The return of astronauts to Johnson Space Center for their yearly physical is a bittersweet affair. All are proud at having passed successfully the many screening tests that enabled them to achieve their lofty status but few are comfortable with the reality of having to repeat most of these same tests annually.
To fail any test might topple even an experienced astronaut from his position of proud accomplishment to the obscurity of a permanent ground support role. But those with the whitest knuckles are the new astronauts, the tight-lipped guys affecting false bravado, waiting nervously for their blood to be drawn. Perhaps they just have been assigned one of the shuttle missions to the International Space Station. For them, perfect health is an obsession.Others, like myself, are former astronauts who return periodically to Flight Medicine to participate in the Longitudinal Study of Astronaut Health. We are the "old guys" and for us the yearly physical can be a sad reminder of our relentless battle with age and the haunting awareness that we all are destined to be victims of one chronic disease process or another. One already has succumbed to malignant melanoma, another to acute leukemia. The more lofty your position the farther you have to fall. Such is life!
I don't have the fiber-optic sigmoid this year and have no reasons for x-rays so I am ready now for the "laying on of hands". "Mother" takes this opportunity to introduce me to some of the front office people who help make all this happen. The receptionist, medical records technician and clinical nurse, all dedicated and thoroughly competent - a wonderful team.
Most of these fine people are employees of Kelsey-Seybold. A few are Wyle personnel. Together they do a fine job. As a family doctor for many years I both recognize and appreciate their professionalism.
The young flight surgeon responsible for the laying on of hands did very well. By the time he was finished I was satisfied he had not missed anything important. It always is somewhat intimidating for one of these youngsters to examine a seasoned family doctor but we hit it off well and he was happy to have my input on their new cholesterol management program. We both agreed that more liberal use of statin drugs was desirable from a preventive medicine viewpoint.
At that time I had fifteen years experience with the very earliest statin drugs and was very positive about their use. Later, however, I was to encounter personally the very serious cognitive side effects of the newer stronger statins and was to become very negative about their liberal use. Now I no longer would even consider such drugs for those whose jobs demand constant attention and vigilance. Though rare, such side effects as memory lapse and amnesia strike suddenly without warning.
My last stop is back again with "Mother" for her friendly smile and my travel voucher. Once again I have run the gauntlet. Now I heave a sigh of relief, focusing on the positive and banishing to the back of my brain the reality that I will not know many of my test results for several more days. As a realist I know it is just a matter of time. Sooner or later, something serious is bound to crop up.
My next stop will be Space Center Houston, right next door on NASA highway 1. Tremendous personal satisfaction comes with my finding a Lower Body Negative Pressure device in the Skylab mockup. Years ago while researching the de-conditioning of zero gravity I created the prototype at the USAF School of Aviation Medicine. The shop foreman told me it looked like half a casket to him ( It did! ) and he would not get in it as a subject. Today it is a valuable space research tool routinely carried on the shuttle and even throughout Mir.
Now I am in the fun part of the trip ready to enjoy the pleasures of Houston and already beginning to wonder what the gauntlet will turn up next year?
NASA Road 1 takes you from Route 45, known also as the Galveston Highway, to the impressive array of modern buildings comprising Johnson Space Center, southeast of Houston. The Lyndon B. Johnson facility is arguably the only notable feature along NASA Road 1, otherwise crowded with restaurants, motels and small office buildings. The reality of our typical, somewhat squalid life style contrasts sharply with our lofty mental image of space travel.
Turning into the main entrance is where it all begins. Your initial impression is a sense of wonder at the relatively small size of this NASA complex, which has placed men on the moon, has a space station under way and hints at a lunar colony in our future. Then you remember there are other components to NASA.
The chief nurse at the flight medicine clinic should be called "Mother" for that is what she is to the current group of astronauts and even to us "old guys". Like a mother hen with chicks, she hovers over us constantly, offering comfort, reassurance and direction. She is our sole source of continuity of health care, for the carefree, young doctors who soon will be examining us will be gone tomorrow, pursuing their own agenda.
"Mother" handles the scheduling job with ease, somehow blending this comprehensive battery of tests into everyone's busy schedule. I notice from the scheduling board that my old roommate at Williams AFB, Jack Schmitt, is coming in the next week. Jack explored the moon during the Apollo program, the only true scientist to do so for Jack was a geologist before we were selected into NASA's scientist astronaut program.
Even Russia's cosmonauts occasionally pass through this facility, "Mother" informs me. "They are really the "right stuff", never complaining about anything." This is in contrasts to many of our health-focused, young astronauts where even a minor ankle strain may result in multiple visits to area specialists.
"Mother" guides me through the interim medical history then ushers me into the blood drawing room. Rick Mastracchio is just emerging, a relieved smile on his young and intelligent face. She introduces us. He is scheduled for STS 106 and if all goes well will make a major contribution to the construction of the International Space Station. Our eyes lock for a moment - I am one of the "old guys". We are out of it. He is in!
An employee from Wyle Laboratories drew my blood. I had decided earlier not to inform her that I was a family doctor or that my multiply lacerated veins have been difficult to locate in the past especially when we come in fasting. Last year the clinic cardiologist responsible for monitoring the stress test on us "seniors" had to draw my blood using a very skillfully done femoral vein approach because technicians had failed using the regular forearm vein method. The Wyle technician was successful on the first try so I felt it safe to tell her the truth about my past. "I already knew before I came over, " she confided, which really broke me up.
She worked for Doctor Joe Kerwin, the president of Wyle Labs and volunteered, "Everyone thought the world of him." Joe and I were medical astronauts together. In 1973, Joe, our first doctor in space, and two fellow astronauts made history by saving the crippled Skylab 2, then spending four weeks aboard, doing zero gravity studies.
Next, "Mother" escorted me to the pulmonary function and stress ECG room, reminding me about the urine specimen and my eye appointment immediately thereafter. Tom Stafford was just finishing his testing and we shook hands. That handshake was symbolic for me of Tom's historic handshake with cosmonaut Alexei Leonov during their orbital linkup in July of 1975. Leonov had said, "Glad to see you," in English with only a trace of Russian accent. Stafford had been to the moon. Leonov was the first person to walk in space. It was a very perfect match.
For about the ump-teenth time the technicians under the watchful eyes of a pulmonary specialist performed extensive lung function tests followed by a stress electrocardiogram. The monitoring cardiologist critically appraised my heart rate, blood pressure and electrocardiogram traces during the final minutes on the treadmill. My first reaction when he said they were stopping the test was that coronary insufficiency must have reared its ugly head. Yes, I felt the first twinges of panic and resignation but it was a false alarm. They stopped the test for us only because I had reached their new heart rate cutoff point. For us "old guys" new rules had been decided on. There is something to be said for blissful ignorance. I hate the reality of knowing that if I take that test long enough, coronary insufficiency is very likely to show.
The optometrist, looking very trim in his Air Force National Guard uniform and full colonel rank did my eye tests again and pronounced me fine except for "a slight fall-off in my distant vision". He hates to hurt my feelings and knows that all of us are super-sensitive to any hint of deterioration. "Some minor changes in your lens and a touch of glaucoma," was the way he put it. Always a gentleman!
My last test in the annual gauntlet was the sound proof booth for hearing testing and my annual attempt to try to distinguish high-pitched test sounds from the ringing chorus always filling my ears. I've heard spring peepers continuously for fifty years.
Duane Graveline MD MPH
Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor