Episode 7 — Can the Human Body Survive Life in Space? with Jérémie Sergé

0:00Welcome everybody to another show of the Curious Space Podcast. Today the episode that we've been waiting for is Can the Human Body Survive in Space? This one is going to be awesome, exciting, and fantastic. So guys, today we're asking one of the most important questions in humanity's future beyond Earth. Can the human body actually survive in space? My gu my guest today, Jeremy Sergey, an aerospace physician, weightless flight surgeon and zerog instructure with more than two decades of experience spanning across aerospace medicine, human performance, emergency medicine, and astronautics. Jeremy is chief medical officer at Titan Space Industries and chief astronaut officer and dean of Titan Space Academy where he's helping

1:01prepare the next generation of commercial astronauts. He has supported microgravity research campaigns, trained people to operate safely in weightlessness, and studied physical and psychological realities of sending humans into extreme environments. Jeremy, what an introduction. Welcome to the Space Curious podcast. >> Thank you so much, Aron. It's a real pleasure. Thank you for the nice introduction. So nice introduction and for the invitation. Yeah, happy to to have this important conversation with you and space curious people here right now. >> Indeed. Indeed. Before we get into all the kind of technical stuff and the the conversation about that which I'm really looking forward to, um I guess my first question Jeremy is what inspired you or um what was your fascination to get into human space flight? Uh, long story short, I'm almost 50 years old, you

2:04know, but I think >> Surely not. You look awesome. [laughter] >> Thank you. I don't know. But actually, it's because of the air. But, um, actually, I I think I I simply never let go a childhood dream. actually I just try to to to become competent enough to help make it real uh or uh to to create the conditions at least for so I've always been fascinated by two things actually uh you you can find it in my in my uh in my work it's human beings and space and so uh grow so it's very important but I think growing up uh we need I I really think we need to keep two parts uh of ourselves alive, very alive. Um the past and the future actually in our present, the inner child, the curious, passionate, creative, still capable of dreaming parts of us. But this child can can can

3:06be a mess if he don't hold the hand of the wires, the wiser self we grow into along the way or we try to. And so in between study, work, thinking, understanding, responsibility and give their dreams the means to exist. So um when I was two years old, I wanted my parents said my answer to the question. I wanted to be a servant, a wise a wise knowledgeable PE person. And then I wanted to to be a stunt man at four. I remember that. And and finally at 5 years old I wanted to be an astronaut like lots of little little girl and boy hopefully girl also but then at the age of reason it was again vivid always enough to become useful at >> yeah and for the for the listeners Jeremy just hit a really strong point

4:06here he me he mentioned childlike and this is what leads to cur curiosity being a child the almost the the why the what the how. Think about when when you're a child it's always you're always questioning always questioning. So guys uh please please listen to Jeremy's words of wisdom so much because they are so profound and so true. We could literally have a podcast just on what you just said just now the the childlike and and the mind and what that actually leads to. But for the purpose of this show, [laughter] we'll we'll move we'll move on to the next question which is uh what exactly does a aerospace physician do? What's what's your role your dayto-day or how does that evolve? >> Actually an aerospace physician is still a doctor. uh is working in very niche field apparently but not so much actually because there always been a

5:08dialogue from the very beginning between space medicine and terrestrial if we call it like that medicine a lot of spinoff a lot and we know a lot of of things in space medicine also thanks to to terrestrial medicine research. >> Mhm. So it is a doctor uh whose patient is interactive with an extraordinary environment. We will I think talk a lot about environment and so traditionally the role has included astronauts and family medical support the fle fittofly assessment research operational medicine the operational part. So on the field mo to mobilize a knowledge on the field is very important. Uh and during parabolic flight campaigns also if you work for space agency you may be also a space physician for this this microgravity science campaign we assist participants. We review safety brief crews. We monitor the flights. We debrief afterwards. It

6:10sits it sits actually uh at the intersection again uh between the family medicine the occup occupational medicine science and operational safety. >> Mhm. So uh yes a niche specialty but uh space medicine has never existed um in isolation actually because discoveries made in space continuously inform medicine on earth. We we understand a lot of things for aging on earth for example because the astronaut is a model of aging. We can come back to this and uh terrestrial medicine of course makes uh space flight possible with a lot of uh initial questions about physiology in space. >> Love it. So yeah, the the the exciting shift right now is created by the commercial uh human space flight because from a niche we are now uh entering um the real space medicine era when we are

7:11not just talking about a very very lucky few or selected few healthy people highly selected highly performant but a diverse range like the population itself And medicine is all about the population. It's not uh it's about that. So we are moving from the medicine of selection toward the medicine of inclusion and from asking who is healthy enough to to fly to how can we enable more kinds of people to fly safely. This is very exciting. >> Love it. Definitely. So so how did you become a weightless flight surgeon and zero gravity instructor? Was it a simple path to go down or did you create or one of the did you have to create this this role with many other people? >> Actually, it's it's not about myself alone and it's not at all about having a plan a rigid plan or a checklist. It

8:12simply doesn't work. Just I I simply kept moving towards what fascinated me. uh uh it's also a heritage because my grandfather was a fighter jet pilot uh very passionate in space so I think I'm influenced by that he was trained in US in the 50s so he was part of the Apollo Mercury Germany generation you know >> so yes it come from from long so of course I specialize in aerospace medicine courses here 20 years ago in in France but my patient is human at first so I became actually it's I was talking about past and future but it's funny because my first uh role as a physician was a lepologist back more than 20 years ago in ocean Indian Ocean it's >> so what's that what's that role sorry what was that role

9:12>> lepologist I was just managing leprosy in with the patients. It's very interesting because you are talking about it's an ancient disease but it's very real at the present. Yeah. It's deeply stigmatizes across the cultures and we are talking about vulnerability, disability, human being and behind the diagnosis. So it it's one very important part also when I was a director medical in geriatrics rehabilitation hospital departments during the covid pandemic it's also about vulnerability disability and how we can manage this as a as a phys as a physician >> human being is very important so it makes sense to me it's meaningful so I just do my best to work like that then I was also family doctor for 20 uh years more than 20 years. So uh it's a it's a big big part of the medical support for

