties into stuff we've talked about already. We've talked about, you know, how that affects, human health from a radiation perspective, the isolation confinement. But the key home key point I wanna hammer home is that with with distance comes communication delays. There is no communication delay when you are on the International Space Station. If you need to ask mission control how to fix something, if you need medical guidance, you have it instantaneously.

By the time you go to the moon, that is a 2.4 second round trip delay. By the time you go to Mars, depending on the alignment of the Earth and Mars, it is a 6 to 46 minute time delay. So as you can imagine, all of a sudden if someone's actively in cardiac arrest, if they're hemorrhaging out, you do not have time to wait for the next instruction from earth.

Yes. And the 2.46 2.4 seconds, I'm assuming in the beginning at least astronauts will have biometrics built into many of their clot much of their clothing, so that there will be some type of data being transferred and so there can be help. So it's interesting you took distance from Earth. And when I thought of distance from Earth, I thought of isolation. Yep. And you know there's what you'll see is there's a lot of ways to think about this.

You know, when I first heard of the big five, for example, I thought well, hostile environments, that's just everything else. That's kind of a cop out because that's a lot of different things and also incorporates the fact that isolation and confinement could, potentially cater to that, you know. To cut to kind of underscore the point of isolation and confinement and how bad it can be, There was a story of 2 Soviet scientists in the Antarctic.

I think this was last year, and this is how bad it got is that one scientist would antagonize the other by telling him the end of every book before he was finished reading it. And the guy who was reading the book and having the endings are ruined for him, his reaction was to stab the guy. So it's it's it's it's Justifiably so though. You know, I mean You didn't even laugh at that.

I'm I'm still in I'm still in shock that, you know, it's it's just it defies the imagination, you know, for you and me who have the context of the defies the imagination, you know, for you and me who have the context of not being that who have the luxury of not being that isolated. To you and me, it seems, you know Well, I I I gotta ask you then. Are you married? I am not. Okay. So then stabbing somebody is not. And I sleep with one eye open.

Telling me if a person spends a week reading a book and the person just before they get to the end tells the ending, and they do this over and over again, you that could push buttons. Absolutely. And so this comes back to, selection and, you know, the psychological profile of who we want to select for these missions, and also expeditionary behavior.

Okay. So let's spend some time because I think we're gonna expand on how these how each of these five evolve when we we talk about the next battlegrounds. We'll spend some time talking about hostile environments and then altered gravity environments. Okay. So when we talk about hostile environments, that is an umbrella term. That includes a lot.

That includes the dust exposure from lunar regolith, which we know from the biomedical lessons of Apollo, is a irritant to the skin, to the respiratory system, and that also it clogs up joints in EVA spacesuits. So that's one example. Altered day night cycles. So when you're on the ISS, you're experiencing a sunset sunrise every 90 minutes. That's, 16 sunrisesunsets every 24 hours when you're on the moon. Your day night cycle is 14 days 14 nights.

And then finally when you're on Mars, it's almost but not quite, that what you'd see on Earth. It's just over 24 hours. So over time, you're gradually becoming more asynchronous with Earth. And so the reason we care about that is we know day night cycles affect, productivity, stress, ability to sleep. You know, this time of year as a practicing physician when the days are long in Canada and the sun starts setting around 4:30 in the afternoon and it will soon be, still dark at 9 AM.

You know, we see people tip who've been managing their mental health all year. The my waiting room is full of people tipping over into depression, anxiety, seasonal affective disorder. So, you know, the circadian rhythms are and the lighting is is just as important to consider. The temperature extremes, so, you know, we might say, well, we know that it's a short sleeve environment on the ISS. You know, why would you plan for anything else?

Well, if you're gonna plan, to do a spacewalk outside the ISS, if you're gonna plan to do a surface EVA extramuclear activity, outside your moon base, well, if you're in direct sunlight, it's gonna be hot. If you're gonna be in permanent night or 14 days a night, it's gonna be very cold. So you need to plan to protect for those. So those are just three examples of what you can expect to face in the hostile environment.

And you know, that also brings into consideration how does your environmental closed loop life support system need to help manage this? The temperature, the air composition, the the carbon dioxide scrubbers, the humidity content. So it's an umbrella term. The list is endless, but it's just kind of that term that says beware of space. Is on the list aliens anywhere there? Not yet, but I suspect given how 2020 has gone down, they're they're staying away.

Well, I would act I would argue that probably it's reclassified as something else. So it's bio, biohazards, viruses or any other types of that we have might have never encountered a biological or a virus or something that can infect the human body. Well, I'm glad you brought that up because, I was gonna include immunology under altered gravity environments, but the truth is we don't know if it's altered gravity alone. We don't know if it's increased radiation.

We don't know if it's a synergistic effect. We don't know if it's the heavy heavily scheduled operational schedule. But we know that, astronauts immunity is suppressed in space. We know that some germs, or have increased virulence in space, but we also know that we're not seeing too much of a clinical effect from this other than we've had seen the odd viral reactivation of, for example, previous herpetic infections in certain astronauts. But immunology in space is an active field of study.

It's one of those things that if I showed you a movie that had a scary plot where someone's going to kill you, you might cower in your theater chair because of the sound and something happening. When it's broken down this way, yes, space might be trying to kill you, but so far, these are we can hang on. Yeah. These yeah. I'm not they're they're not as bad, even though they're technologically challenging. They don't sound as bad as I think I hear it to be.

Is it will you do you am I do you understand what I'm saying? That's exactly it. And so the question, as you will see is how do we plan for the next battlegrounds? What toolkits do we have at our disposal? What is being done today and what's on the horizon? And then how do we bring it back to Earth? Because So we're fine so I'm actually asking the right questions. So is there anything you wanna add to altered gravity environments? Yes. Let's briefly talk about how gravity affects the human body.

And the summary is that gravity zero gravity, we know, affects every single bodily system from our muscles to our bones to our cardiovascular system and fluid shift to our central nervous system. And the surprises keep coming. So quickly, muscles and bones experience decrease so muscles experience atrophy, bones experience increased density loss reflecting an osteoporotic or osteopenic state that we would see in disease states on earth.

Fluid shifts, so fluid is no longer pooling in our feet because of the luxury of 1 g. It shifts upwards, so the consequence of that is several fold. Our heart initially interpret interprets the added fluid shift at the at the torso level as increased circulating fluid. And so for the first few days, astronauts are interpreting this as having more fluid in their body. They're peeing out more. They're slightly dehydrated.

They're also losing some of their red blood cell volume and, reflecting a condition called spaceflight anemia, which corrects itself once they return to Earth. And then the surprises keep coming. So in the past 15 years or so, we've discovered where we've tried Just on the central nervous system, what do you find? Yeah. So this is this is the central the space adaptation neuro ocular syndrome that's been described in the previous, 15 years.

It was initially known as the visual impairment intracranial pressure syndrome. And what we were finding is that astronauts seem to have altered vision that persists for years up to 10 years post space, post flight, that has a male preponderance that maybe certain pathological states on earth mimic this, like the increased intracranial pressure, pathology on on earth, but not exactly because those two syndromes actually differ in a lot of ways.

So the symptoms can be different and the gender prep preponderance is actually favored towards females in the, idiopathic increased intracranial pressure syndrome. Okay. So so to to dissect that jargon is we know that the central nervous system is affected and we're still hypothesizing why this is.

The prevailing theories right now seem to be a combination of, well, just like the fluid shift in the cardiovascular system going upwards, the cerebral spinal fluid or that proteinaceous brain juice that bathes our brains and spines is shifted upwards.

It's outflow drainage, both through lymphatics, through the CSF, through the venous system are draining less, and then there is a local outlet decreased outlet flow around the optic nerve, which is why we see this translated as increased pressure on the optic nerve, increased, choroidal flow folds, so folds at the back of this this tissue at the back of your eye, and then the the shape of the eyeball itself changes and so it the the lengthening, sorry, the the the length of the the axis of the eyeball shortens and so, causing astronauts to develop a refractive error.

Again, mostly seated males, and what we need to figure out going forward is we know that this is mostly seen in long duration space flight. We need to figure out how time dependent this effect is. You know, is, does it plateau off after 12 months? Or, you know, if we're if we're going on a several year mission to Mars, can we expect that the deleterious effect will will go on as long as you're not in a one g environment? How much gravity is enough gravity?

Is 1 third gravity on Mars enough to bring, to mitigate the the fluid shift? So it is a very known, a very real effect. It's recently described, and it's, something that we have to plan for as we prepare for the next ballot. This is a type of trivia question because I don't have an answer for it. Is there any movie or any space based movie or event where the individuals who leave Earth cannot see after a period of time due to these type of conditions? I don't think it's I don't think so.

I don't think it's been covered, but, you know, I wonder about this because when I think about the increased cordial full folds, is there an increased risk because you're changing the anatomy of the eye? Is there an increased, risk of, retinol or vitreous detachment, which is a is which is a, eye emergency. You can lose your sight. Now I've been reading extensively about the SANS, syndrome over the past week or 2, and I have not seen that mentioned anywhere. So this is purely theoretical.

You have people you have people dropping from high, in even in their space outfits, they drop from high levels, and you see them bang, and you never see retinal detachment. And you also never see challenges with people who get into a space vehicle of some type Star Trek or battle. So it doesn't matter which one. And you never see them say, oh my god, I can't see anything. And the solution is always that on the v on the vessel, there is a gravitational field which keeps them.

But it's still you've never seen it, which is kind of a funny thing to avoid in almost every single movie. You know, it's it's critical because it is a nightmare scenario if you what if you lose your vision on Mars? And then, you know, that's not the only threat to your vision. There's some estimates out there that suggest given the amount of radiation you would be exposed to on a one way transit mission to Mars, at least 25% of the crew would develop cataracts from exposure to radiation.

So this is why I say space is trying to kill you. No. And I agree with you. I I love what you're bringing up, so don't don't get me wrong. What I'm saying is that if there's very limited awareness of these topics, which often are taught through scientific programs or or movies, then you lose that sense of where is the danger. I I think this is the first time I've heard about the the cataract condition going to Mars.

I think it's just and it should be out there as a means of solving it or of understanding that we're being killed. Yeah. That's exactly it. And so the last thing I wanna mention under altered gravity environments is that the surprises from space flight keep coming.

You would have thought that after decades of human space flight, we would have all of these systems down to a t, but just at the end of last year, there was a article published about how doing routine handheld ultrasound, imaging with the internal jugular veins of astronauts in flight, they're like, hey. What's that? Oh, oh, that's a blood clot in the internal jugular vein.

So now we have to figure out, is this a one off, scenario or are astronauts getting blood clots, because of the venous stasis, that lack of Mhmm. Flow that you would see in one g? And if so, well, that can be life threatening. How do we mitigate that? I don't know if you had seen recently, there was a woman on 60 minutes.

She has dissected, the anatomy of a 100 COVID patients and they had the they were analyzing the brain and in there they said this virus has caused spotting, blood clots throughout the brain. And so she said, she pointed out and said, this is an example of a stroke in any, in a normal condition. And she said, but what we're finding is all over the brain. This is coming that we're finding these type of conditions from COVID.

And so we don't understand enough about and I don't know how long it will take if it's we're having trouble even or challenges on earth. I don't know how long it will take to be able to cover something such as this condition, especially the one you just mentioned. If you are traveling to Mars, it's not the time to find it out. Yeah. No. You don't want surprises, in such a high risk environment. And, you know, it's it's the the problem with COVID is the exact same.

You're trying to isolate one system that really truly interacts in a multitude of system, and you wanna know and understand how that one effect happens, but also occurs in in tandem with all of the other systems that are operating. With the Kelly brothers, was there, in your opinion I know this this is an opinion question.

In your opinion with the Kelly brothers, was there a spike in understanding or data or analysis that conclusively gave us enough information to make some really great decisions? Clinically and operationally, I haven't seen new guidelines that have reflected how we will change countermeasures pre post and in flight going forward.

At the at the molecular level, at the proteomics level, at the metabolomics level, we we did gain more data about, losing nutrition, losing muscle mass, losing our cognitive function or not losing, but having it negatively impacted. So I the short answer is no, but there may I mean, the the the caveat is I I I I it's a good answer, but I'm just laughing because it's it this was supposed to be a huge answer. Yeah. And I think the answer is that I mean, this is a relatively recent study.

The nature I think it was Nature or Science. It was a good article, but this kind of plays into the bigger question even on day to day Earth medicine. From the time you have basic science to the time that you translate it into a meaningful full clinical guideline is there's a delay because you wanna make sure that what you're doing impacts practice in a meaningful way.

And so they're they're probably what's probably happening is behind the scenes with the human research road map and the risk management program is that they're translating these findings into countermeasures. So what you're saying, and I'm picking on COVID, is what you're saying is you need time to really analyze all of this before a shot or a thing is considered to be conclusively safe, valuable, practical in terms of what needs to happen.

And I think space is an example of an Earth simulation where you need to have that time. You need to be able to identify, does this actually occur across 570 astronauts? Does it occur is it reoccurring? Is it genet is it, genetically based? Is it culturally based? Is it food change? Is it, gender based? And all of those make for challenges. Yeah. Absolutely.

You have to do what you have with the data that you have at the time, noting its limitations, I e a small skewed, dataset, as well as realizing that the data is constantly changing just like in COVID. So that's that's a very concise summary of the challenges Yeah. Clinical medicine. Yep. Okay. So I think are we on to the next battlegrounds, or are we Yes. Do you have more to add to this? No. I think that we can leave it at that.

And so the good news is we've covered a lot of, what the hazards are and how they might change. But let's let's quickly, go over how the 5 topics that we've talked about need to evolve, as we go beyond low Earth orbit, and then we'll talk about what else needs to change. So actually let's reverse that because we to summarize, we've talked about isolation confinement, distance from earth, radiation, altered gravity environments, and hostile environments.

So the blanket summary is we are going to be more isolated further away for longer periods exposed to more radiation, with with less help from Earth. So the point I wanna make here is that we need to start thinking differently about starting at selection. So we need to think about, do we need to select our astronauts differently?

Is the profile of an astronaut who would do well on an ISS mission of 6 to 12 months the same or is it different from someone who might do, surface operations on the moon, who might engage in mining, science, exploratory endeavors, who might stay there for longer periods at a time. So the selection aspect needs to be a consideration. Then the training. So the training will be a reflection of the activities, that we'll be doing at the next battlegrounds.

So to be perfectly clear, the next battlegrounds I'm referring to are the moon and Mars. And so when we talk about doing something like an EVA, well, currently an EVA means we're doing a spacewalk in 0 g fixing something like the Canadarm or the Hubble, outside of the ISS. Well, now when we're talking about an EVA, we're talking about being on a surface, that's rocky, that's slippery.

You just need to Google the picture of the Apollo 17 astronauts falling over in their EVA suit to know that, you know, there's you could certainly expect to break an ankle, break a wrist by falling on the break a wrist by falling on the moon. You need to to realize that your medical capabilities, will need to change because you're further away from Earth.

So as a basis for comparison, when you hit the evacuation button on the ISS, from the time that you hit evacuation, you escape in your Soyuz capsule, you land in Kazakhstan, you could be there in as little as 3 and a half to 6 hours. By the time you hit the evacuation capability on the moon, it's a 3 to 5 day journey. If you run into a medical emergency on Mars, well, help isn't coming for 6 to 9 months. So, Help is not coming.

Yeah. Yes. I I had a, a friend in in university, and he would show up late and I would accept it. And one day, he showed up 2 hours late, and I looked at him. I said, what's wrong with you? He says, David, when you're 2 hours late, you're not coming. So and they're not coming. This is solving it on Mars. It you have to go there with the intention of being able to solve it. Exactly.

We need to increase our autonomous capabilities or as we'll talk about, think about what technologies can empower us to thrive in situ. So coming back to the the summary of challenges, we've talked about the the nature of the activities that we're dealing with changing. And then as you correctly hit on, we need to build up the capabilities to make us more autonomously, capable institute.

Whether that's from dealing with medical emergencies, whether that's taking this concept of prehospital care that we see in military field medicine and in disaster management that we how do we build on those principles? How do we you know, you you kind of said help is not coming by if we're on Mars and we we we run into a medical emergency. That's one way of thinking of it.

It's, but then you have to face some dark, hard decisions of if that happens early on in the mission, well, are you are you able to carry out the mission at minus 1 astronaut? If it happens at the end of the mission, you know, is it you know, what is the impact on crew resources? What is the impact on morale on the crew if you say that we're not gonna engage in futile, efforts?

So you can perform CPR all you want on Mars, but if there's no advanced life support system to support that, well, you know, you're not it's then you argue about the ethics of provide providing futile medical care. Because if you there's no post resuscitative support, well then performing CPR is a futile effort. Or the flip side of that is, are we delving into a new branch of medicine? Are we going from prolonged field care to super prolonged field care?

Are we, you know, do we have the ability to to engineer low mass, low weight, low volume, medical capabilities that can perform the standard of care, on Mars that you would see on Earth or even surpass it?

So when you when in your opinion, when you look at these, let's start with the moon and living in that I'm not let's call it hostile environment to keep in in line with what we're talking about, And you think about new branches of medicine or new approaches, or have you come up with you personally or have you experienced moments where you said, now that is the future of how we would deal with those challenges? Yes. I am glad to talk to you about that.

Because I I I was just gonna call Bruce Willis and ask his thought of how he would solve these hostile environments and see what he came up with, but it probably wouldn't be medical. No. We I'm thinking of Armageddon. So We are gonna spend all our time talking about this when we talk about let's engineer the space out of this. Okay. So we can jump ahead to that or we can I would finish if you've got anything here so we're done?

But you still have a toolkit here or less you think it's if you think it's right because it the flow that you gave me seems logical. Yeah. So let's let's quickly touch upon the toolkit. So the last thing I'll say about the next battleground is, yeah, we've we've kind of broken this down, into the big five, but, really, if you go and read through the risks on the human research road map, it is at least 30 categories.

It is everything from crew dynamics to, the impact of altered day night cycles on stress to poor interfacing with human computer interfaces to skills degradation on the way to Mars. So this is a very high level approach, but there are a lot of considerations. I I never thought about having challenges with computer interfaces, which is an interesting, take on assuming that the computer interfaces work in these environments. Okay. Yes. Yeah. And so so let's yeah.

So that's let's wrap up the next battlegrounds and let's Okay. Move on to we've talked about the problem spaces. So what tool kits do we have at our disposal? So because some of these we've we've alluded to and you've you've already kinda guessed at. So let's talk about the packing packing principles of space. So not only do we have the The packing or cracking? Packing. P a c k. Yes.

So not only do you have this harsh hostile environment, you are severely constrained in what you can bring with you. You're constrained with respect to mass, volume, power. What you bring with you will often come at the expense of something else. It's like the it's what NASA calls the back backpacking principle of space. Everything you bring is the at the expense of something else. It has to have a long shelf life because say you say you decided you wanted a ventilator on Mars for life support.

Well, say it broke down. Well, now you have a very expensive useless paperweight, and it has to be easy to use. So, those are the packing principles, and then you also need to know what are we packing for. So we've talked about the hazards of the space flight, and we've talked about the data, from previous missions, and we've talked about how we can expect the data of previous injuries, previous medical incidences, changing. But we the last part of the puzzle is the You just said something.

Yes. Has anybody gotten very sick in space? Most famously Fred Hays, Apollo 13, Eurosepsis. So what I left out when I talked about fluid shifts is that this fluid shift also leads to a preponderance for the development of kidney stones, which at the very least are super painful. At the very worst, can block urine output and lead to sepsis, which is life threatening.

