AEROSPACE MEDICINE, LYNDON B. JOHNSON SPACE CENTER
AEROSPACE MEDICINE, LYNDON B. JOHNSON SPACE CENTER. As the center of the national space program, the Lyndon B. Johnson Space Center has become the focus of research in aerospace medicine.
NASA and aerospace medicine. The successful launch of Earth's first artificial satellite by the Soviet Union on October 4, 1957, was the initial step in a series of events that made the state of Texas the home of the United States manned space-exploration program. Sputnik I provided the impetus for President Dwight D. Eisenhower to propose and Congress to approve the National Aeronautics and Space Act, which was signed into law on July 29, 1958. To implement the act, Eisenhower selected the National Advisory Committee for Aeronautics. The NACA was soon renamed the National Aeronautics and Space Administration, and T. Keith Glennan and Hugh Dryden were named administrator and deputy administrator, respectively. Although plans for manned space flight were well under way before the establishment of NASA, one of NASA's highest priorities was to consolidate the work done by the NACA laboratories and the military services and focus on the goal of launching a person into orbital flight and returning that person safely to Earth. To accomplish this goal, Glennan established a Space Task Group on November 5, 1958, at Langley Research Center under the direction of Robert R. Gilruth, who had been at Langley since graduating from the University of Minnesota in 1936. During the years before NASA, Glennan assembled an extremely competent and vigorous group of engineers. Included in it were many who later became highly influential, both in technical and management roles, in all NASA's manned space flight programs. Among these were Maxime A. Faget, Christopher C. Kraft, Jr., Paul E. Purser, Charles W. Mathews, Robert O. Piland, and Charles J. Donlan. The technology for manned space flight came from this dedicated and ingenious cadre of engineers, but the aerospace medical expertise resided in the military service and in universities supported by the military. The United States Air Force, in particular, held the required expertise in the physiological aspects of space flight.
After World War II, 130 German scientists and engineers, led by Werner von Braun, were brought to the United States and stationed at Fort Bliss in El Paso, Texas, to continue their work on rockets. The United States Air Force also enlisted the service of a number of German physicians, physiologists, and psychologists who had been the nucleus of the Luftwaffe medical-research program in support of high-altitude and high-speed airplane flight. Six of these were assigned as research physicians to the Air Force School of Aviation Medicine at Randolph Air Force Base in San Antonio. Although they concentrated primarily on aviation medicine, the natural extension of their high-altitude research programs drew their interests to space.
In 1948, nine years before Sputnik I, Col. Harry G. Armstrong, commandant of the school, convened a panel to discuss "Aeromedical Problems of Space Travel." The panel discussion included presentations by Hubertus Strughold and Heinz Haber, two of the German physicians, and commentary from six noted university and military scientists. At this panel, Strughold coined the term "space medicine." Later, through the excellence of his work, he was nicknamed "the father of space medicine." The foundation of aerospace medicine in support of manned space flight had been established. As research continued, concern grew throughout this medical community that weightless flight would gravely affect the physiological systems of those who flew. German physicians Heinz Haber and Otto Gauer, who supported the air force aviation-medicine program, noted that weightlessness could seriously affect the "autonomic nervous functions and ultimately produce a very severe sensation of succumbence associated with an absolute incapacity to act." This concern for physiological and psychological dangers associated with space flight resulted in the establishment of an operational aerospace medical group within the Space Task Group to address the problem. The first members of the medical group were two air force physicians, Lt. Col. Stanley C. White and Maj. William S. Augerson, and one navy psychologist, Lt. Robert Voas; their primary interest was flight-crew selection and training. To provide contact between the Space Task Group medical group, NASA Headquarters, and external medical and life-sciences groups, the Life Sciences Advisory Committee was established, with W. Randolph Lovelace II as chairman. The committee played a role in the selection of the Mercury astronauts.
The Manned Spacecraft Center and Project Mercury. The accomplishments of the Space Task Group over the next three years were phenomenal. The Redstone and Atlas rockets were selected and, after extensive testing, man-rated for suborbital and orbital missions, respectively. The Mercury capsule was designed, tested, and flown. Life-support systems were developed to provide a breathable atmosphere at regulated pressure with temperature and humidity control. Food and water systems were developed. A couch was designed to protect the astronaut from the forces of high acceleration launch and landing.
