When astronauts Doug Hurley and Robert Behnken splash down somewhere in the Atlantic on Aug. 2, one of the first faces to welcome them back to Earth will be a UT Health San Antonio trained physician — NASA flight surgeon Stephen F. Hart, MD.
On May 30, Hurley and Behnken became the first astronauts to launch aboard a commercial rocket, Elon Musk’s SpaceX Falcon 9, to the International Space Station. As the lead flight surgeon, Dr. Hart monitored their health for months preceding the launch and has continued to provide care as the station orbits the Earth every 90 minutes.
As always, observing and treating astronauts in space has inspired Dr. Hart, perhaps even more so during the pandemic.
“You think, wow, people really can do this,” he said. “We can live and work in space. It sort of conveys some optimism for the future of mankind — even off the planet if we have to go there.”
Dr. Hart, 62, grew up in Friendswood, just outside Houston, going to school and church with astronauts’ kids. Along with the rest of the country, he shared in the pride and accomplishments of early space exploration, Projects Mercury and Gemini, and grieved over tragedies such as the Apollo capsule fire that killed three astronauts in 1967.
After graduating with his medical degree from the Texas A&M University Health Science Center in 1990, he spent his four years of residency in San Antonio: internal medicine for a year and then three years of adult neurology.
Dr. Hart credits his time at University Hospital and the Audie L. Murphy VA Hospital, and especially the guidance of UT Health San Antonio physicians/professors, with his career path.
“So much of my bridge into NASA was through neurology,” he said. In residency, he paid particular attention to problems associated with space travel — dizziness, balance issues, vertigo-like symptoms. “These are things that neurologists often take care of on the ground, so my initial inquiries with NASA were in regard to neurological issues.”
His friends and mentors in San Antonio at the time included David Sherman, MD, then chief of neurology who passed away in 2007; Robert Hart, MD, now a professor at McMaster University in Hamilton, Ontario; and John E. Carter, MD, professor of neuro-ophthalmology.
Dr. Hart said the caliber and the quality of his training in San Antonio was extraordinary.
“If you’re lucky you can take all that with you forever, as well as lifelong friendships,” he said. “I’m lucky to still have some of those from San Antonio from my residency days.”
Since joining NASA in 1997, Dr. Hart has served as lead flight surgeon for three U.S. shuttle missions and, after the retirement of the shuttles in 2011, played a role in eight more Russian Soyuz missions to the International Space Station. He is one of about 15 doctors serving the 65 or so astronauts and their families at NASA’s flight medicine clinic in Houston.
“We’re sort of like their family practice doctor for both them and their families, sort of all the time,” Dr. Hart said. “So any medical problem that pops up we take care of them.”
But the routine becomes singular when astronauts get assigned to a flight and doctors are assigned astronauts.
Not only does the flight surgeon monitor their health for months, or even a couple of years, and certify them for flight, the doctors become the astronauts’ medical instructors.
“We do all their basic medical training,” said Dr. Hart, “because they have to learn certain things. They can do everything up to defibrillation and even intubate someone if they had an emergency like that.”
Doctor and patient forge a close working relationship. And with the pandemic, Dr. Hart was even quarantined with astronauts Hurley and Behnken at the Kennedy Space Center in the last days before launch.
“So yeah, we’re hanging out with them,” he said. “It’s a good way to get to know them and what makes them tick. That’s comes in really handy during a mission. There’s a lot that needs to get done on a mission, and we’re empowered to kind of speak on their behalf if they’re tired or being asked to do too much.”
Dr. Hart said he’s fortunate to have met incredible astronauts and become friends with many.
“And because of the friendship, I think I was able to do a better job as their advocate,” he said.
He’s looking forward to going out on one of two ships SpaceX will deploy, one in the Gulf of Mexico and one in the Atlantic, to “catch” the astronauts on Aug. 2.
“The hatch will open. I’ll have eyes on them right away. A couple of other people will go in and help them get out. I could be called to go in, depending on how things are going. We’re expecting that probably they’ll just be seasick. Coming down, even if you’re landing on dry land, people are nauseated. They don’t feel well. They could be throwing up,” he said. “Actually, we fluid load them before they come down just to kind of anticipate they’ll be dehydrated from all the vomiting. They also get orthostatic (feeling faint or dizzy), too.”
The two astronauts will be monitored closely once out of the water. They may need IVs for dehydration and anti-nausea medications.
“I’m hoping for clear skies and calm seas,” Dr. Hart said. “My biggest fear is I’ll be seasick and in worse shape than the crew.”
He said he’s thankful for his residency training and for ending up at NASA.
“It’s great for someone like me,” he said. “I have a short attention span, like to be able to hop from one thing to another, a lot of things going on, a lot of different moving parts. I’m pretty lucky to have a job I like as much as I like this.”
Dr. Hart said the COVID-19 crisis “deserves all the energy and focus we can muster.”
But, he added, “if my sharing a little of what NASA is doing can remind us of what’s on the other side of all this, I’m happy to do it.”