And so that, you know, we haven't had to do anything like perform CPR in space yet, but that was an example of a life threatening condition. I mean, was he in real trouble up there? Was he, or just in pain? Did he pass the kidney stones? I don't know if he passed the kidney stone, but he was he was pretty septic. You know, they did a good job of, like, demonstrating, you know, how diaphoretic, how sweaty, how pale he was. Like, he was just trying to push through, be the astronaut's astronaut.

But, ideally, you you don't want that to happen. Well, it's going to happen. That's It is. The humans break down. So Yeah. Okay. So sorry I jumped in there with that. You you said it in a way that I wanted to know what have we had that because I've not really heard or seen. There's no headline that says, astronaut x has got this issue that we've I don't think that's been a big storyline. Yeah. And so to your point, this is just one of many examples.

So currently, what we're planning for, is what we call the NASA Exploration Medical Capability, XMC top 100 list of medical conditions. So this includes everything from the banal everyday, hey. I have a headache in space to the terrifying, oh my god. There's a cardiac arrest in space to the banal, but also terrifying diarrhea in space. And so there's 100 list 100 medical conditions listed, and these are currently, how we're planning on packing for space.

So to continue on with that is, well, then how do we develop the medical kit knowing for knowing the constraints that we have? Well, we already talked about one of the mainstays, within our toolkit, and that's prevention and selection. If you have asymptomatic kidney stones, you're and you are the best astronaut candidate in the world, you're still screened out because like we just talked about, kidney stones are a nonstarter, knowing the increased risk.

So if we can prevent a medical condition from ever happening in space, then we've done our job. So it starts with rigorous medical selection, psychological selection, team behavior. Then we look at risk identification and mitigation. So we we look at the NASA risk matrix. So we look at the likelihood of something happening versus the severity and impact on the mission if it does happen. So if it's something that is very likely and very severe, then it needs to be mitigated.

So examples of that that are well documented are the radiation problem and the space adaptation neuro ocular syndrome. You know, if it's low likelihood and low impact on emission, you know, say say something super out of the realm of, of possibility, performing a c section in space, well, then you're not gonna plan for it. It doesn't need to be mitigated.

If it's something that's kinda likely but minimal mission impact like getting an abrasion, well, you know, you just accept it and document it and move on. So Yeah. You've probably read about all of us. You've been a space person at Pierce for a very long time. I know peep individuals who are saying we're gonna have 50,000 people in these circular Orion type space facilities in the next 7 years or 10 years. We're gonna have 50,000 people on the moon in 10 years.

We're going to have a 1000000 people on Mars in 40 years. What you're going over, timelines don't add up. They don't. And I, you know, I exactly. Whenever someone says, hey. We have a way of getting to Mars. We figured out the technical solution and the propulsion. I say, great. Well, what's your medical capability, and what is your medical mitigation plan?

You can figure out the engineering all you want, but if you don't figure out the human aspect of it, well, you're not setting yourself up for success. Success. It's one of the challenges that I have often with individuals in the space industry is that their their math doesn't add up. And I just had a conversation with someone the other day, and I said, okay, give me your timeline. So what do you mean? So no, give me the timeline. You've given me all the cases.

Now tell me, we don't have a rocket on earth today as far as I know that can get us to the moon. We don't have a rocket capable of getting us there. How long will it take? What do you mean, David? Well, I'm serious. It's not a tough question. We need to build 1. Will it take a week? Will it take a month? Will it take a year? Okay. So let's add that in. So that's your first shipment. That's not human rated. That's that's there's no humans in it. This is robotic. So let's try another one.

Let's try another one. And by the time you're done, their math adds adds up to 17 years, but they're talking about something that'll happen in the next 5, and the math doesn't add up. So you answered the question. It's it's if we're gonna be pragmatic about living on the moon, if we're gonna be pragmatic about living just within Mearth, when the within the moon Earth, region. There's a 2.4 second delay. I think that was the number you gave me.

There's ability to be able to get someone home within 3 to 5 days depending on how quickly they launch and they're out. There are these limitations, but even with those, it is a challenging, challenging belief structure to say you'll have a 1000 or 10000 people on the moon within 5 years, and it doesn't have That's exactly it.

So the one caveat is is that the data that we have for commercial space flight for suborbital space does support sending every type of human regardless of their medical capability, or the medical comorbidities to space for 3 to 4 minutes at a time because that's a relatively short profile. And Really? So so this is kinda like the zero gravity, touring? Exactly.

So this is what we when we talk about commercial suborbital space flight, SpaceX, Virgin Galactic, Blue Origin, and we have data from centrifuge studies where we've put subjects aged 19 to 89, of all manner of medical com comorbidity from, people with heart transplants, congenital heart conditions, type 1 diabetes with an insulin pump, and they were all able to withstand the hyper g load. So the increased gravity profile front to back, up and down, they all did great.

And while their 0 g component wasn't there, and that's the gap, the medical comorbidities were stable. No one had an HAZMAT attack. No one had a arrhythmia that turned into a clinical concern. There were arrhythmias noted but they were actually in the healthy subjects with no heart conditions and the most common reason that someone was disqualified was because of anxiety, claustrophobia, or just not being safe.

And I would say that in addition to that, the other major reason someone may not enjoy their flight in a 3 to 4 minute suborbital flight is because they're on a the most glorified of comet comets and unfortunately getting space sick. The one of, our team members out of Germany who, has owned Space Affairs. So he has done a tremendous amount of these, space flights, the zero gravity flights out of Balconar. And so he he's one of those, and I've never asked him a question.

Have you run into this challenge? So, yes, I could believe that to bring someone up, if you have the right conditions, you're not gonna run into any challenges in 3 to 4 minutes. So what's the what's the next challenge level up? So the next challenge job is opening up low earth orbit from a commercial perspective. So maybe, yeah, maybe it's not realistic to think about 40,000 people on the on the moon, 1,000,000 people on Mars, but all we need is a single catalyst to open up low Earth orbit.

All we need is the start of a few successful suborbital flights and then the price point to come down, and then in theory, you could have a lot of people accessing low Earth orbit initially as a tourist, and and human tended payload and, scientific endeavor, and opening up the space frontier in that manner, and in so doing, opening up new economies, new platforms for art, for athletics, for entrepreneurship. That to me is is is realistic.

Our next guest on the program, I think it's next, is John Spencer who I believe still is the president of the Space Tourism Society. So we're going to be talking about that in some degree also to say where where does he think, how far and to and to be pragmatic again. We've seen what Virgin was in the early 2000 and still no one has flown.

So safety and even the astronaut just recently who was supposed to go up, and he decided to stay on Earth because he was gonna he wanna be around for his daughter's I think it was his wedding her wet her wedding, and he decided not to be that astronaut because of the risk factors, the capabilities, the training, and all it takes to get up. So okay. Alright. So so what's what else is in that toolkit? You said there's a 100 different. You went over 0 gravity.

Is there anything else in that in that toolkit that we need to develop or any challenges? Because a 100 is a lot of different medical conditions. Yeah. They're not we're not even talking the challenges, technologically, repair, maintenance of an engine, repair, maintenance of anything, life support systems, or whatever components or challenges. Is there anything else that is in that category of the toolkit?

Yeah. So the next question I wanna address so we've talked about what we're packing for and we talked about the packing principles. So then the question is what do we pack with us? And so then we look at, computer models that can help us do some important decision making. So for that, I would refer to the integrated medical model as well as the medical extensible dynamic probability risk assessment tool, which is cumbersome to say, which is why we call it MedPrat. So these are 2 p r a t?

Yes. Because I could not I could not keep up with you to write it. So I'm Med Pratt. Yeah. And so these are NASA and NASA collaborator developed, computer models and they help us decide how to pack for space. So we have medical kits on the International Space Station. We have a first aid kit, we have a medical kit, we have a procedural kit, they're highly compartmentalized and modularized. We also have data of what has happened when, at what frequency from decades of human space flight.

So now what the IMM does is it takes the the volumes and the quantities of what you might have brought with you in terms of gauze, medications, pain medications, antibiotics. You input your new mission profile in terms of duration, crew, number of crew, and then you put your desired outputs. What is your acceptable limit of loss of human life, of loss of mission?

And then it uses those inputs and the desired output to extrapolate the kit contents for what you would need, for example, on a 9 month 4 person crew, sojourn to an asteroid. So that's one of the first tools we have at our disposal. I'm wondering, do you do you know what they use as the risk analysis for acceptable human life? What does that figure? It can change.

I mean, have you have you met somebody who puts it in and says, I'm the guy you or I'm the woman, I'm the person who decides this number. I am willing to accept the 74.3% risk factor. It's not 74%. It's usually less than 1%. Percent. Well, I'm I'm throwing that out to be to be to joke at. Is who's that person? It would be a joint decision. So, when I I personally worked on one aspect of IMM and crew development when I was interning at NASA about 8 years ago.

For the life of me, I cannot give you a figure that I remember off the top of my head, but it would be under 1%. I per I think, and this is, I this will probably come back to haunt me, but I'll say it anyway, is we are explorers and exploring a new terrain that has risk. When we went under the ocean, there were risks and the risks were way above 1% where people died. We were explorers when when humans traveled from one continent and found another continent, finding Australia.

And there were huge risks involved. Ships went down all the time. People who went to new territories, they died of cold. They died of starvation. They died of all sorts of factors. Do we throttle back our capability by being so risk averse? You're asking the right questions because essentially you're asking, well, if you don't like the rules, why not change them?

And then that's where, you know, you get people like Elon Musk saying SpaceX will send 1,000,000 people to Mars just just have to be willing to die and accept that you may die. But it's a sheer numbers problem that if you send a 1000000 people, well, at least some of them should survive and you should get some sort of operational settlement on Mars. So NASA space agencies are generally quite risk averse. They're funded by the taxpayers.

Anytime you have a loss of a a transport vehicle, loss of a human life, it sets the program back for years, if not decades. And you have you have congress to answer to. You have taxpayers to answer to. So that that's in part where their their risk, averseness comes from. And just the whole morale of losing, you know, losing teammates, losing losing a human life.

But you're you're very right that in the commercial sector, it's been publicly stated that, you know, we're willing to accept the higher amount of risk. That 74.3 percent you you you throw out may may very well apply elsewhere. I Project Moonhut has 4 phases of development on the moon. The first one is a a moon hut. Again, we were named by NASA. So it is a, box of the roof and a door.

That's what I called in the beginning, a box of the roof, and then, one of, Bruce from NASA Ames calls added the door. So the the moon hut is 4 to 8 people who go around the moon, minus 150, plus 100, and at least I always say it this way. At least one of them returns proof of concept. The second is an industrial park. The third is extended stay, and the fourth is community over a period of time of development. And I do I do always when I share that, I say, look. This is space. We are explorers.

We're on this new rock that we've been there before. We've landed and come back. We've never stayed there in in throughout history, people die. And not that I want to be the one to die, not that I'm the one who I'd like to be the one to tell people to die, but the Shackleton expedition had risks. Mhmm. And so has many so has all of the other expeditions to change the future of human life or life on earth.

They have had risks, and I think that this commercial side of it might have more of 2% compared to 1% might be enough to be able to make something happen, where 1% is your kid can't go out and they if they're gonna go out and rollerblade, they have I'm using an old terminology because it just or skateboard. They have to have the kneepads on, the wrist pads on, their helmet on, their all those pieces, and the kid says, then I don't wanna go.

You know, I once heard a a neurosurgeon, say that, you know, too, is one of his colleagues who was so risk averse, you know, made everyone wear helmets, avoid ladders. He said, you know, if you if you had your way, everyone would just be walking around in a bubble. Yeah. And, sure, we'd have less less, trauma from falling off the roof from Christmas lights, but also, you know, is that really living?

I I normally do things that are dangerous when and don't share this with anybody, when my wife hops in the car, because I have 2 chainsaws. I do trim trees over my house. I do my own roofing, and it just so happens that yeah. No. I saw that. I got the ladder out and I did it, but I'm very, very cautious, meaning I have full, lumberjack gear, meaning things that I strap myself to the tree. I'm very careful, but to to most individuals, I would be at 72.4.

So I think that we have to when we are creating these kits or what do we take with us, how do you manage that decision making? And even more so, I would say, it's probably extremely challenging when you compare gender needs and requirements. Mhmm. Because you're doubling or you're quadrupling potentially needs. Yeah. And, you know, we we know there's certain gender differences. We talked about how that, you know, plays plays a role with the space adaptation neuro neurocular syndrome.

We know that for example, women, on the flip side are more more prone to being decompensated, when they land back on Earth, because of valvular incompetence in their veins. What does that mean, decompensated? So, you know, when you see astronauts land on Earth coming out of the Soyuz, they're carried out, they get that hero's welcome. It in reality I mean, part of it's pompants pomp and circumstance.

In reality, it's because they're it's so deconditioned and that the valves in their veins, you know, are are decompensated that if they tried to stand up, they would faint immediately because the valves in their veins, their their narrow vestibular system, let's control their balance, would, you know, have yet to re reacclimate to 1 g. So are you or or and I'm trying to get this in my my background is, one of my majors was biology.

Mhmm. But when we're talking about a valve, the valves are sometimes I believe have a muscular component to it, but most of them don't in the same so Mhmm. How does a valve atrophy or lose its capabilities? Is it that it's not getting neural signals? Is it what what's stopping a valve from readjusting fairly quickly on a in being gender specific? We don't know. That's Oh, okay. A great question. We don't know why there's a female preponderance.

So these valves I'm referring to are one way valves in the veins. So when you and I stand up in 1g and the reason that we. Don't have fluid pool elsewhere is because the the veins that bring fluid blood back to our hearts are one way. So that's why it doesn't pool in our feet. But these vowels are just disused, in space. They forget to do their job back on Earth.

And so if you stand up, the the the blood would pool to your feet, taken, and that paired with the, the neurovestibular mismatch, and deconditioning from being in 0 g means that these astronauts would almost certainly faint if they tried to stand up, and that's why they're carried out. Have you, in your history, discovered, any data that says this gender and I know we're being this is kind of a channel. Every time I use the word, I'm trying to be very careful because there are multiple genders.

There's not just 2 genders. It's just it's almost when I hear the words talking about the United States or talking about other countries. Well, the Republicans, Democrats. Yes. But there are other parties, and not everybody is conditionally 1. They could be a mixed belief structure. So when I say gender, I am talking across multiple, variations.

Have you discovered or have they has anybody discovered that there is a preponderance and a benefit to being a woman over a man in this condition or that condition or or or? So the biggest benefit would be from lower metabolism and lower use of consumables. And I've seen that put forward as a re rationale for sending primarily all, primarily female or all female crews to Mars is just to save on resources, and to preserve your your life support, resupply.

And the and the and the the there's a lot less weight traditionally. A lot less weight when you add it up as a collaborative group of 50 people if you just had women. Yeah. And so that's one argument, but then you have to look at all the other systems. So for example, the psychosocial and psychodynamic data suggest that mixed gender crews tend to perform better. So then what's your value judgment here? Do you do you save costs on resupply or do you optimize performance with a mixed gender crew?

Do they really have in space, because you've we only got 12.5, that there is a positive correlation to mixed. And I say that because the roles are not gender specific, meaning on earth, you have a home, woman's a woman has to be the one to bear the child. Can't stop that. So let's let's assume that that that there are certain roles that biologically, structurally, there are roles that women will take on and men will take on size, scale, scope, whatever you wanna use as your variance.

Yet 50% of all marriages or more fail in divorce or things don't work. So is there any evidence that says that the in space that the mixed crew is a higher performing crew? There is data on that, and I'm citing, the book by Nick Canas, Humans in Space Psychological Hurdles that, that looked at the data on gender diversity. As you correctly point out, we do have a limited sample size, and we also have a very small preponderance of females within this population.

So it's it's the data is there with that asterisk. Okay. Interesting. Cool. Alright. So we we covered women are more, decompressed. We went over that. What caused medical antibiotics, computer model. Okay. So what's next? The last the last point I wanna bring up under, the toolkits for human spaceflight is analog environments. So we've established that space is risky, space is hard, and space is expensive.

So it's a no brainer to say that the first time you perform a protocol, you don't want it to be in space. So how do we prepare ourselves for space? And that's through the use of analog environments or analog, environments that are in some way analogous to the spaceflight environment.

And so there is an array of them, but basically, as long as you can replicate some aspect, whether it's the isolation confinement, whether it's the, resource limitedness, whether it is, the altered gravity environment. There's and they can be a mix, of of, you know, all of these characteristics. But basically, when we want to fly something to space, we wanna know we wanna test the heck out of it.

We wanna know how it works, how it could go wrong, how we could break it, how we could fix it, and how it can save us when we before we go to space. And so for that, we look to places, like, vomit comets, parabolic flight, if you want to test something for a few seconds in microgravity. You look at, centrifuge studies to simulate hypergravity.

You look at isolated environments like the Aquarius Reef Base where NASA runs its NASA Extreme Environment Mission Operations or NEEMO Missions, you know, to to practice all of these things. You want to prepare for space. So these are just another example of the the arsenal that you have in your toolkit to to put yourself up for this humans v space battle, the this environment that's trying to kill you. And I I believe you've done, some of this.

Yeah. When you walk away, your personal interpretation again is when you walked away from this experience, did you get so much value out of that? Absolutely. And so the value that I've derived from this has been scientific, it's been technological, and it's been personal in terms of the the depth of the interactions that I've had and the relationships that I've developed. You know, I once I once had a retired Canadian astronaut say to me that, you know, his crew was like his family.

There is nothing he wouldn't do for them. And for me, the the crews that I've been on simulated Mars with, the crews that I've lived underwater with are exactly the same. We correspond on the daily. So I can absolutely vouch for that statement. Okay. I've I've never done one, and I had never I thought of doing a 0 g ones, but I've never really and I've I've got my scuba diver license, but I've never really said I would like to do one of these. So cool. Yeah. It's it's really fun.

And then the last thing I wanna point out is, you know, some of these can be incredibly high fidelity. So when you are at depth at the Aquarius Reef Base, you are 50 feet underwater, which means if you spend 24 hours at the ambient pressure, you are now in saturation. That means if there is a medical emergency or a reason to evacuate the habitat, if you go straight to the surface, you risk a dive injury. Yes. You need to decompress for 15 hours and 47 minutes at the Aquarius Reef Base.

So in theory, you can get to Earth quicker from the International Space Station than you can from 50 feet below the ocean. Yes. That I would understand. And so, are there I I and I don't know if you're the person to ask. Are there a lot of these analog space missions out there? Yes. So over over the past few years, maybe 3 years, they seem to have hit this exponential inflection point. There only used to be a handful. So now we're seeing places like the Atacama Desert in Chile.

We're seeing Poland with the Lunaris, analog. We see high seas in Hawaii. We see Concordia Research Station run by the European Space Agency at the South Pole where it can get to be minus 80 degrees, Celsius, and you're living there, for 12 months at a time. And so we have all manner of fidelity of these, and, you know, they're they're only increasing in in number and in what space environment that they replicate. I wonder if any how out?

I think by this point, most of them the the most famous example I heard, it was, the singer. Jared Leto was in the desert, I think, for 12 days when COVID hit, and then that's when lockdown happened. And so he came out of the desert, and he, you know, he came to this alien world. And similarly, I was commanding a mission at the Mars Desert Research Station at the end of January, beginning of February with very, very limited comms. We had no real time comms.

We had a 2 gigabyte daily allowance, and that included filing our daily reports. So we would see the occasional headline of new virus, described in Wuhan, China, China under lockdown, Wuhan province under lockdown. And, you know, myself being a physician, my executive officer was a physician.

You know, we discussed it amongst ourselves, but, you know, you you really are living that simulation, and we would discuss amongst ourselves with mild curiosity, mild concern, but you're also very, distanced. You're very, maybe dispassionate about it. You're watching with curiosity, but you also have your own day to day operations on Mars, which are ironically closer to home.

