MOONFLIGHTS AND MEDICINE

[Applause] [Music] [Applause] [Music] [Applause] [Music] it was not that long ago when a trip to the moon seemed impossible then it seemed extraordinary now it seems almost commonplace but we learned a lot on those moon flights we learned a lot about man and the results of what we have learned may have extraordinary implications for each of us here on earth the life sciences program of the National Aeronautics and Space Administration is responsible for the study of man before during and after flights what they learned is now being applied to the practice of general medicine the director of the life science program is the astronauts physician dr. Charles berry the command module pilot low 36 CMP hi okay that I do it we'll go back and work that and I'll see you later thank you very my role in this control center here where everybody really is focused on trying to conduct a successful lunar mission is to guarantee the health of these astronauts in some way now to do that I've got to have certain information and I have to have that information in in real time so we need to measure those things actually in flight and we've developed a lot of new gear and are constantly improving that hardware to measure man and active function for a very long duration space flight now that does two important things for us it provides a capability to do dynamic investigation instead of people sitting at the doctor's desk or on an examining table or dynamic examination techniques that we're going to use to determine the in-flight what's going to happen to that individual and what his conditions going to be when he comes back to predict and that's what medicine is all about in the future is preventive medicine and thus predictive medicine every physician wants to do that what you really want to know is not what your blood pressure is when you sit down at the doctor's desk or you're on an examining table you want to know if you're concerned about you being a hypertensive do you have that when you're walking around the golf course every person in the world now is going to be able to look toward the day when we will have remote care available we'll have more scientific medicine available and that's going to allow every person to benefit then from space technology which has been developed for a particular purpose for a very small group of people and it's going to allow that technology to be utilized by people all over the world as their doctor gets it into his bag and can thus extend his own eyes and years in his hands and the packets of Medicine here on the surface of the earth then you get the overall picture okay gotcha good morning mr. Dominic nice but you come over here to see and I told you that we were going to get the patient is that a Veterans Hospital 30 miles away from the examining cardiologist at Massachusetts General Hospital Medical School good morning mr. Dunn pleasure to meet you thank you I had one little question I wanted to ask you and that is whether you have any kind of call or sputum or phlegm much I make sure that his pupils react medicine is really an information-gathering business that's really what it comes down to we have a study going on right now looking at patients both by TV and then directly and comparing what they got out of those two things now the important thing is to be able to get the information from that patient that's a terrific image it's one of that davin Elwes medicine is going to change and the thing that you gotta understand from that is that again you can put the Machine into that system but you're still not really taken away doctor-patient relationship with the special lenses available to it the examining doctor can enlarge a few square centimeters to an image 23 inches across physicians handwritten notes his prescription and his signature can be reproduced simultaneously at the remote clinic a videotape recording of the entire examination can be used for further study and teaching got it okay you've got a grade one River there dalek environment very so we fight it early right okay now you want to listen for some rounds yes you get the director just breathe through your mouth at Massachusetts General more than 1600 patients have been examined by remote television thank you I'm going to look at your x-rays and give my opinion to dr. Clippard and then I in turn hope that he communicates that to you directly John I think if you've returned your camera the other way the other way and you'll come around to where the x-ray is now now we did this program for a very specific purpose it was to get man into space and it wasn't done to try and create side benefits of any sort but you can never do a tremendous task such as landing man on the moon without having a very great advance in science and technology in order to provide you the information to make that task possible the common Firefly a bug that glows in the dark provided an enzyme used by NASA for the rapid detection of bacteria originally intended to detect small amounts of bacteria on Mars the analyser nicknamed Flash is already being used for detection of bacteria in urine and spinal fluid where the conventional agar culture takes four days the automatic flash analyzer takes less than 30 seconds a small manual analyzer will be available for use in doctors offices in the detection of bacterial infection in spinal fluid for instance time can make the difference between life and death maintaining life in space demands constant monitoring of basic life functions this has led to the development of miniaturized transmitters okay this morning we're going to record your body temperature with a transmitter capsule this capsule is a little radio transmitter transmits your body temperature from the inside of your stomach and intestines to the recorder on the bench over here and monitors your body temperature continuously during our testing this morning we're going to have a constant record of your body temperature as we need it for the testing on the bicycle or gamma test exercise test and also for long-term acute testing as soon as the capsule comes to equilibrium with your body it'll begin to transmit your body temperature the temperature is broadcast out approximately 37 degrees centigrade which is a approximately normal temperature for your body any deviations are measured on the recorder so that we know what happens to your core temperature during any of the testing that we'll be doing today you'll have no pain no feeling of the transmitter in your body it'll pass on through as normal food would pass through there's no problems at all with interference with any of your system if you want to lay down for a while you'll get the test started for the day it'll take about two minutes for the temperature to come to equilibrium and we'll get a continuous record of your body temperature just as a space capsule explores outer space the tiny transistorized pill explores inner space it can locate the site of bleeding or infection where body temperature is elevated this experiment is checking metabolic changes during the stress of heavy exercise [Applause] the pill is not powerful enough to transmit farther than a few feet away from your body so we have a retransmitted which will give to you to put in your pocket which will transmit for 150 to 200 feet we've picked up by the serial sent through the data phone over to our laboratory okay so you put that in your pocket and your dial up the number that we have to call here which gets us on our laboratory okay and we get to town that means we're on the labs we push the test button in we're in business so you're now transmitting from here to the aerial through the data from to our lab men and