042. What Does a NASA Flight Surgeon Actually Do in Russia?

00:06 Announcer If you’re struggling with your vitality, energy, mood, focus, or sleep, this podcast is for you. Your host Dr. Ann Tsung, ER doctor and aerospace flight surgeon, will help you reach for the stars and remove the barriers or blockades that have been holding you back from living your best life. If you’ve been challenged by your health, relationships or productivity, then it’s time for a breakthrough. So here’s your host Dr. Ann Tsung.

00:43 Dr. Ann Tsung Hello. Welcome to It’s Not Rocket Science Show. I am your host Dr. Ann Tsung. Today, we’re going to be talking about what does NASA flight surgeon actually do when we go to Russia to support the astronauts. This is part of the educational series I do to kind of teach people about what the aerospace medicine field is about, what does a NASA flight surgeon do. A lot of people don’t really know that we actually go to Russia for support. And if you want a detailed journey of how I got here, please go to Episode 8, 9 and 10 of what I actually had to do in order to get to the point where I am. So that’s a brief summary, though.

01:22 What is a NASA flight surgeon, number one? What we do is, essentially, we’re the doctor for the astronauts. We help keep them safe so that they’re completely optimized so that they’re safe to fly to space. We don’t actually fly to space ourselves. I get that question a lot. If I am a flight surgeon, does that mean that I get to go to space to take care of them? No, we actually take care of them on the ground. We get assigned to an astronaut. When we’re assigned to a mission, there’s usually a primary and a deputy crew surgeon who are assigned. We follow them pre-training, once they’re assigned to training, once they take their flight to International Space Station for six months. We support them on the ground, in the NASA Mission Control Center. Then when they land, we support them through the rehab process. That’s our major role. Then we do also research on the side on any sort of medical issues. We deal with flight rules, et cetera. We have meetings to take a look at the future exploration vehicles and give our medical input to the Human Landing System, Gateway, Orion, all of those programs. So that’s the gist of what a NASA flight surgeon actually does.

02:35 As part of a contract, if you’re a contractor, we get sent to Russia once a year for about two to three months at a time to support astronaut training. And if you’re a civil servant with NASA, you don’t go to Russia. But since I am a contractor, I’ve gone to Russia twice and just got back. The reason why we go there is, number one, the U.S. astronauts go there to train with the Russians on their Russian systems. Because International Space Station, I mean, it’s comprised of multiple modules made up by European Space Agency, Japanese Space Agency, Russian Space Agency. So in case of emergencies, the U.S. astronauts need to know the systems really well. They need to actually learn Russian. So they go to Russia because Gagarin Cosmonaut Training Center is in Star City. It is about an hour-drive from Moscow, if there’s no traffic. If there’s traffic, it can be like two- to three-hour drive. Many crew go — when I say crew, I mean the astronauts — they go there for training. And as the doctor, there sometimes are hazardous training. Say, if they’re pressurized in a suit in the mockups, or maybe a winter survival training, or a water training, you’re the doctor for them. Especially, with COVID lately, you are the doctor to make sure that you do the testing that’s reasonable. You make sure everyone is safe, quarantine if needed, any sort of sanitation practices or health practices. You are there to make sure that they are enforced, and to draft the guidelines if needed. You are the physician also for all the NASA support personnel who are there in Star City. I wanted to let you guys know that there are actually two physicians in Russia. One of them is in Moscow. He or she is stationed there for the whole year. Typically, it’s a year-long contract or a two-year contract. Then there is the physician to go to Star City, which is what my job is. The person who’s hired on long term in Moscow usually is the primary person to assess the epidemiology of disease like COVID in Russia as a whole, he will give a report on that, and also to coordinate any sort of evacuation or any sort of medical needs. They’re kind of like the overarching lead in Russia, medical lead in Russia.

