NASA Shuttle-Mir Oral
History Project
Edited Oral History Transcript
Roger D.
Billica
Interviewed by Rebecca Wright
Houston, TX – 17 June 1998
(Interviewers
were Rebecca Wright, Carold Butler, and Mark Davison.)
Wright: This
is an interview with Roger Billica with the Shuttle-Mir Oral History
Project. Thank you for making the time with us this morning out of
your busy schedule.
Billica: My pleasure.
Wright: Thank you for gathering so many wonderful things that we're
looking forward to hearing about, all that you have out here on the
table. We'd like to start with you explaining to us your roles and
responsibilities with the Shuttle-Mir Project.
Billica: Okay. I'm the Chief of the Medical Operations Branch here
at NASA Johnson Space Center, and Medical Operations Branch is the
organization that essentially is responsible for all aspects of health
care for every space flight. I quickly wrote down, so I could remember
to tell you, what the different things are. It's actually quite a
variety.
When we say "health care," we mean very comprehensively
anything having to do with the human element of flight, anything that
would affect health and safety, illness, injury, preparation for flight.
So things that we cover in general for all programs, whether it's
Shuttle, Space Station, and we did for the Shuttle-Mir Program, Phase
One, are establishing what the medical standards are for the mission
and performing the medical selection and certification of crews. Anything
having to do with health care--pre-flight, before the mission, during
the mission, and post flight. So, all aspects of that.
The design, the development, the manifesting, the management of all
of the health care equipment, the health care systems, so that includes
countermeasures such as exercise activities, environmental health,
as well as what someone would traditionally think of medical care
activities.
Anything having to do with crew training in the area of health. So,
the medical training of the crew, the training on our medical equipment,
the training of the crew of what they would expect to encounter and
how to deal with this experience. And the support of the rest of the
training. So when the crews were to do any sort of potentially hazardous
training, the water training, the winter survival training, or anything,
for example, in the water tanks or in the centrifuge or in the chambers
that would require medical support or medical supervision, that came
under our responsibilities.
Mission support in general. Preparing for the mission, planning the
mission, anything having to do with the human aspect such as schedules,
work-rest regime, the sleep shifting, how much could be done during
a duty day. We're basically the advocate for health and trying to
keep a rational approach to anything having to do with what are we
expecting these people to do. And planning the mission and then providing
a medical support team to the mission while it's occurring, in the
Mission Control Center. And we did do that over in Russia.
So, all the functions I'm describing are typical for any mission,
but we did for the entire Shuttle-Mir mission as well. Preventive
health. Anything having to do with getting ready for the mission,
physical fitness program to get in shape, an infectious disease isolation
prior to the mission, a health stabilization program, anything just
to help get them ready nutritionally, immunizations, things like that.
And then, of course, the countermeasure program, which a lot of people
think of when they think of medical support to space flight during
the mission. Things that are done to prevent the negative changes
that occur to the human body from space exposure, from the lack of
gravity, from radiation, from things like that, that present a risk
to the human, make it potentially unsafe or risky to fly, we do preventive
things to keep the person healthy, keep the performance at the level
necessary for mission success.
Behavioral health, big area, particularly for long missions. The behavioral,
psychological, and emotional aspects of a mission being out of country
for, in some cases, a couple of years, being separated from family
and home, and then being launched and left in this vehicle in space
with only so many places to go for months at a time, that's a pretty
big challenge for that individual. So the support to that, how to
prepare them and then how to support them behaviorally, psychologically,
and also, if necessary, being able to intervene if that became a little
bit shaky during any of those areas.
Physical medicine, rehabilitation medicine. We have the responsibility
not only to prepare them and to maintain them during the mission,
but then when they get back, to help them recover and rehabilitate
physically, emotionally, physiologically, and return back to their
normal baseline. They do not come back the same as when they left,
and our job is to get them back to normal in that regard.
Environmental health, establishing the environmental standards for
space flight. What is safe? What is acceptable in terms of the atmosphere,
the water quality, the microbiological environment, radiation, and
noise, those sorts of things? We set the standards for those areas.
The engineers and the design people, of course, then design to those
standards. That's not our area. But then our job is then to be the
health monitor, to go back and look. How did we do? How are we doing?
As we talk about the missions, you'll see that that became a pretty
big issue for Shuttle-Mir with some of the events, the power outages,
heat and humidity, the atmosphere, the fire event that occurred. We
were very involved. Then because of what we had up there, helping
answer the questions, "Can we stay? Is it safe?" That became
a pretty big issue.
Epidemiology, tracking the trends of what happened, looking at the
data, doing monitoring. What can we learn from this? What was the
effect of the exposure? Have we created any increased risk to them
long term after the mission from what happened to them in space? Is
there anything we can learn from this mission about health issues,
all of the things we've just talked about, that we then need to apply
to future missions? So the epidemiology and the medical data and the
trends and what to learn. We have a project team that does that.
Then finally, using any experience in space flight to look at new
technologies, medical breakthroughs, things that we can learn in terms
of advanced capabilities that we can then apply not only in the space
program, but then spin off back to society, that could be used. Some
of the things that are on this table are some advanced technologies
like that or represent some areas that we're working on that we were
able to use Shuttle-Mir as a platform to continue to move forward
on some new medical technologies that people are excited about.
So, I think that's a summary that describes the category and variety
of things that fall under medical operations in space medicine. It
was quite an experience for us to do that.
Wright: Tell us about your staff and what kind of folks that you have
that help you get all of this done.
Billica: We've got just a great staff. It involves health care professionals.
The team is led by physicians who are flight surgeons. These are physicians
who come from a variety of backgrounds--internists and family practitioners
and emergency room doctors, etc.--who at some point along their way
decided they wanted to pursue aerospace medicine as a career, and
either went to the military or some other training program and then
came here to NASA to be NASA flight surgeons.
They come with those credentials and then they go through additional
training to be certified as NASA flight surgeons, learning all of
this about space medicine and becoming very knowledgeable in these
things, and also being trained up and certified as flight controllers.
So they're not only these physicians, but they're also flight controllers
in the Mission Control Center, fully trained and certified for that.
And they're also on flight status so that they can fly along with
the crews, in terms of T-38s and getting to know and be part of the
crew team. That's the nature and scope of who and what a flight surgeon
is.
We selected and sent some outstanding flight surgeons to Russia. We
assigned at least one to every one of the increments, and that flight
surgeon went over to Russia with the crew and lived over in Russia,
stayed in the Prophylactory there in Star City, and was there during
all the training. Then while the crew member was in space, our flight
surgeon then stayed in Moscow and staffed with the support team in
the TsUP, the Mission Control Center, and came back in time for landing
and then was the supervisor of the rehabilitation program. So our
flight surgeons made almost as much of a time commitment and a time
away from home and I don't know what other words to use, but did the
whole mission just as the crew member did. It was a significant commitment
on their part.
