The need for research into fluid displacement is so urgent that space agency scientists will use the Kelly-Kornienko mission to begin a “fluid shifts” study, in which several station astronauts will undergo regular testing to determine the root cause of vision impairment and whatever other health implications fluid displacement might have.
One welcome result of the study will be a renewal of true partnership aboard the space station. Ever since it was finished, “there’s been the U.S. segment and the Russian segment,” notes John B. Charles, associate manager of NASA’s Human Research Program for International Science. The Americans do their experiments and the Russians do theirs. “The Canadians and the Japanese pretty much stick with us, and the Europeans go back and forth,” Charles says, adding that NASA would like to see that division of labor end. The agency plans to join with Roscosmos and the other partners in astronaut health experiments that involve everyone.
But the enduring mismatch between American and Russian research techniques remains a challenge: The Russians don’t measure all of the same things Americans measure, and don’t use the same terms. Both nations, over the past 50 years, have changed test protocols, hardware, and software; have added or abandoned tests; and have headed off in new research directions. As a result, significant chunks of space science have fallen into a disconnected data hodgepodge.
Furthermore, to protect astronauts’ privacy, the U.S. has a wall between flight doctors and researchers, forbidding scientists to use confidential clinical data in their studies and forbidding doctors from tapping scientists for information on their patients. But “on the Russian side, clinicians and researchers work side by side,” Charles remarks. “Sometimes they are the same person.” (Charles points out he and his colleagues are working on how to minimize that “wall” and collect more useful data, while still obeying federal laws and NASA policies protecting confidentiality.)
Finally, unlike the Americans, Russian researchers don’t use what Shelhamer calls “population-based medicine”: gathering data from lots of subjects, analyzing it, and drawing conclusions. Instead, he says, they do personalized medicine: “They look at each cosmonaut as a case study,” Charles explains. “Their research tells them everything they need to know about that cosmonaut, but it’s not the statistically based data we are accustomed to using.”
Shelhamer sees the value of both methodologies. “Who’s to say which is the more realistic approach?” he asks. “We try to find an average, but if we’re sending six astronauts to Mars, maybe it’s better to know everything about each person.”
One insight into personalized medicine may come from an experiment comparing Scott Kelly to his twin brother and fellow astronaut Mark. (Mark Kelly left the corps after his wife, former Congresswoman Gabrielle Giffords, was shot in the head by a would-be assassin in 2011.) NASA decided to undertake the study after Scott Kelly asked the brass what he should say if reporters asked him whether he and Mark would be compared. NASA turned the idea into what Human Research Program biochemist Craig Kundrot describes as a “pilot project” designed to get “some interesting data points” by “making Mark the control for Scott.” Scientists will monitor the brothers down to the molecular level, comparing their DNA, RNA, proteins, metabolites, and gut microbiomes, among other things. They’ll study macro phenomena too: fluid shifts, walking performance, jumping performance, cognition, and immune systems. Both Kellys got flu shots last fall, and both will receive frequent and comprehensive physical examinations for the duration of the mission.
In an elegant coincidence, Mark Kelly retired with 54 days in space. Scott, if all goes according to schedule, will spend 540 days, outflying Mark in space by exactly one order of magnitude.
The last imponderables are the psychological stresses: long transits, physical confinement, limited contact with family, no chance for emergency evacuation. Replicating these conditions will be problematic: The mission is only a year long, the astronauts under study are exposed to a changing cast of characters, and they are in low Earth orbit, only a Soyuz ride away from home. Still, scientists see testable possibilities in a year-long mission. For the last decade, NASA astronauts have kept diaries for the “ISS journals project,” and even though “touchy-feely is not a virtue” for the astronaut corps, Shelhamer says, the diarists have a lot to say about colleagues, the workload, sleeplessness, and other irritations that the public knows little about. The journal entries have helped researchers understand the importance of communal rituals such as mealtime: When one ISS crew tapped the special supplies earmarked for incoming replacements, “the new guys were furious,” Shelhamer says.
And while astronauts understand they must get along with crewmates, the same is not true of mission control—a frequent focus of animosity. The story of the Skylab crew who balked at their workload in 1973 is legendary. Less widely known is the 2010-2011 experiment wherein Russia’s Institute for Biomedical Problems ran a 520-day Mars mission simulation for six crew members–three Russians, two Europeans, and one Chinese. University of Pennsylvania behavioral scientist David F. Dinges ran a study using a questionnaire that captured any disagreement as perceived by the astronaut. The participants reported five times as many conflicts with mission control as with other astronauts.
Two specific areas of inquiry interest Shelhamer. So far Journals Project leader Jack Stuster has not detected an across-the-board “third-quarter effect” in the psyches of astronauts. “It’s like when you’re in college,” Shelhamer says. “For the first two years it’s new and fun, and for the last year you’re focused on the finish line. Trouble comes in the third quarter, when it’s ‘I still have so far to go.’ If we extend the mission to a year,” he wonders, will disillusionment set in?
Dinges has designed a four-minute test to assess stress levels among astronauts, made up of a three-minute “psychomotor vigilance test” coupled with a one-minute “visual analog ratings” of the subject’s level of stress, degree of fatigue, and quality of sleep, among other factors.
During six-month missions the results resemble “a cubic curve,” Shelhamer says, with stress rising as the cube of elapsed time, “an extremely troubling trend. If there’s an acceleration, we’re going to have to do more research to figure out what to do about it.”
Dinges says the stress ratings generally “started out low-moderate and got higher,” but when he looked at individuals, he saw that only half the astronauts reported increased stress. “We’ve known for a long time that some people deteriorate faster than others,” Dinges says. “Vulnerable people are vulnerable.”
Even so, “there were correlates,” Dinges says. High stress levels among ISS crew members “correlated with poor sleep quality, physical exhaustion, and the workload. This looks very physiological, not mental.”
And there is a final imponderable: “Nobody understands the physiological cost of the mission,” Dinges says. “You have workload creep, inadequate sleep, confinement, and isolation. But you also have nutrition issues, low oxygen, high CO2, bone and muscle atrophy.” And then there are the “more occult issues” like fluid shift to the brain.
“It’s unlikely that there’s something metaphysical or psychological associated with this,” Dinges says. “We want to know if there is a physiological trigger: Are some people coping better, or are they blessed with physical characteristics that enable them to handle it more easily?”
Space, everyone agrees, can be nasty. It will likely be nastier for a year than for six months. Multiplying that time by a factor of 2.5 or three as we reach for Mars might make all those deprivations worse.
But for astronauts, thriving amid adversity is part of the job description.“We love a challenge,” Kelly says. “We love challenging environments.”
An airtight can bound for Mars ought to do the trick.