Physicians as Astronauts

2011 urban Canadians. The physician must adapt to these differences and avoid imposing his own perspective. The same is true on orbit, with crews generally of international composition. Risk management Living in a remote area is a health risk in itself: for example, the chances of surviving a major head trauma are several orders of magnitude lower when the nearest neurosurgeon and ICU are several hours away by flight. Remoteness also drives the way we organize patient follow-up for more benign ailments: northern physicians tend to err on the conservative side, in general, to further minimize risks of complications. The local population understands and accepts these risks; the challenge for northern health care providers, and the responsibility of the healthcare system, is to ensure these discrepancies are minimized, within reason. To quote an Inuit participant to the In 2009 I had the good fortune to fly on a long duration space mission. With two crewmates, I launched aboard a Russian Soyuz rocket from the Baikonur Cosmodrome in Kazakhstan. When our spacecraft reached orbit nine minutes later, we were traveling at a speed of 28,000 kilometers per hour through an environment devoid of air, water and anything familiar. Two days later we rendezvoused with the International Space Station (ISS) at an altitude of 350 km. As our Soyuz vehicle docked with the Station, we began an incredible space odyssey as members of the ISS Expedition 20/21 crew. This Expedition marked the first time that the ISS hosted a permanent crew of six. My international crewmates (from Russia, the United States, Japan and Belgium) and I performed an unprecedented amount of multidisciplinary research (Figure 1). We also performed complex robotic operations , spacewalks, and maintenance and repair work of Station systems and payloads (Figure 2). Six months later my Soyuz crewmates and I undocked from the Station and landed back in Ka-zakhstan. During our stay in space, we completed 3,000 orbits of the Earth and traveled 125,000,000 km. It was truly an odyssey. This ISS expedition as well as my earlier Space Shuttle mission have enriched me in ways I can never fully explain. I often reflect on the career path that took me from medicine to the cosmos. To some of my medical colleagues, this path seems incongruous. They ask, " What does the practice of medicine have in common with space explora-tion? ". In the following paragraphs, I describe the …