Supporting and working with the flight surgeons are hundreds of people.
We have other health care professionals, nurses. We have a staff of
biomedical engineers--BMEs, we call them--who do much of this list.
Every one of these things I just told you, there's a project team
or a core team of people who that's their job and they do these things.
We also have a staff of PhD scientists in the environmental health
area, who handle all the environmental health aspects--toxicologists,
microbiologists, water specialists, nutritionists, pharmacologists,
all of these sorts of people.
There's a staff of laboratories, people who work in the laboratories,
who are supporting the analysis of the exercise changes, the bone
loss, the neurological changes, the nutritional concerns. A clinical
laboratory with technicians who do that.
We have a behavioral medicine team with a psychiatrist and psychologist,
several psychologists and some support people who do that, who handle
that part of the team. We have a clinic with nurses and staff who
do that, and the technicians who support them. A wide variety of just
administrative support and secretaries.
It all adds up, and I'm sure I'm leaving people out, but it's a big
team. It's a team that does support all the programs, but there were
those who were totally dedicated to the Shuttle-Mir Program, and there
were biomedical engineers who, along with the flight surgeons, went
over to Russia for the entire time of the missions and stayed over
there for several months and worked with the flight surgeons. Then
a lot of these other people would then go over for trips, taking the
equipment over to Russia, get things set up, support training. So,
several hundred people, actually, on this team.
Wright: As Frank Culbertson has said, no mission is routine, but I'm
sure you have a pattern of how you would put together your Shuttle
flights. Would you tell us about the challenges that you had to undergo
to get your team prepared for the Shuttle-Mir Projects?
Billica: I don't even know where to begin. This was a huge challenge.
The last time we had done anything like this as an agency, of course,
was Skylab long-duration flight, and then only went up to 86 days,
87 days, I think. I'm not sure that's the exact number, but in the
eighties. And three brief missions, essentially, compared to what
we did on Mir. And not too many people around from then. There are
still some people around who supported that mission, but we really
had to go back and dig out the records and try and remember and learn
what was that experience. The Apollo-Soyuz, the only other joint mission
with the Russians, and that was back during a whole different time
frame of U.S.-Russian relationships. So, really not a whole lot of
similarities there in terms of how that was done.
We had to learn again how to do long-duration space flight over a
couple of weeks, and it's an entirely different experience, entirely
different set of challenges, just a whole different critter than a
Shuttle flight. So, a steep learning curve for us there. Of course,
the Russians had been doing this for years, but, again, that was part
of the challenge.
The other big thing was to learn the Russians, understand them, learn
how they do business, and they do things very differently, not only
just in terms of how they do space flight, but how they practice medicine.
They have a whole different culture and a whole different approach
to health care than we do. Some of that was just fine in that it was
just a matter of finding the common language, and some of that was
not fine. Some of that was things that they do that were not what
we do in terms of health care or philosophy approaching health care.
We had to learn how to deal with that with them in a way that we did
not compromise the ethics or the standards of United States health
care, in putting together a joint program.
So, the two big categories, in summary, although there's lots of stories
behind this, is long-duration space flight and how to do that, and
how to work and get along with the Russians. I think we succeeded
at both of those.
Of course, the big benefit of all of this is we are in such a better
position now for International Space Station. If we had not done Phase
One and just went from Shuttle to an International Space Station,
without this experience, I'm not sure how well we would have done.
I think we would have really fumbled around quite a bit trying to
learn these same lessons, where here we had a much more structured
learning experience where we were put into a situation where we basically
had to fit into an existing program, learn from them, bring back from
what the Russians do the best, and the experience and the knowledge
that we could gain from that, at the same time learn what we wanted
to do differently, and do it in a way that was less risky than just
going out there and trying to learn it without that framework. So,
a very worthwhile experience, but not necessarily always comfortable.
Wright: What are the differences from, say, preparing for Andy Thomas'
flight compared to what you had to do for Norm [Norman] Thagard?
Billica: Oh, wow.
Wright: Can you walk us through some of the preparations or even share
some of the stories with us about how you prepared for Norm's first
flight?
Billica: Sure. When we prepared for Norm's flight, it was just a total
blank sheet. We got a lot of different teams together that we had
been using to get ready for International Space Station, various consultant
groups looking at all of these things that I listed for you, and started
putting together what we thought would be the appropriate things to
do in terms of prevention and countermeasures in medical care. Yet
at the same time going into that, our initial understanding was essentially
we were the guests of the Russian program and we would do things the
way the Russians had set it up. We were essentially going over there
to support Norm, but that we would basically be guests and fitting
into the Russian way of doing business. So we went over there just
ready to support and help, but not really knowing what to expect what
we were going to do, and we did not know how the Russians did things,
and we really didn't know about the health care system or their processes
or procedures, had no idea what to expect.
We sent two flight surgeons over there with Norm, and basically just
showed up and said, "Here we are. What do we do?" Quite
a scramble. Steep learning curve, as I said. We didn't know what medical
support was present in Star City, so there was just a lot of communication
back and forth. "We'd better get this over here. We need some
medical kits."
Probably the biggest learning experience is the Russians had their
own way of doing medical selection and standards, and so I made several
trips over there to meet with my Russian counterparts. They made some
trips over here. There was a weariness. There was an unknown. "Who
are these guys and what are they going to do to our crew member?"
I'm sure they were equally concerned about us. I mean, it was certainly
a two-way thing.
The Russians view medical selection and medical training as one and
the same. In NASA, we have standards and we select astronauts, and
when they're selected, they're good to be assigned to any mission.
And we do monitor them and we do some final checkouts before we okay
them for mission, but essentially once they've been selected, the
threat's gone and they can proceed with their training, and we support
the training, but they know they've been assigned to the mission and
their training.
On the Russian side, they pick cosmonauts, but all during their training
they have more than one crew training for any given mission, and all
during the training the things they're going through are part of the
medical selection. They're being monitored and tested and put through
various things where they're tested all throughout the training. It's
not until right before the mission where they have another complete
set of medical evaluation and tests--it's fairly extensive--that they're
finally chosen who's going to do the missions. So it's high threat
by the medical establishment throughout the training period. So the
relationship of the crew to the medical doctors is very different.
The tests the Russians do, some of them are very different. There
are things that we had a difficult time understanding, "Why do
you do this? What do you benefit from this? What decisions are you
making from these tests?" Some of the technologies that they
had, and still have, are, for us, old technologies and things we would
no longer do or no longer expose our crew members to. Lots of X-rays
and lots of things like that, that we just don't do anymore.
