Is The Human Body Ready For A Real Mars Mission?

There's a lot of talk about humans going into deep space. We've got the Artemis missions coming up for humans going to the moon. We've got all kinds of potential ideas for going to Mars, both from the official space agencies as well as various private billionaires who think it would be terrific to send humans to Mars. But going to a place like the moon, which is just a couple of days away. For short periods of time, going into low Earth orbit in the International Space Station is a totally different experience than trying to send humans all the way to Mars and back. You're looking at years of no or very low gravity, constant radiation exposure, tight space where you've got these people in each other's business all the time. You're far away from all of the resources of. planet Earth, and it is just an incredibly hazardous, dangerous trip, and maybe beyond the capability of our current knowledge and expertise. My guest today has spent decades investigating exactly this. Dr. Mark Schellhammer, he is a professor at the School of Medicine at Johns Hopkins University, but formerly he was the chief scientist. for the Human Research Program at NASA, and it was his job to look at the larger case, the health of all of the astronauts, and consider what is the repercussions of trying to send humans on long-duration spaceflight. And there have been a lot of great ideas, a lot of targets, goals, destinations, a lot of work has been done, and yet it has, in many cases, Help us understand how much work has yet to be done. If you want to know just how prepared modern medical sciences, how mission plans are, can we send humans to Mars? This is going to be the interview for you. Mark, how well has science fiction prepared us for the actual realities of spaceflight on the human body? Science fiction? Probably not. I feel like that's our education. Well, true. True. So I'll say. I'm not a huge science fiction fan, for what it's worth, not denigrating it at all. I would say it generally tends to avoid the topic of the human, what happens to the human. Thank So an example that I use, a movie and book that I did enjoy very much is The Martian, of course. And I thought. Obviously, that has a lot to do with the technical side of things. What I thought was good about that was they captured very well the aspect that it's just one damn thing after another when you're in space, you. especially like Mars, right? I mean, right? Yeah, I believe that could have been the byline on the Mars ----. This is one damn thing after another. Same thing with Project Hail Mary. Yes, exactly. Like, wow, what's going to be the next thing? Well, don't ask. It'll be here soon enough. And so that I thought was very real, realistic. Didn't really talk about the toll that enhanced radiation, reduced gravity levels would take on his body. Maybe being at Mars in that partial gravity level will be sufficient to To provide countermeasures, as we call them, for those, the biggest issues there. We don't know, but it's not addressed. But one thing, just as an example of what your question was getting at, near the end of the movie, when the rest of the crew is informed that their crewmate has been... alive all this time and left behind on Mars. And hey, would you guys mind extending your mission by another whatever number of years and going back to get him? And it's like, immediately, no questions asked. Well, sure, we'll do that. That seems a little unrealistic to me. Not that they wouldn't do it. Astronauts, that's what they do. And they would probably do it. But the fact that after something so grueling, so demanding, and you're so close to home, to then say, let's do it all over again without a second thought, I don't think that's realistic to the psychological demands of a setting like that. So that's one aspect. But in general, I would say, except... I don't know. In general, I would say that the science fiction that I'm aware of basically sidesteps the issue, which is unfortunate because, I mean, that's why the book had to be written. Yes, I mean, this is great, and we'll definitely get into that as well. And that is my experience, even watching the TV shows and movies that I respect most deeply, like The Martian. I think about him just being out there exposed on the, you know, he had the entire journey to Mars, then he spends his entire life. Year plus exposed on the surface of Mars to cosmic radiation and solar radiation, and then has to return again. And so he spent like three years just eating radiation. And, and obviously there's like the, well, you now you get a lot of cancers when you get home, which, you know, can be treated hopefully. But I'm like, I'm reporting all the time on issues with the brain issues with your internal organs. Uh, cardiovascular disease, like it just goes on and on and on how this stuff starts, you know, actual damage to the DNA of your actual genome is starting to, to change over time. And it, it's just, it feels like nobody really addresses the, the true nature of what it would be like. And I think the closest example that I can think of is when you listen to stories from mountain climbers who are in the, the death zone. They're above 8,000 meters or 7,000 meters in the Himalayas, and their bodies are falling apart while they are attempting this Herculean effort to get to the top of this mountain. And that feels, to me, a little bit more realistic that the astronauts are just going to be trying to drag themselves across the finish line on a trip to Mars. So, a very good example, a book that brought that to my attention was John Krakauer's book. Yes. Yeah, Into the Something. Yeah, I think that's right. Yeah, Into Thin Air, yeah. Yeah. And right. And I mean, not that I entertained any realistic notions of ever summiting Mount Everest, but okay. You know, it's always kind of in the back of your mind, like, oh, that would be kind of a cool