Former NASA doctor says agency must do more

Conflict of interest
But leaving the process entirely in the hands of flight surgeons at the Johnson Space Center, she said, has a number of serious weaknesses.

First, many medical specialists in the flight surgeon office are personally campaigning to be selected as astronauts — and senior astronauts sit on the selection boards.

“This presents a conflict of interest,” Santy said. “And the culture will strongly be biased against a flight surgeon who makes an unpopular decision regarding an astronaut's flight status — their future career as an astronaut is decidedly jeopardized.”

And it’s not just threats of retribution.

“NASA does bully flight surgeons when they don't come up with the decision to allow an astronaut to fly,” she said.

One incident during her tour of duty involved a mission commander who was undergoing secret (non-NASA) treatment for kidney stones, a problem that officially called for removal from flight status. “He should have been grounded,” Santy said. “That was part of the medical standards.”

Instead, because he was on a high-profile flight, the doctors were overruled. “It was decided that NASA scientists had it all wrong about kidney stones being a problem for space flight,” she explained. “Maybe they did, but just prior to a flight was not the time to suddenly change the conventional scientific issue and decide differently.”

Look to the military, private sector
Santy said NASA should take lessons from more rigorous psychological screening programs conducted by some military organizations or commercial high-tension professions.

“NASA could look at the procedures for referring problems to the flight surgeon or the flight psychiatrist that are used in the U.S. military,” she said. “They should make psychological monitoring a part of ongoing NASA operations.”

So far, there are no signs that this has ever been done at NASA. “But it has been done in the old Soviet space program and is done in the Russian and European programs today,” she said.

“One astronaut told me once that he didn't see how crews could possibly have interpersonal problems when they train so long together,” she recalled, adding that such a statement “betrays a significant degree of psychological naivete.” It's just the kind of ‘hubris’ she is worried about.

“Astronauts may in many ways be extraordinary people, but they are human beings,” she said. “They have interpersonal conflict with their spouses, their kids, their colleagues. They experience love and hate. They fight with their colleagues just like everyone else does. When they do have strong emotions it can negative effect their judgment — just like anyone else.”

That makes it NASA's responsibility “to determine if any of that — or any other interpersonal stress — is having an effect on the astronaut's performance and judgment.”

NASA’s reaction to the David Walker near-collision in 1989, is still unusual — and ambiguous. as it turns out, there was a certain degree of air-controller error involved in that incident, but Walker was the one who was acting distracted. Why it happened — and what to change to make sure nothing like it ever happened again — was never understood.

James Oberg worked at NASA Mission Control for 22 years.

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