They have a Chief Medical Commission that it took us a long time to
understand. What is this Chief Medical Commission? It's made up--essentially
if we put together the equivalent of it, it would be our Surgeon General,
Surgeon General of the military, the head of the National Institutes
of Health, the president of Yale and Harvard Medical Schools, the
head of Centers for Disease Control. I mean, all of their top medical
authorities in their country that form this Russian Chief Medical
Commission as part of their Department of Health of their country,
basically a Cabinet-level organization. This is the group that would
come together and meet and, at the selection of the crews and right
before a mission, would have a week-long set of medical tests done,
then present it to them. It was very strange and very different from
us.
So the first time we went through all of this experience I just described
with Norm Thagard, we were sort of standing on the sidelines going,
"This is very different," and at the same time trying to
protect Norm from any undue risks or exposures, because we'd heard
a lot of horror stories about--and I'm not trying to paint a bad picture.
I mean, the Russian medical people are very well trained, very professional,
very smart and brilliant people, but the resources they had to work
with in a lot of cases were not up to American standards. You heard
a lot of horror stories about reusing medical supplies and reusing
needles and things like this. So we were on edge and looking for where
we needed to protect our people.
We had heard stories about some of the other countries who had sent
crew members, who were basically put under the authority of the medical
doctors in Russia, and ended up having procedures done to them that
we would never allow or never do, but if these people wanted to fly,
they had to now subject themselves to this medical system in Russia
that was very different, and a different philosophy and approach to
health care and medicine. Different doctor-patient relationship. Not
a same attitude toward confidentiality and privacy of data. Not a
same attitude about informed consent, that you gave the patient the
information and they had to agree to things. So, very different atmosphere
just in terms of health care that we went into.
We got into some confrontations with the Russians on these things,
saying, "No, you will not do this to our person." They had
been used to other countries coming in and basically saying, "Well,
here's our crew member. We want to fly, so we've got to let you do
whatever you want to do." Well, we had a different philosophy.
So there were a lot of tug-of-wars that went on. There were a lot
of phone calls, a lot of meetings. There were aspects of the Norm
Thagard mission where we threatened to pack up and go home. We, essentially,
as the doctors were throwing our body down in front of the crew member,
saying, "Over my dead body you will do this to our crew member,"
after having talked to our management and to our crew member, saying,
"Here's what they want to do. We don't think we ought to do it.
We think this is more and beyond. This is a risk that we shouldn't
do."
So there were some very uncomfortable times during the first one or
two missions where we reached a point of conflict that came close
to ending the whole program, and had a lot of meetings with NASA management
and elevated issues all the way up to the Dan Goldin level, where
we had to stand firm if we were not going to allow a praesen of things
that just were totally unacceptable.
As I get into this now, the emotion of that comes back to me. There
were some pretty tense times. Of course, we were expected to go solve
this. "Don't let this happen." And, "Why is this happening?"
And, "Go fix it." But I think there was an appreciation
on the crew member's part that, "Thank goodness the doctors are
not letting this happen, and standing up." So a lot of trips
back and forth, a lot of negotiations, a lot of writing agreements
and protocols.
So the difference was, having gone through a couple of times, we established
a routine that by the time we got to Andy's mission, we knew what
to expect, the Russians knew what they could do and what we were willing
to do, and we pretty well had it figured out. We knew now how to do
the Chief Medical Commission. The Russians knew what tests we were
going to allow and what not. So it smoothed out and it became routine.
By the last few missions, this conflict that I'm describing was gone
and we had a working relationship and a comfort level and an understanding
we knew how to do things. We understood what things were for the formalities
that we needed to go through so that it would feel okay to the Russians,
and they knew what things that they could not demand of us so that
we wouldn't get in a conflict.
That's just in how we did the health care things. Also, by the time
we got to the Andy mission, we were contributing a lot of medical
equipment and supplies to the missions, where initially we just sent
some extra medicines and things up.
Wright: Tell us about how that evolved. I know when we've had a chance
to visit Mike Barratt, he shared with us the book that was put together
with Russian-English, how to do everything from headache to some of
those procedures that still mystify me, but it was a "how to
do everything" book. But that was just one sample. Can you give
us other things that evolved through this process that the United
States contributed to the Mir?
Billica: By the end of the process, we were sending up environmental
monitoring equipment, some of the equipment where we were getting
ready for International Space Station. Some of that was sent up in
a hurry, with some of the environmental problems that happened. I'm
sure you've got all that down in history. But with the fire event
and the smoke, there were some other problems where the environmental
controls went out, the carbon dioxide system, the humidity controls,
these sorts of things. As we had crew members up there being exposed
to these things and there were questions being asked on the United
States' side, "Well, is this safe? Is this healthy?" and
the Russians had limited technology. They have some, but not enough
really to satisfy a lot of the commissions that were coming together,
asking some very tough questions about, "Is it the right thing
to do to stay up there? Is it the right thing to do to send another
crew member up there, just in terms of health and safety?"
And so at some instances, with very quick turnaround, we were sending
up things on the Shuttle. There were even some missions where we weren't
completely sure at the time that the Shuttle docked that we would
leave our new crew member up there, and we were doing some real-time
testing going onboard the Mir and looking at things and testing the
atmosphere and getting calls down to confirm that, indeed, the atmosphere
was okay, the toxic levels were okay, and we could kind of say, "All
right. It's okay. It's good to let the crew member go on there."
So, some things were real-time quick decisions. "Let's send some
stuff up there." So as time went on, we accumulated some hardware
and equipment, and as medical events occurred on the Mir, where we
realized there were some medical problems, we started expanding the
level of some of the medical kits. They have Russian medical kits,
they have Russian equipment, but, again, in some cases different medicines,
different approaches. They don't have the same pharmacy that we do
in some cases, so we would send up additional pharmacies. It got to
the point on some of the missions where there might be a medical problem
or a medical event that would occur, mostly minor, but still, where
we would talk with the Russians. They'd say, "Well, what do you
have and what do we have?" And that's where the joint medical
book came together.
Wright: That's great.
Billica: It ended up at any given medical event we might use some
Russian stuff, we might use some NASA stuff to deal with that event.
But it evolved. It's hard to go back and point, other than to maybe
some of the environmental events that occurred, where there was a
definite step-up, it's more that in most cases where the Russians
became familiar and we learned their system, where gradually we added
some things on.
There were some things where we met with some of our Russian counterparts
right at the beginning of the activity, and we agreed that jointly
here was the level of medical capability that should be in place for
a long-duration space flight. That list of "Here's what should
be in place to support a long-duration flight"--advanced life-support
medical equipment, things like that--was essentially a wish list on
the Russian side. They didn't have some of this stuff either. For
example, a defibrillator monitor. If there's a cardiac event or a
heart arrhythmia or something, that's what you'd want to have. We
both sat down and signed an agreement between the Russian medical
and the U.S. that this is what should be there. They didn't have it.