thing to do. And I read that book and I thought, what is the point of this? Like, okay, I get it. It's pushing the boundaries of what it means to be human and what, which I'm very much in favor of. I, that's the reason to go and to send people into space, but just. That book was very compelling in the sense that you go through this very demanding thing and if you're lucky enough to reach the summit, you can't even enjoy the experience because your body is so, has taken a real beating. And I don't think it's necessarily going to be quite that bad, and especially if we do the right research and preparation for a Mars crew, but I would say that if we went tomorrow, It would be, it could well be close to that kind of situation where, you know, maybe technically you could get a crew to Mars, four people, six people, and have them spend some time there, but it wouldn't be pretty. And I don't think they would be able to accomplish the things that you're sending them for. You know, they would just barely, I think, barely be able to survive. And we can do better. We can do better by the crew and we can do better by the mission. So first, let's talk about the risks. What are the dangers? You know, this idea of let's send a crew to Mars. People have proposed sort of a shorter mission or a longer mission. You have to kind of wait for Earth and Mars to line up properly. Right. What are the kinds of factors that your research has led you to sort of expect are going to be problems on that kind of a trip? Right. So, but let me say it's not, and I'll do humility. It's not just my research, right? I, I'm, I'm able to draw upon things that a lot of the research, the research, uh, I'm trying to pull 50 years of human space flight and people on the International Space Station. And yeah. Yeah. So people have been studying this stuff. Even before I got into this business. And that was a long time ago. Um, but some 40, some years ago, uh, where I started. So the community, human space-like community, tends to look at these things in terms of five hazards. These are the actual, like the physical reality of humans in space. Altered gravity, including zero gravity during the trip there and back. Isolation and confinement, which is just what it sounds like. Small number of people, small space, long period of time. Can't get in or out. That obviously has psychological demands. Psychological demands often translate into physical manifestations, cardiovascular stress, immune system function. So, ultra-gravity, isolation, confinement, distance from Earth, which is a distinct one because it means the farther away you get, the less you can rely on help from Earth in terms of resupply and even in terms of communicating because the distance A finite travel time for electromagnetic radiation, the distance you're going to have a significant communication delay. Fourth one, closed and sometimes potentially toxic environments. Not only the planetary surface, which can be pretty nasty on Mars, is pretty nasty, You've got... People, a small number of people inside a small spacecraft for a long period of time, you can't open the doors and windows and air the place out. And they're exercising, and they're using the bathroom, and they're eating. It can get pretty gamey inside a spacecraft. And then the last one, of course, is space radiation. And that's, depending on who you talk to, either the biggest single problem or not such a big deal at all. And we really don't know. It's almost certainly going to increase the lifetime chance of getting cancer for Mars astronauts. But if you get that cancer when you're back on Earth, okay, we can deal with that. I mean, that's the trade-off you made for going to Mars. Do the calculation. Are you willing to do that? If radiation effects hit during the mission, like acute radiation sickness from a solar flare, that's a different story, and we're not quite prepared to deal with that. So those are the five hazards, and those five hazards have consequences. Those consequences are that just about every body system is impacted some way by extended spaceflight. And the ones that people tend to know about are loss of calcium from the bones, which causes them to get weak. Muscle atrophy, cardiovascular system gets lazy. There are changes to the immune system. There's a redistribution of fluids in the body because it's like chronically laying down, but constantly. It's never the 16 hours or so for most of us when we're upright. So the blood that would normally be drawn, blood, cerebrospinal fluid, lymphatic fluid, that would normally... ...tend to be drawn to the lower part of the body is now redistributed, including up in the skull, surrounds the brain. That has consequences that we don't completely understand yet, but they seem to be worse the longer people spend in space. So, I mean, in a nutshell, that's kind of the idea that just about every body system is impacted by these. The physical reality of extended duration human spaceflight you just can't get away from being far from Earth in a radiation environment, zero G, comes with the territory. And the whole point of your book is to ask, are we ready? What will it take to be ready to be able to perform this kind of a mission? And that you mentioned this earlier on, even in this interview, that as it stands today, Okay, yeah, it is mountain climbers gasping for air. dying at the top of Mount Everest, but, but, but each of these problems is known to some level. So what kinds of mitigation strategies are like extremely effective? And then what are the ones that are not very effective? And then what are stuff that we just need more research about? Yeah. So I don't want to say that the sky is falling on everything, that we don't know anything. We do know a lot from a lot of research. We know how bad it is. Well, to a great extent, we know how bad it is, although for Mars, like I said, in some cases, we don't know how bad it is because