Well, and that's the having lived in Hong Kong and seeing things happen overseas, you get that disparity, that differential. I think that there are there were some people in the International Space Station who had not come down until after it had, it had spread. And I've got to believe that some people in the South Pole might have come out after months of not being interacting except via media or but not being part of the global society in this way.

So there's a, someone I'm talking to on the space side. He's in, Vanuatu. And Vanuatu is an island between Fiji and where's the, New Zealand. And he said there has been no cases of COVID on the island. So when he got there, they had to make a choice. Do they leave and he can't come back if in fact he leaves? So he has not left the island, and more or less, Vinutu has not had to do anything except for stop people from coming.

So he has lived in a different world even though he sees it from the he sees it, but he's living in a different world. Well, you know, it it's it's it's exactly that. It it isn't a problem until it becomes a problem. So, you know, I'll give you an example. For us on Mars, it wasn't a problem, but with the caveat that I had developed a wicked bronchitis.

I was sick for most of that mission with the, you know, you would have thought that I had the plague with this horrible cough, you know, in isolation. And, you know, we still performed our duties and you thought, okay, you know, we're we're practicing good infection control, good good hand washing. You know, there's no one no no reason for someone to treat me like a pariah.

Uh-huh. And then I got to Las Vegas airport in transit just as COVID was hitting, and I was like, I feel like the worst human being in the world popping in public. Right. Well, when, I've shared this on another podcast living in Hong Kong, they live through the SARS environment. And so they wore masks as a means of protecting society. They already learned that the 29 countries within the Asia Pacific region.

So if you felt sick in the morning, you woke up and you didn't feel well, you put on a mask not to protect yourself, but to protect others from you. And I always question to his scenarios. 1, when individuals would look at an Asian individual walking through an airport and you hear them or look at them like other, they're scared of us. And I would think, no. They're not scared of you. They're trying to protect you.

And when expats would live in Hong Kong pre COVID and they got sick, they would just cough. They wouldn't put on a mask, and I always felt that was that that's an unkind way to live in someone's home to not adopt some of their behaviors, which were basically pathogenetic, path a a means by protecting society, and expats wouldn't wear mask. They'd runny nose or cold. It would just be, okay. I've got a cold.

Now it's changed, but that's so this whole the the analog environment is, I would probably say for if I was gonna share this what we're talking about is that probably you are individuals have experienced through the COVID environment some form of an analog mission type of experience.

I don't know if that's a good way to say that there's a correlation in understanding what an analog environment would be like if you are living through COVID in these type of environments, Vinutu, Hong Kong, Japan, Denmark, each having their own bubble and trying to live within it. Absolutely. Absolutely. You're right.

You know, there's been numerous numerous articles from the space world, from the analog world, myself included, on, you know, lessons learned from analog environments as they might apply to the ultimate analog that is 2020 when we're living under social, isolation and confinement. And so there's actually coming back to this concept of cellular genesis and the type of personality that rises to an austere environment.

There's data around resilience that says there are traits that can be learned to deal with austerity. Mhmm. And so those traits are, impulse control, resisting urge to give up, mental rehearsal, practicing contingencies for the best and worst case scenarios, breaking things down into step by step, actions, positive self talk, and enlisting your social support network.

Just as similarly, Anne McClain, one of the NASA astronauts, published a great Twitter thread on the concept of expeditionary behavior, which all astronauts are taught to practice minding your own health, your crew's health, your mission's health, and then applying that to the world that is COVID. So there's a lot of lessons we can learn about being a good teammate in a very strange time. Okay. Cool. So we're on to let's engineer the hell out of you didn't write that. I wrote that. The space.

The space out of that. Yeah. And this is a this is a throwback to The Martian when, Mark Watney says, let science be, I don't know if I can say the word on the podcast. You can say anything. Well, yeah. He said let's let's science the shit out of this. So this is kind of a play on let's engineer the space out of this. So let's let's get to that. So we've talked about the challenges of how space is trying to kill us.

Well, we've said that, you know, we're pretty set on sending humans to these hostile environments, so how are we gonna overcome them? So let's ask the non constrained question. If we had no constraints, no mass, no volume, no power constraints, no resupply constraints, what would be the ideal? Well, the answer is simple. You would bring another Earth with you.

You would terraform Mars, so you have a full atmosphere, so you have a Van Allen built, so you have one g. If that's not possible, you would develop teleportation so you wouldn't decompensate on the 6 to 9 month journey. And if that's not possible, you would hack the propulsion system. So, you know, there's been, the concept of the VASIMIR rocket which can shorten the We've had him on. Yeah. The VASIMIR was from Diaz. I don't know if you listened to the podcast.

Yeah. I didn't listen to that episode, but he's the one who proposed a 39 day journey to Mars. Yeah. He's he's done a podcast with us. He was he was great. The the biggest challenge for the vast marine engine is power. Exactly. Yeah. So so we know we know that there we can engineer the space out of this.

And so the other question I wanna ask in tandem to this is, what if we not just met the standard of care on earth but surpassed it and in so doing, brought that benefit back to earth which will be my last point. So let's talk about technologies that are seem like science fiction that will blow your mind that are actually being worked on today. Sure. Love it.

Yeah. So, you know, there's if you grew up in the nineties, you're familiar with the concept of genetic engineering in the movie Gattaca where they genetically engineered quote unquote superior perfect intellectual beautiful people. And, you know, ethical quandaries aside, there's this great paper from the MIT review called Engineering the Perfect Astronaut from 2017.

And in that, they talk about the ethical prerogative not against engineering astronauts, but they argue that maybe it's more ethical to engineer an astronaut when you know you're sending them into a hostile environment. So pick the astronauts who genetically have more muscle mass or genetically engineer them to be radiation resistant. And so to translate that back home, there are labs that are starting to look at what happens if you splice the genes of an elephant into a banana.

Well, why would you do that? Elephants have four copies of the p 57 oncogene, cancer editing gene. That's why elephants don't get cancer. So what if you could somebody splice that into a human? Well, the future is even closer than we think. So in September, NASA and its academic collaborators published what they call the mighty mouse experiment. Rodent research 19 was the official title.

And so they took this genetically engineered mice who had, who were gen genetically engineered to have more muscle mass and more bone mass. And then they also added another intervention, which was a receptor blocker to muscle and bone breakdown pathways, the ACVR 2 receptor.

And so what they found was that these genetically engineered mice had more muscle mass, after flight than the non engineered mice, and then the ones who had this receptor blockade to the muscle breakdown pathway actually even gained muscle and bone bone mass. So NASA was literally engineering mighty mouse. It's not quite humans, but it does promise some sort of benefit when we talk about mitigating for the hostile environment to space.

Yeah. I'm waiting for the teenage mutant ninja turtles to come out of the ocean out of the the sewer pipes now. Okay? So that's that's just one example. So then let's talk of yeah. That's that's no different than using fish and oranges to be able to have oranges that can withstand cold. Are there countries that are more prone to are more advanced in this approach to, genetic engineering? So that becomes both a scientific question as well as an ethics question.

So this was an American study with American collaborators. I suspect if you would apply this to humans, perhaps you might wanna look to, countries like China Yeah. And see where they are with that. That is my suspicion. I don't have an definitive answer for you. I wouldn't I'm not gonna say the word pass it by because that's a negative.

Is I would believe that in China, it would not be an unrealistic expectation to achieve not Chinese superiority over Earth, but to achieve a mission that that type of belief structure would not be considered, an ethical negative challenge. Yeah. You know, so it comes down to these societal values. Did I say that politically correctly? It it comes down to the societal values and how you how you view, you know, these these questions that we would view as ethical quandaries.

So so what else are they doing? You got the banana and the elephant. What else are we doing? Alright. So, Lynn, let's talk about, we talked about on the research roadmap. One of the risk was human computer interfaces as well as skills degradation. So what if you could the ideal scenario would be to upload upload information directly to your brain just just like you see in the matrix or to practice on a holodeck.

Well, the answer that we're working on today is virtual reality and augmented reality. So we're using this for training, we're using this for medical skills practice on, on an exploration class mission because you don't want the the next time you practice an IV, you haven't practiced it on Earth 9 months before, to be on a human. You wanna be able to maintain those skills.

So I should disclose that I'm working with a company that's developing this technology, but that's just to say that it is a here and now phenomenon, that also if you can imagine, without very much belief, that also has benefit for education and training on Earth. So computer interface, yeah, the the matrix. So I wouldn't it's not as it's not as it's a I if you go all the way to the matrix or you use the minority report.

Mhmm. Because I think the minority report is the is the middle ground where you've got capabilities that you can utilize, that you interface with, and you've got motion and hand motion and all sorts of tools that you can use as compared to the way we type or the way we work today. Mhmm. Is there any any example of something that is out in the commercial space or has been in the in space being sector. Is there any example of this that someone I could look at and say, yeah, that's kinda cool.

So you're talking about hand controls. Yes? Yeah. Or any of them. Anything where you're seeing this skills degradation or computer interface. Yeah. Absolutely. So then you look at not just, VR integration, but you look at haptic glove integration. You look at biometrics Mhmm. Integration. You look at eye tracking. And then you look at how you can take all of this data and then make your learning better.

What what information do you get from, for example, examples, galvanic skin conduction based on how your learner reacted in a scenario. And then use that to enhance their learning for the next scenario. So there's there's all sorts of here and now technologies that promise to to give us an edge in the human based space battle. And I I don't know how much of this was those that you just mentioned.

Eye tracking was a, had a lot of its behavioral side in, retail, and it has a lot to do with, computer utilization. So there's a lot of emphasis on where someone's looking and how they're looking and what they're doing. And I I've written about this a decade ago. Haptic gloves and the capability of being able to hold, move, interface, those were not developed. I don't believe this is a space interface.

So what your galvanic skin responses, I think that's even partially to do with torture or being able to know if someone's lying or not to be able to measure the the changes in, in moisture that come off of the skin. So Moisture, sweat, Cortisol. Right. Yeah. And we we know it's a stress response. And so it's an early stress response. And that's what the value, of integrating it into into simulating a a a high stress scenario.

So I'm going from one side, and the reason I'm asking or saying it this way is, I know we're taking what's existing on Earth and applying it to space. Have we done the have we discovered anything absolutely off the freaking wall? Mhmm. That was designed only for space that is now permeating the other way. Yeah. So you're you're jumping a little bit ahead. Sorry. I keep on doing that on you. I should That's fine. That's fine. But coming back to Earth. So, yeah.

So that's the last thing I wanted to ask. Because we had another one in far out, questions. So you wanna do you wanna do coming back to Earth and then far out questions? Or, which way do you wanna go? Let's quickly let me give you 3 more examples that will blow your mind about what we're engineering today. So we talked about hacking the space environment to just bypass these these hazards.

So, you know, if we're worried about decompensation zero gravity, why not develop a rotating artificial gravity space station that can give us 1 6th or 1 third gravity on the way to Mars? So that's being done today. There is a there are companies. There is a company that is proposing to to do exactly that, build commercial space station. And in so doing, we can mitigate, you know, the space adaptation, their ocular syndrome, for example.

I mean, the but that's I think it's called the Orion system. That that was proposed back in the 19 I'll throw this out. I'm not an expert on the on years at all, but that was proposed 19 fifties, sixties, or seventies. Correct? So the the theory has been around for a long time. You know, we saw it in science fiction in Space Odyssey 2,001 in The Martian. There was the Nautilus module, which was, proposed as an add on to the International Space Station. I don't think it was ever employed.

So the company I'm referring to, and I should disclose that I'm an advisor to this company, is Orbital Assembly Construction, and this is exactly what they're doing, developing, artificial gravity rotating space stations. Yeah. I I know of some others that, that I can't think of off the top of my head, but they're they're proposing these type of conditions. And yet we're there's a lot of mass that has to go up into space.

We'd have it's a timeline issue for me is how far out is this to be able to, someone just put up there was a picture and I can't remember where. I was talking to one of our team members on Project Moon Hut. And it's it's 94 feet in diameter, and it's a full rotating space environment. And just to be able to bring up the mass would be a tremendous amount of flights to be able to get there. So I I talked with the team about timelines, and timelines are pretty far out there.

Yeah. And then this is where, we come back to to the idea of catalyzing access to space, catalyzing lower earth orbit industries and construction, and then not just making space accessible to more people, but more industries. And that's, you know, that is I think the solution to to doing these large scale projects in space is just, bypassing the major hurdle, transporting materials. You don't know enough about Project Moon Hut because that is the foundation.

We accelerate the Earth and space based ecosystem. Our the technology we're designing, creating, and and working on is exactly the acceleration of the Earth and space based ecosystem, which would allow these things to happen faster. So And that's exactly what needs that's that's brilliant. That's exactly what needs to happen. It's all designed. It's all put together. We've got all the tools.

We've got all the pieces, and I we haven't gone out there looking for funding until just now because I'm a person who doesn't like to go the space industry is prone to this. I don't wanna go out and bang my chest until we have something that's done. And it was a I'll tell a short story. I'm in I'm in NASA on one of our first meetings, and one of the individuals said, so what are we gonna tell people? And I said and there was a communications person there.

And I said, we're gonna we're not gonna say anything. It's a secret project. And the communication person looks over me, and he puts down his head. He says, this isn't gonna go well, David. Because everybody in the space industry wants to say what they're working on. Every everybody is a big term. A lot of individuals wanna pound their chest, and I believe you should have your ducks in order, especially on something that's a new technology or a different approach.

You have to have them in order before you go out and pound your chest. Mhmm. Absolutely. Yes. That's that's what Project Moon Hut is about. It's not about building. It's not about construction. It's not about getting to low earth orbit. None of those things are what Project Moonhunt is about. It is about how do we accelerate the earth and space space ecosystem? How do we create alliances faster?

How do we transpose the human consciousness, not in an awakening sense, but the knowledge based sense, faster than we're doing it today? How do we clear the hurdles that are regulatory or that they're political or they're, economic, the IP rules and laws? How do you do that on a global scale in a way that would take us from x amount of years to a a reduction of 10 x or a 100 x? And that's what we work on.

That you know, and that's I've I've always said I've I've been on the record saying this that access to space is a form of empowerment. It's a superpower. It's a form of infrastructure, development, education, telecommunications development, and and data know knowledge acquisition through Earth observation. And so, you know, I I'll be the first one to say that, you know, we need to catalyze access to space.

So that's And and and it's and it's there are the challenge is we don't have that connection. We have space individuals. We have people who work in the space industry. We're not always space people. You could be a great financial person and not be a space person. We have enthusiasts, people who like to go on missions and do and go to classes or go and read and enjoy. But there is a large portion of the world that's just opportunistic.

They don't know enough about space to be willing to put capital or invest in it. It's a long term. It's a patient capital. And then there are purpose driven people who don't see space as an answer in most cases because they don't understand the correlation between innovations and the ideas.

And that's what you're the reason that came up is you're talking about these tech this tech is they don't, as individuals, me, I'm one of those people fatten in the 2 categories at the end, is that I just don't didn't see the correlation between them. And we that's what we work on. That's what our nonprofit is working on. And we are nonprofit on purpose because we do not want people to believe that we're doing this for an a financial gain and that it's a global initiative.

It's all all species on earth are impacted, not just humans. We are not just about saving the human species. We're about making and improving life on Earth for all species, which includes if in fact you go out and you live on the moon, that's still, connected. So okay. So what give me some others. Give me some other tech. So, you know, a lot of these things were boring from science fiction.

So there was a time when we thought that the concept of so we talked about the problem of resource utilization Yeah. On the way to Mars. So what if you bypass that by hibernating your astronauts? That was once within the realm of of science fiction.

Well, the European Space Agency, ran a study in 2019 where they calculated if you successfully put humans into hibernation for the duration of that journey and moved them 3 months sorry, 3 weeks prior to landing on Mars, you could actually save on your mass budget, your volume budget by up to 1 third. No food. No all of those other things go along with it.

Yeah. Well, the value behind hibernation when we look at what we've learned from animal physiology is that when you take ground squirrels, for example, they, by dropping their body temperature from 99 Fahrenheit to 27 degrees Fahrenheit, they decrease their metabolic usage by 99%. So, you know, the there's there is an argument for human hibernation on longer duration missions.

Well, that's currently being worked on, through comparative physiology, the University of Alaska Arctic Biology Institute, Spaceworks is a company that has published a paper on the practical aspects of human hibernation. So there's some there's some hurdles to overcome. Have we tried it yet? They no no human studies. So with the with the University of Alaska Arctic Biology Institute, they hibernated non hibernating animals. So they tried it on rats.

And so the showstopper currently is that, with the decreased blood flow to the gut is that the the bowels necros and perforate and the rats become septic. So that's currently a show stopper, but at least we could identify the problem. And by identifying the problem, we can take steps to mitigate it. Let's just hope that rats don't one day become smart because they are used for everything. Imagine you're a rat. You're a subject or potential subject.

So so they've done so they're they did find a biological challenge with this this condition. Mhmm. Have they found or is are rats the only that they've tried? In my reading, I've I've read at this at a surface level to kind of orient myself to the landscape. So it's possible that there's other labs out there doing, more invasive with other species. There are for sure other labs out there doing something with other species.

So in my reading in my reading on this topic, the other interesting thing to note is, well, you still have to feed the humans. So then you have to talk about how invasive are you willing to be because they propose that, in in the space works setup is that they would have to have 1 astronaut awake at a time for a 2 week period and then swap off with other astronauts. And part of that would be the maintenance of the sleeping astronauts feeding them through a PEG tube or a tube in your stomach.

So you'd have to surgically insert that tube. So then, you know, that also becomes an ethical quandary. In an otherwise healthy human being, can you justify doing a very invasive procedure? So there's there's all sorts of discussions about this, but the the bottom line in the matrix. It was a battery. We you know, it could also charge. It would give the energy for, DS's engine. So that's a joke whether yes.

You you can theoretically I'm surprised that they thought of having to have a human there where they wouldn't create an autonomous system that would be completely, enclosed to give the human the ability to feed that person while on flight? I think they I think knowing the limits of our autonomous capabilities, it's it's kind of the same reason we don't have AIs replacing doctors. AI is good. It's good enough to supplement humans, but it's not good enough to replace humans.

So something went wrong with the autonomous system. Yeah. And it's only 2 years. Killing off your crew. Right. It's only it's it's not a long enough flight. It's not like we're going on a 10 year mission or 20 years or 30 years. It's Yeah. Just 6 to 9 months. So So, yeah, that's that's worth it. Not a big deal. Okay. Yeah. And so, you know, there's there's myriad examples. So, for example, you know, do we have food that lasts 5 to 7 years on a shelf? Well, not currently.

Not the one that's light enough and nutritious enough. So there's companies out there working on that. One of the NASA research groups is working on a concept called IV Gens. So if we're gonna have to bring IV fluids with us, as a matter of basic life support, but we're also gonna need to either replenish that, which is heavy and expensive, or manufacture plasma fluids institute. So you're manufacturing your own fluid replacement.

There's all these concepts that are being worked on today, that can help. I I I feel like I'm in a humorous a humorous mood on this time. I feel like we should be having Twinkies and SPAM.

Both of them seem to appear to go through nuclear or the movies, they supply they go through a nuclear, disaster, so therefore but, yeah, I could I've been didn't think about the long term duration of having 5 years, but then again, if you're going to be going to Mars and you achieve, moon or Mars or anywhere within that 6 to 8 month times, sight the distance, and it's 2 years, you still will have the 2nd or 3rd capable re resupply mission possible within a shorter period of time. Exactly.

But resupply is expensive and, you know, you're also putting all of your your space ducks in 1 in in a row. So, you know, anything that you can bring with you that you can manufacture in situ, that you keep with you is to your advantage and saves on costs. So that's where we got get into the idea of institute manufacturing both through 3 d printing. Well, there's 3 d printing companies in space, made in space, that already has a, printer on the ISS.