Astronaut-selection planning began seriously in 1958. On April 9, 1959, at a Washington news conference, Glennan introduced the seven military test pilots selected for space flight. They were selected from thirty-two candidates who had passed the initial screening and evaluation process, had been through a rigorous physical examination at the Lovelace Clinic in New Mexico, and had been through extensive mental and physical environmental tests at the Wright Air Development Center in Dayton, Ohio. America's first astronauts were Lt. Cdr. Alan B. Shepard, Lt. Cdr. Walter M. Schirra, Jr., and Lt. M. Scott Carpenter from the navy; Capt. Donald K. Slayton, Capt. L. Gordon Cooper, and Capt. Virgil I. Grissom from the air force; and Lt. Col. John H. Glenn from the marines. Doctors Stanley White and Robert Voas were members of the first astronaut-selection committee, which was chaired by Charles Donlan, assistant project manager of the Space Task Group. Two years later, on May 5, 1961, Alan Shepard became the first American in space when the Redstone rocket boosted his Mercury space capsule into suborbital flight for five minutes and sixteen seconds of weightlessness. Shortly after Shepard's flight, President John F. Kennedy, in a special message presented to Congress on May 25, 1961, made a statement that profoundly affected America's space program. He said, "I believe this nation should commit itself to achieving the goal, before this decade is out, of landing a man on the Moon and returning him safely to the Earth. No single space project in this period will be more impressive to mankind, or more important for the long-range exploration of space; and none will be so difficult or expensive to accomplish."
President Kennedy's statement gave the Space Task Group both a future and a challenge. The STG had grown from thirty-three persons at its inception to 794 by mid-1961. A new facility dedicated to manned space flight was necessary to accomplish the challenge. Kennedy approved the new facility in principle as an adjunct to his emphasis on an enlarged space program. Congress, sensing the interest of the American people in responding to the earlier successes of the Soviet Union, approved the budget, and a site-survey team was established in August 1961. On September 19, 1961, James E. Webb, the new NASA administrator, announced that a new NASA center named the Manned Spacecraft Center would be built near Houston, Texas, on 1,000 acres of land transferred to the government by Rice University and an adjacent plot that the government purchased. The site was in Harris County near Clear Lake and was connected through Galveston Bay to the Gulf of Mexico. There was criticism that Vice President Lyndon B. Johnson and Houstonian Albert Thomas,qqv chairman of the Independent Offices Subcommittee of the House Appropriations Committee, had exercised undue political influence in the selection of Houston as the site of MSC. The charges were denied by NASA. Gilruth, now officially director of MSC, moved quickly to lease facilities in the nearby Houston area, while plans were completed for the construction of fourteen buildings at an estimated cost of $60 million to accommodate more than 3,000 persons. During the next year, as construction began on a permanent facility, NASA successfully launched three orbital missions. On May 15, 1963, Gordon Cooper completed twenty-two orbits of Earth in the final Mercury mission.
Aerospace medicine and manned space flight. Project Mercury provided confidence in the ability of the astronaut to perform satisfactorily in the weightless environment and in the capability of the spacecraft environmental-control system to support life in space. In addition, many worries about psychological and physiological dangers that could be associated with space and the weightless environment were dispelled. Several physiological problems did, however, emerge from the Mercury project. Dehydration was observed in every crew member, accompanied by decreased water consumption and increased urine output. Some degradation of performance capability was evident and was thought to be related to fatigue associated with sleep disturbances. Two astronauts experienced orthostatic hypotension after flight; soon after leaving the spacecraft their pulse rate increased and their blood pressure decreased as their cardiovascular systems were challenged by Earth's gravitational forces following their exposure to weightlessness. Postflight clinical evaluations indicated blood and urine electrolyte imbalances and bone demineralization, as evidenced by the increased levels of calcium and phosphorus in body-fluid samples collected and analyzed after the flight. The medical implications of these physiological changes in the Mercury astronauts heightened the awareness of management officials at MSC of the need for a more aggressive medical program in support of the planned longer-duration Gemini and Apollo projects.
In 1963, at the height of Project Mercury, MSC had grown to 2,500 civil-service employees, but only about 500 supported Project Mercury. The rest of the employees were involved in preparing for the Gemini and Apollo projects. Gemini was planned to demonstrate that spacecraft rendezvous was possible, that an astronaut could exit the spacecraft in space and function safely in a pressurized space suit, and that he could endure and perform satisfactorily during extended periods of time in the weightless environment. Capt. Charles A. Berry, an air force physician, had been assigned from the School of Aerospace Medicine in San Antonio to participate in medical examinations for the Mercury astronauts. He was reassigned to MSC to provide medical care and medical-operations support for Project Mercury. Dr. Lawrence F. Dietlein, a physician from the United States Public Health Service, was assigned to MSC to develop a medical-research program to investigate the physiological changes observed on Mercury flights and evaluate these changes for the longer missions. These two physicians, plus Dr. Stan White's life-systems group, which was transferred from Langley to MSC, formed the major elements of biomedical support for Gemini and Apollo.