we haven't had people in space for that long a period of time continuously that far from Earth. So with that level of radiation exposure, deep space radiation is harsher than radiation in low Earth orbit. So those things we just haven't experienced. We haven't experienced the combination of those, which is the real answer to your last question, is it's the combination. But we do know a lot, a fair amount about some of these things. We know that some of the most effective countermeasures are not a surprise. They're things that your mother told you when you were growing up. Exercise, nutrition, get a good night's sleep. All things that are kind of challenging on a space flight, but astronauts, at least on the, what's called the U.S. operating segment, the U.S. side and its allies, as opposed to the Russian segment, U.S. segment of the space station, astronauts exercise for about two hours a day, six days a week. Each individual astronaut. That's a lot of exercise. Hence, wear and tear on the equipment and you're raising the temperature inside. You're expelling a lot of CO2 and a lot of moisture. So that puts, that's the gamey environment that starts to develop inside the spacecraft. And if you've seen pictures of it, the exercise equipment that they have on the International Space Station is really nice, but it's really big and it's really heavy and you're not taking that to Mars. How much do you have to take? We don't know. So that's work in progress. Nutrition, of course, that's, you know, you can at least get a handle on that. But maintaining a viable food supply for, you know, how many foods do you have laying around your house that have at least a three-year shelf life that you would want to eat every day for three years? You know, the idea of fresh foods, yeah. So the idea of fresh fruits and vegetables, unless like in the Martian, you're growing potatoes on the surface, that's going to be nothing but a dream. So those are exercise, nutrition, sleep. Those are things, there are others, especially for the fluid shift issue. We're still getting a handle on that and what some of the countermeasures might be to try to maintain. Thank A fluid distribution that's more like it is on Earth, just basically keep the fluids out of the head. Right, I had seen like a negative pressure sleeping bag. Lower body negative pressure, exactly. Yep, there's a group that's working on that, and that's, it's just what it sounds like. You draw a vacuum on the lower part of the body you. or try to suck the fluids back down, and they're pretty successful, whether it's viable to do that. How long do you have to do that? Can you do it an hour a day? Do you need to do it for eight hours a day every day? We don't know what the dosing would be necessary. And then if the dosing is on the order of hours a day, then it's got to be portable. Okay. Yes, sleeping in it would be a great idea, and there is work based on that. What we have... Well, there's also, like I said, every body system is impacted, the immune system, the gut microbiome, all the organisms that are not your cells, but microorganisms that live inside the intestines and then the gut. Those are changed during spaceflight. Now, maybe not in bad ways, maybe in benign ways. But we don't know for sure yet. They do change. And so if there's a solar flare and then you're taking a lot of antibiotics, for example, well, those are two things that could have a pretty big impact, negative impact on the gut microbiome. How do you get it to recover back to its normal state? Not clear yet. Because you're living in an isolated environment, so you don't have the normal turnover of stuff that I can get just by opening a window and you're getting fresh air, which carries another set of challenges for the immune system and more microorganisms. You don't have that luxury on a mission like that. Those are, like I said, there's work going on on those, but the thing that concerns me the most is what I alluded to. We don't have an understanding of the possible synergistic interactions of these stressors, elevated radiation exposure combined with extended exposure to zero G. We don't know what that looks like. It might be that it's just an additive effect. And so as you provide countermeasures for the radiation part, countermeasures for the zero-g part, you'll be fine. But there could be a nasty interaction that we haven't seen yet. And if there's one thing we know about sending humans into space is that we are regularly surprised by something that happens to the body in space. Things that happen that we have not seen in space before after 60-some years, and you think, well, where did that come from? Deep vein thrombosis, blood clot in the jugular vein a few years ago after 60-some years in space. Potentially fatal, if that were on a Mars mission. First ever medical evacuation from the space station earlier this year. We'd never had to do that before. So, Being at Mars or on your way to Mars is a bad time for something unexpected medically to take place, and yet it's almost sure to happen, possibly because of some combination. My life and the lives of everybody that I know, I can't think of many three-year periods that there hasn't been some kind of medical... Issue that required some level of intervention from a tooth infection to dehydration from, you know, bad diarrhea to heart disease, all kinds of things. And and you're like running that those numbers. And if your crew is dependent, if it's slimmed down, you just got like the bare minimum crew and they're all dependent on each other. You you have one person out of commission for some period of time that. Compounds and cascades throughout the entire mission. That's exactly right. Yep. What you want to do is figure out how to maintain the resilience of the mission, which means the resilience of the crew, which means their ability to cover for each other, to get their jobs done under very demanding