And then there's, of course, institute resource utilization. And so, one of the the most commonly cited uses, for regolith other than, of course, extracting, elements from the regolith is also well, what it's gonna be costly and you'll have to bring a lot of material to provide enough meters of a wall to filter out radiation. So why not just live under the regolith? Why not live under meters of regolith?

You know, so those are other solutions that are being suggested for engineering the space environment aspect out of the human hazards of spaceflight. They just had the European Space Agency just, I don't know if it's just. I just saw it, doesn't mean just they just announced a or they recently announced a living type structure where I think it's on their website where you primarily living underneath the you you enter on the ground, you don't set up in a crater.

And then you go down into the bowels of the living environment to protect yourself from the radiation or for for micro media, for from any type of damage that could happen. Okay? Any other any other cool cool tech? You know, the the list is is long, but the the last 2 I wanna mention are point of care testing.

So you want to be able to just prick your finger and not just get your blood glucose like we currently do but get accurate samples for your electrolytes, your kidney function, heart attack function. And so those are currently under development. They're catalyzed by programs like the Translational Research Institute of Space Health, the Trish, Element, and finally, AI. So we talked about we talked about this briefly.

We right now, the plan for AI in terms of the medical capability is to, supplement diagnostics and therapeutic decisions because, we talked about how training may need to change. We talked about, currently the crew medical officer on the ISS has 40 hours of medical training. From ours, I would argue that probably needs to change to a full on physician. But every physician will tell you we don't have all the answers. We simply know where to look them up.

And then what if the crew physician is is capacitated? Well then how does the rest of the crew mitigate that scenario? So you you want both augmented reality for just in time guidance but you also want AI to help guide diagnostic, decisions. It's always there's I don't know what's sci fi just watched the person who was responsible for doing the engineering. He lost his eyesight, but he was still better with his eyes closed than he was everybody else.

But he had the fight to was it was just a a recent, HBO series or something where they where they went to Mars or to another planet. So yes. Okay. Those are all within they actually don't seem far out in terms of what we're working on today is just humans on earth. Okay. So what's the do you wanna go to the coming back to earth or do you wanna hit the far out questions? Let's hit the far out questions.

This should be a fairly quick scenario, but these look at the kind of things that I spend my time thinking about. So, you know, we thought about, you know, the next steps, the next battleground, but what about the next next battleground? So, you know, a very obvious question is if we're talking about becoming a permanent off world settlement, well, settlement implies multi generations. Multi generations implies breeding off world.

So what does the data and the ethics of starting to broach that subject look like? Because we have decades of data from human space flight, or sorry, animal research in in space that shows that we know that every aspect of development from conception to implantation to development to post flight development is affected. But the data is conflicting. We have data from wasps, from zebrafish, from, rats.

And you know, in some cases it's deleterious and wasps die wasps flown to space die off, at a higher rate than their non flown offspring. In some cases, it's a transient effect. So rats that were flown to space, rat embryos that were flown to space, showed a temporary development in neuromuscular development, and then the 3 months, the effect had passed. So then how does that translate to humans?

You know, from everything from, arousal to intercourse to gamete production to implantation, you know, our if we're talking simply about 0 g, are embryos more likely to implant in the wrong location? Is the risk for ectopic pregnancy in 0 g increased? That's a disaster. That's life threatening as well as mission threatening. So these are the far out question. This is an example of a far out question.

Another example is, you know, when we're talking about maintaining the standard of care, well, we have we have national guidelines. We have state and provincial guidelines. We have the over lie over, lying governing body of the World Health Organization. So then how do we govern medicine in space? Who do we train? What kind of training does that look look like? And then do we need to evolve from having a World Health Organization to a Galactic Health Organization?

I think we should start off with a Mearth, but the A Mearth health organization. M h o. No. No. Mearth were a health organization, moon and earth Mhmm. Then we can go bigger. So galactic is another one. I was just picking on you.

You know, and then another example is, you know, we we talking about mitigating risk, but if we were talking about going forward to the moon to stay, if we're talking about permanent off world settlements, then we need to talk about building up a medical capability in tandem with that. So how do we evolve from 40 hours of crew training with medical kits on the ISS to building up basic, life support, advanced life support, a basic field hospital to advanced surgical capabilities in ICU.

And then finally doing the mundane day to day stuff like providing the screening capabilities. So you can have a colonoscopy on the moon or Mars if you live there long enough. So how do you approach that? What models on earth do you use like field hospitals and, refugee camps? And then how do you approach that in a practical fashion through resupply? Or should you even bother?

So these are some of the far out questions that I think we still have to answer, and, you know, I think it's just the next step, the next next battleground. Yeah. I I do I do, believe that there are people asking some of these questions, and the answers are range from sci fi, yet too far out where these there's a tough connection to making that work? Or my question, it tends to be what's the timeline, or what are you looking at, or when will this happen?

And I had someone just the other day said, oh, this is 200 years from now. Okay. Gotcha. So when I look at Mearth and the moon Earth economy and ecosystem is that some of these can be sooner than later depending on, where our efforts are. And that's, again, what Project Moon Hut is about us to make it sooner than later. Yes. And for me, it's the opposite perspective.

It's sort of it's sort of like for me, if you're telling me you wanna establish permanent off world capabilities, I want you to be able to answer those questions. I want you to be able to answer what your medical capabilities are, what they're going to be, how you're gonna build it up, how you're gonna plan for intergenerational humans, off worlds, and also, you know, how you're gonna maintain the standard of care. Okay. All logical. So what about coming back to Earth? So bring me back.

So the the question is, you know, we I'm sure you've been in the space industry. You've seen the people who ask, you know, why go to space when, there's so many problems on And, you know, it's not an either or phenomenon. We get to derive a lot of benefit from sending, robots and humans to Earth. We've talked about the the non human exploration benefit through, observation and remote sensing. So let's talk about the medical benefits. So, you know, there's the list of technology transfer.

You asked earlier this podcast, what benefits in medicine have we have we seen from space? And they they could fill a book. You know There's actually over 2,000, I think, just on NASA's website, but let give me what you what you look at. You know, these are examples. So looking at the mighty mouse experiment we just talked about.

So the the answers that we found with respect to increased muscle mass, and how the ACVR 2 receptor blockade works also promises to have spin off benefit for neuromuscular degenerative diseases like, muscular dystrophy, as well as osteoporosis. When we look at, benefits that we're already seeing on Earth, the charge coupled devices in the Hubble Telescope were spun off to, provide, increased less invasive, less painful, increased high resolution breast cancer imaging.

Sensors that have previously been used on the International Space Station have been spun off to infant pajamas to provide monitoring in case of sudden infant death syndrome. When we look at the technologies we've just discussed, the VRAR technology is already being implemented on Earth for medical education and treating. The idea of providing nutrition that has long shelf life has equal, applicability for expedition medicine, Antarctica, military deployments.

And so the argument isn't why why earth versus space, it's how do we catalyze, these technologies, because I think we've made the case that space is not just a survival imperative, but it also brings tremendous benefit to the earth ecosystem as well.

And so that's the note I wanted to close on is that even if we're talking about science fiction ideas, even if we're talking about far out literally destinations, that it always comes back to Earth as well as benefit for all of the humans on earth who live in to me, day to day on earth and for whom maintaining health is, you know, we don't question that as part of the imperative to to keep you society thriving.

So, you know, it's we have far out questions, but they're just as relevant here on Earth. And I I completely agree. We, the former Charlie Charlie Bolden did a program, and he listed countless. And I think one that was surprising was Peter Garretson, in one of our episodes. Peter came up with a topic, and for those who are listening, you went through it. I don't know what the topics we decide on the title. That's it. I didn't know anything that we're gonna talk about today.

There was no preparation for me. I didn't sit and look up and review if this is all in real time. Is he came up with a topic which was about the Space Force, and Peter is a former military. Mhmm. And I was, do I wanna cover this? Do I not wanna cover this? Is this interesting? So I said, yeah. Let let's go there.

And he started talking about the number one most environmentally environmental product on Earth today that saves more fuel, more petrol, more gas than any other technology on the entire planet. And I'm thinking, environmentalism, how does he how is he tying this together? And he said, GPS. GPS. It was just he he brought the he tied those things together.

And I don't I do not believe that while you had mentioned it was evident, I would argue that the majority of people out there that I talk to and I'm talking to non space people very, very often have no clue. And one of the things that we're working on right now is to help individuals make those connections. So I say to people that did you can't live today. Did you look up the weather today? Space. Did you you've been on a plane, the boots on the wings.

Have you ever seen a firefighter run into a building? Baby food. And I and I say, did use a power tool today, cordless power tool today of any type, cordless vacuum, that space. Did you go to a gym and use an exercise piece of equipment? That space. And they they don't know. And I didn't know. So I think it's not a a given, and we are working on that as also a means to help people connect make those connections. So the this was this was fascinating.

This was I loved I loved every moment of it, Shauna. This was great. This is this is a lot of fun, and, you know, it's it's funny because I just finished listening to that episode of Pete Garrison, and I remember that exact moment. You know, he said GPS because you're right.

You know, we we need to do a better job of publicizing the benefit we get, you know, from water filtration systems to portable telecommunications to powerless solar solar power paneled, solar powered red refrigerators for vaccine storage. You know, it all came from space. And it's it's so I I I have people in the space industry who always list what tends to be those that are very obvious that individuals, they're on lists.

You could see the top 20 things that have come from space, and I try to list things that you don't hear about that are everyday utilization tools that someone's gonna say, I didn't know that. Did but by the way, Peter did an amazing job, didn't he? Mhmm. That was I enjoyed that podcast. It was brilliant. He did an amazing interview. So I was, I loved it. It was one of those I wasn't sure where we were gonna go, but it did work. So, you've done a fantastic job. Thank you very much.

Is there one, well, let me say. For everybody who is listening, I want to thank you for taking the time out of your day to listen in. And I do hope that you learn something today that will make Foundation is we are looking to and you can come and help us be a part of what we're doing, is we're looking to establish a box of the roof and a door on the moon. And the reason being is that is the proof of concept.

If we can get there, go around the moon, and come back, we open up this Mearth moon Earth ecosystem, and everything between it can can give us potential future of, unlimited, the the infinite. That's why it's called the in age of infinite. Infinite possibilities and infinite resources, which gives hope for the future. With all the challenges we are facing on Earth, we can then solve some of those challenges with Space Tech. So we want to accelerate the earth and space based ecosystem.

We wanna then take all those endeavors, that paradigm shifting, those innovations, which you heard about today, and we wanna turn them back on earth to improve how we live on earth for all species. We have to be very careful that we always use the term or often are hearing the term about saving the human species. Well, dolphins, whales, amoebas, they make our lives rich.

They make our lives interesting, and we still will have if there's a 1000000 people on Mars in 40 years, there will be 10,000,000,000 people living on Earth. Can't forget that we should be taking care of this home as we have it today also. So for, again, Shawna, this was great. What's the one best way for people to get in touch with you if they wanted to? You can find me on LinkedIn at Shawna pandya, s h a w n a p a n d y a. Okay. Great.

And if you're looking to connect with me, you can connect with me at [email protected]. You can connect, to Project Moon Hut through at project moon hut on Twitter, or at goldsmith for me personally. I am on LinkedIn. I am on Instagram, so you can find me in a variety of places. And there is a YouTube channel when we've put only very minimal up today. There's probably about 40 videos behind we haven't released.

And we also have on Facebook, we have secured the name, so we do post there also. So for all of you who've dialed in, listened in today, I'm David Goldsmith, and thank you for listening. Hello, everybody. This is David Goldsmith, and welcome to the Age of Infinite. There are many different types of podcasts out there talking about different direction that the world will meet potentially going.

Ours is not to be thinking about the 4th industrial revolution and the speed of, 5 g. It's to not to talk about just biotechnologies. We are to talk about a bigger picture, the age of infinite, infinite possibilities, and infinite resources. And through our podcast, we hope to be able to show you a new definition of the future. The podcast is brought to you by the Project Moon Hut Foundation where we look to establish a box with a roof and a door on the moon, a moon hut.

We were named by NASA, and it is through the accelerated development of an Earth and space based ecosystem. Then to use the endeavors, the paradigm shifting, those innovations, and to turn them back on Earth to improve how we live on Earth for all species. Today, we have an amazing topic. It is humans versus space, the next battleground. And with us, we have Shauna Panda. Did I say that right? Actually, I'd I'd never asked you how do you say your last name. Is that how it's pronounced? Pandya.

Pandya. Okay. I I should have asked, but I didn't. I apologize. So No worries. Shauna is a physician. She's the director of Internet the International Institute of Aeronautical Sciences. She's a medical adviser. She's also a martial artist. When we first met, we talked a little bit about that. She's a a diver. List goes on and on and on, and I believe you're going to learn a lot from listening in on the conversation. So, Shauna, do you happen to have an outline for us? Absolutely.

Are you ready for them? I am ready. K. I have 6 bullet points. First one, space is trying to kill you. Okay. Tried to kill you, number 2. The next battlegrounds Number with an s. Battlegrounds. Okay. 3. The toolkit for human spaceflight. Let's engineer the space out of this. Far out questions. And the last. Coming back to Earth. Well, I'm excited. Let's start with this first one, which is really a killer title. Space is trying to kill you. So what do you mean by this? Help me.

Sure. So you you you heard that I'm a physician, and I have a massive interest in space. So, I often get asked space medicine, like, what is the correlation? And it's what we know through decades of human spaceflight is exactly that. Space is trying to kill you. So that's the first premise. So how is space trying to kill us? So when we talk about the various hazards of the space flight environment, it's helpful to know, and have a framework of how we think of the hazards of space flight.

So borrowing from our friends at NASA, the human research program has broken this down into what we call the big five. So these are isolation and confinement, distance from Earth, altered gravity environments, radiation, and then hostile environments. I missed 1. Hostile and radiation. And what was the third one? Probably altered gravity environments or distance from Earth. Okay. I k. Understand them all. Yes. Go ahead. So that's the second layer of the framework. So space is trying to kill us.

Well, how? Those are the big five categories. So now let's get into the nitty gritty. So starting with radiation, we know that the higher up we go in altitude I'd like to just quickly why why did you Mhmm. Start with radiation instead of the way in which you gave them to me? Because I've gotta believe the only reason you did that is there's an emphasis on this one in your in your own mind's eye. That's a good question.

I think it's as we tie into the next topic, you'll see that certain of these initial hazards become more hazardous. Okay. So so it was exactly what I'm thinking. You brought it up because you feel this is a bigger point than the others, and so you wanna emphasize it first. But you could understand there's a rationale. You gave me the list, and then what you did is you picked 1 in the middle.

Yeah. And the other thing is in in my mind, you have to give each and every one of these topics the respect they deserve. You cannot underestimate any one of these components, because if you do, then you're failing the first drill of space. It's half contingencies for everything. Okay. So I'm I'm fine with you starting radiation. It you could just understand. You started there and then you went someplace else. So so tell tell me about radiation.

What is where do you and how do you look at radiation? Yeah. So what we need to know about radiation is that the higher up we go while still in low Earth orbit, the more radiation we are exposed to. And then as we go beyond low Earth orbit, we are outside of the protective confines of the Van Allen Belts, and now it's not just trapped, radiation that within the within these belts.

We're we're exposed to increasingly high energy ionized ionizing radiation, when we go outside of the Van Allen belt. So now we have to contend with, ionizing ray ionizing radiation from 2 extra sources, GCRs or galactic cosmic rays, as well as SPEs or solar particle events, or what you may more familiarly know as solar flares. What's the difference in terms of to humans? That's a great question.

And so the these two types of radiation that I mentioned are ionizing, ionizing energy, ionizing radiation. So much higher energy so they have the potential to cause more damage, in different ways than the typical radiation exposures we would have within the, Van Allen belts. And so SPEs, those solar flares, have a low to medium energy, ionizing energy, and then the galactic cosmic rays background, radiation is higher energy. It's those highly charged particles. It's those, protons.

It's, it's higher energy and so what that means for translation into human hazards and human health is the way it affects DNA, the locations, and the pattern in which it affects DNA is much more complex. So is it a matter of DNA replication that's an issue, or is it just the fact that they're damaged, they can cause cancer, or they can cause anomalies that can happen in the future, when we're talking about the highly charged as compared to the low and medium? All of the above.

So this is why I say space is trying to kill you.

So what we know and we're kind of getting a little bit ahead of ourselves, but this is good recovering it, is that when we're exposed to these this highly these highly charged particles is that, yes, there's an increased cancer risk, there's an increased cataract risk, any type of epitheliized epithelialized surface whether it's the inside of our blood vessels, the linings of our guts, any mucosal surface like the inside of our mouth are more susceptible to cancers, and then we know there's a cardiovascular and cerebrovascular, effect as well.

So we're more likely to have cardiovascular disease, and cerebrovascular disease such as, a stroke. And, so I understand this, and I'm gonna bring it up right now because it keeps it's gonna pound me until it gets answered. We have had 570 approximately astronauts in the International Space Station or have gone beyond the International Space Station to the moon.

With those individuals, has the data came come back that the 24 who have seen the earth from afar, meaning they've gone farther than lower orbit, to those 24 have such a larger degree of, biological challenges as compared to those on the International Space Station, as compared to those on the on Earth that it would be a statistical anomaly enough to say it's causality? Not yet.

Or if it's been mentioned in the literature, I haven't seen it, and I am bringing to you the rate the latest citations on what we know about the hazards. For example, if you if you are motivated enough to read more beyond this, beyond our talk today, which my hope is that you are there's a great review in Nature Microgravity from 2 weeks ago that talks about red risks for the red planet and they they don't talk about data from Apollo.

And there's hundreds of pages of documentation, from the Apollo era called biomedical results from Apollo. So my I suspect, David, it's a very astute question but maybe the sample size is too small.

And we know, you know, it is acknowledged in the literature that we we know that the types of radiation are different, but we we aren't doing a good job of modeling the highly charged particles, the ionizing energy radiation of GCRs and SPEs, when we look at models for long duration space flight beyond low Earth orbit. The only the reason I bring it up, and it it's not that I wanna harp on it.

It's that if, when I started the space, the entry into space, which is only 6 years ago, I was invited to 2 events. 1 was a PhD level event. I don't know why I was there, but they won me there. There's a 50 top people in the space industry. Buzz Aldrin was there, many of the top people in the industry, and it was a global meeting. And the second one was in Washington DC, and it was the Pioneering National Space Summit. And it was a 100 of the top people in the United States space industry.

And, again, buzz was sales, 7 us 7 astronauts, the administrator, a large group of people who are highly, highly specialized. And then I and I had constantly heard about this Van Allen belt and the challenges of going to space and radiation. So I went to the Smithsonian Institute in Washington DC. I had it some time before, and I said, let me look at the space the space material, these rockets. And I walked around. I said, my lawnmower I don't have a lawnmower.

I people cut my lawn, but let's the lawnmowers I've had were better manufactured than the tools that were used in 1969 to go up. And so I said to myself, we talk about this radiation in the Van Allen belt and getting through it, and yet I don't see much protectiveness. No water barriers, no special technologies that protected these astronauts. And there you've got Buzz Aldrin and the the the individuals who've been to the moon who have more or less led a reasonably long lifespan.

So I I'm challenged with it because if it is that challenging, why haven't we seen it? And that's a very good point. You're you're absolutely right in that we need better data. There have been a few, astronauts who have died of cancer. And so what I haven't seen mentioned is that astronauts are dying of cancer, at a higher rate than, the general population.

But for example, astronaut Piers Sellers, unfortunately, he was an American British, astronaut, passed away from pancreatic pancreatic cancer not too long ago. How old was he? That's a great question. I wanna say sixties. He was, he was born in 55 and died in 2016. So, 45 plus 16, 61. Yeah. So he's that's that he's right within the the, lifestyle range of when an individual would get it if they were to discover it as a male, condition.