10:15many reasons but it's not it's not the topic today. And also I I I started to say operational operational medicine it's not just books or knowledgeable in books in theory in knowledge. uh when you're a physician like any professional you have to mobilize your uh knowledge to skills and competency of course but operational medicine is also you have to adapt really hard to the environment and sometimes you have to unlearn what you know to adapt and it's very interesting so for example I was on war zone on conflict zone for as a nomadical um evacuation team rotary rotary wing evacuation team a flight surgeon for peacekeeper in conflict zone very very in the desert yeah it's very harsh >> so you have to forget stethoscope you have to forget every everything you know uh to adapt to this very particular activity so I learned a lot of course

11:17thanks to my crew actually this is not the flight surgeon the best in that it's the paramedics with a commando experience that learn that taught me a lot of things So >> you have to adapt to to environment. I I think and I did that not because I had a checklist. I did that because it was meaningful to me. And then it's all about unlikely turns in life. Life is the best training actually. And uh you have to do what you you you you have passion for what is meaningful again. And then I it's about encounters and opportunities unlike this is a reason why you you shouldn't have a rigid plan. And so I couldn't imagine to create alone that the path definitely uh and that and the this kind of unlikely turns led me to parabolic flight. We are not we are very a very uh happy few actually we are

12:18seven to do that >> in the world because in France we need to have a flight surgeon on board it's not the case in US sorry to um interrupt you there can you just say that again seven there's only seven people of what you do in the world >> uh yes but because of unlikelihood actually you have we have the biggest laboratory in weightlessness in France here in Franceuge for Europe huge Yeah. >> But you have also other planes like in the US, in Russia and little plane in Canada, Japan, Netherland, etc. But we have the biggest laboratory. We have also test pilot, three test pilots in the cockpit. So we are very precise in the level of of microgravity which is very important >> uh for researcher and so now NAZA or China is coming in Europe for with us. But the the thing is that for many reason France and Europe asked for a

13:21flight surgeon on board from the very beginning in 1989 in ' 89 sorry. So the the US started far before because it was in the 60s back in the 60s even late 50s in US you start parabolic flights uh but in Europe it was 89 uh but with a medical doctor on board this is uh needed uh this is discussed but needed for regular reason and so >> here we are. So but this is a little team uh and so I had I was very lucky actually. So it's not about what you create uh or your checklist. You actually I think uh in our career whatever our career we have to go through uh two kind of time. The Kronos okay the time the training the experience but also through the chaos uh those rare moments when uh an

14:23opportunity and your preparation suddenly meets and you have to grab it actually of to recognize and to grab it and you cannot plan every path. uh you can prepare yourself well enough >> to recognize the right moment >> and be ready to take it and to be okay also if you have unlikely turns or hurdles or everything it doesn't matter if you are doing what is meaningful and what you like >> I absolutely love it and just to um bring it back to the viewers as well what Jeremy said is is so profound so deep and so wide and I'll use myself as a personal story about this. So when I was in when I was studying at college, university, I was studying um sports therapy, biomechanics, anatomy, physiology, and I was the opposite of Jeremy, guys. I was very rigid. All I thought was I'm going to be a

15:24physiootherapist. Um so I'm either going to be a physiootherapist for a sports team, uh so for a rugby club, uh or a football club. and or I'll be a lecturer as well in in a university. So, I'll be a part-time lecturer and I'll be a part-time um nutritionist or um a sports therapy. Little did I know if I fought like Jeremy, the the the the world could have been at my oyster. So, what I'm trying to bring back to people listening is what Jeremy is saying, please take on board because I was very rigid. I was very stuck in my own way. But if I just was a bit more curious and mindful about what I could have gone into. Who knows? Cuz I This is the reason why I've created this podcast cuz I love to learn about space. But because I wasn't I was thinking 2D and 3D. Let's say Jeremy's thinking 5D. If I was just more curious

16:26like that, who knows where that would have taken me. But that's what I just wanted to point out. So thank you for that. >> Absolutely. And actually life is a training and our experience. We are old guys, grown guys, but we need to share it and thanks to that kind of podcast, we can transmit that life experience. >> Yeah. >> Yes. Love it. Thank you so much. So um so as as you were saying it was so profound in terms of the knowledge and what you said it it is you know life is a school. you know, we're we're all learning and it will twist you and turn you in different ways and you just have to be curious about the possibilities. >> Please. >> Um, so I guess one of my other questions is what happens to our balance, spatial awareness and coordination when the brain no longer has gravity as a point of reference. Because I've never experienced this before and I'm excited

17:26to know what what actually what's actually happening. But actually you are disoriented. You have no up, no down. Uh you're just free float with your own body because actually weightlessness is just you are falling with the plane or or the space station at 28,000 kilometers with your cells, your suit, everything. So you you you don't feel your weight anymore. So this is not absence of gravity is absence of sensation of weight and no help you're down and you're of course we were shaped our our brain our sense our vestibule of the the the balance uh center neurological center was shaped calibrated in one G and so suddenly this is not the same calibration so you can have this kind of disorientation >> [snorts] >> And so but you adapt very quickly actually our brain is able to adapt very

18:29very quickly to to weightlessness. >> Okay. And another question so over the weeks months what happens to the muscles bones and cardiovascular system? >> Actually every systems are altered or affected by weightlessness. space conditions. Uh space is not just about weightlessness but weightlessness is very predominant part of of course the modification on your body more than 1% every month 1.2 two in on average but it's very different from individuals uh every months and to date uh we had a mission for example in one in in one time polyacov for 437 uh days uh and also fraction more than 800 days in space thanks to uh some astronauts like from Peggy Witson to

