NASA postpones space station spacewalk due to crew member’s “medical concern”
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First space illness incident for NASA, but not overall. One soviet cosmonaut fell ill in space and mission has to be aborted. He was self-medicating health issue before flight to avoid risk to be pulled out of mission. Sorry, I do not remember name and mission.
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Medical emergencies are another reason for the next extension (in terms of distance from earth) of long term human habitation taking place on earth’s Moon. An emergency return to earth from the Moon could be done in 3 days in terms of travel time with a 7 day a week launch window (weather permitting) for several landing sites on earth (including the US, Russia, China).
As lunar outposts and bases are eventually built, medical clinics in low gravity will be constructed there. In lunar low gravity conditions, various medical procedures can be researched and developed. These future low gravity medical facilities on the Moon will set the stage where eventually a medical clinic/hospital (with solid research to back it up) can be constructed in deeper space (in low gravity) such as on Mars.
As lunar outposts and bases are eventually built, medical clinics in low gravity will be constructed there. In lunar low gravity conditions, various medical procedures can be researched and developed. These future low gravity medical facilities on the Moon will set the stage where eventually a medical clinic/hospital (with solid research to back it up) can be constructed in deeper space (in low gravity) such as on Mars.
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I suspect that the shipping costs and lead time for a replacement, and some of the specialty skills preferred, will make old-school 'just make as many crimes punishable by deportation to the colonies as it takes' strategies unattractive; but I'd honestly be curious what the breakdown would be between carrying more sophisticated medical apparatus and just being honest about the fact that longterm operations in hostile environments are going to get some people killed.
Space activity has a relatively high level of very hard to avoid risk; given that essentially anything that will get you into orbit is an experimental or close to it vehicle throwing around absurd amounts of power under fairly extreme conditions; but at present NASA and friends are very conservative about the occupational safety and health risks that they can control. I'm not even suggesting some sort of sci-fi sacrifice-the-weak efficiency society thing where they sneer enthusiastically while shoving the sick into the recycling pods; just comparing to, say, what counts as so acceptable as to go largely unnoticed in logging, fisheries, roofing, and garbage collection(the head of the leaderboard for civilian occupational fatalities per BLS data for 2023).
I suspect that NASA's risk intolerance is sensible given the relatively high level of PR involved in a lot of ISS activity; and the fact that(for now) most activity is close enough to earth that the reason you'd have to give to roll the dice on someone is "we don't care enough" rather than "the Apollo program is only technically capable of delivering one lunar lander at a time; and no options exist for recovering one that can't recover itself"; but the more ambitious the potential project the more likely it is that certain crewed vehicles will simply not be recallable or catchable when they are already committed to some trajectory.
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As a matter of DALY/QALY type measurements; wouldn't space hospitals for astronaut emergency medicine score just shockingly poorly vs. a nearly endless list of boring terrestrial investments?
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There have been some work on space suits using elastic instead of air to apply pressure. Donning and doffing it is challenging.
However, I'm a fan of the single-person spacecraft for EVAs. You'd operate at normal 15 PSI atmosphere, as opposed to the usual low pressure space suit requiring hours of prebreathing. You would use remote effectors (though I'd want four rather than just two).
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Not particularly, any more than antarctic researchers or Mount Everest climbers have ready access to medical help. Some things are dangerous and being an astronaut to Mars will be one of them.
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What would the station population have to be before it makes sense to staff a mini-hospital? 20? 100?
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The launch window to and from Mars is every 26 months. If an earth, terrestrial hospital cannot be reached in 2 years from Mars for a medical emergency, then a hospital on Mars could score better in terms of treatment outcomes compared with an earth / terrestrial hospital that cannot be reached soon enough. It’s a matter of improving medical treatment in low gravity
This is where medical research in lunar bases can be very valuable, to develop effective treatments in low gravity.
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Off-topic, but now I'm wondering which is deadlier: flying to orbit or ascending Mt. Everest.