So, yeah, it's it's I hear this and I'm still it's almost like I'm searching for an answer to say radiation here is challenging. Radiation is very difficult. It can. It can. It can. And I think that we're still in that are you would you agree that we're in the hypothesis stage still as to what damages we do?

Yeah. Yeah. Good good for you because you're you're very astutely noting that we the the theory doesn't fit the evidence to date, but also the sample sizes of people who've gone beyond low earth orbit are small, 24 people, and they're all of a very homogeneous demographic, middle aged white males, mostly, and, well, all Americans. So, sounds very, very, very profiled as to a certain group.

Okay. Okay. So the so when you're talking about this, I'm assuming we're taking this data, the ionizing radiation, and comparing it to what we know and the radiation that's on earth, and we know that radiation on earth, from example, from too much x-ray exposure or too much too much of a type of, radiation, a nuclear will cause damage, and we're extrapolating that to space. Yeah. Exactly. And then you're you're right. We need to do a better job of saying, okay.

Well, if we will if we hypothesize that these high highly charged particles, the GCRs, are the ones that are are the ones that pose pose the greatest risk to human health, then that's what we need to set up our studies to to look at. You know, it's you can't cap compare the apples and oranges of, low non ionizing energy versus the higher energy, of GCRs and SPEs.

Is there anything going on right now that you know of in terms of find discovering that in to a level which would be conclude that they expect to be conclusive enough to go beyond the Van Allen belt and live? There is there yes. There is a lot of data. There's the, NASA Human Research Space Radiation Lab. There's computer models.

There's, a simulation of how these work in synergy with, the altered gravity environment, the stress of the human, sorry, the stress of the operational schedule, up in space. I am certain that there are animal experiments in my review. I did not, dig too much into the weeds about what's going on with animal studies.

I wonder what the Chinese, and I know the Russians have worked very hand in hand with the Americans, but I wonder what they have, especially the Russians in terms of data on these type of things. I don't know if that's shared to the same degree as other information. Okay. I stopped you. I stopped you in the middle of this. Keep on going.

Give me give me more because I'm trying to I'm really trying to figure out how we can achieve this Mearth, moon and earth space economy, and one of the challenges always brought up is radiation, And how do we protect from it? And how do we live within it? And, I'm looking for more answers. Yeah. And that's exactly it.

This is, what you're gonna find either to your delight if you wanna dig more into this, as we go on or to your frustration because what you're all about the questions is a lot of these are to be determined further studies are needed giant question mark. And so that will be a running theme but it just means that we have more solutions to engineer, and by the end of this, more benefit for problems on earth. Okay. So, more with and anything more with radiation?

The last note I'll say is that we need to know when we talk about we'll put it this way. What is the radiation prescription? What is the maximum limit for what duration, for what type of radiation. Right? So this will this kind of starts tying into the next battlegrounds as we talk about going beyond low earth low earth orbit. What is the absolute limit? Because we know the numbers.

We know that we can be exposed, to up from 10 to 4 to 10 times more milligrays, on, on the moon and beyond the Van Allen belts that we would see on the ISS. But also, again, you're comparing apples and oranges. So stay tuned to be determined. But the bottom line is we need to figure out the first We have to yes.

I we have to address that, and I know the data keeps on coming back that there's actually more of certain substances than we've ever we've imagined, and that we we really don't have a clue as to how how much or how intense this would be until potentially we're actually in that environment. So okay, so what's the next one that you've picked off your NASA list? So let's go with isolation and confinement. Okay. So yeah.

So, you know, when we talk about isolation and confinement, we talk about not having your usual creature comforts. And so starting with the International Space Station, you are shuttered in a tin can hurtling through space at 17,500 miles an hour with 6 other people on average for months at a time. You know, you have your twice weekly conferences with the psychologist, your weekly conferences with the flight surgeon, and mission control is within immediate, there's no time delay.

They're within immediate comms. K. So so the question is, how do you be that guy or gal who thrives in this environment? The guy who's not voted off the hab or the spacecraft. And so that comes down to to crew dynamics and personality. And I'll leave it at that because this is kind of a teaser for when we talk about the next battlegrounds about how much this more of an issue this becomes. So I I I know you wanna leave it, but I need to ask something. For sure.

I've, I've never asked and I did not know the twice a week psycho psychological connection and the once flight surgeon. Have you been privy? Have you seen? Do you know what actually goes on in these sessions? I don't. And this is this this is a testament to realizing that as high profile, as public as human spaceflight is, at the end of the day, patient confidentiality is patient confidentiality.

So we know there's there's data from the lifetime health surveillance of astronauts, the LHSA, but that data is highly anonymized because in such a small sample size that's only 12% female, we it's, you know, there's a huge push to anonymize and protect that medical data. The so even though it's, it's now cleansed for visibility, are there certain types of challenges is there any data on the certain types of challenges that are faced more often than others?

Yes. Yeah. So then, you're getting into what is the history of medical events from decades of human spaceflight. So that anonymized data is definitely published. And so, to quickly answer that question, we know that, suprafacial injuries and traumas, figure highly. We have seen potentially scary things like cardiac arrhythmias that have been noted in flight, but have actually been of no clinical consequence and have been in passing.

We've seen headaches and backaches, particular likely due to the adaptation to the altered gravity environment. We've seen sleeplessness and fatigue. And then, you know, psychiatric issues have come up, but maybe not as frequent frequently as one would expect. The the topic of being away from home.

I wonder how much the preparation has to do with the ability for an individual to understand that be capable of under and and being able to live through it as compared to the shorter and shorter timeframe over the time spans that or education, the experiences that the training the word I was looking for, the training that would go into somebody and say 10 years might be a much shorter time frame.

So we might end up with more challenges in space because of less time acclimating individuals and selecting them to be a part of a mission? It starts at selection. So even before you ever get accepted to the astronaut corps, they wanna see that you've had that experience and that you haven't, you know, gone crazy, experienced depression, been affected to the point where you can't function.

So for example, on the 2016 CSA, Canadian Space Agency astronaut selection, you know, the the application asked about what is your experience working in remote environments? And, you know, the people who made the top 72, who made the top 30 were the ones who had spent time on working on remote ships in the middle of the ocean, who had spent time on Arctic and Antarctic deployments.

So, you really want this this person who approaches this this isolated confined environment with a salutogenic sorry, salutogenic approach. And so that's a positive psychology term for someone who takes this adversity and rises to the occasion. And this comes down to resilience. And we know from the data, of not just space flight, but austere environments, there are people who view, you know, 6 months of darkness in the Antarctic, for example, a a challenge to rise to the occasion.

And so it's it's partially at selection you're looking for these people, but you also want people who have the experience of thriving in these environments. Do you know if there's been any major conflict on the end on the station? Not typically, not openly discussed, but there is data from previous I think it was Skylab where, the operational schedule was so heavy that the commander ended up and the crew ended up rebelling against mission control and simply turned off comms. Oh, wow.

Yeah. Well, I mean, they never flew again. So, you know, it was that active, active rebellion. But, you know, looking back at the data, I say I wonder if that was too harsh because Yeah. As the commander, I've also been I we'll talk about analog environments a little bit later on, but I've been in situations where the operational schedule that was given to us was too heavy, and I've said, no. You know, we need to stray from the schedule.

So, you know, may you as the commander in that situation are doing what's best for your crew in the moment and in the long term. So they can they might not be working today, but you're doing that so they can work. Yeah. You're you're you're protecting your crew at the same time. You're giving them that breathing room. You're you're supporting their challenges so that they can unlock. There are many reasons for it.

So, yeah, that that seems harsh at the time, yet it was at the time that it happened that makes, an understanding. So in terms of isolation and confinement, it is a challenge, yet we've not been we've not really run into a challenge that's because the sample size again going back is too small, and these individuals are all weeded out to fit that behavioral capability. Exactly. Exactly.

And so as we as once we finish covering these or if you wanna talk a bit now, we're gonna talk about the evolution of these hazards, and how we need to start thinking about them differently. I think we should hit the others, and then we can come back to the evolution of them, so that this is good. I mean, I'm I I know this is these are issues. I just have never been gone into them. So what's the next one you wanna hit on your list? Let's talk about distance from earth.

So this kind of ties into stuff we've talked about already. We've talked about, you know, how that affects, human health from a radiation perspective, the isolation confinement. But the key home key point I wanna hammer home is that with with distance comes communication delays. There is no communication delay when you are on the International Space Station. If you need to ask mission control how to fix something, if you need medical guidance, you have it instantaneously.

By the time you go to the moon, that is a 2.4 second round trip delay. By the time you go to Mars, depending on the alignment of the Earth and Mars, it is a 6 to 46 minute time delay. So as you can imagine, all of a sudden if someone's actively in cardiac arrest, if they're hemorrhaging out, you do not have time to wait for the next instruction from earth.

Yes. And the 2.46 2.4 seconds, I'm assuming in the beginning at least astronauts will have biometrics built into many of their clot much of their clothing, so that there will be some type of data being transferred and so there can be help. So it's interesting you took distance from Earth. And when I thought of distance from Earth, I thought of isolation. Yep. And you know there's what you'll see is there's a lot of ways to think about this.

You know, when I first heard of the big five, for example, I thought well, hostile environments, that's just everything else. That's kind of a cop out because that's a lot of different things and also incorporates the fact that isolation and confinement could, potentially cater to that, you know. To cut to kind of underscore the point of isolation and confinement and how bad it can be, There was a story of 2 Soviet scientists in the Antarctic.

I think this was last year, and this is how bad it got is that one scientist would antagonize the other by telling him the end of every book before he was finished reading it. And the guy who was reading the book and having the endings are ruined for him, his reaction was to stab the guy. So it's it's it's it's Justifiably so though. You know, I mean You didn't even laugh at that.

I'm I'm still in I'm still in shock that, you know, it's it's just it defies the imagination, you know, for you and me who have the context of the defies the imagination, you know, for you and me who have the context of not being that who have the luxury of not being that isolated. To you and me, it seems, you know Well, I I I gotta ask you then. Are you married? I am not. Okay. So then stabbing somebody is not. And I sleep with one eye open.

Telling me if a person spends a week reading a book and the person just before they get to the end tells the ending, and they do this over and over again, you that could push buttons. Absolutely. And so this comes back to, selection and, you know, the psychological profile of who we want to select for these missions, and also expeditionary behavior.

Okay. So let's spend some time because I think we're gonna expand on how these how each of these five evolve when we we talk about the next battlegrounds. We'll spend some time talking about hostile environments and then altered gravity environments. Okay. So when we talk about hostile environments, that is an umbrella term. That includes a lot.

That includes the dust exposure from lunar regolith, which we know from the biomedical lessons of Apollo, is a irritant to the skin, to the respiratory system, and that also it clogs up joints in EVA spacesuits. So that's one example. Altered day night cycles. So when you're on the ISS, you're experiencing a sunset sunrise every 90 minutes. That's, 16 sunrisesunsets every 24 hours when you're on the moon. Your day night cycle is 14 days 14 nights.

And then finally when you're on Mars, it's almost but not quite, that what you'd see on Earth. It's just over 24 hours. So over time, you're gradually becoming more asynchronous with Earth. And so the reason we care about that is we know day night cycles affect, productivity, stress, ability to sleep. You know, this time of year as a practicing physician when the days are long in Canada and the sun starts setting around 4:30 in the afternoon and it will soon be, still dark at 9 AM.

You know, we see people tip who've been managing their mental health all year. The my waiting room is full of people tipping over into depression, anxiety, seasonal affective disorder. So, you know, the circadian rhythms are and the lighting is is just as important to consider. The temperature extremes, so, you know, we might say, well, we know that it's a short sleeve environment on the ISS. You know, why would you plan for anything else?

Well, if you're gonna plan, to do a spacewalk outside the ISS, if you're gonna plan to do a surface EVA extramuclear activity, outside your moon base, well, if you're in direct sunlight, it's gonna be hot. If you're gonna be in permanent night or 14 days a night, it's gonna be very cold. So you need to plan to protect for those. So those are just three examples of what you can expect to face in the hostile environment.

And you know, that also brings into consideration how does your environmental closed loop life support system need to help manage this? The temperature, the air composition, the the carbon dioxide scrubbers, the humidity content. So it's an umbrella term. The list is endless, but it's just kind of that term that says beware of space. Is on the list aliens anywhere there? Not yet, but I suspect given how 2020 has gone down, they're they're staying away.

Well, I would act I would argue that probably it's reclassified as something else. So it's bio, biohazards, viruses or any other types of that we have might have never encountered a biological or a virus or something that can infect the human body. Well, I'm glad you brought that up because, I was gonna include immunology under altered gravity environments, but the truth is we don't know if it's altered gravity alone. We don't know if it's increased radiation.

We don't know if it's a synergistic effect. We don't know if it's the heavy heavily scheduled operational schedule. But we know that, astronauts immunity is suppressed in space. We know that some germs, or have increased virulence in space, but we also know that we're not seeing too much of a clinical effect from this other than we've had seen the odd viral reactivation of, for example, previous herpetic infections in certain astronauts. But immunology in space is an active field of study.

It's one of those things that if I showed you a movie that had a scary plot where someone's going to kill you, you might cower in your theater chair because of the sound and something happening. When it's broken down this way, yes, space might be trying to kill you, but so far, these are we can hang on. Yeah. These yeah. I'm not they're they're not as bad, even though they're technologically challenging. They don't sound as bad as I think I hear it to be.

Is it will you do you am I do you understand what I'm saying? That's exactly it. And so the question, as you will see is how do we plan for the next battlegrounds? What toolkits do we have at our disposal? What is being done today and what's on the horizon? And then how do we bring it back to Earth? Because So we're fine so I'm actually asking the right questions. So is there anything you wanna add to altered gravity environments? Yes. Let's briefly talk about how gravity affects the human body.

And the summary is that gravity zero gravity, we know, affects every single bodily system from our muscles to our bones to our cardiovascular system and fluid shift to our central nervous system. And the surprises keep coming. So quickly, muscles and bones experience decrease so muscles experience atrophy, bones experience increased density loss reflecting an osteoporotic or osteopenic state that we would see in disease states on earth.

Fluid shifts, so fluid is no longer pooling in our feet because of the luxury of 1 g. It shifts upwards, so the consequence of that is several fold. Our heart initially interpret interprets the added fluid shift at the at the torso level as increased circulating fluid. And so for the first few days, astronauts are interpreting this as having more fluid in their body. They're peeing out more. They're slightly dehydrated.

They're also losing some of their red blood cell volume and, reflecting a condition called spaceflight anemia, which corrects itself once they return to Earth. And then the surprises keep coming. So in the past 15 years or so, we've discovered where we've tried Just on the central nervous system, what do you find? Yeah. So this is this is the central the space adaptation neuro ocular syndrome that's been described in the previous, 15 years.

It was initially known as the visual impairment intracranial pressure syndrome. And what we were finding is that astronauts seem to have altered vision that persists for years up to 10 years post space, post flight, that has a male preponderance that maybe certain pathological states on earth mimic this, like the increased intracranial pressure, pathology on on earth, but not exactly because those two syndromes actually differ in a lot of ways.

So the symptoms can be different and the gender prep preponderance is actually favored towards females in the, idiopathic increased intracranial pressure syndrome. Okay. So so to to dissect that jargon is we know that the central nervous system is affected and we're still hypothesizing why this is.

The prevailing theories right now seem to be a combination of, well, just like the fluid shift in the cardiovascular system going upwards, the cerebral spinal fluid or that proteinaceous brain juice that bathes our brains and spines is shifted upwards.

It's outflow drainage, both through lymphatics, through the CSF, through the venous system are draining less, and then there is a local outlet decreased outlet flow around the optic nerve, which is why we see this translated as increased pressure on the optic nerve, increased, choroidal flow folds, so folds at the back of this this tissue at the back of your eye, and then the the shape of the eyeball itself changes and so it the the lengthening, sorry, the the the length of the the axis of the eyeball shortens and so, causing astronauts to develop a refractive error.

Again, mostly seated males, and what we need to figure out going forward is we know that this is mostly seen in long duration space flight. We need to figure out how time dependent this effect is. You know, is, does it plateau off after 12 months? Or, you know, if we're if we're going on a several year mission to Mars, can we expect that the deleterious effect will will go on as long as you're not in a one g environment? How much gravity is enough gravity?

Is 1 third gravity on Mars enough to bring, to mitigate the the fluid shift? So it is a very known, a very real effect. It's recently described, and it's, something that we have to plan for as we prepare for the next ballot. This is a type of trivia question because I don't have an answer for it. Is there any movie or any space based movie or event where the individuals who leave Earth cannot see after a period of time due to these type of conditions? I don't think it's I don't think so.

I don't think it's been covered, but, you know, I wonder about this because when I think about the increased cordial full folds, is there an increased risk because you're changing the anatomy of the eye? Is there an increased, risk of, retinol or vitreous detachment, which is a is which is a, eye emergency. You can lose your sight. Now I've been reading extensively about the SANS, syndrome over the past week or 2, and I have not seen that mentioned anywhere. So this is purely theoretical.

You have people you have people dropping from high, in even in their space outfits, they drop from high levels, and you see them bang, and you never see retinal detachment. And you also never see challenges with people who get into a space vehicle of some type Star Trek or battle. So it doesn't matter which one. And you never see them say, oh my god, I can't see anything. And the solution is always that on the v on the vessel, there is a gravitational field which keeps them.

But it's still you've never seen it, which is kind of a funny thing to avoid in almost every single movie. You know, it's it's critical because it is a nightmare scenario if you what if you lose your vision on Mars? And then, you know, that's not the only threat to your vision. There's some estimates out there that suggest given the amount of radiation you would be exposed to on a one way transit mission to Mars, at least 25% of the crew would develop cataracts from exposure to radiation.

So this is why I say space is trying to kill you. No. And I agree with you. I I love what you're bringing up, so don't don't get me wrong. What I'm saying is that if there's very limited awareness of these topics, which often are taught through scientific programs or or movies, then you lose that sense of where is the danger. I I think this is the first time I've heard about the the cataract condition going to Mars.

I think it's just and it should be out there as a means of solving it or of understanding that we're being killed. Yeah. That's exactly it. And so the last thing I wanna mention under altered gravity environments is that the surprises from space flight keep coming.

You would have thought that after decades of human space flight, we would have all of these systems down to a t, but just at the end of last year, there was a article published about how doing routine handheld ultrasound, imaging with the internal jugular veins of astronauts in flight, they're like, hey. What's that? Oh, oh, that's a blood clot in the internal jugular vein.

So now we have to figure out, is this a one off, scenario or are astronauts getting blood clots, because of the venous stasis, that lack of Mhmm. Flow that you would see in one g? And if so, well, that can be life threatening. How do we mitigate that? I don't know if you had seen recently, there was a woman on 60 minutes.

She has dissected, the anatomy of a 100 COVID patients and they had the they were analyzing the brain and in there they said this virus has caused spotting, blood clots throughout the brain. And so she said, she pointed out and said, this is an example of a stroke in any, in a normal condition. And she said, but what we're finding is all over the brain. This is coming that we're finding these type of conditions from COVID.

And so we don't understand enough about and I don't know how long it will take if it's we're having trouble even or challenges on earth. I don't know how long it will take to be able to cover something such as this condition, especially the one you just mentioned. If you are traveling to Mars, it's not the time to find it out. Yeah. No. You don't want surprises, in such a high risk environment. And, you know, it's it's the the problem with COVID is the exact same.

You're trying to isolate one system that really truly interacts in a multitude of system, and you wanna know and understand how that one effect happens, but also occurs in in tandem with all of the other systems that are operating. With the Kelly brothers, was there, in your opinion I know this this is an opinion question.