19:31Padelka We know a lot but for long duration flights to date we don't see a stop in the bone mass loss actually. So of course it increases the risk of fracture when you are back to earth in one gene actually it's adaptation it's a point of adaptation it's not a pathology actually it's your body adapt to another environment. So if you understand if your body understand you don't have any making me mechanical loading anymore for on the mid and long term of course you don't need your your anti-gravity muscles to function. You don't need your your skeletal to be like in 1G. So you start to have this kind of adaptation and we can see a set point for some system like uh the cardiovascular system the fluid the fluid shift the metabolism but we don't see a set point

20:33yet perhaps thousand days perhaps more perhaps never uh for muscle and for bone mass loss but it's also about the interaction of all the systems because to to understand this and to describe this and in laboratory in research we just reduce the the the problem and the the study to one system one specific system but this is not separate. You have a lot of interaction between the vestibular and the cardiovascular system for example and between the the immune system the metabolism endocrinology everything. So you have um a lot to describe a lot is happening in weightlessness. It's all about adaptation. >> So you you may have answered you definitely answered won the question but you've def you may have answered this question as well because the next one was uh what have astronauts taught us that the laboratory experiments on earth

21:35could uh never could. Um, so I I guess the one thing that it couldn't teach us was that side of the bone density because that would be very difficult to to do in a lab, right? Or could have that been done in a lab? >> Uh, you have you have a lot of things that you can uh do and a lot of things you cannot do in a in laboratory. On her actually you you you don't have a real weightlessness condition. You have simulation. For example, we know for you have the the long duration the long duration study of uh the biome medical system. You have the bed rest study for example. So you are you are lying in a bed six degrees down head down okay for long duration sometimes weeks sometimes months you have also the dry immersion um in Russia or in Europe for example. So why that that it's very constrainful but why that it's because you it's very

22:37very close to what we observe in astronauts. So we we we study canto measures uh physiological effect to have a long duration uh simulation of weightlessness without having uh the cost the difficulty the scarcity of having to study an astronaut. And we have also the the researcher close to the bed uh doing his experiment. >> But this is not weightlessness. the the only way to have real weightlessness is in parabolic flight >> or in the space station in space. And so um to have an experiment or biome experiment in space you need to fly the system the qualification of the experiment in parabolic flight before sending to the international space station and also it's limited for now it's limited we are trying to do

23:38something bigger with with our work in Titan space but for now it's very very limited >> so we can have we can run a lot more experiment in bed rest study. >> Yeah. I just want to Sorry, go ahead. Sorry. >> Yeah. >> Yeah. I just want to go back to what what you mentioned about the the because it's just um flicked up another light bulb kind of uh question uh about the the bone density reducing the way that the body changes when it's in space. And I think that's like remarkable and just so extraordinary the way that this is how clever our human system is. As you mentioned, you're not on Earth anymore. It's not used to the 1G and it's changing. It's it's almost trying to help us saying we are in a completely different environment. So we don't need the body to function how it normally does on this place we call Earth. So is

24:39that and I could be completely wrong here. Is that then a form of rapid human transformation or evolution when you're going into space? And that's what just came to my head. It's it's almost like the body is like a rapid evolution because it's been put into a different environment. Or am I just way off the the point there? >> Very interesting. I think I don't think it's evolution. It's more in in the long term in the evolution process and mechanism as we know it. But this is definitely adaptation. But from the very beginning even if human being is shaped by the 1G environment and we are remarkably well uh adapted around the 1G condition we also as human being with our physiology very adapt adaptable and we can adapt very very very quickly and space environment is a big illustration of that. how quick we adapt without >> having evoluted in another kind of uh

25:42space species. >> But you know we are not tardigrad. The tardigrad is physiologically a champion you know is is uh is able to sustain without any uh device any technology any suit anything uh to the void to the pressure to the radiations uh we are not like that but >> because we are very vulnerable as a species uh because we are very immature as a species it's the concept of neoteni Yes, >> you we needed to develop fiction uh imagination, creativity, so technology as an extension and so we are not able to survive like that in space. But thanks to the technology we develop, the creativity we have, the engineering we develop, >> we are able to survive and hopefully to live and to thrive. This is a question

26:43in space and to work in space. Uh but with if we are in spacew walk with of course you know the extra veicular activity suit thanks to the vehicle engine we engineer the environment so that human can live survive and live in space. But now we we also have to think to adapt the environment to to the human uh specificity. But yes, we are adaptable but not in the same way that the than the other extrem or biological system >> but thanks to uh a vulnerability that become an asset actually in in that kind of environment because we always have to adapt to new environment. So space is an extreme one but the the the whole story of humans being is adapting to new environments.

27:46So yeah but uh the evolution process is very interesting your question is so good question it's uh later. >> Yeah. [laughter] So we'll move on gently now to um my other point which is the greatest medical risks beyond uh beyond earth. So my my question on this topic is outside microgravity what are the most serious medical threats facing humans in space? >> Well I think it's radiations because we we are protected by the uh the magnet sphere of earth. Uh of course when we are in low earth orbit it's not the case when we are going back to the moon or or or deep space uh we can we know a lot but it's very difficult to have a precise model of anticipation. Actually radiation is one of the major concerns.

