OMA Spotlight on Health

Exploring the field of space medicine with Dr. Roberta Bondar

May 03, 2022 Ontario Medical Association
OMA Spotlight on Health
Exploring the field of space medicine with Dr. Roberta Bondar
Show Notes Transcript

As the first Canadian female astronaut and first neurologist in space, Dr. Roberta Bondar’s research aboard NASA’s Space Shuttle Discovery broke ground on the effects of space travel on the nervous system. Those trailblazing contributions to the field of space medicine inspired the researchers and astronauts who followed her.

Spotlight on Health  – Exploring the field of space medicine with Dr. Roberta Bondar

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Georgia Balogiannis: In this podcast the Ontario Medical Association looks at current issues of interest in health care. Spotlight on Health gives you all the straight talk. We’re Ontario's doctors and your health matters to us. I'm Georgia Balogiannis for the Ontario Medical Association.

Dr. Roberta Bonder was the first Canadian female astronaut and the first neurologist in space. In this second of a two-part series, we delve into her ground-breaking research on the effects of space travel on the nervous system.

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Dr. Roberta Bondar: Being the first neurologist in space was, and remains, very important to me because a lot of the changes that we see in spaceflight really have their basis in understanding the nervous system, and not understanding the nervous system. That is the thing that we studied a lot on my particular flight and people continue to study it — how our nervous system changes to accommodate freefall in space, and how we have to get our gravity sensors back working when we land on a planet such as Mars, which would be a third of Earth's gravity, or back here on Earth which is one-G.

Or even on the moon, which is one-six-G. One still has to, if one wants to not float around, you have to be in a world where there's some gravitational pull, so the nervous system is your control system of the body. So, to be the first one to actually describe these things, in a knowledgeable way and an informed way, made me feel that I was contributing a great deal to inspiring the whole field of space medicine and researchers and astronauts who would follow me. 

As a medical doctor, I also look at space medicine as being a very interesting and novel way of approaching the solutions of different types of diseases, whether it's bone loss whether it's neurologic issues that we face, where it unravels certain things we can't study here on earth because gravity is a very confounding factor. Just even in terms of blood distribution, or how we locomote, how our muscles and nerves move. So, there's all kinds of things that space medicine can provide. 

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I felt that it would be a great opportunity for me to continue to participate in sharing with others the types of emotion, the view that I had from space —to be able to try to understand more about the nervous system and how we see and view the world around us because I trained not just in neurology, but I'd sub-specialized in a field called neuro ophthalmology. To be able to understand how we bring visual information in and how we best can try to create something to allow someone else to see and feel what we see and feel. 

One of the things that I looked at during my space medicine research was why people get sick in space and all along, very early on, I was saying to everybody well, you know, there's a common mechanism here when people throw up it's not just because they're going to space and they have a, it's not like travel sickness, it's not like getting on a boat, it's completely different because fluid shift. So, very early on, I was trying to identify fluid shifts in the brain that might cause people to be sick because I was going through all the mechanisms why someone would be sick. 

So neurologically, it was very difficult to study and the closest I could get to was using a transcranial Doppler to look at blood flow in the brain. So, all my research was based on looking at that, so we'd have ground-based testing and we developed algorithms that could spin off to certain clinical situations. And I do feel that space medicine can have that kind of impact that makes us think differently and go into a different solution tree.

So now, when people come back from long term spaceflights, it's even more and more evident that there's something going along with fluid shifts. I mean, people in spaceflight, don't need their glasses, if they're short-sighted they become very far-sighted, but that has a wrinkle in the universe and a wrinkle in the retina when they get back. And sometimes people have visual change that is not very easy to get back to normal just because they come back to gravity. So, there's mechanisms at play in space that help us understand what these kinds of things might be doing in the human body that we've not been able to properly control or to look at and tease away.

The other aspect of space medicine is how everything has to be covered to normal. And this is an experimental situation, you take normal healthy individuals, you put them in an environment, you only change one thing and that is you put them in freefall. And there are things in the body that normally don't get activated by, we think, activated by gravity that obviously do because, remove it and things change. 

