White Coat, Black Art

Astronaut Dr. Bob Thirsk's excellent adventures in space

Dr. Bob Thirsk recalls the challenges of carrying out simple medical procedures in space.
Practising medicine in space presents a unique set of challenges. 'Everything floats in space, so your instruments float and your patient floats,' Dr. Bob Thirsk, former Canadian Space Agency astronaut said. (Canadian Space Agency/Canadian Press)

Originally published on Jan. 5, 2018.

Performing CPR can be a daunting task, but as an experienced MD, Dr. Bob Thirsk is a pro. At least he was until he faced the challenge of practising the life-saving procedure in space. 

"Everything floats in space, so your instruments float and your patient floats," Thirsk told Dr. Brian Goldman, host of White Coat, Black Art.

Thirsk, a former Canadian Space Agency astronaut who made two flights into space, had to adapt the way he performed CPR to "deal with Newton's first law." 

"As soon as you give that first chest compression, you're headed up to the ceiling!" Thirsk explained. 

The doctor, who is also trained as an engineer, found a way to adapt his technique.  

"I hover over top of the victim with my feet vertical above me on the ceiling and then instead of using my arms to apply the chest compressions during CPR, I actually use my legs to press." 

Canadian astronaut Bob Thirsk holds plants while on board the International Space Station in 2009. (Canadian Space Agency/Canadian Press)

It's a manoeuvre he practised every month during his time aboard the International Space Station. Luckily, it was all test runs. He never had to use CPR on a crew member.  

As the only physician on that mission in 2009, he was responsible for the health of the entire team onboard. 

From family physician to astronaut

Thirsk was a family practice physician when he answered the call to become an astronaut with the CSA in 1983. His first flight into space was in 1994 aboard the Space Shuttle Columbia. 

Between his two space flights, Thirsk spent nearly 205 days in space, more than all other Canadian astronauts combined.

And it wasn't easy. According to Thirsk, vacuums, extremes in temperature and radiation in space make practicing medicine much more challenging.

It got even more so when he became his own patient. 

About a month into his time on the ISS, he and another crew member started having trouble with their vision. Given that he had experiments to perform and needed to control the robotic arm, clear vision was a must. 

"[I was] very worried ... I was seriously incapacitated ... You've got to have sharp vision," Thirsk said. 

Between his two space flights, Thirsk spent nearly 205 days in space, more than all other Canadian astronauts combined. (University of Calgary)

Ultrasound images that he himself had taken and sent back to Earth should that he had Papilledema (irregularities in the optic nerve), a condition that has since found out to be common amoung at least a dozen other astronauts.

No cause was ever pinpointed. "It's a big mystery," he said.

Doctors in space

Now retired from the CSA, he continues to consult with the agency and is currently helping to plan the next space trips to the moon and Mars.  

Thirsk is advocating for a medical doctor be part of the intended four-person crew. But these doctors will need more than just medicine behind them, he added.  

"They're going to need to be a handyman, or handywoman ... That medical doctor needs to know the guts of the equipment." 

He even has some physicians in mind — like the ones who work in remote areas of Canada's north who, along with being great clinicians, also have what he calls MacGyver-like skills.