28:46Uh but we have to think in terms of the whole space exposome actually you have not just radiation you have radiation interacting with altered gravity isolation confinement disrupted circadian atmosphere dust noise nutrition microorganism the bofilm uh and so and also the limited medical capability and all everything is interacting over time in the same and so uh the mistake the classical mistake Because the way we need to to perform research and to run experiments is to imagine this risk independently. And this is this is the reason why studying astronauts in space is the only manner in real weightlessness with all the interacting risk the the the real manner to to understand what happened and what we have to develop as a counter measure of or managing systems. So uh it's not like in in a lab. So um yes when you are

29:49a crew on the moon or later in Mars you you you just don't experience radiation on Monday isolation on Tuesday and microgravity Wednesday the experience is all of them simultaneously and this is the risk. >> Wow that that is uh that is powerful. Um so what do we know about the possible effects upon the brain, eyesight, immune system and internal organs? >> Uh for radiation for example uh it's the hardest problem because >> we we we can't simply switch it off. You have the galactic cosmic ray the the these are um continuous radiation and you have also the solar particle events with coronal mass ejection or or solar storm. So um when you you are submitted of you are subject to this uh you have a cumulative risk of cancer. So we set a limit for example when I say occupational medicine uh 1,000 sever is

30:52because you are increasing by three points the the risk the overall risk to die from a cancer. >> So it seems a lot you have to discuss the aversion of risk of your society. It's not the same back in 60s with Apollo 50 50 loss of crew 50%. Today 3% seems acceptable but it's a ethical discussion. >> Yes. >> And but for carcinogenesis for example is because we are just going from 20% to 23. So uh actually but you have also cardiovascular effects and tissue effects and you said it immune immune immune effect. You have also a centrality around the central nervous system. We have some studies with a little animal but it's not always extrapolable for the human being. >> So we need uh shielding, we need uh the

31:54forecasting helps from solar particle events. We need a spacecraft design that helps. Uh for example, we we have a shield inside with just 20 cm of water for solar particle event. It's okay. But for galactic cosmic ray is not okay because of spaliation secondary particles. So yes this is an engineering problem. Actually the the the medicine the space medicine is transdisiplinary. You have to work with engineers with uh mission designers and to to find the best solution. It's not just a medical problem. It's a biological engineering and mission design problem. >> Okay. two things that we always hear about now anyone that's uh any tiny bit curious about space is moon and Mars Mars and moon so what would be the the difference in level of seriousness if you was living on on one or the other in terms of what effect it could have in

32:56your on on your body >> you are talking about the seriousness or the funniness the seriousness yes the seriousness is you have very different medical problems but the common thing is the reduced gravity. It's very interesting for a medical doctor because you don't need you don't know we don't know the G prescription. Uh we need not to have to develop all the cancer measure we have to develop in zero G because zerog is no bofly as you know uh this is a an aging apparent aging process not the same than than on earth but it's an aging process. six months on the space station you have a lot of systems is like you are aging from 10 to 20 years >> reversible for most but not for for for everything so >> do we need one6 of gravity like on the moon or onethird of gravity like on Mars uh to solve this kind of zerog problem

33:57or uh do you we need 0.8 a 0.9 we we don't we have a G spectrum it's very very interesting we are doing a lot lot now of reduced gravity parabolic flights not just zero G for research campaign because it's very very interesting but this is a common the common uh the common aspect but the moon gives partial gravity radiation abbrasive dust the dust is not the same that on the regulate on Mars uh extreme [clears throat] operational constraint but still the earth is relatively really close 3 days and the communication are not live but almost a few seconds but mouse adds something fundamentally different the out of view effects the duration and the distance communication delay say up to uh 22 minutes back and forth or more than 40 minutes. So you need uh the highest level of autonomy of the medical system. uh you can't envision evacuation.

35:00It's impossible especially because you need to have the whole it's on average nine nine depending on the choice is nine more than 900 days the mission >> and without to come back easy because you need to to go around the planet. So this is operational constraint very different uh the moon challenge met in another environment the Mars challenge our dependence on earth itself. >> Mhm. Well explained. Thank you so much. I really really appreciate that because it's helping me. The most of these are just what I'm very curious about. Um so putting aside the um the tech side of it and focusing on the medical side, are we medically ready to do a multi-year Mars mission today? >> Actually uh we know enough to contemplate it seriously >> but not enough to pretend that it will

36:00be medically routine and we are ready. Actually the there are a lot of uncertainties around radiation, partial gravity, long duration physiology. This is one of the reason moon is a good um bay experimental bay preparation readiness uh stage uh to prepare it uh long duration physiology because we are not talking about six months we are talking about uh almost three years. >> Yeah. Uh so uh and especially the biggest challenge is the behavior and the psychological aspect. The out of view effect isn't you can duplicate a lot of things on the ground in space station on the moon. You can prepare a lot of things but not everything >> and especially you you can prepare the out of your effect. So you need to bet but you have to do it with the manageable risk with the ethical consideration with uh with the uh the

37:02know the the alla concept as low as reasonably possible you have to prepare it uh this is not a we don't have a a stop >> so I think because I'm very optimistic that we are able to do that especially because life is a training but also the human specy trajectory through his history is illustrating the the re remarkable adaptability we have >> and also psychological one but we are not uh we can say we are uh ready actually so this is the gap and uh we have never observed human living uh for years in the combined environment of of Mars mission would create and um but exploration We are explorator by nature. Exploration has always involved uncertainty. You don't need to be certain to do and accomplish something. I if so you you

38:04don't do anything and also you don't you lose so much wonder. >> Yes. >> But Mars is not just about wonder. It's the paradox be between the extraordinary uh monotonous and boring thing and the extraordinary day-to-day life because you are doing something very special. The ethical challenge uh is not to promise zero risk. Uh it's impossible but to understand uncertainty to reduce it intelligently and make it genuinely informed and acceptable and it depends also of our society because aversion of risk is not the same during the history of humans. So >> exactly love it. Absolutely love it. And um there was I did a I posted um Neil the CEO of Titans um and I'm just trying to remember what the post was about now and it was some some skeptic who I can't

39:07remember what the question was but it was like saying something like can you show me the data on this and I politely said to him it's almost like saying I'm going to create um a car when there's just horses of just horses. And it's almost like someone's saying, "Okay, you're going to create a combustion engine. Give me the data on the combustion engine. You you you have to have that curiosity." Um, and like what you said with the ethical side of it as well as we're creating something new. We're going into something new. The data isn't there yet. We have to create the data as we go along. Um, but yeah, I can't remember what the what the post was about, but I just remember the person asking for data and I was like trying to explain to him, you know, for pioneers and visionaries and people that are creating the unknown. It is the unknown. You have to take, as you said, calculated ethical steps to make sure everything is right. But when you're