We didn't have it. But by doing that, we had an agreement and we said
to the Russians, "All right. We'll go develop one. We're getting
one ready for Space Station. Then we'll provide it to you and then
you can make it part of your medical equipment up there." So
part way through, we had one ready. We flew it up on the Shuttle and
it became part of the Russian medical equipment that was available
up there. So, some things like that. And we have that on the table
here.
So, different pathways. Different ways we were able to gradually expand
things to, first and foremost, make sure we had a level of comfort
for our crew member, but, secondly, to jointly evolve and expand our
joint medical capabilities and experience to a level that both of
our teams had always said, "This is what we should have,"
but the opportunity wasn't there. You're always competing with, of
course, other resources, and we have to be able to use a risk management
analysis that convinces not only the medical group, but the rest of
the NASA program management that there is a sufficient need to justify
putting some additional medical equipment or medical capability up
there.
Wright: It's not like you can make a house call.
Billica: No.
Wright: They're pretty self-sufficient, aren't they.
Billica: Right. And it's not like you can just walk in the door with
a truckload of medical equipment and say, "We're the doctors.
Send this up there." You've still got to have a rationale and
a justification that makes sense. So that's where the epidemiology
and all of that comes in. What are we learning? What are we seeing?
And there were some significant medical things that happened on Mir
that I think opened a lot of people's eyes outside of the medical
community where they finally were saying, "Wow. There could really
be some bad things that happen. We need to make sure that there's
a medical program available to support this."
So one of the things that happened as a result of Shuttle-Mir was
a realization on the part of NASA management where we had been getting
ready for Space Station, we'd been fighting a lot of battles saying,
"You guys, we'd better have some medical stuff up there. There's
going to be some problems." And we're telling this to people
who had not had the experience. So here comes Phase One. We get the
experience and now all of a sudden everybody's saying, "Boy,
we need some psychological support. We need some environmental health
monitoring. We'd better have some stuff ready in case somebody gets
sick."
So, finally, gosh, for the first time in years our battles, our struggles
convincing our own NASA management that you needed this stuff went
away--not completely. Got easier because now they're asking for us.
So in a way it was kind of nice for us, because now instead of us
trying to force our way in, they want us. So I think, again, it went
a long way to helping the paradigms, the attitudes about what's needed
for long-duration space flight for ISS. So it made preparation for
ISS a whole lot easier.
Wright: I know that every member of the crew, American and Russian,
not all have been physicians. They've had to undergo some type of
medical training. How was that a challenge to your group, to train
folks to be gone for that long a time, to be self-sufficient? I know
that if I don't feel well, I can go down to my pharmacist or I can
call my doctor, but yet they may be able to call a doctor, but they
may not be able to get what they need. So how did you take care of
that part of the program to make them feel like whatever happened
up there, they were going to be taken care of?
Billica: Again, we started with the Russian experience. They had been
doing this--and I give them credit--successfully for many years, so
they had evolved a fairly solid program in terms of how to prepare
the crews and get them ready. Again, they formed several crews before
a mission and that crew goes through a lot of training, not only to
get them ready for the skills and the technology of the mission, but
also to bring them together as a crew. And they do a pretty good job
of that.
We had some challenges during Shuttle-Mir because we swapped out some
crews, and so the crew that had trained together at the last minute
was changed out, and that presented some challenges to those crews
just in terms of learning real time, "How do we get along with
one another?" because they didn't have the luxury of training
together. Big lesson learned there.
We also had a pretty good idea from the Russians of what sort of things
that they'd encountered medically, so what sort of things were needed.
There are some things that were fairly obvious that we knew to get
ready for that.
By the fact that we assigned one flight surgeon who worked with the
crew the whole time getting ready and then was the doctor there at
the TsUP for our crew member, I think was a huge benefit. It was a
really smart thing to do, in retrospect. We did it initially just
because we only had one or two docs who were willing to do it, but
it makes sense. We also knew it was a good thing to do. So what it
did is it made it so that crew member knew this doctor and was comfortable
with him and willing to really work with him when there were problems.
It wasn't some strange voice or strange person; it was their flight
surgeon. I think that helped a lot when things came up, when the crew
member had questions or concerns, for them to feel comfortable, secure,
confident that we were going to be able to deal with whatever the
situation was.
We do a lot of telemedicine. That's how we practice medicine. Our
patients are in space and our doctors are on the ground. And even
those situations where the astronaut is a physician, the physician
for the crew and that astronaut is still our flight surgeon; you've
just got someone who's a lot better trained and their skills and their
background. But the person who's responsible for the health care issues
is still the flight surgeon on the ground.
So I'm not sure I'm answering your question.
Wright: You have. That brings up another subject. There were several
physicians that flew. Did at any time these physicians turn into be
the physician in residence?
Billica: Absolutely. Some of the things that happened, particularly
with Jerry Linenger and some of the other situations that happened,
there were calls being made by that astronaut physician that contributed
significantly into the decisions about the medical and environmental
situation, having that crew member being a physician, so that when
we talked things over and that physician said, "Well, I've checked
the crew out. I've done a brief exam. Lungs are clear, burns are minor,"
things like that, and we can speak the same language and have that
person on the scene to say with a little bit more confidence, "I
think we're okay."
There were a couple of incidents where that contributed significantly
to the decision about whether we could stay up there and were we good
to continue the mission or not. So, most definitely, I wouldn't want
to play down the benefit of having in long-duration missions one of
the crew members being a trained medical person.
Wright: Because they were able to help with other facts.
Billica: You bet. You bet.
Wright: All the different incidents that happened. We've talked about
American crews, but we know we have cosmonauts that trained here as
well, that flew. How did your area work with these cosmonauts?
Billica: We actually ended up negotiating exchange where, since we
had flight surgeons over in Russia, we had the Russians send a flight
surgeon here. So all the time during the program we had one of the
Russian physicians here and tried to work with them the same way we
wanted to be worked with over in Russia.
The interesting thing is, the concept of a flight surgeon, the concept
of who that person is and what they do and all the things they cover,
there was no equivalent of that in Russia. Russians split things up
very differently, and it took us a while to learn this. In Star City,
in the Gagarin Cosmonaut Training Center, that's a military establishment.
They have military doctors, but these doctors were responsible for
the pre-flight training and the pre-flight selection. Remember how
they're both together. That's what those doctors do, and they have
their different departments. But they have doctors who do physicals.