Project Gemini included twelve manned space flights. The Gemini spacecraft, launched by a modified Titan missile, carried two astronauts. The two longer flights, Gemini V (eight days) and Gemini VII (almost fourteen days), included nine medical experiments designed to investigate the problems identified during the Mercury missions. These experiments provided an opportunity for the medical community outside NASA to participate in the space-flight experiment program: Dr. Pauline Mack of Texas Woman's University and doctors Harry Lipscomb and Peter Kelloway of Baylor College of Medicine were selected as principal investigators for two of the nine Gemini experiments. The results of the medical experiments, the performance of the Gemini astronauts, and the information obtained from the extensive medical examinations conducted before and after each mission gave MSC medical officials increased confidence as the challenge of Apollo—to land on the moon and return safely to Earth—approached. As Dr. Berry stated in a technical paper presented at the Gemini Summary Conference held at MSC in February 1967, "Although much remains to be learned, it appears that if man is properly supported, his limitations will not be a barrier to the exploration of the universe."
Preparations to take the first step in exploring the universe continued unabated as the Mercury and Gemini projects provided the information necessary to send men to the moon and return them to Earth. As the manned Gemini launches proceeded, the three unmanned launches testing Apollo's powerful Saturn boosters and the three-man spacecraft were completed. The first Apollo manned launch, an orbital flight of Earth, was scheduled for February 21, 1967, less than four months after the final Gemini mission. This mission did not take place as scheduled, for, on January 27, 1967, during a final manned checkout of the complete vehicle, a fire in the spacecraft resulted in the death of Virgil I. Grissom, Edward H. White II, and Roger B. Chaffee, who were trapped inside. A twenty-month delay followed as NASA strove furiously to investigate the cause of the fire and correct every factor involved. The Apollo fire had a profound effect on the aerospace medical program at MSC. The complexity, diversity, and growth of the medical elements at the center during Gemini resulted in combining these elements into one organization-the Medical Research and Operations Directorate, with Dr. Berry as director. Although ensuring the health and safety of the flight crew had always been the primary objective of the medical program, the emphasis of the in-flight program was now almost entirely on medical support and safety. A planned series of in-flight experiments to investigate cardiovascular function, the musculoskeletal system, and metabolic function in space was eliminated. The medical-research program concentrated on preflight and postflight examinations, clinical analyses of collected body-fluid samples, and preflight and postflight physiological investigations. One potentially serious medical problem emerged during the Apollo missions. Space motion sickness, thought to be associated with disturbances of the vestibular system's ability to function normally in the weightless environment, had been reported by Russian cosmonauts but had not been evident in either the Mercury or Gemini astronauts. However, of the thirty-three Apollo astronauts, eleven reported motion-sickness symptoms ranging from slight stomach awareness to severe vomiting and degraded performance capability.
The biomedical results of Apollo were impressive. The number of flights and the number of astronauts provided the medical investigators with extensive information to examine the physiological changes observed in previous flights and to plan and design the detailed medical experiments to be flown on the longer missions of the world's first space station, Skylab. The legacy of Apollo, however, was pride in meeting a challenge. President Kennedy's challenge was answered on July 20, 1969, when Neil A. Armstrong, from the lunar lander sitting on the surface of the moon, reported, "Houston, Tranquility Base here—the Eagle has landed." People throughout the world shared in the pride of accomplishing the first step in the manned exploration of the universe.
The Skylab missions, which occurred between May 1973 and February 1974, differed significantly from all previous manned missions. From its inception, Skylab was intended to be a science program. The space laboratory, a modified Saturn IV-B stage, provided a large area (294 cubic meters) for science investigations and living in space. Skylab was launched unmanned; and during its time in orbit, it was occupied by three crews of three astronauts per crew for 171 days. The first manned mission lasted twenty-eight days; the second, fifty-nine days; and the final, eighty-four days. These long-duration missions, which included twelve primary medical experiments, were the answer to the medical scientists' dreams. The investigators had an opportunity to study in flight, over a much longer period of time, the physiological changes observed on earlier missions. The twelve in-flight medical experiments included investigators from areas throughout the United States. Six of the experiments included principal investigators from the Lyndon B. Johnson Space Center (as the Manned Spacecraft Center was now called) and two from Baylor College of Medicine. These experiments and fourteen other special in-flight medically related tests, which were added to the second and third manned Skylab missions, provided a wealth of biomedical information. This information answered many of the questions raised concerning physiological changes observed in earlier missions and established that man can adapt to the weightless environment, perform effectively over an extended time, and successfully readapt to the gravity of Earth. The medical data indicated that some physiological changes observed in earlier, shorter flights were apparently self-limiting. These changes related to blood volume, body-fluid output, and body-fluid biochemistry. Other changes, such as bone demineralization and muscle degeneration, continued throughout the longer missions. Though the cardiovascular system appeared to stabilize after four to six weeks in space, problems of orthostatic intolerance continued to appear postflight. Many biomedical questions were answered by the Skylab missions, and the data were useful in designing measures, such as regimented exercise programs, to counteract some of the physiological changes. However, there were still many unanswered questions that only long-term flights and an increased number of flight crew members could address.