40:07going into these unknown situations, there isn't any data that you can particularly go from. Absolutely. Actually the lunar landing of Apollo 11 give me the data before Apollo 11 landing. Okay. So we we we can do that because we don't have the data. Mhm. >> You have some first like that it's but actually we can say that that the Apollo 11 crew or or the all NAZA uh team wasn't preparing as much as possible with the as low as reasonable acceptable the risk at this time of everything. But yeah, you're so right. And so this is this is difficult actually to to jump into something where you are not certain but I if we need every data uh you are not doing uh so much it's okay you you you can just stay home and uh and uh and be and trying to

41:07be certain on everything you are not certain life is not certain life is unlikely but it's like the dreamy child of the beginning uh it doesn't mean You don't have to be reasonable to to be as serious as possible to be as competent as possible to to manage things and to be aware. You have to be aware of what you are doing. >> Exactly. >> And for that you have to study to have the knowledge to have the training everything. It's about readiness >> and confidence you can have into the the your your capability to adapt. So life teach you that uh you can see also without leaving you you you can't you can't know in advance what will be your behavior in in several type of conditions. So during a war during you have something is you have to defend

42:08some some someone what how do we do we react in that condition? This is life. This is the way this is why operational training fields is very analog training is very important. You can have a representation a model of yourself >> but you have to put you in conditions. So at first with control risk. >> Yes. But at some point this is to do something that nothing is under control but still you can create the the the best system to control what you can control. >> Exactly. Love it. Um now moving on to the next point. The mind in space. One of my favorite topics the mind. Um so the body is part obviously of the challenge. Um now we're going to talk about the the mind. Um so how significant are disruptive sleeps uh

43:11sensory dis um deprivation uh monetary and you know basically being away from your family as well. So how does this affect one one person on on their mind being away lack of sleep etc etc. So we all have a very little little very illustration of what is uh somehow confinement during the pandemic but actually humans are remarkably resilient and robust but uh it's not exactly the same but the isolation robustness is uh you have to sometime forgot performance to be robust >> it's not at all the same when you are very highly performant you are not robust though you need to combine But isolation and confinement progressively change the psychological environment. So pre privacy becomes scarce. Small irritation can accumulate especially in a multicultural uh crew. And sometimes it's not the the

44:11conflict the big conflict you you you are trained to manage that happen but just accumulation of little things the socks or that that trigger something. So monotony affects simulation workload fluctuates and the same few people uh every time every day for a long duration and just the this is not the entire social world. So psychological health in space uh is not about selecting just tough and great people. It's about creating the conditions in which ordinary human beings can continue functioning in extraordinarily well together. You have a selection part because not everyone can endure um uh the space deep space conditions for a long time. For example, if you need the all the data, show me the data and the rigidity is not is not okay. So you have to have a multi you have to have

45:13flexibility. agreeable. The right stuff is not just like the the the space cowboy is is about agreeableness. It's about flexibility, creativity, uh tolerance to boredom for example. But >> you have also a lot of things interacting. You have sleep and separation for example. Uh they are not secondary comfort issues. These are these are also performance variables because sleep affects condition emotional regulation as you know decision making. The monotony can reduce the stimulation and the motivation separation remove many of the relationship through which um we normally regulate ourself emotionally. You know the the best way of coping is to be able to ask for help uh and to enter in relationship. So it depends on our personality are we extrovert introvert ambivert out etc. So you have

46:15a lot of as psychological and coping and personality criteria we know thanks to Antarctic missions, space force of special force, submarine, space analoges, many kind of analogs but uh we don't know everything. So we we don't we are not looking for the best individuals, we are looking for the best crews. M >> uh so and in space flight well-being especially for long duration especially for deep space is a a real part of the safety system actually because it's a safety pro it's like the astronaut that say everything is real nights in space to commit a m a murder so and the space cowboys of the early day of space >> it was a problem during space station long duration uh it was good for mercury Germany, the adrenaline rush, the this

47:16kind of right stuff >> but but now it's not and more and more the psychology of individual and the social psychology of the crews and multic multicultural crews will be will be at the center of the composition of the crew. >> So we look for adaptability, emotional stability, self-awareness. Yeah. >> Competence without ego or too much ego. We all have ego but it has to position itself at the right place. Okay. >> Uh the ability both to be lead and to follow when it's needed. Uh the tolerance to uncertainty or ambiguity. You have to take actions and decision even when you don't have any every data. It's part of the readiness. >> Uh [snorts] and humor curiosity podcast for example is a good selecting thing. No humor and curiosity

48:17is very important. Yes. Because it's a big psychological consumer measure actually >> and considerations for others. It's important not to be just an individual doing uh his own path, own career. It's a big problem you know in uh in when you want to be an astronaut you have to question your dream and you have to question the career path you set for yourself and you have to think about the good and the the the the worst reason and the ego is the worst reason. So, and to to separate it, you you you just have to feel the vibration you have. Yeah, it means something. If you vibrate for something, it's meaningful. But if it's just because you want to be an hero, um you are not suit the the the space psychological criteria. >> Yeah, I love it. Absolutely love it. I'm I'm one who I've um I've got a couple of friends who were in the Marines a long

49:19time ago. Uh and they've told me about um selection progress process and all that stuff. And it's it kind of brought me to that and it also brought me to David Gogggin's book, You Can't Hurt Me uh when he was talking about the selection pro process when he was going to be and became a Navy Seal because the talk they always it's always the same thing as you mentioned. It's not about you know this tough big person who you know who's the the alpha. It's not but they're the only people who never make it and or the person who is very good in one area specific. They're not the person that always make it. It's about the like you said the curiosity, the empathy, the team play, the camaraderie, the the jelling with different minds, um communication and adaptability. It it's all of that that brings it together that makes the great team. Uh but I I again I

