Human failings serve as NASA wake-up call

A catalog of medical crises
All of the individuals who responded to my inquiries did so under the condition that their names not be used. The only guarantee of authenticity that I can give in this analysis is that they are all people I have known and worked with, often for decades. I have relied on their judgment and candor in the past, and I still do.

Only a handful of astronaut medical disqualifications are in the public record. The problems of Mercury astronauts Deke Slayton (heart murmur) and Alan Shepard (inner-ear disorder) are well known, and both eventually were restored to flight status and flew in orbit. John Bull, selected as an astronaut in 1966, was later dismissed after displaying a significant intolerance to aspirin. Doctors insist Bull's dismissal was a good call, even as they express sympathy.

The famous grounding of would-be Apollo 13 flier Ken Mattingly for indirect exposure to German measles was controversial at the time and remains so. He later flew a very successful lunar mission. One astronaut involved in 1970's Apollo 13 drama noted that Mattingly played a crucial role in developing procedures for reviving the imperiled spacecraft. “Ken’s presence on the ground was of inestimable value in returning the crew safely,” he said.

One veteran flight surgeon endorsed the view that astronauts were usually given the benefit of the doubt on medical calls. "I think overall the number of 'breaks' the crew gets far outweigh the hits,” he said in an e-mail.

He said the final fly/no-fly decision was often out of his hands, and over his head: “Most of the time 'management' seems to make the decisions (as they probably should, since I would submit every decision is a balanced risk). They probably don't weigh the medical opinion as much as I would, but that's a biased opinion to be sure.” A good example of this might be one very successful pilot astronaut who, it was discovered late in his career, was color-blind. He seemed to fly OK, so the condition was "exempted."

Renal stones and retinal detachment
The flight surgeon listed other cases: "We flew a guy with a positive hepatitis antibody [and] we flew [a guy with] known renal stone history." In a more serious case, he added, “We found out about a guy who had a retinal detachment lasered on the outside but didn't report it. [We] only found out after the fact but still could have hit his pension."

Renal stones, better known as kidney stones, can be problematic for spaceflight because the dehydration that commonly occurs in zero-gravity could lead to rapid precipitation of painful stones during a mission. But after several cases of astronauts receiving private treatment for such conditions (without telling NASA about it), and then flying without incident, NASA seemed to lighten up on that constraint.

One astronaut on a later flight said in an e-mail: “I do know of a case of kidney stones for one of our payload specialists, which occurred a few months before flight. NASA took him to have them ultrasound zapped, and he was able to fly.”

Bending the rules seemed acceptable in such cases — except, apparently, when the astronaut in question was European, and a history of kidney stones had been the reason NASA gave officially in 1980 for keeping him out of mission specialist training. He later flew several times as a payload specialist, which is a different astronaut classification.

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