04:59 And so when I go there to Star City, I am responsible for the other NASA personnel. There’s somebody called Director of Operations of Russia, who’s usually an astronaut. There’s a deputy director. There may be other support personnel around there from NASA. And if anybody gets sick, I’m responsible for them. I’m the doctor for them. The second thing I do is, I maintain the inventory in the medical office. We have a medical office with supplies, and also for launch and landing packs too with supplies. So I’m in charge to make sure all of the equipment are up to date, nothing is expired, and to order the inventory ahead of time. Because it does take a few months lead time to get to Star City, so I need to make sure everything is up to date, that I have enough medication for both treating if there are any patients in Star City, vaccines. And for launches and landing coming up in six months, sometimes we plan, we order things seven or eight months ahead of time. So it’s a lot of logistics, essentially, and to maintain the launch and landing medical pack. We have medical pack we take. That’s another thing a lot of people are not familiar with, the U.S. crew. We have been riding on the Soyuz rocket. From Kazakhstan, we will launch and land there. That’s the reason why a lot of the flight surgeons go there for launch and landing support. That’s the reason why the medical packs are in Star City, because one of our jobs is to maintain the medical packs and make sure they’re ready. Then the prime and deputy crew surgeons will come, take the packs — there’s also launch and landing supplement packs — and take them to Kazakhstan. Then after launch and landing, they go back to Houston. Then the packs come back to us, and we make sure that they’re ready to go, they’re repacked again, everything works, checking the battery, diagnostics, nothing is expired, medications, et cetera, et cetera. That’s one of the most important jobs for us: to make sure that launch and landing goes smoothly. And if in case there’s a chance that there’s an emergency on International Space Station and they actually have to de-orbit early — what that means, basically, they have to take the Soyuz and then come back early — then a lot of times, we are in charge of going there to support launch and landing because we’re the closest ones there. That’s a gist of our roles and responsibilities.

07:30 Next I’d like to talk about what we actually do day-to-day when we’re in Star City. I mentioned that we support astronaut training. And so every week, we have meetings with NASA back in Houston. We also get the schedule. The astronaut training would plan out ahead of time what is hazardous, which event needs a physician. We make sure if it’s a new crew member who’s never been here, a new astronaut, if it’s something medical, like a medical education type like on the Russia medical pack or their medical system, then we either go with them. We explain it to them, et cetera, and really any questions that they have. Those are the main things. We make sure that they’re supported throughout their training, answer anything that they have, and to kind of predict ahead of time what they may need. If something happens, you will coordinate with their primary surgeon or their deputy surgeon.

08:30 Also, you make sure there’s a medical fridge. You have to make sure that the temperature is all good. You take a look at the inventory. I’ve done surrounding hospital reviews to make sure I know what capabilities they have so that in case of emergencies or maybe it’s something urgent, I know where to go, which hospitals to go. You coordinate. You build relationships with our Russian staff who works for NASA there. The NASA hired a group called TTI. Essentially, it’s a Russian group who acts as our liaison between us and also GCTC and the Russian Space Agency. They really help us out with logistics, with training, with interpretation as well. We also learned Russian when we’re there. We take Russian classes three times a week. It’s a really unique job because, like I said, the day to day. Really, you’re the closest with the astronauts when you’re there. Because usually, after their training, Monday through Friday, we have potlucks every now and then. People cook or go to the store and buy things. Once or twice a week, sometimes every day, people want to make fires, or they want to get together in one of the cottages. Then you have a potluck together. In those few hours, you really get to know people there. You spend quality time, face-to-face time, being present with them. It’s really really rare in Houston working at Johnson Space Center because now everything is remote. You don’t get that face-to-face time. You don’t get the feeling where you’re kind of living and working together. So it’s a really, really special time.