50:21could talk about that a lot. Um but it's a beautiful way that you've um um uh advised it and and talked about it as well. So for the viewers listening as well, who knows you too could be in space within the next 5 10 15 years. It just shows that you know it's about yourself and the ego is is a big thing and for for most people you fe they think and feel that you have to have a big ego but no it's the opposite there has to be a death of the ego so you can listen to others and learn as you go into this the the unknown um sector. So my next question is which skills and professions will be needed to build uh health care systems for orbital stations, lunar bases and eventually um ma you know missions to

51:21Mars. Have you given that thought or do you have a thought about which job skills will be needed? Actually yes I have a lot of guess about that actually first a resilient or robust crew should not think alike should be able to think differently without coming apart and especially to to enlarge the scope of solving problems. You need different kind of personality, different kind of culture background. uh you you have to be as generalist as possible, but uh you really need a diverse crew in every uh aspect. And so this is why we we we start to talk about some criteria we need but actually we don't need an emotion emotion crew. It's very uh very important. So um because of the uncertainty the out of view effect what

52:23we can't uh train on the ground or even in space. So we need uh we need that for the medical training for example we need medical capability belongs to the crew rather than just a single individual. So yes certainly a physician is needed. He can provide enormous value but the doctor can also be the patient or not able to work. So crews need a distributed skills uh in emergency care, diagnostic, procedural competence and the ability to use the decision support system because I think we we will need artificial or also in autonomous m autonomous medicine. We will have also you know the digital twins and the artificial but it's human centered. The human override everything. It's not just you follow without questioning what AI is is telling you. So the the the safest medical system is uh the one that

53:24doesn't collapse when the best trained PE person become unavailable. It's very important. So we need generalists. So we need some someone who someone who who want to learn. It's a lifelong learner. Yeah. with this curiosity to learn all the carrier and to to to to gain lot of knowledge in in cross discipline. So it's a distributed uh capability but you you need also some some uh specialty inside it especially when uh you want to have a fluid leadership followership in that situation we need uh the lead of the engineer in that situation we lead the engineer of the of the medicine trained people so uh yes we need also a lot of creativity the wide range of functioning but also uh creativity. So this is why the reason for example if you are

54:25talking about deep space an artist is really important. If this artist has the the right functioning beside it because why? Because because his is imagination is creativity we are we are making assumption and you can be a hard engineer and an artist in in your soul but >> you have the creativity. It's important not to to tolerate boredom. >> Yes. >> To be creative and to have another way of solving problem and you you need creativity in some some a lot of new problems and uncertainties. So uh and also you need an hybrid crew. We will we will not rely but we will work with robotics also a lot. This is not about just science fiction or projective or technomianism. It's just because it's already happening and we we it's a it's an important thing also to be able to operate uh rightly the the

55:27the robotics AI and what we what the technology offer. >> Uh so we need a a large a wide set of capability. We need engineer capability uh physician capability. We need uh of course uh also maintenance technical capability for every systems. Uh so we need a a generalist crew with everyone is able to replace another one but with the peak of specialty uh in some in in every field also. So it's a it's vertical and horizontal you know. >> Love it. Absolutely love it. Um and I guess I've just lost my train of thought. There was a question I was going to ask but it will come back to me in in in a moment. Um yeah so I'll move on to this question and I'll come back to the other one. Um so if a doctor or medical student wants to uh enter um aerospace medicine uh coming into your

56:29sector, what kind of pathway would you recommend if you could or are you allowed to say that to give someone the kind of uh you know the playbook or at least the path what what they what they could walk to? >> Actually first become a good doctor. You have to be good [clears throat] at what you are doing. >> So it's it's like in the introduction you need to do what I'm good at what I'm taking pleasure to do. If you are just doing thing because you think the plan is doing thing your checklist but you have no pleasure you are not very good because you have no pleasure you don't it's a problem. So >> uh choose what and especially because the future of space carrier is more and more open. We we you you don't need to be a fighter pilot or test pilot to be astronauts in the near future already today thanks to Titan Space Academy for example but also this is real for the

57:31commercial space flight area that we are entering in. So uh you can first be good at what you are doing and choose if you are if you are very interested in in medicine of course be a good doctor whatever the specialty >> because we we need family doctor occupational doctor surgeon we don't have any surgery in space to date but for example in the exploratory list um by NASA we know that for a Mars mission for example we will have 100% of a medical surgical event during the two and a half years uh mission. So uh for what what is very interesting for example is that in our plane in my big laboratory we had the first surgery in in weightlessness ever uh back in 2006 by a friend who is who was the head of the surgery plastic surgery in Bordeaux.

58:34Uh and now at 50 years old he said he was at the top of his career at 50 years old. He said okay now I'm just leaving. I'm doing I'm a mag a professional magician. So but he performed before that the first space surgery in our laboratory. So it a lot of uh unknown at this point the fluid behavior uh how do you uh manage the operatoring room and and everything. So US is a lot working about that Dr. Pantalos for example for for now. But yes uh it was a parentist. So you you you have to be a good doctor and then you have to develop genuine expertise in something useful for you need to be operational. You you need to to adapt to the field to the environment. So emergency medicine um >> uh and also you have to have an interest in research and human factors uh to be as generalist as possible. And if you uh

59:37uh also dive into the space at large >> space if you if you gain because you are lifelong learner engineering skills uh if you know by heart the space systems is is of course an asset. You need to remain curious outside medicine and your own specialty. You need to have a transisip spirit you know transdisiplinary spirit and to be able to work in team and what one of the problem when you are family doctor is to be alone you have a lot of patient but you are alone in your private practice. >> Yeah that's a good point. >> So you need to work in a team. team skills are really really important and especially to travel to have a multicultural uh also uh to develop multicultural awareness and skills also. So I would not design a carrier simply to collect space related tles. Uh become

