How would you feel if at the start of a surgery I made you choose between anesthesia and a doctor having the medical images from x-rays and CT scans? In that scenario, would you rather be unconscious for the surgery or have the doctor be able to form a plan of how to operate? This is a terrible decision but on a trip to Mars, there are weight and size restrictions for everything. If something is added to the list of packed items, then something else needs to go. With the life support, communication, and propulsion systems integrated into a spaceship, and exercise facilities, living quarters, and research projects occupying even more space, there is a limited amount of room for three years worth of food, water, and other consumable supplies needed for a round trip. Any supplies needed once the astronauts reach Mars have already been sent in a separate mission or are competing for cargo space. These limitations mean that we cannot bring a whole hospital onboard. In the first question I asked, an anesthesia machine or x-ray and CT scanners are bulky and heavy devices utilized in many surgical procedures, but may prove too costly to bring on a trip. Part of making this decision, NASA doctors, engineers, and mission planning officials will need to ask how likely these devices are to be needed or how risky it will be to leave these devices at home? NASA astronaut candidates are selected after they pass a physical because the hope is that they won't need much medical care and hopefully no surgeries. If a ship is equipped with a full trauma surgical room, which probably won't be used, it will only slightly decrease medical risks. Meanwhile, the whole mission risk would increase as backup food, water, and electronics could not be brought. However, we still should bring some medical equipment rather than just hope, that our healthy astronauts have no medical emergencies for three years. In the event that someone is experiencing a bleeding emergency, bandages and potentially a tourniquet become necessary to save the life, while not taking up too much space or weight, and thus they can be justified quite easily. The solution to the problem of what to bring and what to leave is whatever minimizes the overall mission risk. Of course, the solution to that question is up for debate. One branch at NASA's Johnson Space Center, exploration medical capabilities provides the important interface between doctors, engineers, and mission controllers to help quantify these risks, design medical devices for space and set the medical education for astronauts. These decisions are based on the medical emergencies observed on the ISS, as well as our understandings of the environment of space. Finally, important consumables to consider are the medications. Acetaminophen, more commonly known as Tylenol, is frequently used by astronauts onboard the International Space Station. On a three-year trip to Mars, we might need to ask how much medication we will need? But another important factor to also consider is how long each of these medications will last? Acetaminophen has a shelf life of 36 months, but other medications may expire before the trip ends. Bringing an entire drug manufacturing plant is definitely out of the question, and there are thousands of medications of potential value, all of which have different shelf lives. The question here then is, which medications do we bring and how do we overcome shelf life limitations? Two areas of hope come from genetically modifying plants to produce medications and 3D printing drugs. Each of these techniques, may allow the drugs to be manufactured during a flight rather than packing them ahead of time. This would both save space and avoid the issue presented by shelf lives. Here, the other solution is developing new, smarter technologies that both save space and reduce the number of supplies needed for packing ahead of time. Developments such as these are not limited for space applications and could revolutionize medicine here on Earth. Already, NASA techniques and research have found widespread use in the medical field. A current research project comes from a Duke professor and physician, Dr. Dan Buckland. He's working with a team to develop artificial intelligence controlled surgical devices that can work in space, or here on Earth in remote areas without access to a full hospital. The other way to save resources though is recycling everything.