circumstances, which means their bodies are changing. Because of the stresses of spaceflight, and, you know, they have a job to do, a very demanding job, and the equipment is also in a stressful environment, so they spend, astronauts on the space station, now the space station has been up in space now for decades, so that's a different set of parameters, but astronauts spend a lot of time on the space station doing regular maintenance and repairs and things like that. Probably going to be the case, certainly in the later stages of a Mars mission, when the environment has taken its toll. And the crew depends on the spacecraft to keep them alive and functioning. In turn, so that they can repair the spacecraft so that it can do its job while the crew is doing its job. So it's this, what we're trying to convey is that it's this tightly woven network that you cannot just say, let's just design the spacecraft. We know how much food and water and oxygen the crew needs, and we know how much excrement they produce, and that's fine. We'll plug that into the equations and we'll design a spacecraft. And we'll stick the humans in at the very end of the design process. That's not going to work anymore. That's kind of, I mean, I'm exaggerating a little bit for effect, but to some extent, that's still kind of the mentality that the spacecraft, the technology is the hard part. The humans will figure it out because humans are humans and astronauts are remarkable people. And they generally do figure it out. But on a Mars mission, you're going to be pushing everything to the limits. We need to do better. I just hope they figure it out. Yeah, I mean, you can imagine the design process where someone goes, okay, what if this breaks? Okay, we're going to have to use the backup. Okay, what if the backup breaks? And then what if this other thing breaks? And then also someone's got diarrhea and then that person is having a toothache and this person has gotten depressed. What then, right? Right. And it's, and you, and you keep this, keep this boat flying for. For three years. Exactly right. Compounds. And the NASA process on the human side is very much kind of engineering driven. The idea is you identify the known problems, right? Possible bone fracture due to losing... calcium, muscle atrophy, immune system. You delineate those, prioritize them, implement countermeasures. It's a very much kind of an operational and engineering approach. But it doesn't, that approach, and that approach has obviously been very successful because we send people to space all the time and they come back and they do really well. But Mars is going to be so complicated and there's going to be unforeseen effects that we haven't captured and mitigating the known problems, each on their own, well then what's the thing that's going to come back and kill you? It's the interactions and it's the unknown thing that you didn't think to mitigate because we just never saw it before. Well, yeah, I can guarantee you will see something you've never seen before. Right. Yeah, that long. That many rolls of the dice. So, you know, I think on the physiology side, I mean, we've had astronauts be in space for the better part of a year. They've exercised. They've, as you said, mitigated many of these issues. Some of the ones on the margins, they're still working their way through, but they are still protected by the Earth's magnetosphere. Once you are outside the magnetosphere, I mean, we have a one-week trip in the Artemis 2 mission. We've had all of the Apollo missions to the moon. And that's, like, that's the sum knowledge of what deep space does to the human body. So do we have a sense on really, because, like... It feels like almost every week or every couple of weeks at Universe Today, we're reporting on here's what radiation will probably do to the liver. And here's what it will probably do to the brain. And here's what it's kind of doing to the cardiovascular system. And sometimes it's good news. Usually it's bad news. And yet these are all sort of taken in isolation. Imagine it's the It's the whole system. And as you mentioned, your gut microbiome. So do we, do we, like. Is it possible that a human being who tries to go to Mars just dies? There's just no way to keep a human being alive without some kind of radiation shielding to be able to get there and back. It's certainly possible. I think that's unlikely. I mean, radiation, boy, I cannot really wrap my head around the radiation question. I mean, the questions you posed are the right questions. They're pertinent questions. A lot of this kind of research is done in animal models, in isolation, with plants, with cells. NASA has a facility on Long Island, Brookhaven, where they can use particular types of ions to irradiate. Samples of various kinds, and they try to mimic the galactic cosmic radiation, including very fast-moving heavy ions in deep space. But there's a limit to what you can do with the simulation. And if you want to simulate the dose, the total dose of exposure in any reasonable period of time, because you have a research project to do, Well, then you're basically taking... Three years of radiation exposure and putting it down to several hours, maybe a few days. Well, now you could potentially be swamping the internal DNA repair mechanisms that on a longer basis would be perfectly fine. But now they're overwhelmed because it all comes at once. So the idea of, and then there's the question of extrapolating from non-human models to humans. And there are, of course, ways that you might mitigate these things operationally. It turns out hydrocarbons, including water, are pretty good shielding material for some forms of radiation. So, You've probably heard this before from spacecraft people, right? let's Take a part of your spacecraft and store the water around the circumference of that part. That's your fallout shelter, basically. get As long as you have sufficient warning, the