As NASA’s chief health and medical officer, J.D. Polk, DO, has had a totally cosmic career trajectory.

Dr. Polk wears multiple hats at the space agency, where he is in charge of the health of all NASA employees—including its astronauts, who are monitored for life. Dr. Polk is also the health and medical technical authority for the agency, overseeing a team that serves as experts on the health specifications for new vehicle development at NASA.

“We have to make sure each vehicle is built to medical standards that we have for transit from Earth to space,” Dr. Polk says.

Dr. Polk returned to NASA in 2016 after leaving the agency in 2011 to join the Department of Homeland Security as principal deputy assistant secretary before becoming dean of medicine for Des Moines University College of Osteopathic Medicine.

The DO recently caught up with Dr. Polk to talk about his ongoing work and the agency’s planned mission to the moon and then to Mars. This is an edited version of our conversation.

What is in the works at NASA these days?

NASA’s involved in work on eight different vehicles right now. It’s the busiest time we’ve ever had. In the next 2-2 ½ years, we will have five companies launching humans into space. Virgin Galactic has already launched a suborbital flight; they reached the terminator of space in December and came down.

They also just took a passenger to that same line that separates our atmosphere and the space horizon. Blue Origin, Jeff Bezos’ company, is getting ready for its first suborbital flight. NASA also contracted Space X and Boeing to build capsules to go to our space station, so those two companies are launching for us. Then there’s NASA’s own Orion capsule and vehicle, which are being built for the moon and Mars mission.

This doesn’t count X-planes, which can include experimental, high-velocity aircraft, very high altitude (of 50,000 feet) aircraft, and low-boom aircraft. There are a whole bunch of programs to get us aloft again in air and space.

How much of this work ties into the Mars mission?

A lot of this work is building to go to the moon and Mars. Orion is built to withstand radiation under standards that allow for much longer duration and farther exploration. There will be two separate missions: First, to the moon with a goal of boots to the moon by 2024, and then to Mars in the 2030s.

We will send a lander from the Gateway spacecraft down to the moon to explore different areas of it. The Gateway allows us to base above the lunar surface and to go back and forth and explore multiple areas of the moon, including the poles. There are lessons to learn before we head off to Mars.

What are some of the concerns of the Mars mission?

Mars will be a 2 ½-year mission. It takes six months to get there. Then, Mars and Earth don’t line up again for 18 months, so astronauts will be on Mars that long, then take a six-month journey back home.

So if we take a doctor to Mars, that person will need training in a whole host of things because they’re it. They’re the only medical care on that planet. Real-time telemedicine options will be limited because there’s a 20-minute delay between communications from Mars to Earth.

There is much to work out. For example, do you have a backup doctor? How much training would we give other crew members in case something happened to the physician? What’s the technology that we will need to survive on Mars? What are the countermeasures needed to keep the astronauts healthy?

What’s the coolest thing you’ve gotten to do?

Flying in the vomit comet aircraft that does parabolic flights has to be up there. In space you become weightless, so we do that in order to narrow down procedures in a weightless environment. For example, eye drops don’t drop in space, so we figure out a protocol for that.

Being in Mission Control and talking to astronauts is always enjoyable, as is talking at a very high level with folks inside the Beltway about space policy.

And, of course, there’s working on these spacecraft that will eventually touch down on another planet. Occasionally you pinch yourself when you think, ’how did I get here?’

What are three pieces of advice for medical students interested in aerospace medicine?

First, good training will carry you forward. I’m probably one of the highest-ranking physicians in the federal government. I got here through training and persistence and becoming an expert in my field. Have confidence in yourself.

Second, get a good foundation in a clinical specialty separate from aerospace medicine. Emergency medicine, neurology and family medicine are all good options. Get to know and see patients first.

Third, aerospace medicine is a rapidly evolving specialty right now. It includes folks who work for the FAA, military, NTSB and for commercial vendors. And with the Air Force expanding its role as a unified space command, there may be ever-increasing roles for aerospace medicine physicians.

There are definitely more opportunities, but there are not that many aerospace medicine residencies. They are very competitive. For the most part, it’s a second residency, an add-on. I am AOA board-certified in emergency medicine and ABMS board-certified in aerospace medicine, so I have a foot in both houses.

How much does NASA’s trajectory change with different presidential administrations?

The president and the National Space Council set agendas for space policy, but so does Congress, which legislates and funds space endeavors. And the president appoints the NASA administrator, so this can have an impact on NASA and its strategic direction.

Long lead items, such as the moon and Mars missions, are going to cross multiple election cycles and parties. There’s always a risk that directions could change, but space flight and space exploration has the respect of both parties. NASA as an agency is very apolitical and working for the benefit of all humankind.

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