Several times a year a flight containing a new team of astronauts launches into outer space, heading to the International Space Station. For six months to a year they will stay up there, performing engineering tasks, research and maintenance, and during that time access to medical care is crucial. As other-worldly routines and microgravity wreak their deconditioning effects on crew members' bones, muscles, fluid distribution and immune functions, how do they see the doctor?

At the vortex of providing out of this world healthcare is Dr Shannan Moynihan, the Deputy Chief of Space and Occupational Medicine and Deputy Chief Medical Officer at NASA’s Johnson Space Centre, who manages the physicians providing medical care to the occupants of interplanetary craft and those on the ground.

Dr Moynihan will be taking part in the Views from the Top session at the HIMSS18 conference in Las Vegas in March, and as a preview she chats about working with “brilliant people from all over the world, and even a few who are off world.”

Q: Why did you choose your career path?

Dr Moynihan: I have been drawn to the exploration of space for as long as I can remember. As a 4-year-old little girl, I wrote a note to my favourite astronaut and my personal hero, Dr Shannon Lucid, asking how I could work with her one day. I didn’t take the most direct route to my dream position having spent some time in aerospace engineering as well as medicine, but I believe that all of the choices that I have made have contributed to helping me prepare for the career that I have today. It’s the best job on the planet. I have the opportunity to work with brilliant people from all over the world, and even a few who are off world, as we strive to support the goal that we all have in common … to further humanity’s exploration of space.

Q: What are some of the daily challenges and opportunities you face in your current role?

Dr Moynihan: My job is a unique mix of medicine, operations, international cooperation, research and engineering. As a result, the challenges can be complex and multi-focal. We have an excellent team that excels at integration and communication. As physicians, we have a unique challenge at NASA because our patients are not only remote but they are also in a unique environment that affects their physiology in ways that we are still trying to understand.

Our ability to communicate with and examine our patients is limited to audio and video communication via telemedicine. We rely greatly on training of the crew prior to launch as well as our video conferencing capability on orbit and our remote guidance capability.

We are often presented with new and unique issues for which we need to create a solution. Something as simple as a mild case of abdominal pain in orbit takes us on a very complex path in the attempt to examine and diagnose the patient so that we can treat.

It is that challenge and the ability to push the envelope and forge new paths forward that brings me to work every day with enthusiasm.

Q: Talk about successes in your current job and speak to failures you have experienced in your job. How did you overcome unsuccessful opportunities?

Dr Moynihan: To me, success in my job is simple – it is an astronaut who comes home happy and healthy from orbit. We have treated any medical issues that arose on orbit. Our countermeasures have prevented bone loss, muscle atrophy and mitigated deconditioning effects. The astronaut has successfully navigated a ride back through the atmosphere, which is not a gentle process, and landed safely. We have picked the astronaut up over in a remote desert in Kazakhstan and travelled back to our home base at the Johnson Space Centre in Houston, during which time we assist them in their re-adaptation to the earth’s gravity.

Seeing them back home after an average of six months in space with their family and friends, healthy and enjoying all the simple things that we normally take for granted as earth dwellers is extraordinary.

With such a complex, multi-component system things do go wrong. It is inevitable. What NASA does so very well is foster a culture that teaches us to evaluate what has happened so that we can mitigate the impact and learn for the future.

The best leaders that I have had the honour to work with are individuals who are obviously technically proficient and intelligent but who also listen to their personnel and guide with support. 

Q: In a time of crisis, what are the core elements a strong leader must possess? If possible, please provide examples of how your leadership skills impacted a critical situation.

Dr Moynihan: The best leaders that I have had the honour to work with are individuals who are technically proficient and intelligent, and also listen to their personnel and guide with support. They help their team be successful by providing whatever is needed to attain that outcome.

We have had our times of crisis. The business of space exploration comes with inherent risks. But we have been graced with leaders from the institution level down to the individual level who have helped our team deal with the impact, focus on mitigations and put lessons learned in place as we focus on future successes, while never forgetting those who have helped us get to where we are.

HIMSS is the parent company of Healthcare IT News Australia.





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