They have doctors that do the training. But then those doctors do
not support the mission. That's Institute of Biomedical Problems at
TsUP. So there's another whole team of doctors and a whole different
organization, very separate, very different, that's the medical support
team to the mission. They were not used to working together. The only
time they came together was at the Chief Medical Commission.
So you had a group of doctors who'd been training and working with
the crew, the cosmonauts, in preparation for the mission, then a whole
different group of doctors who did not work and know the crew supporting
the mission in the Mission Control Center. They did not call them
flight surgeons. They were not used to giving them the authority and
responsibility, and there was no one doctor who worked with the crew
through the whole thing on the Russian side. So this was very confusing
to us and confusing to the Russians, because they weren't used to
investing the amount of authority and responsibility into a physician,
a single flight surgeon, that we're used to doing, who is the medical
authority for a mission. So for us to tell the Russians, "Well,
send us a flight surgeon," they didn't even know what we were
talking about. So essentially they ended up sending us a military
physician from Star City to come over here, but then we were expecting
this physician to work with us like a flight surgeon.
So we're essentially, for the first time ever, training Russian physicians
to be the equivalent of a NASA flight surgeon, and we've had, for
a year at a time, we've had a series of them now, great people. We've
enjoyed meeting and working with them. We've trained them up as NASA
flight surgeons, and then they go back now, and now they're working
back in Russia. This has been great for communication and building
a rapport.
So in answer to your question, when cosmonauts were over here, we
said to those Russian physicians, "All right. You are the flight
surgeon for these cosmonauts." And we would have to train and
explain to these Russian physicians what was expected of them, but
they were expected to essentially be the medical liaison with their
cosmonauts. And all the stuff that we do then, we did with that Russian
flight surgeon, I think in a lot of cases surprising the Russians
at the amount we expected this doctor to do, of course, supervising
from our point of view. But it worked out great. We gave them an office
and they're teamed up with our flight surgeons, and it went real well.
Wright: That's a great benefit for their program, that first-hand
experience.
Billica: Yes, it's really paying off for ISS now, because now as we
get into this and we're meeting all of the international partners,
saying, "We expect whenever you have someone flying on ISS that
you provide a flight surgeon," the Russians now know what we're
talking about. So the first few increments of International Space
Station, the doctors who've been over here from the Russians are the
ones they're assigning as their flight surgeons for International
Space Station. So that went real well.
Wright: We've talked a lot about the program and your staff and the
team as a whole, but we really haven't talked about your personal
experiences. You've worked so many times, so many years with Americans
and American space and some international partners, but this has been
a full-time international partnership. Share some of the experiences
personally that you've felt your growth or maybe even a high point
or a low point that you could share with us, something personal.
Billica: For me it has been very enriching. I think it's taken me
to another level of what the job is, and to go from just taking care
of the NASA program to now having to grow into someone who is negotiating
on an international level medical issues. We've done some things that
when you step back and watch what's going on and say, "My gosh,
we're here negotiating standards, medical standards, with other countries
and coming up with joint standards and protocols between the United
States and Russia on how you practice medicine." We're not sure
that that's really ever been done before, and we're setting some precedents.
So for me initially, we sent our first two flight surgeons over there,
Mike Barratt and Dave Ward, just two topnotch people, and they're
over there and I'm back here having the usual misconceptions, suspicions,
paranoia about the Russians whatever. Up until that time, the only
people from the medical side who had ever gone over to Russia were
high-level management, and I'm kind of half management, half flight
surgeon. I'm kind of the interface between them. I still like to think
of myself as a flight surgeon. That's my background and that's what
I've done, and they stuck me in a management position. But I still
work missions, so I'm kind of the point in between.
The only doctors who had ever gone over were high-level management,
who would go over, and this is not to say anything bad about them,
but in their role they would go over to Moscow and meet in meeting
rooms and things. So then we sent our flight surgeons over, and they're
over there in the trenches. They're over there in Star City doing
training, dealing with this tug-of-war day-to-day, and they're calling
me, saying, "This is not easy. We've got problems. We need help.
We need you to come over here."
So with some uncertainty and trepidation, I agreed to go over. They
said to me, "Now, when you come over here, you don't go to Moscow
and stay in a nice fancy hotel. You come to Star City. We'll find
you a room over here in the Prophy where we're training and where
we're living, and we want you to stay here with us and see what it's
really like." Because they're telling me that they've got some
problems and some tough times.
So I go, "Okay." I've done a lot of travel, but never to
Russia before, so my first experience was to go over there by myself.
Of course, it's very different coming in. It's not the same as going
to England or France or something like this. It's a different experience.
So I end up over in Star City and they meet me, fortunately. It's
getting through Customs and even just any of that, it's different.
And they meet me and take me out to Star City. So I stayed out in
Star City with the team for a couple of weeks and got to really know
what it was like. And there I started meeting with the true counterparts--the
head of medicine from IBMP and the head of medicine from Star City,
where before over here we'd met a couple of times, but never on their
turf. So there were a lot of late-night meetings, sitting in a room,
negotiating, arguing, working out all of these things. I told you
we had challenges about really getting down to the detail nitty-gritty,
staying up late night. That first time we ended up writing a joint
medical requirements document, and we stayed up, we worked all night.
I was staying in the Orbita, which is their equivalent of a hotel
there at Star City. Very different. And still very early in the program,
so they're suspicious. They've got guards. It's military. So I'm up
late at night with my team, working on this document, up at two and
three in the morning, walking back through the snow to the Orbita.
It's shut down. There was one night--when you leave, you left your
key at the counter; you didn't take it with you. And there was one
night I got back there about two or three in the morning and they
had shut down. There was no one around. So there was no way for me
to get to my room. So I ended up sleeping on the couch in the lobby
of the Orbita that night, worrying at any moment that some guard,
military guard, was going to come in and I would wake up with some
guard sitting there wondering who was this American sleeping in the
lobby of the hotel or something. So, just little adventures like that.
It wasn't ever a problem.
What happened that first time was, I really got to know the Russian
counterparts. I got to really see what it was really like, because
I was the first one of the management that actually went over there.
I experienced a camaraderie of the team there in Star City and they
got to know me, and I got to know them. It made a huge difference,
because now when they would call back, I knew what it was really like.
One thing that happened that was really special was, one of the Russian
flight surgeons who had been over here and had gotten to know me was
now back over there in Star City. Dr. Morgun, who is my counterpart,
Valeri Morgun, who is the head of medical at Star City, invited me
one night after everything had shut down, to come over to their training
facility where they have their sauna and their pool and their workout
facility. He showed me around. We had no interpreter; it was just
Dr. Morgun and myself and this Russian flight surgeon. He showed me
the traditional Russian ceremony of the sauna and the bath. So we
had refreshments, and it was just us. We had some refreshments and
it was just a whole different setting, and toasts and all of that,
and little snacks and things. We started out with that. Then we went
in the sauna and he explained all the tradition to me. Then we would
go swim in the pool and then come back in the sauna, and swim in the
pool, and do that bath tradition that the Russians have, and then
retired back to a room and continued. And we got to know one another
and we established a relationship which we didn't have before.
