From a young age, astronaut David Saint-Jacques was obsessed with space.
When he was five-years-old, he says he could recall looking at photos of the Earth taken by astronauts and was perplexed by how big the world is.
“I never thought I could ever become an astronaut,” Saint-Jacques, now 52 years old, told CTVNews.ca in a phone interview. “There wasn’t even a possibility when I was a child anyway, there were no Canadian astronauts.”
Lured by his childhood fascination, he become an astrophysicist and family doctor. He says it also fostered a sense of adventure that’s seen him pursue sports, travelling and working in Puvirnituq, Nunavik, an Inuit community on Hudson Bay as a medical doctor.
In 2008, on a whim, he applied to become an astronaut with the Canadian Space Agency, despite knowing how difficult it would be.
“I heard the voice of me as a boy in my head, ‘Oh, please apply…Try, try, try,'” he said. “But until then, it was never a practical possibility, it was more like a fantasy.”
Saint-Jacques’ dreams became reality as he was selected in May 2009 to become one of two Canadian astronaut researchers, focusing on how human health is impacted by space travel. The mission expanded the knowledge of medicine in space and showcased how technology used on the International Space Station (ISS) can benefit remote health care systems across Canada and the world. Now, Saint-Jacques is one of a trio of physicians who are using their unique experience to help improve health care, particularly for remote communities.
Bringing their love for space and knowledge in medicine, Dr. Dave Williams, Dr. Farhan Asrar and Saint-Jacques co-authored an article in the Canadian Family Physician Journal published Monday (the official peer-reviewed journal of the College of Family Physicians of Canada).
Much of the physicians journal contribution is based on Williams’ and Saint-Jacques’ trips to space.
Prior to launch, Saint-Jacques underwent gruelling training sessions in 2009 at NASA headquarters in Houston, and lasted until 2011. He learned the ISS systems, spacewalks, robotics, T38-N flight training, along with learning to speak Russian and survival training.
He was assigned to Expedition 58/59 from December 2018 to June 2019, a 204-day mission – the longest Canadian expedition to date.
While on the ISS, Saint-Jacques and his colleagues studied how the body would react to months in space and what sort of effects it would have on their muscles, heart, blood and mind.
“About half our time, we spent doing research on … ourselves,” he said. “So the ill effects of the space environment on the human body.”
The other half of the time, the astronauts were busy repairing the ISS, ensuring it continued functioning, he told CTVNews.ca
Part of the research involved Saint-Jacques testing medical equipment and ensuring he remained in good health while in space for an extended period.
This was not the first space mission focused on human health led by Canadians. Williams was launched into space in April 1998, sent aboard Space Shuttle Columbia for a 16-day flight. His expedition was dedicated to experiments for neurosciences research. Williams was the medical officer on board and was trained to conduct spacewalks.
“We were trying to understand things like the orientation of the organ imbalances affected, how the heart, the lungs, the cardiovascular system are affected,” Williams told CTVNews.ca in a phone interview.
HEALTH CARE IN REMOTE COMMUNITIES
The similarities between the remote northern communities and space were uncanny, said Saint-Jacques. Getting patients to hospitals or bringing the necessary equipment to remote areas is very difficult and impossible in terms of space health care.
The hands-on thinking, or “MacGyver spirit” as Saint-Jacques says, was an important skill he developed.
“I remember in very remote places, you often have to just figure things out on the fly with minimum equipment, or maybe non-ideal preparation,” he said.
Williams echoed similar instances when it came to using his physician skills in space.
“In any area of medicine, you need that technical knowledge and skill and competency to be able to practice but more importantly, you need behavioural skills, to be able to interact with patients from different backgrounds,” he said. “Broadly speaking (these skills) are really important for doctors, but they’re also really important for astronauts.”
Realizing how technology from space could help remote communities on Earth, the two astronauts paired up with Asrar, an assistant professor with University of Toronto, Dalla Lana School of Public Health and Trillium Health Partners and a Global Faculty member at the International Space University to co-author an article on their experiences.
“Canada’s main focus right now has been looking at health care, delivery or the provision of health care in deep space,” Asrar told CTVNews.ca in an interview. “So if you’re thinking about going to the moon going to Mars, it just may not be feasible to rely on Earth with just the time delays, even sending samples could take even months to come back.”
The same can be said for communities with difficult access to transportation, dangerous military operations or older adults who have mobility issues.
“All these methods to bring medicine to the patient, as opposed to bringing the patient to medicine, these are problems we have in space, and we have on the ground in common,” Saint-Jacques said.
TECHNOLOGY USED IN SPACE
In order for the astronauts to maintain their own health and understand the effects of space travel on their bodies, modified equipment was needed.
In Williams’ 1998 mission, he used a point-of-care test kit, or Bio-Analyzer, which allowed him to sample his blood and get an instant result. This important discovery told researchers such technology could function in space.
“We also ended up doing animal surgery in space where the animals survived and we had to give a general anesthetic,” he said. “It was the first time it had ever been done in history. It was pretty incredible.”
What Williams learned from his mission was important building blocks to understanding how space medicine can be performed. A decade later, Saint-Jacques went to space, using knowledge from missions past and discovering more capabilities of space health care.
On this trip, the astronauts tested for the first time a Bio-Monitor, a Canadian technology that can show a person’s vitals. The device was built into a shirt allowing for easy use by Saint-Jacques and his colleagues.
“It’s a prototype, and it’s a bit clunky, maybe not super user friendly, but eventually that is the aim of every engineer is to polish their system,” Saint-Jacques said of the Bio-Monitor.
One of the approaches to health care astronauts and earthlings have adopted is telemedicine, which allows a physician to see patients remotely over a video call.
Asrar says another important discovery the health care system can benefit from is remote sensing data (provided through satellites) which can help map and identify disasters. Using this technology, Asrar says it has a role to play in sensing outbreaks/pandemics and helping plan the delivery of vaccines.
“These technologies actually look at satellite technology and mapping perspective (like) the migratory patterns of birds or even certain,” he said.
This technology is already being applied in certain outbreaks, like Avian Influenza, which is a flu virus transported by poultry. Using migratory patterns of birds from across the world and on-the-ground reporting by farmers, Asrar says this technology could map where the next outbreak could begin, allowing people to prepare.
Small-scale versions of mapping tools in virus mitigation were seen in COVID-19 maps showcasing the concentration of cases in certain communities.
“I think we’ve all learned through the pandemic, that we all have a great appetite for a more decentralized, personalized way to practice medicine,” Saint-Jacques said. “There’s so much in common, that to me is a great potential benefit of space exploration for everybody.”