I was a Medic on Mars....sort of

· Remote Health Care,Space Medicine

Words By Steve Sunny Whitfield

The pipes above my head groans in the cold darkness of the habitat. It is below freezing, and I am yet to extract myself from my living quarters. Living quarters is a bit of a stretch. I can’t even kneel in my living quarters. The crew sleeping quarters are stacked on top of each other and I drew the short straw, so I am on the top. It puts me at the top of a long ladder and right next to the thin metal boundary that separates us from the freezing Martian landscape. 

Sound weird? It should! I am part of a Mars Mission Simulation at the Mars Desert Research Station (MDRS) in the United States (US).  Currently we are on Sol 5 (a day on a Mars is 24 hours, 39 minutes, and 35 seconds) and the days are routine. Mars is about survival and scientific research. So is the simulation, and the freezing deserts of Utah are one of the most ideal location for Mars research on Earth.

The crew alarm buzzes gently downstairs and the reverberating grumble that echos in the overhead pipes suggest that someone is already awake and downstairs, and I chuckle to myself. There is no privacy here, not in this tin can. It measures less than 8 meters in diameter and is currently housing 6 crew. When the toilet is flushed it rumbles the habitat, the whole habitat. 

“There is no privacy here so get comfortable with it”.

The question on most people minds is how a paramedic from Australia ended up on a remote Mars simulation however there is no simple answer. My background is paramedicine, but I have been fortunate enough to work in a number of remote medical roles which landed me here (excuse the pun). Each crew member represents a different aspect of humanity and science. Crew commander Andrew is the resident geologist, Guy the botanist and historian, Jen the architect and ‘Marsitecture’ specialist, Larissa the acoustic engineer and artist, Shane the engineer who specialises in chemical engineering, and me the crew medical officer and resident journalist.

The crew were complete strangers entering the simulation however we are now a tight knit crew. The variety of expertise was deliberate and vital to keep the habitat and its life support systems running. As the resident medical officer, I have several roles. Health and wellbeing of the crew being the most obvious which includes both physical and mental health, however I also assist daily in the green house and science dome. The health checks are conducted daily on the crew members as well as analysing crew sleep cycles (NREM /REM) and fatigue. 

 “We are also the lab rats”. 

Although I had previously worked on several remote medical projects in the past, none were like this. Here, during this simulation I have the clinical authority, it’s my speciality amongst the multi-professional team, but here on Mars if something goes wrong I have only the things I could bring, which is barely a backpack worth of medical supplies. This means a large part of the role is risk redundancy and prevention. However, this simulation is about research and I know something is bound to occur for research sakes.

“Get comfortable with being uncomfortable”

As I said earlier, today is Sol 5. I literally slide out of my sleeping quarters and down the ladder where I find Larissa, the acoustic engineer from New Zealand monitoring the decibel levels of the echoing pipes. She also woke early to prepare the breakfast for the crew. Each crew member takes turns to prepare the meals. God help them when it’s my day to prepare the meals. 

After breakfast I am downstairs on the airlock level of the habitat helping prepare 3 crew members for an extra habitat activity (EHA). The atmospheric volume of Mars is less than 1% of Earth's. This means the crew must live within the airlock of the habitat. When scientific teams are heading out to conduct field research, they must don the EHA space suits before moving out through the first airlock to a five minute depressurisation. Once outside their time is limited by an oxygen supply that last approximately 3 hours. As part of the risk redundancy, crews must be returning after 2 hours. This means once they have departed, I can attend to my other duties.

Although technically not my problem, the life support systems and basic functioning of the habitat is a crew responsibility. If the engineers are involved in an EHA, the other crew members must work together to ensure the generators and water system are functioning, the solar batteries are charging, and the food stocktakes are complete. Likewise, if I am injured or incapacitated, the engineers must be able to care for me, so I spend time between tasks covering basic life support refreshers for the crew. Although it may sound monotonous, this place is a hive of scientific activity. In the science dome crew members are processing micrometeorite samples collected from the previous EHA, food is being grown in the green hab, and interior design to enhance astronaut psychological wellbeing has commenced in the crew quarters. 

Just before lunch, the EHA team return with a collection of gypsum from the field sites as well as some more micrometeorite samples. Following the removal of the space suits and cleaning, we process the samples and then gather for lunch. Lunch consists of dehydrated everything, even dehydrated egg and cheese. 