Now, I had done Russian cultural training before all of this, to prepare,
so I was prepared, but this was different. And things changed after
this. I mean, this went well into the night and we became friends.
So even though after that we would have tough negotiations, and I
had also built a relationship with Dr. Bogamolov, who was the head
of medical for IBMP, and after this, whenever they came here, we always
would go--I would take them out to dinner, and we didn't do a lot
of this again. This was really the only time we did this. This was
my first time there. But it changed the whole relationship and we're
friends now.
As a result of that, I think it made a huge difference in our relationships.
The suspicions were gone. There's still the struggles. There's still
the arguments. But what I learned was that you could have the arguments
in a meeting, but now there was a level of comfort and trust. It's
made a huge difference. Mike Barratt and Dave Ward said this made
a huge difference. It changed everything. So that was a real turning
point. I've made many trips after that. I've lost count of how many
times I've gone to Russia now and done this.
The other thing I've learned was how to negotiate with the Russians,
and I'm told I'm good at it. It's a different way of thinking and
you concentrate. It's very draining, but I've developed the ability--and
I sound like I'm bragging here.
Wright: No, no, no.
Billica: But I've developed the ability to figure out what they really
want. I would sit there and we'd be talking, intense several-hour
meetings, and they're going on and on about something and I'm just
sitting there trying to figure out what is it they really--what's
the real point here? Because they don't come to the point; they talk
around it, and you have to kind of figure out what is it they're really
after. Then you have to figure out how to address the point without
addressing it, but letting them know, "Oh, all right. I figured
out what you want now," and kind of deal with it.
But I had to learn that they say no and don't mean no, and that's
just on any negotiation. They start out saying no. Then that's your
starting point and you go from there. They don't mean it, but they're
just trying to see what the real agreement level is. We'd just go
over and it was a problem initially, where you'd sit down at a meeting
and they'd say no, and you'd go, "Okay, they said no." And
you'd leave, and they'd be thinking, "Well, that must not have
been very important. We said no and they left." They're ready
for you to get in with it here and get emotional and pound the table
and leave the room.
We got into all of that and did that several times with them on things,
sitting there and learning how to use an interpreter to make things
work and not look at the interpreter, but instead be right eye to
eye with them. Based on some of the earlier things I described to
you, we had some really emotional "get up, leave the room, storming,
pounding on the table" negotiations, where they were insisting
that things would be done their way and I was drawing the line, saying,
"Absolutely not." And coming back the next day after huddling
with your management. So we did a lot of that kind of stuff.
It's been real interesting then to take that and then, as a result
of it, have some international discussions where you've got the Russians
on one side and the Japanese on the other, where the Japanese always
say yes and don't mean it, because they're so polite and they're trying
to keep everything comfortable. So here we're in the middle of a meeting
with the Russians saying no and the Japanese saying yes, and nobody
means what they're saying, and trying to figure out.
So I've learned a lot about international negotiations. I've learned
a lot about the Russian culture. I've gotten to where we've basically--the
first time I went over there, it was like a honeymoon. They treated
me great. We did the sauna thing. They showed me around. I came back
from that first meeting just on an emotional high. "Isn't this
wonderful! Isn't this going to be great." Then went back fairly
soon thereafter there and really had to deal with a lot of the conflicts,
and came back with an emotional low, thinking, "This is not going
to be easy. I'm not going to enjoy this. Those dang Russians,"
you know. And then we found the common ground and now it's a great
thing. I enjoy working with them. There are still struggles. There
are still things we don't agree with them on. There are still things
even now, getting ready for ISS. They were over here with other partners.
These same people, Dr. Morgun, Dr. Bogamolov, and their staff, are
the team that we're working with for International Space Station.
So we're now starting over again, figuring out what's going to be
the precedent for Space Station.
I know I've rambled, but those are some of the memories and some of
the experiences.
Wright: No, that's exactly what we want to hear. I'm sure it's been
very reassuring to them to know that you have been with them the entire
time. That's been a constant. I know that in any negotiations it helps
when you get to know somebody so that you can continue on with them
and not change that pattern out.
Billica: Yes. I think of Star City and I think of the Russian staff
who supports our team over there in the Prophylactory. They're such
wonderful people and have taken such good care of our staff, and because
of that first time I stayed over there with them, and sometimes subsequent
I've stayed with them, they're just always so delighted to see me.
I get my wife to help me prepare some gifts, maybe some skin-care
things or some gifts or something, so I show up. And they've never
met my wife, but I always come and say, "Here's some gifts for
you from my wife." And so then they send stuff back. Occasionally
they've sent something back and say, "This is a gift back for
your wife."
It's just been such a treat with my flight surgeons and some of the
people when I'm staying in Moscow, that we'll meet and then we'll
go and we'll wander around Moscow just to see the culture and the
tradition, and go to some of the Russian restaurants. It's just been
a real treat.
It's been a real eye-opening experience in terms of the Russian way
of practicing medicine and how they have combined a lot of the Eastern
approaches--the herbal and holistic and some of the other aspects
and some of the things that they do and how they have evolved their
health care without the technology that we have. So how then have
they evolved how to take care of people without the reliance on technology
that we developed?
Wright: And that we've learned a lot from that? You've been able to
study their methods as well, to see if some could be put here?
Billica: Yes. And some of the things that they do in space for countermeasures
that we don't do, and we're still trying to figure out is there any
validity to this or not, and is this something we need to agree to
for Space Station, or is this something we want to create an exception
and say, "We'll agree for Space Station to have the capability,
but you're still going to do some things differently than we do,"
and now maybe we'll learn a little bit more and see who's got the
best way.
Wright: Let's take a look.
Billica: Okay.
Wright: If you'll remember, as you're walking us through this, we
do have audio going as well, so if you can tell us what it is as well
as show it to us, we'd love to have your tour.
Billica: Okay. Let me start over here with the medical kits. What
we started out with when we set Norm up, we took a couple of our Shuttle
medical kits, which is what these two blue containers are, that are,
oh, I don't know, cubes of eight inches square. One of them is the
emergency medical kit that has in it a lot of our emergency medical
equipment: stethoscope and otopthalmoscope [phonetic], the medicines
that would be used in a medical emergency, that you would find in
an emergency room for a heart attack or a bad problem, with the injectors.
All these pouches have different medicines and things in them. It's
a very tightly packed kit. It also has the blood pressure cuff and
the otopthalmoscope and things to do an emergency exam.