In your opinion with the Kelly brothers, was there a spike in understanding or data or analysis that conclusively gave us enough information to make some really great decisions? Clinically and operationally, I haven't seen new guidelines that have reflected how we will change countermeasures pre post and in flight going forward.

At the at the molecular level, at the proteomics level, at the metabolomics level, we we did gain more data about, losing nutrition, losing muscle mass, losing our cognitive function or not losing, but having it negatively impacted. So I the short answer is no, but there may I mean, the the the caveat is I I I I it's a good answer, but I'm just laughing because it's it this was supposed to be a huge answer. Yeah. And I think the answer is that I mean, this is a relatively recent study.

The nature I think it was Nature or Science. It was a good article, but this kind of plays into the bigger question even on day to day Earth medicine. From the time you have basic science to the time that you translate it into a meaningful full clinical guideline is there's a delay because you wanna make sure that what you're doing impacts practice in a meaningful way.

And so they're they're probably what's probably happening is behind the scenes with the human research road map and the risk management program is that they're translating these findings into countermeasures. So what you're saying, and I'm picking on COVID, is what you're saying is you need time to really analyze all of this before a shot or a thing is considered to be conclusively safe, valuable, practical in terms of what needs to happen.

And I think space is an example of an Earth simulation where you need to have that time. You need to be able to identify, does this actually occur across 570 astronauts? Does it occur is it reoccurring? Is it genet is it, genetically based? Is it culturally based? Is it food change? Is it, gender based? And all of those make for challenges. Yeah. Absolutely.

You have to do what you have with the data that you have at the time, noting its limitations, I e a small skewed, dataset, as well as realizing that the data is constantly changing just like in COVID. So that's that's a very concise summary of the challenges Yeah. Clinical medicine. Yep. Okay. So I think are we on to the next battlegrounds, or are we Yes. Do you have more to add to this? No. I think that we can leave it at that.

And so the good news is we've covered a lot of, what the hazards are and how they might change. But let's let's quickly, go over how the 5 topics that we've talked about need to evolve, as we go beyond low Earth orbit, and then we'll talk about what else needs to change. So actually let's reverse that because we to summarize, we've talked about isolation confinement, distance from earth, radiation, altered gravity environments, and hostile environments.

So the blanket summary is we are going to be more isolated further away for longer periods exposed to more radiation, with with less help from Earth. So the point I wanna make here is that we need to start thinking differently about starting at selection. So we need to think about, do we need to select our astronauts differently?

Is the profile of an astronaut who would do well on an ISS mission of 6 to 12 months the same or is it different from someone who might do, surface operations on the moon, who might engage in mining, science, exploratory endeavors, who might stay there for longer periods at a time. So the selection aspect needs to be a consideration. Then the training. So the training will be a reflection of the activities, that we'll be doing at the next battlegrounds.

So to be perfectly clear, the next battlegrounds I'm referring to are the moon and Mars. And so when we talk about doing something like an EVA, well, currently an EVA means we're doing a spacewalk in 0 g fixing something like the Canadarm or the Hubble, outside of the ISS. Well, now when we're talking about an EVA, we're talking about being on a surface, that's rocky, that's slippery.

You just need to Google the picture of the Apollo 17 astronauts falling over in their EVA suit to know that, you know, there's you could certainly expect to break an ankle, break a wrist by falling on the break a wrist by falling on the moon. You need to to realize that your medical capabilities, will need to change because you're further away from Earth.

So as a basis for comparison, when you hit the evacuation button on the ISS, from the time that you hit evacuation, you escape in your Soyuz capsule, you land in Kazakhstan, you could be there in as little as 3 and a half to 6 hours. By the time you hit the evacuation capability on the moon, it's a 3 to 5 day journey. If you run into a medical emergency on Mars, well, help isn't coming for 6 to 9 months. So, Help is not coming.

Yeah. Yes. I I had a, a friend in in university, and he would show up late and I would accept it. And one day, he showed up 2 hours late, and I looked at him. I said, what's wrong with you? He says, David, when you're 2 hours late, you're not coming. So and they're not coming. This is solving it on Mars. It you have to go there with the intention of being able to solve it. Exactly.

We need to increase our autonomous capabilities or as we'll talk about, think about what technologies can empower us to thrive in situ. So coming back to the the summary of challenges, we've talked about the the nature of the activities that we're dealing with changing. And then as you correctly hit on, we need to build up the capabilities to make us more autonomously, capable institute.

Whether that's from dealing with medical emergencies, whether that's taking this concept of prehospital care that we see in military field medicine and in disaster management that we how do we build on those principles? How do we you know, you you kind of said help is not coming by if we're on Mars and we we we run into a medical emergency. That's one way of thinking of it.

It's, but then you have to face some dark, hard decisions of if that happens early on in the mission, well, are you are you able to carry out the mission at minus 1 astronaut? If it happens at the end of the mission, you know, is it you know, what is the impact on crew resources? What is the impact on morale on the crew if you say that we're not gonna engage in futile, efforts?

So you can perform CPR all you want on Mars, but if there's no advanced life support system to support that, well, you know, you're not it's then you argue about the ethics of provide providing futile medical care. Because if you there's no post resuscitative support, well then performing CPR is a futile effort. Or the flip side of that is, are we delving into a new branch of medicine? Are we going from prolonged field care to super prolonged field care?

Are we, you know, do we have the ability to to engineer low mass, low weight, low volume, medical capabilities that can perform the standard of care, on Mars that you would see on Earth or even surpass it?

So when you when in your opinion, when you look at these, let's start with the moon and living in that I'm not let's call it hostile environment to keep in in line with what we're talking about, And you think about new branches of medicine or new approaches, or have you come up with you personally or have you experienced moments where you said, now that is the future of how we would deal with those challenges? Yes. I am glad to talk to you about that.

Because I I I was just gonna call Bruce Willis and ask his thought of how he would solve these hostile environments and see what he came up with, but it probably wouldn't be medical. No. We I'm thinking of Armageddon. So We are gonna spend all our time talking about this when we talk about let's engineer the space out of this. Okay. So we can jump ahead to that or we can I would finish if you've got anything here so we're done?

But you still have a toolkit here or less you think it's if you think it's right because it the flow that you gave me seems logical. Yeah. So let's let's quickly touch upon the toolkit. So the last thing I'll say about the next battleground is, yeah, we've we've kind of broken this down, into the big five, but, really, if you go and read through the risks on the human research road map, it is at least 30 categories.

It is everything from crew dynamics to, the impact of altered day night cycles on stress to poor interfacing with human computer interfaces to skills degradation on the way to Mars. So this is a very high level approach, but there are a lot of considerations. I I never thought about having challenges with computer interfaces, which is an interesting, take on assuming that the computer interfaces work in these environments. Okay. Yes. Yeah. And so so let's yeah.

So that's let's wrap up the next battlegrounds and let's Okay. Move on to we've talked about the problem spaces. So what tool kits do we have at our disposal? So because some of these we've we've alluded to and you've you've already kinda guessed at. So let's talk about the packing packing principles of space. So not only do we have the The packing or cracking? Packing. P a c k. Yes.

So not only do you have this harsh hostile environment, you are severely constrained in what you can bring with you. You're constrained with respect to mass, volume, power. What you bring with you will often come at the expense of something else. It's like the it's what NASA calls the back backpacking principle of space. Everything you bring is the at the expense of something else. It has to have a long shelf life because say you say you decided you wanted a ventilator on Mars for life support.

Well, say it broke down. Well, now you have a very expensive useless paperweight, and it has to be easy to use. So, those are the packing principles, and then you also need to know what are we packing for. So we've talked about the hazards of the space flight, and we've talked about the data, from previous missions, and we've talked about how we can expect the data of previous injuries, previous medical incidences, changing. But we the last part of the puzzle is the You just said something.

Yes. Has anybody gotten very sick in space? Most famously Fred Hays, Apollo 13, Eurosepsis. So what I left out when I talked about fluid shifts is that this fluid shift also leads to a preponderance for the development of kidney stones, which at the very least are super painful. At the very worst, can block urine output and lead to sepsis, which is life threatening.

And so that, you know, we haven't had to do anything like perform CPR in space yet, but that was an example of a life threatening condition. I mean, was he in real trouble up there? Was he, or just in pain? Did he pass the kidney stones? I don't know if he passed the kidney stone, but he was he was pretty septic. You know, they did a good job of, like, demonstrating, you know, how diaphoretic, how sweaty, how pale he was. Like, he was just trying to push through, be the astronaut's astronaut.

But, ideally, you you don't want that to happen. Well, it's going to happen. That's It is. The humans break down. So Yeah. Okay. So sorry I jumped in there with that. You you said it in a way that I wanted to know what have we had that because I've not really heard or seen. There's no headline that says, astronaut x has got this issue that we've I don't think that's been a big storyline. Yeah. And so to your point, this is just one of many examples.

So currently, what we're planning for, is what we call the NASA Exploration Medical Capability, XMC top 100 list of medical conditions. So this includes everything from the banal everyday, hey. I have a headache in space to the terrifying, oh my god. There's a cardiac arrest in space to the banal, but also terrifying diarrhea in space. And so there's 100 list 100 medical conditions listed, and these are currently, how we're planning on packing for space.

So to continue on with that is, well, then how do we develop the medical kit knowing for knowing the constraints that we have? Well, we already talked about one of the mainstays, within our toolkit, and that's prevention and selection. If you have asymptomatic kidney stones, you're and you are the best astronaut candidate in the world, you're still screened out because like we just talked about, kidney stones are a nonstarter, knowing the increased risk.

So if we can prevent a medical condition from ever happening in space, then we've done our job. So it starts with rigorous medical selection, psychological selection, team behavior. Then we look at risk identification and mitigation. So we we look at the NASA risk matrix. So we look at the likelihood of something happening versus the severity and impact on the mission if it does happen. So if it's something that is very likely and very severe, then it needs to be mitigated.

So examples of that that are well documented are the radiation problem and the space adaptation neuro ocular syndrome. You know, if it's low likelihood and low impact on emission, you know, say say something super out of the realm of, of possibility, performing a c section in space, well, then you're not gonna plan for it. It doesn't need to be mitigated.

If it's something that's kinda likely but minimal mission impact like getting an abrasion, well, you know, you just accept it and document it and move on. So Yeah. You've probably read about all of us. You've been a space person at Pierce for a very long time. I know peep individuals who are saying we're gonna have 50,000 people in these circular Orion type space facilities in the next 7 years or 10 years. We're gonna have 50,000 people on the moon in 10 years.

We're going to have a 1000000 people on Mars in 40 years. What you're going over, timelines don't add up. They don't. And I, you know, I exactly. Whenever someone says, hey. We have a way of getting to Mars. We figured out the technical solution and the propulsion. I say, great. Well, what's your medical capability, and what is your medical mitigation plan?

You can figure out the engineering all you want, but if you don't figure out the human aspect of it, well, you're not setting yourself up for success. Success. It's one of the challenges that I have often with individuals in the space industry is that their their math doesn't add up. And I just had a conversation with someone the other day, and I said, okay, give me your timeline. So what do you mean? So no, give me the timeline. You've given me all the cases.

Now tell me, we don't have a rocket on earth today as far as I know that can get us to the moon. We don't have a rocket capable of getting us there. How long will it take? What do you mean, David? Well, I'm serious. It's not a tough question. We need to build 1. Will it take a week? Will it take a month? Will it take a year? Okay. So let's add that in. So that's your first shipment. That's not human rated. That's that's there's no humans in it. This is robotic. So let's try another one.

Let's try another one. And by the time you're done, their math adds adds up to 17 years, but they're talking about something that'll happen in the next 5, and the math doesn't add up. So you answered the question. It's it's if we're gonna be pragmatic about living on the moon, if we're gonna be pragmatic about living just within Mearth, when the within the moon Earth, region. There's a 2.4 second delay. I think that was the number you gave me.

There's ability to be able to get someone home within 3 to 5 days depending on how quickly they launch and they're out. There are these limitations, but even with those, it is a challenging, challenging belief structure to say you'll have a 1000 or 10000 people on the moon within 5 years, and it doesn't have That's exactly it.

So the one caveat is is that the data that we have for commercial space flight for suborbital space does support sending every type of human regardless of their medical capability, or the medical comorbidities to space for 3 to 4 minutes at a time because that's a relatively short profile. And Really? So so this is kinda like the zero gravity, touring? Exactly.

So this is what we when we talk about commercial suborbital space flight, SpaceX, Virgin Galactic, Blue Origin, and we have data from centrifuge studies where we've put subjects aged 19 to 89, of all manner of medical com comorbidity from, people with heart transplants, congenital heart conditions, type 1 diabetes with an insulin pump, and they were all able to withstand the hyper g load. So the increased gravity profile front to back, up and down, they all did great.

And while their 0 g component wasn't there, and that's the gap, the medical comorbidities were stable. No one had an HAZMAT attack. No one had a arrhythmia that turned into a clinical concern. There were arrhythmias noted but they were actually in the healthy subjects with no heart conditions and the most common reason that someone was disqualified was because of anxiety, claustrophobia, or just not being safe.

And I would say that in addition to that, the other major reason someone may not enjoy their flight in a 3 to 4 minute suborbital flight is because they're on a the most glorified of comet comets and unfortunately getting space sick. The one of, our team members out of Germany who, has owned Space Affairs. So he has done a tremendous amount of these, space flights, the zero gravity flights out of Balconar. And so he he's one of those, and I've never asked him a question.

Have you run into this challenge? So, yes, I could believe that to bring someone up, if you have the right conditions, you're not gonna run into any challenges in 3 to 4 minutes. So what's the what's the next challenge level up? So the next challenge job is opening up low earth orbit from a commercial perspective. So maybe, yeah, maybe it's not realistic to think about 40,000 people on the on the moon, 1,000,000 people on Mars, but all we need is a single catalyst to open up low Earth orbit.

All we need is the start of a few successful suborbital flights and then the price point to come down, and then in theory, you could have a lot of people accessing low Earth orbit initially as a tourist, and and human tended payload and, scientific endeavor, and opening up the space frontier in that manner, and in so doing, opening up new economies, new platforms for art, for athletics, for entrepreneurship. That to me is is is realistic.

Our next guest on the program, I think it's next, is John Spencer who I believe still is the president of the Space Tourism Society. So we're going to be talking about that in some degree also to say where where does he think, how far and to and to be pragmatic again. We've seen what Virgin was in the early 2000 and still no one has flown.

So safety and even the astronaut just recently who was supposed to go up, and he decided to stay on Earth because he was gonna he wanna be around for his daughter's I think it was his wedding her wet her wedding, and he decided not to be that astronaut because of the risk factors, the capabilities, the training, and all it takes to get up. So okay. Alright. So so what's what else is in that toolkit? You said there's a 100 different. You went over 0 gravity.

Is there anything else in that in that toolkit that we need to develop or any challenges? Because a 100 is a lot of different medical conditions. Yeah. They're not we're not even talking the challenges, technologically, repair, maintenance of an engine, repair, maintenance of anything, life support systems, or whatever components or challenges. Is there anything else that is in that category of the toolkit?

Yeah. So the next question I wanna address so we've talked about what we're packing for and we talked about the packing principles. So then the question is what do we pack with us? And so then we look at, computer models that can help us do some important decision making. So for that, I would refer to the integrated medical model as well as the medical extensible dynamic probability risk assessment tool, which is cumbersome to say, which is why we call it MedPrat. So these are 2 p r a t?

Yes. Because I could not I could not keep up with you to write it. So I'm Med Pratt. Yeah. And so these are NASA and NASA collaborator developed, computer models and they help us decide how to pack for space. So we have medical kits on the International Space Station. We have a first aid kit, we have a medical kit, we have a procedural kit, they're highly compartmentalized and modularized. We also have data of what has happened when, at what frequency from decades of human space flight.

So now what the IMM does is it takes the the volumes and the quantities of what you might have brought with you in terms of gauze, medications, pain medications, antibiotics. You input your new mission profile in terms of duration, crew, number of crew, and then you put your desired outputs. What is your acceptable limit of loss of human life, of loss of mission?

And then it uses those inputs and the desired output to extrapolate the kit contents for what you would need, for example, on a 9 month 4 person crew, sojourn to an asteroid. So that's one of the first tools we have at our disposal. I'm wondering, do you do you know what they use as the risk analysis for acceptable human life? What does that figure? It can change.

I mean, have you have you met somebody who puts it in and says, I'm the guy you or I'm the woman, I'm the person who decides this number. I am willing to accept the 74.3% risk factor. It's not 74%. It's usually less than 1%. Percent. Well, I'm I'm throwing that out to be to be to joke at. Is who's that person? It would be a joint decision. So, when I I personally worked on one aspect of IMM and crew development when I was interning at NASA about 8 years ago.

For the life of me, I cannot give you a figure that I remember off the top of my head, but it would be under 1%. I per I think, and this is, I this will probably come back to haunt me, but I'll say it anyway, is we are explorers and exploring a new terrain that has risk. When we went under the ocean, there were risks and the risks were way above 1% where people died. We were explorers when when humans traveled from one continent and found another continent, finding Australia.

And there were huge risks involved. Ships went down all the time. People who went to new territories, they died of cold. They died of starvation. They died of all sorts of factors. Do we throttle back our capability by being so risk averse? You're asking the right questions because essentially you're asking, well, if you don't like the rules, why not change them?

And then that's where, you know, you get people like Elon Musk saying SpaceX will send 1,000,000 people to Mars just just have to be willing to die and accept that you may die. But it's a sheer numbers problem that if you send a 1000000 people, well, at least some of them should survive and you should get some sort of operational settlement on Mars. So NASA space agencies are generally quite risk averse. They're funded by the taxpayers.

Anytime you have a loss of a a transport vehicle, loss of a human life, it sets the program back for years, if not decades. And you have you have congress to answer to. You have taxpayers to answer to. So that that's in part where their their risk, averseness comes from. And just the whole morale of losing, you know, losing teammates, losing losing a human life.

But you're you're very right that in the commercial sector, it's been publicly stated that, you know, we're willing to accept the higher amount of risk. That 74.3 percent you you you throw out may may very well apply elsewhere. I Project Moonhut has 4 phases of development on the moon. The first one is a a moon hut. Again, we were named by NASA. So it is a, box of the roof and a door.

That's what I called in the beginning, a box of the roof, and then, one of, Bruce from NASA Ames calls added the door. So the the moon hut is 4 to 8 people who go around the moon, minus 150, plus 100, and at least I always say it this way. At least one of them returns proof of concept. The second is an industrial park. The third is extended stay, and the fourth is community over a period of time of development. And I do I do always when I share that, I say, look. This is space. We are explorers.

We're on this new rock that we've been there before. We've landed and come back. We've never stayed there in in throughout history, people die. And not that I want to be the one to die, not that I'm the one who I'd like to be the one to tell people to die, but the Shackleton expedition had risks. Mhmm. And so has many so has all of the other expeditions to change the future of human life or life on earth.

They have had risks, and I think that this commercial side of it might have more of 2% compared to 1% might be enough to be able to make something happen, where 1% is your kid can't go out and they if they're gonna go out and rollerblade, they have I'm using an old terminology because it just or skateboard. They have to have the kneepads on, the wrist pads on, their helmet on, their all those pieces, and the kid says, then I don't wanna go.

You know, I once heard a a neurosurgeon, say that, you know, too, is one of his colleagues who was so risk averse, you know, made everyone wear helmets, avoid ladders. He said, you know, if you if you had your way, everyone would just be walking around in a bubble. Yeah. And, sure, we'd have less less, trauma from falling off the roof from Christmas lights, but also, you know, is that really living?