60:41useful first and good >> and take pleasure and then pure yourself in what is meaningful to you and then take that usefulness towards space and sometimes even the special the experts >> even didn't know what you are bringing on board because you are very singular. You are very specific. usefulness and we understand afterwards this is very important for space. >> Love it. Absolutely love it. Um there's one a few questions [clears throat] that I did miss and I know we're pressed on time but I just want to um quickly get on on to this which is the the training commercial uh astronaut side of it. Um, I know you've touched on this before, but this is really useful, important because you you've mentioned it that you know the the typical fighter jet pilot marine or you know now it's it's changing who can be an astronaut in the not too distant future. So, how will

61:42preparing a commercial astronaut differ from training a career astronaut selected by uh NASA or the ESA? Oh, it's very it's a very very different actually. We we now need to adapt the the space system of the the infrastructure or of the vehicles, the stations, everything to a diverse range of spaceflight participants >> and not just have an homogeneous group of uh people able to fly in a mission specific uh mission centric um design actually. So to accommodate a wide range of diversity it's it's it makes sense for many reason the the the wider first the the the access to space for a justice thing for we why just some very lucky few and I'm

62:44talking not about space agency but also can countries and different conditions so we are we are starting even space agency to think about that the astronaut project etc. But why disability and sometimes disability become an ability in space uh if you uh if you uh yeah we have many example of that. So uh this is what is interesting because a disability in an environment can become an an ability in in another environment. So justice the access to space and not reserved to just a lucky few. Uh but also very pragmatic uh solving problem ambassadorship and steep also if the more you fly people in space the more we are aware of you know the cognitive shift of the overview effect. But this is re this is real when you see with your own body and your own eyes. We all all know uh the the pictures of the

63:44earth rise or the videos of water bubble in space. But when you see with your eyes with your own body in it's totally different. You have a cognitive shift. You have something happening. So it's a long story to speak about overview effect but this is what is important also and also because this is what we it's like the extension of the story of aviation you know aviation you start with high risky pioneer aostal military pilots fighter pilots the history of the aviation and now you can see everyone can take the or Most anyone can take uh the plane and uh we are following the same path with uh with space but for that we need to build the right infrastructure with a with a with an increasing number of seats available. This is what we are

64:46building with the infrastructure with the real infrastructure not just the plane or mission centric we need for the plane or for the train or for the aviation we need airport port road rails everything. So we are building that because we need to accommodate a wide range and this is what is exciting, interesting and challenging for a space medicine uh doctor is uh how how we do that with the safest infrastructure possible for a wide range of conditions and medical conditions. >> Uh this is a challenge but this is very very important. I don't know if I answer your question because you've answered my question and you've answered quite a few questions along the way. So, thank you very much. I'm absolutely loving this. I'm loving [clears throat] obviously the passion, the curiosity, the words of wisdom, the the profound uh message that you're passing on not just to the

65:47audience, me as well. So, I'm deeply touched by this uh conversation or as I call it a meeting of minds. So, I feel the synchronicity and I thank you for that. Um as we are coming to a close um one of the questions is I like to ask is myth busting. Um so Jeremy what is one widely believed myth about I guess it could be weightlessness or astronauts health or living in space that you would like to correct? I love first uh for example that's um means gravity and weightlessness for example gravity sometimes adults don't not children but a lot of adults not curious about space think astronaut are free floating and flying uh flying weightless because they are outside the gravity field of earth because they are very very high no they are for example

66:50space station 400 kilometers high it's 90% of the gravity fields and paradoxically when you are weightless you are uh just the only force upon you is G is gravity >> nothing else so uh when you don't unc control a support you don't feel your weight when you are on the ground if you jump high in the void but even jump high on a roller coaster on an elevator you are a fraction of seconds weightless because you don't feel your weight until you are on the support. This is right the reason in our laboratory in our plane the real weightlessness um this is the only way a part of uh the space station to to run a biomedical experiment because we have 50% of biommedical experiments in the plane because uh it's okay from the beginning to the end of

67:51the flight for human being the cost of being zero is 1.8G 25 seconds before at the pullup and after at the pull out uh the zero g or the reduced gravity phase. Uh but that's okay. We have a we are able to run um weight microgravity science experiment for nonhuman being in a drop tower for example >> for a few seconds. uh but the crash itself is not uh good for the human being. So for human being the real weightlessness is the parabic flight or the space station. >> Okay. >> So you are free falling. I I already talked about that. Um also the image of the astronaut are a super athlete. Actually an astronaut is very rare because the astronaut of a governmental astronaut the selected few by space

68:51agency is abnormally normal actually is is is above the threshold for a wide range of set and this is what is extraordinary is a supern normal individual actually >> uh this is interesting to think about norm and abnormally disability ability this is interesting And um yes most of them because it's a selecting prevention uh and they are doing a lot of sport as a counter measure they are uh athletic but actually the astronaut in space is the worst case of sedentarity. Actually, you have the healthy young individual active, the passive, the sedentary, the elder one stuck in your in the wing shell and then you have the astronaut because 22 hours of the day is not at all in me mechanical loading. So this is

69:52a model of aging and this is not at all about athletism uh image. It's the opposite. So would say that >> love that. Thank you so much. Thank you so much. And uh quickly on to the future of humanity beyond earth. Uh one of the questions is should we concentrate on changing our environments to protect the human body or could humanity eventually begin to modify the body itself? So, think Elon Musk putting a chip in our head versus will we evolve to become what we believe we could. Sorry, I have a little disruption. Yes. Uh my first instinct is to adapt the environment to humans wherever it's reasonably possible. The radiation protections for example, the atmosphere, the life support system.