We basically just modified these two kits. The second one here is
called the medications and bandage kit, and it's full of bandages
and medicines. These are all pill bottles and things, and bandages.
We just took these two kits--this is a subset of what we fly on Shuttle--and
modified them with things that we thought would be more appropriate
for long mission, and sent these couple of kits up with Norm. Every
time a Shuttle went up, we would send a new kit, restock, and bring
the old ones home, and just kind of swap them out each time.
As the missions went on and we realized there were some other needs,
we made some additional kits specifically for the Mir program that
we started sending up in addition. This one, we called it the medical
resupply kit, and everything in these kits is both in Russian and
English. This is where one of the books that Mike Barratt may have
showed you, where we came up with a book, just as we do for the other
programs, that explained what's in the kits, how to use them, what
medical problems that you would use them for, in Russian and English.
Of course, all of this stuff not only had to go through our certification,
but then it also had to go through the Russian system and for them
to say, "What is this? What's the danger?" We had lots of
discussions on that and everything.
So some things that are in this kit, for example, the resupply kit,
we've got a clinical analyzer that would do blood tests and would
allow you to get tests on your blood sugar and your electrolytes and
sodium and things. This was used to help monitor and diagnose how
the crew members were doing. You can see this is something that a
technology that we developed where it's a modification of something
that's off the shelf, and here's these little cartridges, but it basically
uses just a little bit of blood and you're able to run this through
and get blood tests from it.
We also have a real small pulse oximeter that we modified for space
flight, that essentially allows you to check blood oxygen and things
like that just from placing this on your finger and getting data.
This was all miniaturized and new technology that the Russians did
not have, that expanded our capabilities to diagnose and monitor things.
There's also additional IV fluids and bandages and things that we
learned that we needed. I mean, they had some heart arrhythmias up
there, the crew--I can't say who and I can't get into specifics. There
were cuts and there were lacerations; there were skin infections;
there were foreign bodies in eyes. After some of the fire, there was
some smoke inhalation. There were some other spills and things that
occurred where we may have had toxic exposures. So we learned that
we needed this sort of stuff. Some of those things happened with the
Russian crews, some with ours, and it got to the point where the Russian
crews were using our medical kits as well. And it got to the point
where the Russians were asking for things. At the end of the program,
they asked us to leave a lot of our stuff up there. So now that Andy's
come home, some of this stuff I'm showing you is still on Mir for
them to use.
Then we had another kit that's our extended duration pack that we
put together for the mission that we added even more stuff into. So
again you open this up. This is all additional medicines and things
that are in the kits. You see how it's designed and organized with
different pallets. It's quite a packing job, actually, with things
stuffed in. Then this is also our airway supplies if we had to start
an airway. These are different aspects of putting an airway together
if somebody needed that. This is now starting to get into emergency
medical equipment and things like that, that you'd find in an ambulance,
that we traditionally fly on the Shuttle. Some of this they had. Some
of this they didn't have up on the Mir, so we looked at that with
them and agreed that we needed the capability in space at any time
to respond to a medical emergency, stabilize them so that we could
transport and have a good chance of getting them home.
We've learned that the body changes in space and there's a lot of
things that are different about the physiology and how it works, and
we don't know whether some of that triggers medical problems or just
puts them more susceptible to it, but we have seen some heart arrhythmias,
we've seen some changes. The Russians have even brought one of their
crew members home early because of heart problems, not during Mir,
but earlier. They've had people that once they've come home right
after the mission they've had some heart problems that may have developed
during the mission.
So as a result, we agreed there needs to be a defibrillator and a
monitor. So we developed an off-the-shelf defibrillator that then
was modified for space flight, that real quick could be deployed and
set up with the cables and get a rhythm and, if necessary, to defibrillate.
This was the first time a defibrillator's ever been flown in space.
It's actually now part of the Shuttle program and will be part of
the Space Station program.
Along with that, actually, you couldn't do a lot of medical procedures
or couldn't defibrillate or something like that with someone just
floating around. Medical restraint is an issue. So we went and we
sent some of our biomedical engineers over to their mockups to look
and see where would we do all of this. They designed this pallet,
this medical restraint, which unfolds, that goes on the table in the
Mir, the galley table, that these things actually would hook around
the legs of the table and then you could strap a person in. It has
insulation in it so that if you defibrillated, the shock's not going
to go into the structure of the--we're not going to send the Mir into
some kind of out-of-control spiral there. This is the precursor of
the medical restraint that we're going to fly on Space Station. So
we had to do this.
Now, the other things that we had to do were some environmental monitoring.
These are some things that have been developed. Some of this is new
technology that doesn't exist outside the space program that's pretty
exciting. But we had an air sample analyzer that would take air samples
and then we would bring this down. We'd take several samples and bring
it down and analyze it and produce a report. This played a big role
in determining whether the atmosphere was safe. So these sorts of
things were used, and you could get several samples. You basically
turn it to the next sample you need and then just turn it on for twenty-four
hours and it actually brings in air. Then turn it off and then later
get the next one.
We also have these grab samples. This is basically a bottle with a
vacuum in, that after an event, if you just want to get a sample of
the air, you just open this up and it gets the air. You close it and
we bring it down, and now we've got air from the Mir after the fire
or after something, and we can see what it really was.
We have a combustion products analyzer with some new technology that
allows us to actually get a real-time reading of carbon monoxide,
hydrogen, chloride, hydrogen fluoride, and some other contaminants
that would tell you real time do you have an unsafe atmosphere. This
is something that they didn't have the ability to do. This was used
quite often, and there were some times when we had some abnormal readings
that we were able to track and say, "All right. Let's make sure
this comes back down to normal." So this played a big role.
We had to put together, because of a lot of the science equipments
that we were doing, it was possible that we could end up with some
formaldehyde, and the Russians were very concerned about things like
this, as were we. These are just little samples of formaldehyde that
you would see some color changes to. They hadn't designed their air
filtration system on Mir to handle some of the stuff that we wanted
to send up there to do science, and so we had to come up with our
own ways of monitoring, to reassure that we wouldn't create some problems.
So these are just some of the things that we put together and designed.
It's not everything, but it's an example of things that we had to
then contribute, where we started out just being a guest and we ended
up being a partner. Any questions about some of this?
Wright: It's fascinating. Any questions for the medical equipment?
Davison: I have one. You said that you adapted this equipment to the
Mir. Did you end up changing some of the equipment as well for ISS
through what you learned on Mir?