crew can go in there and maybe be relatively protected for a certain amount of time, started. if they have the warning and if it's sufficiently good protection. Other than that, we don't know. You know, you start to talk about potential countermeasures like banking your stem cells. You know, the stem cells are the cells that are basically undifferentiated in the body. They become what they need to be later on in the course of development. So you take your individual stem cells out of your body, put them in a jar, take them on the spaceflight with you, put that jar inside a heavily shielded part of the spacecraft, And then. Absolute worst case scenario, you get swamped by radiation, pull out your stem cells and hope that you can regenerate the cells that your body needs. But the first time that that's going to happen is going to be on the mission. Right. I mean, there's so little concrete knowledge about what will actually happen that it's really... I just find that the discourse right now is just not that useful. So on the one hand, you have like the people who really want to send humans to Mars, people who perhaps want to build cities on Mars, and people who've proposed all kinds of really very cool multi-year missions to Mars who are like, don't worry about the radiation. It's fine. It's no problem. And then you have on the, on the other side, you know, people saying, actually. When you're having three years of cosmic rays to your brain, also to your cardiovascular system, also to your lungs, also to your internal organs, kidneys, liver, that no physical form can handle that. And so then we need to mitigate it in some manner. As you said, you know, you're talking about mitigation techniques. You surround yourself in water. You build a fort out of your electronic equipment and you spend some time inside. How much time? How thick is the fort? How much water? You know, do we need it always there because it is just even like a little bit is a problem? Because I forget the number. It's like 200 times as much radiation when you're on, say, the surface of the moon than when you're protected by the Earth's magnetosphere. Like, it's a lot. It's a lot. Yeah. And, and so these are the kinds of questions. And, and so, and that's where I think I, you know, I went back to my question when I opened up about, about science fiction is that science fiction is fine. It's probably fine. Don't worry about it. You know, like, no, like they'll be in tremendous pain, all of their various functions, you know, wash out, you know, where someone has had radiation treatment and on steroids and they get, you know, it doesn't go well. And, and so we just don't know on that side because nobody has done the experiment. And, and so even this idea, like, do you feel like we are anywhere near being able to say, okay, let's put together a team of humans to go to a mission to Mars in the 2030s. Or do we still have 50 more years of proper testing that needs to be done before we can say, yeah, it's, it's the kind of thing that's safe. So I would say, first of all, the premise of your question is, I believe, exactly right. We just don't know. There's just a lot that we don't know. Now, I'm not saying we will never know. So to your last part of your question, it always seems that a human mission to Mars is 20 years away. Yes. Right? It's been that way for like 30 or 40 years. Yeah, like shortly after fusion. Exactly right. And something else always comes up. Right now, we're going to the moon first, and then we'll go to Mars. Fine. I'm not quibbling about that decision. It's actually a good idea to learn at the moon a lot of things you'll need for Mars. I just hope it doesn't become a permanent detour, and that eventually you will go. So I would say. Realistically, 25 to 30 years before, assuming that people start to take seriously the kinds of issues that we're talking about. The moon is one place to start taking these things seriously. You can do more than just make sure that the people are okay for their time on the moon. You can do things to make sure that, look again, trends, how would these things extrapolate to a three-year Mars mission. But the idea of, I think at some point overall for a Mars mission, we'll have to face the The fact that there's going to be... A significant level of uncertainty about, certainly about the human response to space, because the distance, the time, the exposure, we're just, there's no way to reproduce that until you actually do the mission. So let's face the facts that we need to think of everything, but we can't think of everything. So there's no way that you can mitigate all of the possible things. So this, again, comes back to this idea of resilience. Facing that, how do you design a mission and train the crew so that they can anticipate the unexpected? What kind of monitoring needs to be put in place? Monitoring of the crew, monitoring of the spacecraft. And maybe the best you can do, and it's not so bad, but maybe the best you can do is that you have a computerized AI-based machine learning system that raises a red flag and it says, I'm seeing a troubling trend in... Something. There's a pattern of things going on here based on some medical measurements that I'm seeing, the computers it's seeing, and based on how the crew is interacting with each other and the fact that a couple people are starting to slip on their tasks and something. The captain's journal talks about... He talks about... You know, great old ones from another dimension. Yes. Perhaps we've got a problem here. Right. What's this all about? Either he's more perceptive than the rest of the crew or else you have a problem with developing on your head. Whatever it is, the computer could then say, this is outside of the domain of my experience. But that's the whole point. It's outside of the domain of your experience too, which means you might want to pay attention to it. And that might be good