Following lunch, I am assisting Guy in the green hab when an all systems alert is triggered. When this occurs, all crew are to return via the pressure tunnels back to the main habitat. Once there we are advised that one of engineers was outside the airlock checking the solar batteries when a large bang was audible. Inside the habitat he was seen by the EHA commander to fall. From the habitat port window, his boots are visible next to a rover however he is not responding to the radio communications. An emergency EHA is prepared to recover him. 

As the crew medical officer, I must remain within the habitat, whilst other crew members don EHA space suits to move through the airlock and retrieve him. This is not a fast process. Whilst the crew conduct the retrieval, I unpack my kit and prepare the makeshift clinic on the bottom floor of the habitat. The retrieval team indicate that the patient is unresponsive, but being in the relative vacuum of Mars, they must get him inside before any real assessment can occur. Mulling things over in my head, a large bang would either indicate possible blast injury and burn, or an electrical injury. Either way he will be hypoxic by the time he is through the airlocks and back inside. 

Once inside, his space suit is rapidly removed by crew members and it is obvious he has suffered a significant electrical injury from a battery malfunction. Although unconscious, he is maintaining a good blood pressure and ETCo2. The injury to his arm is significant.  After a rapid assessment, he is supported with wound dressing, pain relief, oxygen therapy and as time progresses, fluid support. I relay the incident over CAPCOM to mission support and communicate the criticality of our engineer. The only issue is the signal travel time. Mars orbit is elliptical and at its nearest, Mars is approximately 60 million kilometres from Earth (occurs roughly every two years). This causes a substantial delay (anywhere from 4-24 minutes) in signal transmission time known as one-way light time (OWLT) (the speed of light).  Two-Way Light Time (TWLT), is the time it would take to receive a reply (8-48 minutes). However, this is when all systems are working and not effected by solar flares, geomagnetic storms and equipment failures (all can all cause further delays in transmission). This means by the time that the CAPCOM medical team receive my message, I will have been managing my patient for almost 30 minutes. So my case details need to be pre-emptive and consider where I believe I will be in 30 minutes with this patient. Likewise, CAPCOM also pre-empt where my patient will have been for almost an hour by the time I receive their advice. 

Over the course of the next 48 hours, delayed updates are exchanged with the consultation team and I receive instructions based on the equipment I have in the habitat for an emergency escharotomy.

Sol 11. I am to take part in my 3rd EHA to assist with the distribution of a mineral called gypsum in an area known as white moon. Its approximately 2.3 kilometres from the habitat and once through the airlock, we will convoy two rovers to the site. The site is phenomenal, and you  may be forgiven for actually believing you were on Mars. The red rock and sand, deep canyons and small mountains dwarf our small team. Whilst loading samples onto the rover with Andy, we hear Larissa call for help. She was extracting gypsum samples when she fell. Moving quickly in a space suit is not easy, nor is it advisable. 

Arriving we find Larissa has impaled her left leg on a field tool. Although concerned about her injuries, our priority is to seal the suit breech and prevent hypoxia setting in. Andy produces a roll of duct tape from his tool kit and we secure the tool and tape the hole (cue Matt Damon). Once sealed we carry her through improvised methods back to the rover for a rapid extrication to the airlock. Her suit continues to leak during the journey back however we successfully arrive at the habitat. Once though the airlock (not a fast process) her suit is removed and her wounds, cleaned and dressed. The improvise carry was the most challenging part because the space helmets prevented us from manoeuvring around her properly and hindered our already limited vision. More notes made for research sakes.

Freezing weather was forecast for the remaining days of the simulation which kept us habitat bound. In reality this was a very possible scenario. Six crew in eight meters squared for long periods of time. My role continued through this shut down with health and wellbeing support a priority whilst I also became rather educated on all thing’s geology in the science dome. Two weeks without sun on your skin or breeze on your face is nothing compared to the crews who staff the international space station (ISS), but this was a unique experience to participate in a Mars mission research project.

Paramedics in space may seem like a bit of stretch but remember 50 years ago it was only the elite who could attempt Everest. Access to the mountain has dramatically increased over the years and the number and experience of people shifted the medical needs of the area. Now there are fully equipped clinics staffed by doctors, paramedics and nurses in a remote area where once there were none. As paramedicine continues to evolve into primary care the paramedic practioner will become a staple in remote and extreme medicine. My role as a paramedic in a medical officer role on a Mars was a first, but as access to space and Mars increases, so too will opportunities for paramedics.

Adapted from the original article: I was a medic on Mars.....in Utah (Vol 47). Found at https://paramedics.org/publications/response. Used with permission.

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