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If you are going to use remote effectors why go outside with them? That's basically a telepresence setup so short range that you have to include a life support coffin on the same vehicle as the robot arms.
Obviously ping considerations limit how far away the operator can be; you aren't going to be controlling robot arms easily when it's 10 light minutes round trip; but for the sort of short range EVAs that spacesuits are used for it seems awfully tempting to just have the operator stay inside and manage a smaller, more expendable, just-the-robot-arms module via short range RF or optical tether.
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I think orbit has to be worse.
Everest has about a 1% fatality rate.
The two Shuttle disasters alone account for 14 deaths.
I don't think there have been 1,400 person-flights to orbit.
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The closest example to a space station here on Earth would be Amundsen-Scott South Pole Base. During the southern winter it is nearly impossible for planes to land and so the base is largely on its own.* It has an overwintering crew of about 40, of which are 2 medical staff - a doctor and an assistant. Based on this, I imagine a station needing at least 15-20 people before one person can be devoted solely to running a hospital.
*
If memory served, there have been just a couple of winter medevacs from the base in its nearly 70 years of habitation, both of which were incredibly expensive, difficult and dangerous.
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McDowell lists 1633 person-flights (including attempted person-flights) to space. 20 of those (1.2%) were fatal. That includes suborbital flights, 2 of which were fatal. 9 of the 20 fatalities occurred on flights which did not reach 100 km altitude.
The rate seems pretty comparable to Everest.
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The biggest problem with stretching compressive suits is interior curves. Getting good compression on cylinders is easy; as are things like finger tips. The spaces between where your fingers join your palm are a different story since the stretch along the fingers will be attempting to pull the glove away. You can feel this wearing a pair of rubber gloves; it doesn't really matter there though. For a pressure suit that's a point where it's not applying pressure and you risk swelling or decompression injuries depending on how badly it fails.
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You really do need two doctors though. Back in the 60s there was a Soviet Expedition with only one; who ended up having to operate on himself to remove his own appendix.
https://en.wikipedia.org/wiki/Leonid_Rogozov
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Even with mechanical counter-pressure suits, you still have pneumatic gloves. You design the suit around lines of non-expansion, but the more complex the geometry, the harder that is to do. Ball your hand up into a fist, and feel the skin on your phalanges expand.
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The two main challenges on ISS are the resources available, and microgravity. Microgravity is a problem for surgery as it means blood and other fluids don't drain naturally. Hopefully on Mars surface there will be enough gravity that this is not a problem. And then the hope is that the resources challenge can be addressed by sending lots of resources, including crew with the skills needed, and medical equipment and supplies. A Mars mission would need to be bigger than the ISS outpost, which is pretty minimal.
However, it is an argument against NASA plans that involve long transit times, Venus fly-pasts, and then remaining in Mars orbit instead of going down to the surface. It's another reason why Mars surface is less hostile than Mars orbit. Or, probably, setting up base on one of Mars moons.
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There was also this more recent example of self-treatment, which also included an early evacuation flight:
https://en.wikipedia.org/wiki/Jerri_Nielsen
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Bill Swallow
Ars Centurion
1954's Von Braun / Disney "Bottle Suit".
https://cyberneticzoo.com/teleoperators/1954-bottle-suit-wernher-von-braun-walt-disney-american/
If you can find the Disney 'Tomorrowland' show from the early 'Disneyland' TV series (not to be confused with the more-recent feature film of the same name), it has some material on the bottle suits.
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Wrong reference frame for the joke, I think. The bus in the movie didn't have to be moving in any particular geospatial vector, it just had to maintain a minimum speed.
In discussion of buses operating more or less normally (in the physical sense, not the operational sense), the velocity vector of the bus and the long axis of the bus being in fairly close coaxial alignment is generally taken as a given. Any diversion would have constituted an extraordinary condition and should have been explicitly called out by the scenario designer.
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