enough for the crew to then say, we don't understand what's going on either, but we need to start doing something different here. We need to start exercising more or less or take supplements or do this or whatever. That might be, like I said, that might be as good as it gets, just knowing when you're approaching the boundaries. One of the things I love about the moon as a place to practice is it's actually a more brutal environment than Mars, that the gravity is lower, and so if it turns out that a human being can thrive in one-sixth gravity, then you can just kind of safely assume that they will be fine in one-third gravity on Mars, that the radiation is more intense because there is no atmosphere. And so. On Mars, although there is no global magnetosphere, there's at least a thin atmosphere that can block some of the radiation. The wide open spaces on Mars, like it does, you know, when you watch the Martian, it sort of feels like Southern Jordan, because that's where it was, that there are, you know, perhaps that you've got places you can go. And so I think that... And for every, like, oh, they ran out of toilet paper. Well, we just send that on the next supply mission. It's in their hands in three days. No problem. And so every single one of those gotchas that pops up gets solved if the will is there as quickly as possible and to run those iterations. And. And I think what you had said is like, no one has taken it. The reason we've not gone to Mars is because no one has taken it seriously. Enough to feel comfortable to go to Mars. And so no one's willing to sign off or even take significant steps in that direction. That's part of it. But we don't have the technology at the moment for sending humans safely to Mars. So there's that. But the technology, I don't mean to diminish the difficulty of the technology. But if you decided today. That we want to send people to Mars in five years, you could probably have the rockets and the spacecraft, the closed-loop life support systems and things like that in place. But I still, for reasons that I think should be obvious now, that doesn't solve the entire problem. There's still this messiness of biology and physiology and human behavior and performance. And the fact that you're... You're putting them in a very demanding situation and expecting a lot from them while their bodies are subject to some challenging circumstances. But I mean, the psychology is definitely an issue, but I feel like of all of those, that's one at least that we do have some experience with. People are in submarines. And. So you have this experience where they can't go outside, they're trapped in a tin can with each other for long periods, and we have seen the kinds of behaviors and the kinds of personality traits that work well versus the ones that tend to not work out. For me, that feels like the most solvable of all of the problems. And astronauts are amazing, right? They're all just the best of the best. Absolutely true. Astronauts are incredible, and that's why this particular subject can tend to be kind of a touchy one, especially if there's an astronaut in the room, because they tend to be... You know, they're not supermen, they're, they are, we're super people. I mean, they are super people, but they're not, you know, they're not, uh, uh, they're still humans. And so they are still subject to some, and we've seen this in, in astronauts too, mood, depression, motivation, even on some longer missions. There's an anecdote in the, in the book conveyed by Peggy Whitson about an astronaut who was a crew member who was on her crew, who just had this almost intractable bout of, Of homesickness, like homesickness, homesickness. You're in space for seven days. You'll be okay. Well, it probably was a three, it may have been a three-month mission on ISS, but whatever it was. Yeah. But. But, you know, that's real. These are very real, very real things. The thing, I tend to agree with you that. Through the selection process, through the training process, through the other support mechanisms that you'll have in place, yeah, astronauts would probably do really well. But we need them to do really well, not just tolerate the circumstance, right? They need to get to Mars ready to go, not just saying, I can't wait till this is over. The thing that we haven't experienced, because you've given some examples of good analog environments, Antarctic winter rovers. Turns out to be a pretty good one because it's a relatively small group of people and it's really isolated and it's really dangerous and you cannot come home early. But what you don't have from those is what some researchers call the Earth out of view effect, which is just what it sounds like. And you've seen the pictures of Earth from the Mars rovers, right? It does not look like Earth. It looks like a star. Or on another planet or something. And we don't know. I'm not saying that astronauts are going to look at Earth being so small and they're going to freak out. But that's got a way on your mind. The fact that that makes it very apparent that you are really out there. And you are really on your own. And no one's coming to help you if there's a problem. So you better get along with your crewmates. You better get your act together. That's got to take a toll. So for the people who do hope that one day we will have some future civilization on Mars, do we know if that's even feasible under that kind of gravity radiation environment? Is gestation even possible? We don't know, of course. But let me clarify the context. We're not making the case in the book, I think particularly that we'll be settling or colonizing, living on Mars in any realistic way for even longer than 25 years, I mean decades. I'm trying to make the case that we should definitely go and explore with the idea of coming back. And maybe you can make those missions of exploration longer and longer. But I'm trying to point out that just getting