I I normally do things that are dangerous when and don't share this with anybody, when my wife hops in the car, because I have 2 chainsaws. I do trim trees over my house. I do my own roofing, and it just so happens that yeah. No. I saw that. I got the ladder out and I did it, but I'm very, very cautious, meaning I have full, lumberjack gear, meaning things that I strap myself to the tree. I'm very careful, but to to most individuals, I would be at 72.4.

So I think that we have to when we are creating these kits or what do we take with us, how do you manage that decision making? And even more so, I would say, it's probably extremely challenging when you compare gender needs and requirements. Mhmm. Because you're doubling or you're quadrupling potentially needs. Yeah. And, you know, we we know there's certain gender differences. We talked about how that, you know, plays plays a role with the space adaptation neuro neurocular syndrome.

We know that for example, women, on the flip side are more more prone to being decompensated, when they land back on Earth, because of valvular incompetence in their veins. What does that mean, decompensated? So, you know, when you see astronauts land on Earth coming out of the Soyuz, they're carried out, they get that hero's welcome. It in reality I mean, part of it's pompants pomp and circumstance.

In reality, it's because they're it's so deconditioned and that the valves in their veins, you know, are are decompensated that if they tried to stand up, they would faint immediately because the valves in their veins, their their narrow vestibular system, let's control their balance, would, you know, have yet to re reacclimate to 1 g. So are you or or and I'm trying to get this in my my background is, one of my majors was biology.

Mhmm. But when we're talking about a valve, the valves are sometimes I believe have a muscular component to it, but most of them don't in the same so Mhmm. How does a valve atrophy or lose its capabilities? Is it that it's not getting neural signals? Is it what what's stopping a valve from readjusting fairly quickly on a in being gender specific? We don't know. That's Oh, okay. A great question. We don't know why there's a female preponderance.

So these valves I'm referring to are one way valves in the veins. So when you and I stand up in 1g and the reason that we. Don't have fluid pool elsewhere is because the the veins that bring fluid blood back to our hearts are one way. So that's why it doesn't pool in our feet. But these vowels are just disused, in space. They forget to do their job back on Earth.

And so if you stand up, the the the blood would pool to your feet, taken, and that paired with the, the neurovestibular mismatch, and deconditioning from being in 0 g means that these astronauts would almost certainly faint if they tried to stand up, and that's why they're carried out. Have you, in your history, discovered, any data that says this gender and I know we're being this is kind of a channel. Every time I use the word, I'm trying to be very careful because there are multiple genders.

There's not just 2 genders. It's just it's almost when I hear the words talking about the United States or talking about other countries. Well, the Republicans, Democrats. Yes. But there are other parties, and not everybody is conditionally 1. They could be a mixed belief structure. So when I say gender, I am talking across multiple, variations.

Have you discovered or have they has anybody discovered that there is a preponderance and a benefit to being a woman over a man in this condition or that condition or or or? So the biggest benefit would be from lower metabolism and lower use of consumables. And I've seen that put forward as a re rationale for sending primarily all, primarily female or all female crews to Mars is just to save on resources, and to preserve your your life support, resupply.

And the and the and the the there's a lot less weight traditionally. A lot less weight when you add it up as a collaborative group of 50 people if you just had women. Yeah. And so that's one argument, but then you have to look at all the other systems. So for example, the psychosocial and psychodynamic data suggest that mixed gender crews tend to perform better. So then what's your value judgment here? Do you do you save costs on resupply or do you optimize performance with a mixed gender crew?

Do they really have in space, because you've we only got 12.5, that there is a positive correlation to mixed. And I say that because the roles are not gender specific, meaning on earth, you have a home, woman's a woman has to be the one to bear the child. Can't stop that. So let's let's assume that that that there are certain roles that biologically, structurally, there are roles that women will take on and men will take on size, scale, scope, whatever you wanna use as your variance.

Yet 50% of all marriages or more fail in divorce or things don't work. So is there any evidence that says that the in space that the mixed crew is a higher performing crew? There is data on that, and I'm citing, the book by Nick Canas, Humans in Space Psychological Hurdles that, that looked at the data on gender diversity. As you correctly point out, we do have a limited sample size, and we also have a very small preponderance of females within this population.

So it's it's the data is there with that asterisk. Okay. Interesting. Cool. Alright. So we we covered women are more, decompressed. We went over that. What caused medical antibiotics, computer model. Okay. So what's next? The last the last point I wanna bring up under, the toolkits for human spaceflight is analog environments. So we've established that space is risky, space is hard, and space is expensive.

So it's a no brainer to say that the first time you perform a protocol, you don't want it to be in space. So how do we prepare ourselves for space? And that's through the use of analog environments or analog, environments that are in some way analogous to the spaceflight environment.

And so there is an array of them, but basically, as long as you can replicate some aspect, whether it's the isolation confinement, whether it's the, resource limitedness, whether it is, the altered gravity environment. There's and they can be a mix, of of, you know, all of these characteristics. But basically, when we want to fly something to space, we wanna know we wanna test the heck out of it.

We wanna know how it works, how it could go wrong, how we could break it, how we could fix it, and how it can save us when we before we go to space. And so for that, we look to places, like, vomit comets, parabolic flight, if you want to test something for a few seconds in microgravity. You look at, centrifuge studies to simulate hypergravity.

You look at isolated environments like the Aquarius Reef Base where NASA runs its NASA Extreme Environment Mission Operations or NEEMO Missions, you know, to to practice all of these things. You want to prepare for space. So these are just another example of the the arsenal that you have in your toolkit to to put yourself up for this humans v space battle, the this environment that's trying to kill you. And I I believe you've done, some of this.

Yeah. When you walk away, your personal interpretation again is when you walked away from this experience, did you get so much value out of that? Absolutely. And so the value that I've derived from this has been scientific, it's been technological, and it's been personal in terms of the the depth of the interactions that I've had and the relationships that I've developed. You know, I once I once had a retired Canadian astronaut say to me that, you know, his crew was like his family.

There is nothing he wouldn't do for them. And for me, the the crews that I've been on simulated Mars with, the crews that I've lived underwater with are exactly the same. We correspond on the daily. So I can absolutely vouch for that statement. Okay. I've I've never done one, and I had never I thought of doing a 0 g ones, but I've never really and I've I've got my scuba diver license, but I've never really said I would like to do one of these. So cool. Yeah. It's it's really fun.

And then the last thing I wanna point out is, you know, some of these can be incredibly high fidelity. So when you are at depth at the Aquarius Reef Base, you are 50 feet underwater, which means if you spend 24 hours at the ambient pressure, you are now in saturation. That means if there is a medical emergency or a reason to evacuate the habitat, if you go straight to the surface, you risk a dive injury. Yes. You need to decompress for 15 hours and 47 minutes at the Aquarius Reef Base.

So in theory, you can get to Earth quicker from the International Space Station than you can from 50 feet below the ocean. Yes. That I would understand. And so, are there I I and I don't know if you're the person to ask. Are there a lot of these analog space missions out there? Yes. So over over the past few years, maybe 3 years, they seem to have hit this exponential inflection point. There only used to be a handful. So now we're seeing places like the Atacama Desert in Chile.

We're seeing Poland with the Lunaris, analog. We see high seas in Hawaii. We see Concordia Research Station run by the European Space Agency at the South Pole where it can get to be minus 80 degrees, Celsius, and you're living there, for 12 months at a time. And so we have all manner of fidelity of these, and, you know, they're they're only increasing in in number and in what space environment that they replicate. I wonder if any how out?

I think by this point, most of them the the most famous example I heard, it was, the singer. Jared Leto was in the desert, I think, for 12 days when COVID hit, and then that's when lockdown happened. And so he came out of the desert, and he, you know, he came to this alien world. And similarly, I was commanding a mission at the Mars Desert Research Station at the end of January, beginning of February with very, very limited comms. We had no real time comms.

We had a 2 gigabyte daily allowance, and that included filing our daily reports. So we would see the occasional headline of new virus, described in Wuhan, China, China under lockdown, Wuhan province under lockdown. And, you know, myself being a physician, my executive officer was a physician.

You know, we discussed it amongst ourselves, but, you know, you you really are living that simulation, and we would discuss amongst ourselves with mild curiosity, mild concern, but you're also very, distanced. You're very, maybe dispassionate about it. You're watching with curiosity, but you also have your own day to day operations on Mars, which are ironically closer to home.

Well, and that's the having lived in Hong Kong and seeing things happen overseas, you get that disparity, that differential. I think that there are there were some people in the International Space Station who had not come down until after it had, it had spread. And I've got to believe that some people in the South Pole might have come out after months of not being interacting except via media or but not being part of the global society in this way.

So there's a, someone I'm talking to on the space side. He's in, Vanuatu. And Vanuatu is an island between Fiji and where's the, New Zealand. And he said there has been no cases of COVID on the island. So when he got there, they had to make a choice. Do they leave and he can't come back if in fact he leaves? So he has not left the island, and more or less, Vinutu has not had to do anything except for stop people from coming.

So he has lived in a different world even though he sees it from the he sees it, but he's living in a different world. Well, you know, it it's it's it's exactly that. It it isn't a problem until it becomes a problem. So, you know, I'll give you an example. For us on Mars, it wasn't a problem, but with the caveat that I had developed a wicked bronchitis.

I was sick for most of that mission with the, you know, you would have thought that I had the plague with this horrible cough, you know, in isolation. And, you know, we still performed our duties and you thought, okay, you know, we're we're practicing good infection control, good good hand washing. You know, there's no one no no reason for someone to treat me like a pariah.

Uh-huh. And then I got to Las Vegas airport in transit just as COVID was hitting, and I was like, I feel like the worst human being in the world popping in public. Right. Well, when, I've shared this on another podcast living in Hong Kong, they live through the SARS environment. And so they wore masks as a means of protecting society. They already learned that the 29 countries within the Asia Pacific region.

So if you felt sick in the morning, you woke up and you didn't feel well, you put on a mask not to protect yourself, but to protect others from you. And I always question to his scenarios. 1, when individuals would look at an Asian individual walking through an airport and you hear them or look at them like other, they're scared of us. And I would think, no. They're not scared of you. They're trying to protect you.

And when expats would live in Hong Kong pre COVID and they got sick, they would just cough. They wouldn't put on a mask, and I always felt that was that that's an unkind way to live in someone's home to not adopt some of their behaviors, which were basically pathogenetic, path a a means by protecting society, and expats wouldn't wear mask. They'd runny nose or cold. It would just be, okay. I've got a cold.

Now it's changed, but that's so this whole the the analog environment is, I would probably say for if I was gonna share this what we're talking about is that probably you are individuals have experienced through the COVID environment some form of an analog mission type of experience.

I don't know if that's a good way to say that there's a correlation in understanding what an analog environment would be like if you are living through COVID in these type of environments, Vinutu, Hong Kong, Japan, Denmark, each having their own bubble and trying to live within it. Absolutely. Absolutely. You're right.

You know, there's been numerous numerous articles from the space world, from the analog world, myself included, on, you know, lessons learned from analog environments as they might apply to the ultimate analog that is 2020 when we're living under social, isolation and confinement. And so there's actually coming back to this concept of cellular genesis and the type of personality that rises to an austere environment.

There's data around resilience that says there are traits that can be learned to deal with austerity. Mhmm. And so those traits are, impulse control, resisting urge to give up, mental rehearsal, practicing contingencies for the best and worst case scenarios, breaking things down into step by step, actions, positive self talk, and enlisting your social support network.

Just as similarly, Anne McClain, one of the NASA astronauts, published a great Twitter thread on the concept of expeditionary behavior, which all astronauts are taught to practice minding your own health, your crew's health, your mission's health, and then applying that to the world that is COVID. So there's a lot of lessons we can learn about being a good teammate in a very strange time. Okay. Cool. So we're on to let's engineer the hell out of you didn't write that. I wrote that. The space.

The space out of that. Yeah. And this is a this is a throwback to The Martian when, Mark Watney says, let science be, I don't know if I can say the word on the podcast. You can say anything. Well, yeah. He said let's let's science the shit out of this. So this is kind of a play on let's engineer the space out of this. So let's let's get to that. So we've talked about the challenges of how space is trying to kill us.

Well, we've said that, you know, we're pretty set on sending humans to these hostile environments, so how are we gonna overcome them? So let's ask the non constrained question. If we had no constraints, no mass, no volume, no power constraints, no resupply constraints, what would be the ideal? Well, the answer is simple. You would bring another Earth with you.

You would terraform Mars, so you have a full atmosphere, so you have a Van Allen built, so you have one g. If that's not possible, you would develop teleportation so you wouldn't decompensate on the 6 to 9 month journey. And if that's not possible, you would hack the propulsion system. So, you know, there's been, the concept of the VASIMIR rocket which can shorten the We've had him on. Yeah. The VASIMIR was from Diaz. I don't know if you listened to the podcast.

Yeah. I didn't listen to that episode, but he's the one who proposed a 39 day journey to Mars. Yeah. He's he's done a podcast with us. He was he was great. The the biggest challenge for the vast marine engine is power. Exactly. Yeah. So so we know we know that there we can engineer the space out of this.

And so the other question I wanna ask in tandem to this is, what if we not just met the standard of care on earth but surpassed it and in so doing, brought that benefit back to earth which will be my last point. So let's talk about technologies that are seem like science fiction that will blow your mind that are actually being worked on today. Sure. Love it.

Yeah. So, you know, there's if you grew up in the nineties, you're familiar with the concept of genetic engineering in the movie Gattaca where they genetically engineered quote unquote superior perfect intellectual beautiful people. And, you know, ethical quandaries aside, there's this great paper from the MIT review called Engineering the Perfect Astronaut from 2017.

And in that, they talk about the ethical prerogative not against engineering astronauts, but they argue that maybe it's more ethical to engineer an astronaut when you know you're sending them into a hostile environment. So pick the astronauts who genetically have more muscle mass or genetically engineer them to be radiation resistant. And so to translate that back home, there are labs that are starting to look at what happens if you splice the genes of an elephant into a banana.

Well, why would you do that? Elephants have four copies of the p 57 oncogene, cancer editing gene. That's why elephants don't get cancer. So what if you could somebody splice that into a human? Well, the future is even closer than we think. So in September, NASA and its academic collaborators published what they call the mighty mouse experiment. Rodent research 19 was the official title.

And so they took this genetically engineered mice who had, who were gen genetically engineered to have more muscle mass and more bone mass. And then they also added another intervention, which was a receptor blocker to muscle and bone breakdown pathways, the ACVR 2 receptor.

And so what they found was that these genetically engineered mice had more muscle mass, after flight than the non engineered mice, and then the ones who had this receptor blockade to the muscle breakdown pathway actually even gained muscle and bone bone mass. So NASA was literally engineering mighty mouse. It's not quite humans, but it does promise some sort of benefit when we talk about mitigating for the hostile environment to space.

Yeah. I'm waiting for the teenage mutant ninja turtles to come out of the ocean out of the the sewer pipes now. Okay? So that's that's just one example. So then let's talk of yeah. That's that's no different than using fish and oranges to be able to have oranges that can withstand cold. Are there countries that are more prone to are more advanced in this approach to, genetic engineering? So that becomes both a scientific question as well as an ethics question.

So this was an American study with American collaborators. I suspect if you would apply this to humans, perhaps you might wanna look to, countries like China Yeah. And see where they are with that. That is my suspicion. I don't have an definitive answer for you. I wouldn't I'm not gonna say the word pass it by because that's a negative.

Is I would believe that in China, it would not be an unrealistic expectation to achieve not Chinese superiority over Earth, but to achieve a mission that that type of belief structure would not be considered, an ethical negative challenge. Yeah. You know, so it comes down to these societal values. Did I say that politically correctly? It it comes down to the societal values and how you how you view, you know, these these questions that we would view as ethical quandaries.

So so what else are they doing? You got the banana and the elephant. What else are we doing? Alright. So, Lynn, let's talk about, we talked about on the research roadmap. One of the risk was human computer interfaces as well as skills degradation. So what if you could the ideal scenario would be to upload upload information directly to your brain just just like you see in the matrix or to practice on a holodeck.

Well, the answer that we're working on today is virtual reality and augmented reality. So we're using this for training, we're using this for medical skills practice on, on an exploration class mission because you don't want the the next time you practice an IV, you haven't practiced it on Earth 9 months before, to be on a human. You wanna be able to maintain those skills.

So I should disclose that I'm working with a company that's developing this technology, but that's just to say that it is a here and now phenomenon, that also if you can imagine, without very much belief, that also has benefit for education and training on Earth. So computer interface, yeah, the the matrix. So I wouldn't it's not as it's not as it's a I if you go all the way to the matrix or you use the minority report.

Mhmm. Because I think the minority report is the is the middle ground where you've got capabilities that you can utilize, that you interface with, and you've got motion and hand motion and all sorts of tools that you can use as compared to the way we type or the way we work today. Mhmm. Is there any any example of something that is out in the commercial space or has been in the in space being sector. Is there any example of this that someone I could look at and say, yeah, that's kinda cool.

So you're talking about hand controls. Yes? Yeah. Or any of them. Anything where you're seeing this skills degradation or computer interface. Yeah. Absolutely. So then you look at not just, VR integration, but you look at haptic glove integration. You look at biometrics Mhmm. Integration. You look at eye tracking. And then you look at how you can take all of this data and then make your learning better.

What what information do you get from, for example, examples, galvanic skin conduction based on how your learner reacted in a scenario. And then use that to enhance their learning for the next scenario. So there's there's all sorts of here and now technologies that promise to to give us an edge in the human based space battle. And I I don't know how much of this was those that you just mentioned.

Eye tracking was a, had a lot of its behavioral side in, retail, and it has a lot to do with, computer utilization. So there's a lot of emphasis on where someone's looking and how they're looking and what they're doing. And I I've written about this a decade ago. Haptic gloves and the capability of being able to hold, move, interface, those were not developed. I don't believe this is a space interface.

So what your galvanic skin responses, I think that's even partially to do with torture or being able to know if someone's lying or not to be able to measure the the changes in, in moisture that come off of the skin. So Moisture, sweat, Cortisol. Right. Yeah. And we we know it's a stress response. And so it's an early stress response. And that's what the value, of integrating it into into simulating a a a high stress scenario.

So I'm going from one side, and the reason I'm asking or saying it this way is, I know we're taking what's existing on Earth and applying it to space. Have we done the have we discovered anything absolutely off the freaking wall? Mhmm. That was designed only for space that is now permeating the other way. Yeah. So you're you're jumping a little bit ahead. Sorry. I keep on doing that on you. I should That's fine. That's fine. But coming back to Earth. So, yeah.

So that's the last thing I wanted to ask. Because we had another one in far out, questions. So you wanna do you wanna do coming back to Earth and then far out questions? Or, which way do you wanna go? Let's quickly let me give you 3 more examples that will blow your mind about what we're engineering today. So we talked about hacking the space environment to just bypass these these hazards.

So, you know, if we're worried about decompensation zero gravity, why not develop a rotating artificial gravity space station that can give us 1 6th or 1 third gravity on the way to Mars? So that's being done today. There is a there are companies. There is a company that is proposing to to do exactly that, build commercial space station. And in so doing, we can mitigate, you know, the space adaptation, their ocular syndrome, for example.

I mean, the but that's I think it's called the Orion system. That that was proposed back in the 19 I'll throw this out. I'm not an expert on the on years at all, but that was proposed 19 fifties, sixties, or seventies. Correct? So the the theory has been around for a long time. You know, we saw it in science fiction in Space Odyssey 2,001 in The Martian. There was the Nautilus module, which was, proposed as an add on to the International Space Station. I don't think it was ever employed.