Bone loss we can understand. Blood flow distribution we can understand. Some of these neurological features are harder to understand. So, when people come back, it's actually the first time in our history as a life form, especially interested in medicine, where we could if we had the ability to look at how all the systems integrate with each other for recovery. 

One of the things we don't do well, I think in medicine, is look at recovery well enough. To be able to say what are the mechanisms of recovery in the body? What can we learn from assets coming back, because they're Earth abnormal when they come back because they have to be space normal when they're up there? So, you can't have it both ways. 

So, when people come back from space, they have to recover bone, they have to recover blood flow distribution, they have to recover cardiac output, they have to recover blood pressure changes, fluctuations. I'm only speaking about two systems. Look at the whole renal system, I mean there's, everything in the human body gets affected by spaceflight. And now when people come back, it's got to get back to normal. What are the mechanisms that allow that to happen?

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When I was a clinical clerk and went to medical school at McMaster after my PhD at U of T, and I remember one of the electives I took was in St. Lucia. And I did this because I wanted to see how medicine was being done in an environment where we didn't have sophisticated technology and how that changed morbidity. And then I went up to Moose Factory for an elective because I wanted to see how aviation was being used to bring people in and out and how you deal with remote medicine, telemedicine. 

It was in the very, very early days of looking at X-rays and sending the image back and people were over-reading heart failure because you could actually see much better looking at X-rays on the screen. All of it really behooves us to understand, or to at least get somebody on our team to help pull this together. A lot of medical education is spent getting us all excited about the technology and, and the kinds of things that, that are coming online and what we can do, but there isn't a lot that deals with the environmental implication of it all. 

There's no reason why we can’t, because we're very creative individuals. I think that people can't be discouraged about trying to make innovative paths in medicine. I think it needs to be in parallel with what we're going to do and how we employ it ethically so that we don't contribute to being part of the problem of climate change. 

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I do believe as a life form, we are capable of so much. We just get ahead of ourselves sometimes with doing things in a certain way without perhaps the traditional retrospectoscope, where we can say “Hey, you know, maybe we could have done it differently.” So maybe we shouldn't be in a place where we say, “Maybe we could have done it differently.” Maybe we should be in a place where say, “We can do it differently now and have a good outcome.” We also need to have generations of people involved in this, it can't just be with one group of one age and one culture. It has to be very broadly based with input from various sectors.

Inspiration comes from, sometimes, very unusual places and ones that we never would have counted on. But they're the ones that provide us some thought. Introducing Arts into STEM, and so it becomes STEAM. I’m a big proponent of that because as a neurologist, I know that the brain has so much more to give and so much more we can become, if we are able to express ourselves. And I believe scientists are creative. 

I wish I could take people into space, and they could see that it takes 20 minutes to go across Canada,15-20 minutes go across the Atlantic and then you're in Africa and you go across that. So, it's a continuum. We miss that continuum when we look out the window and we see what people have traditionally called the flat Earth because we are such a small little creature, gravity-bound. Even when we get up in airplanes, we can see a little bit better, but we’re gravity-bound and, I, sometimes our way of thinking is gravity-bound.

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Thirty years on now, and my view has changed over the years, but 30 years on from my flight, when I look up in space I still have that same kind of wonder looking at the planets. At sunset, for example, seeing Venus, seeing Jupiter and then being able to get between the two and seeing Saturn. To be able to look at the stars, that when I saw from space didn't twinkle, to know that there are great things out there that we have absolutely no idea what they are. 

We're just beginning to grasp the idea of blackholes and the space-time continuum and deep philosophical, physical things. But they, they all mean that we can still have a creative imagination. We can still plot in our heads, given the opportunity to have some time to think — to be able to look up at the sky, to be able to actually look at ourselves as a life form and wonder. And I think that is a great gift and I hope I never lose it.

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Georgia Balogiannis: This podcast is brought to you by the Ontario Medical Association and is edited and produced by Jodi Crawford productions. To learn more about the Ontario Medical Association please visit