70:53sometime perhaps artificial gravity and not for every system because for in space station short duration it's very nice and fun to be weightless but as I can the the G prescription or the G spectrum it's it's interesting so we have for example the artificial gravity solution the ergonomics the nutrition all the systems but biological modification raises much deeper medical and ethical questions um particularly if change become heritable. So there is an important distinction between helping humans adapt to another world and redesigning humans for another world. Uh then you you are >> crossing some red flag line actually. If you are thinking of transhumanism or uh biological it's a lot of eth ethical question actually and so uh I'm you human centered so you understand I'm not

71:54transhuman centered I'm not in the technology meist but I think technological creativity is very important and this is the way we uh we we advance >> love it thank you very much um do you believe people will live permanently on the moon or Mars within our lifetime. >> I think um we may see increasingly sustaining human presence beyond Earth um particularly around on the moon. >> Sure, I'm sure about that. But this is my optimism perhaps, but I'm sure about that. I'm working with the team for that. >> Uh but permanent settlement, what is the definition of that? uh is a much higher threshold than visiting repeatedly or uh have a long duration mission there. It requires uh reliable energy food maintenance healthcare uh governance. So we are working to toward that uh economic capable of sustaining people across generations actually. So by

72:57definition if you are talking about generation is not just and this is why the reason why I work so hard in that field it's for next generation also because I think a lot of a terrestrial problem energy recycling energy management uh protection of our environment you are it's the best it's the best challenge when you are in a life support closed environment in space it's you you need to solve this kind of of problem So it's you are outside of yourself to to do that. So a settlement begins when staying is no longer merely a mission objective but it becomes an ordinary condition of life. >> Love it. >> And yeah a lot of work toward that but we are working for that and if we are not done at the end of my life the next generation will follow. But yes it's very important. >> Love it. Absolutely love it. Right. Okay. We're going to go to a simple quick fire round where I'm just going to

73:58give you just a few uh words and I'll leave you to answer that. Um so let's do it. Quick fire round. Moon or Mars? >> Uh definitely moon first. Mars next. I have a passion for Mars but it's next later. >> Exactly. Professional astronaut or commercial astronaut? Doctor is astronaut at large and especially because you can be a professional commercial astronaut what matters is what you can contribute to >> artificial gravity or biological adapt adaptation. >> I'm sorry for the quick fire because I would say both ideally intelligent. >> You can say both. You can say both. Yeah, I can say both. Ideally intelligently combined. Actually >> the toughest part of astronaut training >> remaining excellent with the whole crew and the unexpected replace the simulation.

74:59>> The most underrated threat in space >> I think the interaction between small risks actually. Yeah, they do. And they start to compound. Um the human organ uh so the human organ most affected by space flight >> usually we are talking about bone etc. But I think the brain because ultimately it has to reinterpret everything >> everything is so you have the physical and the and the cognitive and the psychological aspect even I think also the spiritual one >> of santoist. Yeah. >> Yeah. Yeah. I love that. Uh doctor on board or autonomous medical system. >> A medically capable crew distributed the doctor supported by autonomous systems especially for long duration deep space. >> Love it. One item every future Mars crew must carry.

76:00>> Curiosity. And so the Curiosity podcast, I think it weighs nothing and solves more problems than expected, actually. >> Would you personally accept a one-way mission to Mars? If everything was set up, everything's set up and they're only doing one-way missions to Mars, would you accept it? >> No, because I never believe in one way. I'm able to uh jump into uh something where uncertainty and you don't have the the return ready but I'm too optimistic not to think that uh you will have a return so exploration should expand human possibilities not unnecessarily remove them definitely >> I love your philosophy absolutely love it let me get past the script [laughter] um human settlement beyond Earth is inevitable or still uncertain. >> I'm not comfortable with the inevitable.

77:02I think it's possible. I hope so for many reasons, but it's too long for a quick fire, but never inevitable. >> Okay, one word to describe weightlessness. >> Freedom. >> Love it. Love it. Right, as we're getting close to the close, um, final question. So Jeremy, uh, imagine that the first child is eventually born on Mars and develops in a gravity so different that returning safely to Earth may be impossible. Would that be the moment humanity finally became a space fairing civilization or the moment we began creating an entirely new branch of humanity? Oh, so deep and profound questions. Question. Um I think civilization begins when another word begins shaping the

78:03humans who live there actually. Uh so the first child born on Mars will represent something fundamentally different from sending explorers there. Um so because exploration means humans visiting another world >> and so if Martian gravity shaped the child bones muscle cardiovascular system and development so profoundly that earth became difficult perhaps impossible you said it to inhabit. Then for the first time home would no longer mean the same planet for every human being. So that would be an extraordinary achievement. Achievements you have to discuss it but but also an extraordinary responsibility. >> So we have to think about responsibility, ethical governance, ethical discussion beforehand are so important. We don't have to follow what

79:03technology uh open. We have to think it. We are human to think it before end. So because we would no longer be asking only whether human can adapt to other words. We would be confronting to a much deeper question. I think at what point >> uh does adapting humanity to another world begin creating another humanity? actually because becoming a truly space fairing civilization is precisely the moment when that question stops being science fiction becomes medicine ethics uh and the life of a child. >> Exactly. Yeah. I love it. Thank you so much. Thank you. Um so we are at the close now. Jeremy, is there anything that I that you want to add or some a question that um you believe I've not asked that you want to put forward um to

80:05the viewers, the listeners at all or do you think we've covered a vast amount of information? >> I think we covered a vast amount everything but a vast amount. I think that's it for audience and for listen. >> Yes, it's been it's been quite it's been exciting. It's been fun. Uh and hopefully the the audience has followed us along the way. So uh to connect with you um obviously I'll send over your LinkedIn um connection um details on there. Is there any other way of connecting with you or is LinkedIn the best way for people to reach out to you? >> LinkedIn definitely uh professional and LinkedIn. >> Right. Perfect. Okay, I'll get that done. So guys, thank you so much for listening in. Um, and we'll see you on the next episode of the Space Curious podcast. Thank you very much. Thank you. Thank you so much. Bye-bye. Right, >> that is it. That is a wrap.