Billica: We basically were already preparing equipment for ISS, and
the timing is such that by the time we're done with Phase One, we
had to be well along with-- [Brief tape interruption]
... exercise equipment, the treadmill, as a result of our experience
on Mir. And we've added a resistive exercise devise which we didn't
have before. So, yes, I guess there are some things we've changed
and done different, but these things that I've shown you, other than
maybe changing what some of the medicines are, these were well along
in their ISS design. In fact, if that weren't the case, we probably
wouldn't have been able to fly them on Mir if they weren't as far
along, getting ready for ISS as they were. So, for us it's more just
a nice testbed and proving ground that we're on the right track.
Wright: We started our conversation and you listed all these many,
many areas that your group takes care of regarding Shuttle-Mir Program.
Was there one more difficult than the other, or were they all equally
challenging?
Billica: There's two areas that we've probably grown the most in,
and I wouldn't say that they were difficult, but we probably had the
farthest to go, because they weren't things that we typically had
to do for Shuttle. That, number one, is the area of behavioral support,
the psychology support. The other area is the physical medicine and
physical rehabilitation. For a week to a week and a half, two-week-long
Shuttle mission, neither of those are big deals, but for a several-month
mission and deployed overseas and those sorts of things, they suddenly
became very important and very big deals.
We, in the time period of Phase One of Shuttle-Mir, had to build up
a program in both of those areas from scratch and put a team together.
It was not only a challenge for us, but it required some changing
and thinking of the management and the people back here at Johnson
Space Center, because the Mir Program is going on over in Russia and
it's real easy for the people here at Johnson Space Center for it
to be out of sight, out of mind, and for the people over here to still
have the Shuttle mentality, because they're still doing Shuttle missions
and they're thinking short, quick.
So we start coming to the people over here, saying, "We need
to put together a psychology program, behavioral support. We need
to do some crew training. We need to do some family support. We need
to come up with some things that will be of entertainment value and
relaxation value. We need ham radio communications. We need some people
to help with the training and selection of the crews." All of
these sorts of things that fit into a behavioral and performance support
program. And had to go from concept to reality and convince the management
that it was needed. So that was a challenge and a lot of lessons learned,
and they did a good job, a real good job.
Wright: Was this due to a result of what you were hearing back from
crew members or was this something you did as more of a preventative,
or maybe a combination of both?
Billica: All of the above, realizing back from Skylab, realizing from
looking at some of the analog groups that we study--Antarctica, submarines,
things like that--that part of our epidemiology we study other groups,
what kind of problems, what kind of needs do they have, that we can
then look at and apply to the space program. So we expected there
to be some issues in this area. We also knew this from talking to
the Russians and we learned it very quickly from the experiences as
it happened. So, a steep learning curve. It grew as it went.
The same thing for the physical medicine and rehabilitation, that
before this program, we did not have a structured exercise fitness
program for the astronauts. We had a gym that we supported and stuff
was there, but we didn't require any of them to do any kind of structured
program. They just did whatever they felt like. As we started going
into this, we hired an exercise physiologist strength and conditioning
coach, a trainer, who then brought on some other trainers and a physical
therapist, and we put together a structured program for crew members
doing these long flights, and put them into a mandatory fitness and
training program that was monitored, and then led into what they did
during the mission.
Then this was the same team that when the people came back, they were
very involved with getting them strong again, getting their bone density
back, their strength back, their coordination, all of that, and actually
put them through, as Andy Thomas is going through as we speak, a reconditioning,
recovery, rehabilitation program. And none of that existed, and we
had to put the program together. We called in experts from all over
the country to help design the program, leading experts in rehabilitation
and physical medicine to come in and advise us and help us put a program
together. We now have our own program that we do, that we have a facility.
The old WETF, the old water and training facility that's not used
now, we now have. We've put in exercise equipment. We have a treatment
room there and we have the pool that is now part of our medical facilities
for rehabilitation that we do.
So, both of those areas, I wouldn't say that they were problems, but
we'd not done that before, and we had to build up programs from scratch
and put them in place. Those were probably two of the biggest areas.
The main problem areas were things I've already described to you just
in terms of learning how to do joint medical support with the Russians.
That we had some problems with and really had some struggles with,
but we succeeded.
Wright: Now that Phase One's closing down, are things going to get
back to whatever normal was before? Are you looking at things to have
a different type of normality for your department?
Billica: That's a good way of putting it: a different type of normality.
I mean, I look forward to the break. I'm thankful that it's over.
It's been a very strain and drain on our resources. We did staff up
somewhat, but we have always been right at the limit of our resources
here in supporting this program, and it has burned out some of our
people. We've had some people leave after doing it, just like some
of the astronauts, I think, got burned out and left. Some of our best
doctors and some of our best engineers, biomedical engineers, after
doing their part of the program, left. That was real unfortunate.
I think we just used them up and burned them out. That was not our
desire. So it wasn't easy on everybody.
So, thankful we're through it, learned a lot, glad that this part's
over. I think it's been a real historic part of our program and I
think there will be a lot of looking back on it, going, "Wow!
That was really something special." But looking forward to now
having a few months' break here to kind of figure out what did we
learn, what do we need to do now, and giving people a break and moving
on with ISS.
But we've got four crews training for ISS. I've still got doctors
and people over in Russia. So, really, it's just pressing on. The
thing that's different, however, is we're not guests of ISS; we're
the lead partner for International Space Station, so now it's sort
of like, "All right. We've done it your way. We've learned a
lot. Now we're in charge." And we have a little bit more control
over how things are.
We're not under the Russian authority in terms of the medical, so
there's some significant changes in how we're doing business for ISS
versus what we had done for Phase One. For example, our crew members
don't have to go be approved by the Russian Chief Medical Commission
now. They approve their crew members, we approve ours. But as a result
of Phase One, we've got joint standards. So, I mean, like I said,
if we were starting now for ISS, having to come up with the joint
program with the Russians and were having to go through the struggles
and fights and negotiations now that we did at the beginning of Phase
One, I don't know that we would be able to do it and meet the time
line for ISS.
So, there is some normalcy. There is a sense of stand-down a little
bit, but not completely, because we're delivering hardware for ISS,
we've got crews over there training, so I've got docs over there back
in Russia, and getting ready to send Mike Barratt back again. So it's
changed. We're in an international mode now, and we're not out of
it. Just because Phase One's over, we're not back to just doing Shuttle
flights. I don't know that I foresee us ever going back to what it
was like before Phase One. When I took over in 1991, I think we had
about 6 flight surgeons; we've now got 15 flight surgeons. They may
be trying to cut us back a little bit, but I don't see us going back
to like what it was.
Wright: There's literally the whole horizon out there to take on,
isn't there.
Billica: Yes.
Wright: Sounds like that with your list, I'm sure it's going to grow
and your contributions will be many to the program. We certainly thank
you for talking with us. Again, thanks and good luck in the future.
[End of interview]