there, exploring and coming back. Wow, that's going to be sufficiently hard for the foreseeable future. So let's at least, let's think about that problem for now. To your question, it's a really good question. Obviously, there are things that we do not know about reproduction in a non-1G environment. Very. It's likely, I would say, based on what little that's known, that if you were to actually give birth, if you can actually do that, on a lower gravity environment, that individual may never be able to come back to Earth because the body has not developed sufficiently strong bones, muscles, cardiovascular system to fight against gravity, sufficiently strong to be on a 1G environment. So, okay, now you've... Throwing your hat over the wall, right? There's, you got to go get it and there's no coming back. But we don't know. And the book that I refer to in this is A City on Mars that makes the, really I think makes the point in a pretty compelling manner that in so many words, imagine the worst possible scenario on Earth that might make you want to flee and live on Mars. You're still better off staying on Earth than trying to live on Mars. Yeah, nuclear war and global warming with Terminator robots roaming the streets, and you still want to be on Earth. You still have air. You still have gravity. You still have the potential to grow plants and things like that. You can walk outside. You still have all these things that we take for granted that, jeez, if you were to start terraforming, Mars would take. Mark, what are you obsessed with right now? I would say that I am obsessed with what exactly we are talking about, the idea of Breaking down disciplinary barriers in research, not only for a spaceflight, but then to transfer that information to healthcare on Earth. So imagine the situation if we can, if not solve this problem, but at least address the problem for a spaceflight. It becomes, this problem is very acute for a Mars mission, right? Relatively small number of high-performing of individuals who basically follow directions, right? So if you tell them to eat and sleep and exercise, they will do that. So you've removed a lot of confounds. I get it. That's not realistic for most of us here on Earth, but that's a good thing, right? It allows us to treat a Mars mission, all space flights really, but certainly a Mars mission. It allows us to treat that as a laboratory. Now, I'm not saying this is why we should send humans to Mars. I'm saying There's other reasons to send humans to Mars. We will be sending humans to Mars. As long as you're doing it, let's face up to the fact that basically you're performing an experiment on the people, the people individually, as a group, as a crew, how they interact with the mission, how they interact with the spacecraft, et cetera, et cetera, et cetera. Well, geez, just change some of the titles on those things slightly. That becomes your position here on Earth. How are you getting along with other people in your life? How are you interacting with the goals? Study on high-functioning individuals in long-term stressful environments or whatever. Exactly. Right. Yeah. And when you go to your doctor, when's the last time your doctor said, well, how are you getting along with your closest friends? How's your... How's your job going? What's the stress level you're getting from that? Do you actually want to get better? I mean, I can throw a bunch of medications at you, but really, do you have a reason to want to get better? Not a crazy question in some cases for people with intractable illnesses, right? So that's the question of what are the goals of your life on a Mars mission? Well, we don't know what the goals of the mission are, but they may have to change. Over the course of the mission, so as people's capabilities change, so how do you capture this and make it so that a Mars mission can be resilient in the face of these challenges? What lessons can we learn from that so that we can make our situations here for primary care medicine, basically, better? And I'm not saying, oh, if we know how to treat Bone loss in space, we can better treat osteoporosis. Yes, that may be true. I'm talking about something on a whole different conceptual level. I'm talking about treating the human body and your place in your environment, broadly construed, as a holistic network and understanding how that... network of interactions, body interactions, social interactions, work interactions, environmental interactions, how that network either leads you to live a good, happy, healthy, productive life or doesn't. That's my obsession. Yeah, like my interactions with my doctor, right? I have a phone appointment with her every six months. She says, you know, I looked at your latest blood test. It all looks great. How's your blood pressure? It's good. Okay, great. Great. We'll talk to you in six months, right? And I can imagine, you know, if she, like, moved in to the house, looked around, talked to my friends, watched me on my daily interactions, and she might have feedback and suggestions and things. Like, actually, you're staying up pretty late playing video games, Fraser. And this is having an impact on your long-term cardiovascular health. Okay, yeah, you're right, you know? Yeah. You could probably get some more protein, you know, we're measuring your protein. So, and then you can imagine, you know, I think this friend is kind of a little toxic. Maybe you should spend less time with them because I think they're kind of bringing you down, right? And maybe, you know, readjust your relationship with your wife a little bit so that, you know, you perhaps are doing more of the housekeeping. So this is perfect. I can imagine this. And so, yeah, and so when you've got this Mars crew. Everything they say, everything they do, every commitment they make to one another and back to mission control, every flick of a knob, every blood test that they're taking nonstop is recorded. And