women as well as metals for aircraft and spacecraft have been examined by x-ray but conventional x-ray equipment is large unwieldy and expensive this huge polycomb x-ray for example is a brilliant aid in locating the exact depth of tumors or fractures but it weighs over a ton and costs $100,000 the space program requires equipment which is small portable and capable of instant readouts nASA has financed the development by dr. Zoltan cepes II of Westinghouse of an instantaneous x-ray plate which can be used over and over again the fluorescent plate produces an immediate image without any developing process the image can be wiped and the plate reused thousands of times or it can be stored up to eight hours the miniaturized radiation source used here was developed by the Bucky corporation I was thinking of a tremendous train wreck or a large aircraft crash or something this sort you know in the triage and sorting of patients when you get a tremendous number with fractures and I'm gonna go ahead and and repair all those fans there but you could certainly do a great deal to try and have those patients moved in a safer manner to the hospital facility and this is the sort of thing that would give you that that kind of an advantage very neatly another problem for the space program was the need to monitor the brainwaves of astronauts on a continuous basis during both sleep and wakefulness the conventional polygraph like this one is too bulky for the space program and it is subject to human error it necessitates fastening electrodes directly to the scalp they didn't stay on in space flights we're looking at relationship between heart rate and depth of sleep this is important to us because we need to know how much rest the crewman has it for predicting what you're gonna allow an activity on the next day and are you getting into a fatigue State or not a soft electrode cap was developed to replace the conventional electrodes it can be used to continuously monitor a patient who is awake asleep in coma or under anesthesia combined with a sleep stage analyzer the electrode cap can also broadcast signals to a remote computer for more detailed analysis one of the things we learned very early was that we were dealing with the normal individual who was responding to an abnormal environment you don't learn anything from static testing you need to stress that individual in order to determine are there abnormalities in some of these body systems doing a dynamic test where you're trying to measure somebody find a stress the cardiovascular system as a whole is the key thing that has to get into medicine we have had to look at you know I'm destructive testing of all of the systems that go in a rocket or a spacecraft this is a part of the procedure to assure that it can withstand all the rigors of a spaceflight and these analyzers which were built for testing machines are now being applied to human use we're doing is funny the bottom of your lung tickle the testing of rocket engines by sound analysis has led to a major advance over the common stethoscope each one of these little marks on here is a spot but I'm going to be listening to what I want to be able to come back to it every physician knows from experience that the major cause of illness and children is respiratory disease the problem is to locate exactly those portions of the lung which are affected by comparing the sound of both lungs simultaneously that's good that's good lung sounds are displayed on an oscilloscope while they are amplified and tape recorded by a technician sensitive microphone has replaced the conventional stethoscope that's for deep breath what they're trying to do here is to analyze these sounds in a very direct way by by computers and we're going to learn a lot more things about what's going on in the lung both in normal lungs and in diseased lungs deeper because you're gonna have a lot more information to look at and so if you'll probably find a number of other things that you haven't even known were there before deep breath even deeper ah the recorded sounds are then played back and analyzed by a computer which can differentiate between normal patterns and those caused by asthma cystic fibrosis or emphysema the sudden impact of reentry and landing prompted space scientists to develop a tempered poly foam to protect human tissue this method is being studied as a way to prevent ulcers which add thousands of dollars per patient to the cost of treating paraplegics burn victims and other long-term bed patients the tempered foam responds to body heat breathe easily and may prevent ulcers where a stump joins an artificial limb the testing of astronauts under the stress of gravity led to speculation that a pilot might not be able to manipulate controls with his hands during blast-off or reentry simulators confirmed that the eye muscles were least affected by G stress the logical answer was the development of a switch activated by the human eye what are you doing to turn on this wheelchair it when I looked at the left light the wheelchair drives forward until I look at that light again and it stops and I look at the left light the third time it'll drive in Reverse until I look at it the fourth time which shouldn't stop the right light controls right and left turn ultimately first time I looked at it it goes left second time I look at it is right well sure you were you about a movie the sites which is actually a photoelectric sensor which depends on the difference in infrared reflection between the iris which absorbs infrared and the eyeball which reflects infrared it can be mounted on a pair of ordinary glasses it promises new opportunity for patients who cannot now operate wheelchairs page-turners and feeding units there is also a need for improvement of braces and artificial limbs which depend on the transfer of power from a muscle which is still functional that's all I can handle big bites the refinement of remote-controlled manipulators for the space program has led to the development of a sophisticated mechanical arm which can be used by patients who are totally paralyzed from the neck down Celeste Thompson has been completely helpless since the age of 19 as a result of polio NASA provided her with a mechanical arm which uses tiny brushless motors and sensitive proportional controls in less than a year Celeste has learned to resume the tasks of daily living recently she sent her first handwritten letter in 18 years to her daughter she has also learned to type 25 words a minute the liberating effect of such devices can change a patient's outlook from one of despair to hope [Music] [Music] is that intended to scratch your nose like that I just do it sometimes yeah I knew it no I didn't like the idea of the tongue control it spotted little unpleasant and yeah I didn't think I'd like it but it turned out that it it wasn't as bad as I thought I was it worked out real good I think it is really very very wonderful that we can help individuals who have handicaps of all sorts whether we're learning to recover from a stroke or whether they've had a disease like polio or encephalitis but what's even more important than that is is to be able to prevent those things from happening in the first place and preventive medicine is the thing that we really ought to be putting a tremendous amount of emphasis on someday the I switch the tongue switch the transmitter pill or computerized analysis of illness may like the moon flights of today seem almost commonplace someday perhaps preventive medicine will eliminate the need for so many cures someday perhaps a nation of healthy people like the moon flights of yesterday will not be the impossible dream but a reality [Music] [Applause]