The final flight of an Apollo spacecraft took place on July 15, 1975. The Apollo-Soyuz Test Project was a nine-day international mission that featured the rendezvous and docking of the Apollo spacecraft with a Russian Soyuz spacecraft. While some in-flight biomedical data were obtained, the inadvertent exposure of the crew to nitrogen tetroxide fumes during reentry and their subsequent development of chemical pneumonitis negated most postflight medical-experiment data collection. The Apollo-Soyuz mission was the final opportunity for medical scientists to conduct in-flight experiments or tests in an American spacecraft for more than six years.
The Medical Research and Operations Directorate was renamed the Life Sciences Directorate on September 5, 1972. On October 17, 1977, the Life Sciences Directorate was combined with the Science and Applications Directorate and became the Space and Life Sciences Directorate. This organizational change increased the functional responsibilities of the directorate by adding lunar and planetary science, Earth observations, and space science, and by retaining responsibility for life sciences, medical research, medical operations, experiment development, and payload management. Although no in-flight experiments were conducted, the next six years were busy ones for the Space and Life Sciences Directorate. The ground-based medical-research program, which supported the development of flight experiments and devised and tested countermeasures to the physiological problems identified in previous missions, was expanded and accelerated in anticipation of more frequent space missions when flights were resumed. In-flight experiments were designed to address the primary concerns of weightless flight—space motion sickness, cardiovascular deconditioning, fluid and electrolyte imbalance, bone demineralization, and muscle atrophy. Medical and environmental requirements were defined for the next generation of United States spacecraft. The spacecraft design chosen was the space shuttle. Launched into orbit with the aid of two reusable solid rocket boosters, the shuttle would reenter the Earth's atmosphere, land, and after refurbishment be available for another mission. The shuttle was to be capable of carrying satellites and other free-flying scientific payloads into orbit and launching them into space. Additionally, the cargo bay of the shuttle could carry an attached laboratory, called Spacelab, in which science programs could be conducted in orbit. Though the shuttle could not provide the extended-duration missions of Skylab, the frequency of the seven to fourteen day shuttle missions and the ability to carry larger crews to serve as subjects and operators of medical experiments provided a valuable test venue to assess the progress made during six years of ground-based studies. The first shuttle orbital flight was launched on April 12, 1981. Commanded by John W. Young with pilot Robert L. Crippen, this mission was a flight test of the Space Shuttle Columbia. The shuttle program was an outstanding success. Its performance was even better than anticipated until January 27, 1986, when the shuttle Challenger exploded shortly after liftoff. One of the solid rocket boosters malfunctioned, and the resulting explosion killed the seven crew members. This catastrophe resulted in a twenty-month period of investigation and reengineering of the shuttle and its launch systems to provide the highest possible assurance that such an accident could not happen again.
In addition to the Spacelab, the shuttle middeck offers an area in which approved operationally oriented medical tests and investigations can be conducted. These tests, called Detailed Supplementary Objectives, are approved with the provision that they will not interfere with the mission's primary objectives. The third shuttle flight, launched on March 22, 1982, carried the first medical DSO. The DSOs flown on shuttle missions have contributed significantly to understanding the important mechanisms of physiological change in weightlessness, testing of medical equipment, and developing operational medical procedures. By late 1994 Spacelab had flown eight times, and each mission included biomedical investigations. Two missions, moreover, were dedicated life-sciences missions and were the most intensive biomedical-research missions ever conducted by NASA. The second of these life-sciences missions was concluded on November 1, 1993, and, at fourteen days, was the fourth-longest mission ever flown by NASA. Sixteen medical experiments were conducted.
The space station currently being built is intended to provide a sophisticated orbital laboratory to investigate human responses to space travel. With the help of principal scientists from Texas colleges, universities, medical institutions, and industries, the space station missions may provide the information necessary to establish a permanent human presence in space, so that we will have the knowledge to establish lunar bases, to explore Mars, and—someday—to explore the universe. See also AEROSPACE MEDICINE, AIR FORCE.
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