you have this very holistic picture of people who... If it all goes wrong, then they don't come back from Mars. And so they're well-motivated to both fulfill on all of the advice of the doctors back home. And then you get to go, like, and what if we brought this kind of, I mean, I think this is sort of the kind of dream that a lot of people have for AI. Like instead of it creating slop out on the internet, what if you could have this sort of personal assistant that's doing a much better job of helping you manage your health? I agree. I think it should be an AI-assisted. Although it's almost like too much. It could be too much. So the idea of, of course, and nobody likes the big brother aspect of this, astronauts least of all, right? They're high-performing individuals. They don't want to be monitored, micromanaged. But it's the way that it's conveyed. And we make this point in later stages of the book to say that the idea isn't to give mission control. insight into every little aspect of what you're doing. The idea is to give, to empower you, the crew, so that you don't need to rely on mission control to tell you, oh, you guys are on a bad trajectory, you know, in terms of health and performance. Like, no, it empowers you just like if you transferred this to your medical situation on earth, it's empowering you to patient. To ask better questions from your doctor, to share information with the doctor, you pull up your dashboard when you go to your doctor and you say, you know, I was feeling kind of off that week and here's what the thing is. Is that something I should be worried about or not worried about? You look at all the parameters and you say, yeah, that's, we can explain that because of this and this and this, or yeah, you know, not only that, it's happening more often and I don't understand why it's happened. Try to detect some early warning indicator before it becomes a disease or an illness. So what's sometimes called systems medicine, thinking of the person, not only all the systems in the body, but the person as part of the system that makes up your life. I'll put in a pitch here for my friend and colleague, Bill Queel, who's a physician in private practice, and he's affiliated with my laboratory at Hopkins as well. But this is the type of medicine, primary care medicine, that he practices, which, as you might imagine, makes him very popular with his patients, because he actually wants to establish this relationship so he can kind of figure out, you know, maybe there's something Something you're not telling me because... What I'm seeing in your lab test doesn't match up with what you're telling me about the way you're living your life. Let's talk about this, right? So it's this very much more broad-minded approach. That's one of my obsessions. Mark, before I let you go, place your bets. First footprint on Mars. First human foot on Mars. One small step for... 22 years from now. 22 years from now. All right, we'll hold you to that. And check with you when that happens. Mark, thank you so much for taking the time to chat. I really appreciate it. And I hope it happens even sooner than you think. I hope I live to see it. All right, take care. Thank you. I hope you enjoyed this interview with Mark Schellhammer. I mean, what a legendary researcher knows so much about this entire process. And it was able to fill in a lot of, I guess, confirmations of mine that it's just so scary and it's just so far away. Now, we had a longer conversation about one specific program that Mark was involved in called Cipher. And this was an attempt to integrate. A whole bunch of different aspects of human spaceflight, both from the physiological side, as well as the hardware side, as well as the psychological side, and be able to drill down on individual astronauts and sort of find out how they're doing, and then think about the implications and some of the sort of downstream technologies that might happen for just regular human medical procedures here on Earth. So if you want that longer conversation, we have it over on Patreon. It's completely free. You don't have to sign up. You know, you can watch the entire episode over there with no ads, which we always want you to be able to do unless you love ads and then don't. Now I'm going to give you some final thoughts. But first, I'd like to thank our patrons. Thanks to Abe Kingston, Andrea Pedretti, Baldazar, All Your Bases Belong to Us, Brian Bode, Cameron, Chuck Hawkins, Commander Baylock. David Gildon, David Matz, Evan.Pro, James Clark, Jerry Madden, Jim Burke, Marcel Svitz, Michael Purcell, NASA Ocean Guy, NordSpace, Onestepforanimals.org, Rankaidu, Richard Williams, Sean Sargent, Team 49, Telescopes Canada, Vlad Chaplin, Wolfgang Klotz, Zelda, Baldazorg, Your Silence is Fooling No One, who support us at the Master of the Universe level, and all our patrons. All your support means the universe to us. Mark mentioned a book in the interview that I was doing with him. Which was A City on Mars, which was written by the Wienersmiths, and I have interviewed them, and their book was great in helping us all truly understand the tremendous risks there's going to be for any kind of long-term human civilization on Mars. And so if you want to kind of compound the advice and the science that Mark has been gathering so far about how ready we are to even just send humans. to Mars and bring them safely home, you're definitely going to want to read A City on Mars and see the interview that I did with Zach and Kelly Wienersmith about this, you know, longer term, can we have any kind of civilization on Mars? It's a fascinating idea. And I mean, we all want it to happen. We all loved our science fiction. We all are enthusiastic about the idea of spreading out into the cosmos. It's just at what cost? At what cost in finances? At what cost of human lives? What's it going to take? All right. I hope you enjoyed this interview. We'll see you next time.