10:12 A little bit about the life in Star City. When you travel there, you take a flight to Moscow. Then they have drivers too that arrange a ride for you to go to Star City, GCTC. Star City is a secure area. You actually have to get a badge. It used to be a military base, but now there are non-military people there now. What you have to do though, you have to badge in and out. There’s a gate. The NASA created a few cottages. There are six cottages. They’re kind of like duplexes for the astronauts to stay and the director of operation to stay. Then there’s the NASA office right next to it. It’s called Prophylactorium. There’s multiple floors. The first floor is the Russian. The second floor is our floor. The third floor is the European Space Agency floor. And so as a flight surgeon, I stay on the second floor in the Prophylactorium. If you want to see more of what the video, of what life is like, if you just go to my Instagram @anntsungmd or my Facebook, you’ll see videos of what it’s like inside the office and what it’s like in the one-bedroom suite that I get to stay in, the photos and videos of the medical office, et cetera, et cetera, and the grounds of Star City as well. So you get to stay there. It’s really cool just because you also have a balcony. Then if you step out, then you’re basically at the office at work. You just walk down the hallway, you’re at the medical office already. So you really get to build relationships with the Russian staff when you’re there. Because their workday, just so you know, it’s nine to six. And you’re so close. Sometimes during the winter, you’re really glad you don’t have to walk a bunch through the snow, through the ice, just to get to work. And so that’s where you would stay. There is a common kitchen, a shared kitchen, that you can cook all your meals from. There are a lot of supplies there. Then you can also — since the schedule is kind of flexible as well, because sometimes we go on meetings in Houston and sometimes we work until nighttime, it’s not just for us. It’s not just nine to six. You’re very flexible in terms of when you can go to the gym. We have a really nice gym on the ground in one of the cottages that we get to use when the crew is not using it. And so you get to schedule that into your day, and you get to basically structure your day based on the meetings that you have, based on the crew schedule that you have.

12:45 Star City itself, there are a lot of apartment high-rise buildings that are built in the ’60s. There’s a lake right outside that you can take a walk around that freezes over. There are ducks. There’s locals walking around. There are two grocery stores. Really, one that’s close to us though. There’s maybe one restaurant. So we cook a lot when we’re there. On the weekends, we have a trip to Globus which is like their super Walmart or Costco maybe. But it’s more like a super Walmart, I would say, or super Target. We get everything that we need there every week. So that’s really nice. On the weekends, you can spend time reading. There’s a DVD movie collection you can watch, working out. Sometimes we have trips to Moscow. Sometimes the crew likes to go to Moscow, and sometimes we go with them. You can take the train. Sometimes if the driver is free, you can take a ride with them. There’s also the flea market that’s a mile above market close by Moscow. Sometimes people go there on the weekend. So it’s a really fun time, and you learn a lot about operations. You get to spend time with the people on NASA, with the astronauts. You get to learn the Russian culture, the language, explore Moscow, explore Star City. I will say Moscow is like a crazy busy New York essentially, like a huge city and very fast-paced. Then I spent a weekend there. I came back to Star City, and I was feeling like a sigh of relief. It was so calm, quaint, and so peaceful. I loved it. So it’s a big difference depending on what city you’re in.

14:33 That’s essentially a gist of what a NASA flight surgeon actually do in Russia. I hope that was educational for you. If you are just learning about this at all, or if you’re a medical student, a resident, or an attending physician interested in aerospace medicine, yes, please go to Episode 8, 9 and 10. I will detail what I did up to the time when I was a medical student, a resident, my fellowship, my aerospace medicine fellowship, simply the opportunities that are coming up right now with the commercial space companies ramping up, and with us going to the moon in the mid 2020s. I mean, there are so many opportunities. We need more flight surgeons, so please go listen to those episodes.

15:21 If you have any questions, you can go to itsnotrocketscienceshow.com. The show notes are there. There’s going to be resource links there. You can also contact me there. Or find me on Instagram, find me on Facebook @anntsungmd, and I will respond to you whatever questions you have. I will say the first thing to do is, there’s aerospace medicine fellowships at University of Texas Medical branch in Galveston, which is what I did. Then there’s also the one in Mayo, and then there are also in the military ones. So if you’re interested in that, go to those websites. Check it out. I really thank you for your time and attention for today. And just remember that everything we need is within us now. Thank you.

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