So the company I'm referring to, and I should disclose that I'm an advisor to this company, is Orbital Assembly Construction, and this is exactly what they're doing, developing, artificial gravity rotating space stations. Yeah. I I know of some others that, that I can't think of off the top of my head, but they're they're proposing these type of conditions. And yet we're there's a lot of mass that has to go up into space.

We'd have it's a timeline issue for me is how far out is this to be able to, someone just put up there was a picture and I can't remember where. I was talking to one of our team members on Project Moon Hut. And it's it's 94 feet in diameter, and it's a full rotating space environment. And just to be able to bring up the mass would be a tremendous amount of flights to be able to get there. So I I talked with the team about timelines, and timelines are pretty far out there.

Yeah. And then this is where, we come back to to the idea of catalyzing access to space, catalyzing lower earth orbit industries and construction, and then not just making space accessible to more people, but more industries. And that's, you know, that is I think the solution to to doing these large scale projects in space is just, bypassing the major hurdle, transporting materials. You don't know enough about Project Moon Hut because that is the foundation.

We accelerate the Earth and space based ecosystem. Our the technology we're designing, creating, and and working on is exactly the acceleration of the Earth and space based ecosystem, which would allow these things to happen faster. So And that's exactly what needs that's that's brilliant. That's exactly what needs to happen. It's all designed. It's all put together. We've got all the tools.

We've got all the pieces, and I we haven't gone out there looking for funding until just now because I'm a person who doesn't like to go the space industry is prone to this. I don't wanna go out and bang my chest until we have something that's done. And it was a I'll tell a short story. I'm in I'm in NASA on one of our first meetings, and one of the individuals said, so what are we gonna tell people? And I said and there was a communications person there.

And I said, we're gonna we're not gonna say anything. It's a secret project. And the communication person looks over me, and he puts down his head. He says, this isn't gonna go well, David. Because everybody in the space industry wants to say what they're working on. Every everybody is a big term. A lot of individuals wanna pound their chest, and I believe you should have your ducks in order, especially on something that's a new technology or a different approach.

You have to have them in order before you go out and pound your chest. Mhmm. Absolutely. Yes. That's that's what Project Moon Hut is about. It's not about building. It's not about construction. It's not about getting to low earth orbit. None of those things are what Project Moonhunt is about. It is about how do we accelerate the earth and space space ecosystem? How do we create alliances faster?

How do we transpose the human consciousness, not in an awakening sense, but the knowledge based sense, faster than we're doing it today? How do we clear the hurdles that are regulatory or that they're political or they're, economic, the IP rules and laws? How do you do that on a global scale in a way that would take us from x amount of years to a a reduction of 10 x or a 100 x? And that's what we work on.

That you know, and that's I've I've always said I've I've been on the record saying this that access to space is a form of empowerment. It's a superpower. It's a form of infrastructure, development, education, telecommunications development, and and data know knowledge acquisition through Earth observation. And so, you know, I I'll be the first one to say that, you know, we need to catalyze access to space.

So that's And and and it's and it's there are the challenge is we don't have that connection. We have space individuals. We have people who work in the space industry. We're not always space people. You could be a great financial person and not be a space person. We have enthusiasts, people who like to go on missions and do and go to classes or go and read and enjoy. But there is a large portion of the world that's just opportunistic.

They don't know enough about space to be willing to put capital or invest in it. It's a long term. It's a patient capital. And then there are purpose driven people who don't see space as an answer in most cases because they don't understand the correlation between innovations and the ideas.

And that's what you're the reason that came up is you're talking about these tech this tech is they don't, as individuals, me, I'm one of those people fatten in the 2 categories at the end, is that I just don't didn't see the correlation between them. And we that's what we work on. That's what our nonprofit is working on. And we are nonprofit on purpose because we do not want people to believe that we're doing this for an a financial gain and that it's a global initiative.

It's all all species on earth are impacted, not just humans. We are not just about saving the human species. We're about making and improving life on Earth for all species, which includes if in fact you go out and you live on the moon, that's still, connected. So okay. So what give me some others. Give me some other tech. So, you know, a lot of these things were boring from science fiction.

So there was a time when we thought that the concept of so we talked about the problem of resource utilization Yeah. On the way to Mars. So what if you bypass that by hibernating your astronauts? That was once within the realm of of science fiction.

Well, the European Space Agency, ran a study in 2019 where they calculated if you successfully put humans into hibernation for the duration of that journey and moved them 3 months sorry, 3 weeks prior to landing on Mars, you could actually save on your mass budget, your volume budget by up to 1 third. No food. No all of those other things go along with it.

Yeah. Well, the value behind hibernation when we look at what we've learned from animal physiology is that when you take ground squirrels, for example, they, by dropping their body temperature from 99 Fahrenheit to 27 degrees Fahrenheit, they decrease their metabolic usage by 99%. So, you know, the there's there is an argument for human hibernation on longer duration missions.

Well, that's currently being worked on, through comparative physiology, the University of Alaska Arctic Biology Institute, Spaceworks is a company that has published a paper on the practical aspects of human hibernation. So there's some there's some hurdles to overcome. Have we tried it yet? They no no human studies. So with the with the University of Alaska Arctic Biology Institute, they hibernated non hibernating animals. So they tried it on rats.

And so the showstopper currently is that, with the decreased blood flow to the gut is that the the bowels necros and perforate and the rats become septic. So that's currently a show stopper, but at least we could identify the problem. And by identifying the problem, we can take steps to mitigate it. Let's just hope that rats don't one day become smart because they are used for everything. Imagine you're a rat. You're a subject or potential subject.

So so they've done so they're they did find a biological challenge with this this condition. Mhmm. Have they found or is are rats the only that they've tried? In my reading, I've I've read at this at a surface level to kind of orient myself to the landscape. So it's possible that there's other labs out there doing, more invasive with other species. There are for sure other labs out there doing something with other species.

So in my reading in my reading on this topic, the other interesting thing to note is, well, you still have to feed the humans. So then you have to talk about how invasive are you willing to be because they propose that, in in the space works setup is that they would have to have 1 astronaut awake at a time for a 2 week period and then swap off with other astronauts. And part of that would be the maintenance of the sleeping astronauts feeding them through a PEG tube or a tube in your stomach.

So you'd have to surgically insert that tube. So then, you know, that also becomes an ethical quandary. In an otherwise healthy human being, can you justify doing a very invasive procedure? So there's there's all sorts of discussions about this, but the the bottom line in the matrix. It was a battery. We you know, it could also charge. It would give the energy for, DS's engine. So that's a joke whether yes.

You you can theoretically I'm surprised that they thought of having to have a human there where they wouldn't create an autonomous system that would be completely, enclosed to give the human the ability to feed that person while on flight? I think they I think knowing the limits of our autonomous capabilities, it's it's kind of the same reason we don't have AIs replacing doctors. AI is good. It's good enough to supplement humans, but it's not good enough to replace humans.

So something went wrong with the autonomous system. Yeah. And it's only 2 years. Killing off your crew. Right. It's only it's it's not a long enough flight. It's not like we're going on a 10 year mission or 20 years or 30 years. It's Yeah. Just 6 to 9 months. So So, yeah, that's that's worth it. Not a big deal. Okay. Yeah. And so, you know, there's there's myriad examples. So, for example, you know, do we have food that lasts 5 to 7 years on a shelf? Well, not currently.

Not the one that's light enough and nutritious enough. So there's companies out there working on that. One of the NASA research groups is working on a concept called IV Gens. So if we're gonna have to bring IV fluids with us, as a matter of basic life support, but we're also gonna need to either replenish that, which is heavy and expensive, or manufacture plasma fluids institute. So you're manufacturing your own fluid replacement.

There's all these concepts that are being worked on today, that can help. I I I feel like I'm in a humorous a humorous mood on this time. I feel like we should be having Twinkies and SPAM.

Both of them seem to appear to go through nuclear or the movies, they supply they go through a nuclear, disaster, so therefore but, yeah, I could I've been didn't think about the long term duration of having 5 years, but then again, if you're going to be going to Mars and you achieve, moon or Mars or anywhere within that 6 to 8 month times, sight the distance, and it's 2 years, you still will have the 2nd or 3rd capable re resupply mission possible within a shorter period of time. Exactly.

But resupply is expensive and, you know, you're also putting all of your your space ducks in 1 in in a row. So, you know, anything that you can bring with you that you can manufacture in situ, that you keep with you is to your advantage and saves on costs. So that's where we got get into the idea of institute manufacturing both through 3 d printing. Well, there's 3 d printing companies in space, made in space, that already has a, printer on the ISS.

And then there's, of course, institute resource utilization. And so, one of the the most commonly cited uses, for regolith other than, of course, extracting, elements from the regolith is also well, what it's gonna be costly and you'll have to bring a lot of material to provide enough meters of a wall to filter out radiation. So why not just live under the regolith? Why not live under meters of regolith?

You know, so those are other solutions that are being suggested for engineering the space environment aspect out of the human hazards of spaceflight. They just had the European Space Agency just, I don't know if it's just. I just saw it, doesn't mean just they just announced a or they recently announced a living type structure where I think it's on their website where you primarily living underneath the you you enter on the ground, you don't set up in a crater.

And then you go down into the bowels of the living environment to protect yourself from the radiation or for for micro media, for from any type of damage that could happen. Okay? Any other any other cool cool tech? You know, the the list is is long, but the the last 2 I wanna mention are point of care testing.

So you want to be able to just prick your finger and not just get your blood glucose like we currently do but get accurate samples for your electrolytes, your kidney function, heart attack function. And so those are currently under development. They're catalyzed by programs like the Translational Research Institute of Space Health, the Trish, Element, and finally, AI. So we talked about we talked about this briefly.

We right now, the plan for AI in terms of the medical capability is to, supplement diagnostics and therapeutic decisions because, we talked about how training may need to change. We talked about, currently the crew medical officer on the ISS has 40 hours of medical training. From ours, I would argue that probably needs to change to a full on physician. But every physician will tell you we don't have all the answers. We simply know where to look them up.

And then what if the crew physician is is capacitated? Well then how does the rest of the crew mitigate that scenario? So you you want both augmented reality for just in time guidance but you also want AI to help guide diagnostic, decisions. It's always there's I don't know what's sci fi just watched the person who was responsible for doing the engineering. He lost his eyesight, but he was still better with his eyes closed than he was everybody else.

But he had the fight to was it was just a a recent, HBO series or something where they where they went to Mars or to another planet. So yes. Okay. Those are all within they actually don't seem far out in terms of what we're working on today is just humans on earth. Okay. So what's the do you wanna go to the coming back to earth or do you wanna hit the far out questions? Let's hit the far out questions.

This should be a fairly quick scenario, but these look at the kind of things that I spend my time thinking about. So, you know, we thought about, you know, the next steps, the next battleground, but what about the next next battleground? So, you know, a very obvious question is if we're talking about becoming a permanent off world settlement, well, settlement implies multi generations. Multi generations implies breeding off world.

So what does the data and the ethics of starting to broach that subject look like? Because we have decades of data from human space flight, or sorry, animal research in in space that shows that we know that every aspect of development from conception to implantation to development to post flight development is affected. But the data is conflicting. We have data from wasps, from zebrafish, from, rats.

And you know, in some cases it's deleterious and wasps die wasps flown to space die off, at a higher rate than their non flown offspring. In some cases, it's a transient effect. So rats that were flown to space, rat embryos that were flown to space, showed a temporary development in neuromuscular development, and then the 3 months, the effect had passed. So then how does that translate to humans?

You know, from everything from, arousal to intercourse to gamete production to implantation, you know, our if we're talking simply about 0 g, are embryos more likely to implant in the wrong location? Is the risk for ectopic pregnancy in 0 g increased? That's a disaster. That's life threatening as well as mission threatening. So these are the far out question. This is an example of a far out question.

Another example is, you know, when we're talking about maintaining the standard of care, well, we have we have national guidelines. We have state and provincial guidelines. We have the over lie over, lying governing body of the World Health Organization. So then how do we govern medicine in space? Who do we train? What kind of training does that look look like? And then do we need to evolve from having a World Health Organization to a Galactic Health Organization?

I think we should start off with a Mearth, but the A Mearth health organization. M h o. No. No. Mearth were a health organization, moon and earth Mhmm. Then we can go bigger. So galactic is another one. I was just picking on you.

You know, and then another example is, you know, we we talking about mitigating risk, but if we were talking about going forward to the moon to stay, if we're talking about permanent off world settlements, then we need to talk about building up a medical capability in tandem with that. So how do we evolve from 40 hours of crew training with medical kits on the ISS to building up basic, life support, advanced life support, a basic field hospital to advanced surgical capabilities in ICU.

And then finally doing the mundane day to day stuff like providing the screening capabilities. So you can have a colonoscopy on the moon or Mars if you live there long enough. So how do you approach that? What models on earth do you use like field hospitals and, refugee camps? And then how do you approach that in a practical fashion through resupply? Or should you even bother?

So these are some of the far out questions that I think we still have to answer, and, you know, I think it's just the next step, the next next battleground. Yeah. I I do I do, believe that there are people asking some of these questions, and the answers are range from sci fi, yet too far out where these there's a tough connection to making that work? Or my question, it tends to be what's the timeline, or what are you looking at, or when will this happen?

And I had someone just the other day said, oh, this is 200 years from now. Okay. Gotcha. So when I look at Mearth and the moon Earth economy and ecosystem is that some of these can be sooner than later depending on, where our efforts are. And that's, again, what Project Moon Hut is about us to make it sooner than later. Yes. And for me, it's the opposite perspective.

It's sort of it's sort of like for me, if you're telling me you wanna establish permanent off world capabilities, I want you to be able to answer those questions. I want you to be able to answer what your medical capabilities are, what they're going to be, how you're gonna build it up, how you're gonna plan for intergenerational humans, off worlds, and also, you know, how you're gonna maintain the standard of care. Okay. All logical. So what about coming back to Earth? So bring me back.

So the the question is, you know, we I'm sure you've been in the space industry. You've seen the people who ask, you know, why go to space when, there's so many problems on And, you know, it's not an either or phenomenon. We get to derive a lot of benefit from sending, robots and humans to Earth. We've talked about the the non human exploration benefit through, observation and remote sensing. So let's talk about the medical benefits. So, you know, there's the list of technology transfer.

You asked earlier this podcast, what benefits in medicine have we have we seen from space? And they they could fill a book. You know There's actually over 2,000, I think, just on NASA's website, but let give me what you what you look at. You know, these are examples. So looking at the mighty mouse experiment we just talked about.

So the the answers that we found with respect to increased muscle mass, and how the ACVR 2 receptor blockade works also promises to have spin off benefit for neuromuscular degenerative diseases like, muscular dystrophy, as well as osteoporosis. When we look at, benefits that we're already seeing on Earth, the charge coupled devices in the Hubble Telescope were spun off to, provide, increased less invasive, less painful, increased high resolution breast cancer imaging.

Sensors that have previously been used on the International Space Station have been spun off to infant pajamas to provide monitoring in case of sudden infant death syndrome. When we look at the technologies we've just discussed, the VRAR technology is already being implemented on Earth for medical education and treating. The idea of providing nutrition that has long shelf life has equal, applicability for expedition medicine, Antarctica, military deployments.

And so the argument isn't why why earth versus space, it's how do we catalyze, these technologies, because I think we've made the case that space is not just a survival imperative, but it also brings tremendous benefit to the earth ecosystem as well.

And so that's the note I wanted to close on is that even if we're talking about science fiction ideas, even if we're talking about far out literally destinations, that it always comes back to Earth as well as benefit for all of the humans on earth who live in to me, day to day on earth and for whom maintaining health is, you know, we don't question that as part of the imperative to to keep you society thriving.

So, you know, it's we have far out questions, but they're just as relevant here on Earth. And I I completely agree. We, the former Charlie Charlie Bolden did a program, and he listed countless. And I think one that was surprising was Peter Garretson, in one of our episodes. Peter came up with a topic, and for those who are listening, you went through it. I don't know what the topics we decide on the title. That's it. I didn't know anything that we're gonna talk about today.

There was no preparation for me. I didn't sit and look up and review if this is all in real time. Is he came up with a topic which was about the Space Force, and Peter is a former military. Mhmm. And I was, do I wanna cover this? Do I not wanna cover this? Is this interesting? So I said, yeah. Let let's go there.

And he started talking about the number one most environmentally environmental product on Earth today that saves more fuel, more petrol, more gas than any other technology on the entire planet. And I'm thinking, environmentalism, how does he how is he tying this together? And he said, GPS. GPS. It was just he he brought the he tied those things together.

And I don't I do not believe that while you had mentioned it was evident, I would argue that the majority of people out there that I talk to and I'm talking to non space people very, very often have no clue. And one of the things that we're working on right now is to help individuals make those connections. So I say to people that did you can't live today. Did you look up the weather today? Space. Did you you've been on a plane, the boots on the wings.

Have you ever seen a firefighter run into a building? Baby food. And I and I say, did use a power tool today, cordless power tool today of any type, cordless vacuum, that space. Did you go to a gym and use an exercise piece of equipment? That space. And they they don't know. And I didn't know. So I think it's not a a given, and we are working on that as also a means to help people connect make those connections. So the this was this was fascinating.

This was I loved I loved every moment of it, Shauna. This was great. This is this is a lot of fun, and, you know, it's it's funny because I just finished listening to that episode of Pete Garrison, and I remember that exact moment. You know, he said GPS because you're right.

You know, we we need to do a better job of publicizing the benefit we get, you know, from water filtration systems to portable telecommunications to powerless solar solar power paneled, solar powered red refrigerators for vaccine storage. You know, it all came from space. And it's it's so I I I have people in the space industry who always list what tends to be those that are very obvious that individuals, they're on lists.

You could see the top 20 things that have come from space, and I try to list things that you don't hear about that are everyday utilization tools that someone's gonna say, I didn't know that. Did but by the way, Peter did an amazing job, didn't he? Mhmm. That was I enjoyed that podcast. It was brilliant. He did an amazing interview. So I was, I loved it. It was one of those I wasn't sure where we were gonna go, but it did work. So, you've done a fantastic job. Thank you very much.

Is there one, well, let me say. For everybody who is listening, I want to thank you for taking the time out of your day to listen in. And I do hope that you learn something today that will make Foundation is we are looking to and you can come and help us be a part of what we're doing, is we're looking to establish a box of the roof and a door on the moon. And the reason being is that is the proof of concept.

If we can get there, go around the moon, and come back, we open up this Mearth moon Earth ecosystem, and everything between it can can give us potential future of, unlimited, the the infinite. That's why it's called the in age of infinite. Infinite possibilities and infinite resources, which gives hope for the future. With all the challenges we are facing on Earth, we can then solve some of those challenges with Space Tech. So we want to accelerate the earth and space based ecosystem.

We wanna then take all those endeavors, that paradigm shifting, those innovations, which you heard about today, and we wanna turn them back on earth to improve how we live on earth for all species. We have to be very careful that we always use the term or often are hearing the term about saving the human species. Well, dolphins, whales, amoebas, they make our lives rich.

They make our lives interesting, and we still will have if there's a 1000000 people on Mars in 40 years, there will be 10,000,000,000 people living on Earth. Can't forget that we should be taking care of this home as we have it today also. So for, again, Shawna, this was great. What's the one best way for people to get in touch with you if they wanted to? You can find me on LinkedIn at Shawna pandya, s h a w n a p a n d y a. Okay. Great.

And if you're looking to connect with me, you can connect with me at [email protected]. You can connect, to Project Moon Hut through at project moon hut on Twitter, or at goldsmith for me personally. I am on LinkedIn. I am on Instagram, so you can find me in a variety of places. And there is a YouTube channel when we've put only very minimal up today. There's probably about 40 videos behind we haven't released.

And we also have on Facebook, we have secured the name, so we do post there also. So for all of you who've dialed in, listened in today, I'm David Goldsmith, and thank you for listening.