Curbside Consult with Dr. Jayne 4/6/26
All eyes are on the moon this week. The hot topic around the virtual water cooler after the launch involved the issues that Artemis II commander Reid Wiseman had with Microsoft Outlook.
Apparently one astronaut had two instances of the software, and neither was working. NASA had to access the system remotely to fix the glitch, which took about an hour. The capsule communicator at Mission Control said, “It will show offline, which is expected,” which had me chuckling since my Outlook frequently shows as disconnected despite my laptop being on a wired connection.
It was interesting to hear launch-related reactions from different generations of friends, family, and co-workers. Those who felt a close connection to the Apollo launches have a pragmatic take on the event, anchoring on earlier memories of our travel to the moon. Many in younger generations who have seen numerous International Space Station launches wonder why everyone thinks it is such a big deal. And some of us who were real-time witnesses to the loss of Space Shuttle Challenger remembered sitting in a classroom watching the events of that day unfold.
I admit that I was one of the people who held their breath until Artemis II crossed the Karman line and achieved main engine cutoff. Hopefully the Outlook glitches and a temperamental toilet will be the biggest of the issues the crew faces.
This is the farthest that we have traveled from Earth in a long time. We remember the loss of Space Shuttle Columbia on its return, so I am sure that the crew’s loved ones will be coping with anxiety until they are safely back on Earth.
Many parallels exist between the work that NASA does and what we do in healthcare. A commitment to a safety culture is required to achieve success. People may not realize that the surgical safety checklists that operating rooms around the world use every day were inspired by aerospace protocols, since that industry realized that human memory isn’t enough when you are dealing with life and death situations.
Side note: if you haven’t read “The Checklist Manifesto” by Atul Gawande, I recommend it.
Like space flight, medicine requires backup systems, whether it’s EHRs or generators that keep critical equipment functioning during a power loss. I’ve been in the middle of doing a procedure on a patient when the power went out, and it wasn’t pretty. It was in an ambulatory office in an office building that wasn’t exclusively medical, so we didn’t have a generator. I have never been so grateful to have a laptop in the exam room with me. The light from the screen allowed me to safely halt the procedure, ensure that the patient was safely positioned, and open the door to the hallway where emergency lights had come on. You can bet that every exam room had a flashlight in it after that event.
Watching the closeout crew help the astronauts get situated inside the launch vehicle reminded me of being in the operating room. The crew had rehearsed the boarding procedure many times. They know exactly where they can and can’t place their feet or hands, and they know how to move so that the team that is assisting them can get the job done.
The people who were performing the tasks need to know exactly what they are doing and to execute flawlessly. Those who observe the process need to be able to identify if something deviates from the expected sequence and to feel empowered to call out those deviations. If you’ve ever been told by an OR nurse that you have somehow violated the sterile field, you know what that feels like.
Deviations occurred, and I was impressed listening to the NASA livestream by how they handled warning lights or other alerts. One of my colleagues likened it to caring for an extremely sick patient who is at a hospital that doesn’t have advanced services, where you rely on the tele-ICU team to help you talk through the situation and determine the best course of action.
It is reassuring have remote experts available to analyze problems as a team. Having been in situations where I was operating at the edge of my scope of practice, I know what it feels like when the experts arrive to help you through what you are doing or to take the handoff so that you can focus on other priorities.
I enjoyed listening to pre-launch media reports that described how NASA optimizes the human performance elements of the mission. Whether it’s designing the crew’s day, including sleep and activity periods, or determining what foods will be included on the mission, every decision is worked through carefully. Space is an unforgiving environment, and they want to ensure that the crew has what they need to be at their best without introducing unnecessary variables that could compromise the mission. After launch, the crew reviewed the first aid kit and some clinical procedures.
My favorite orbital mechanics engineer explained that the planned mission is on a free-return trajectory. It will use the moon’s gravity to slingshot it back to Earth, which reduces additional points of potential failure. It’s nice to have an in-house expert at times like these.
Although following a NASA-style approach can improve safety in healthcare, it can’t account for every variable that happens in hospitals every day. Unless they are coming in for preventive services, patients are already in a suboptimal state of health. The teams that are caring for them are working with resource constraints that are driven by economic, cultural, and regulatory factors.
Sometimes we have to make split-second decisions without a backup team to advise us or to make sure that we have considered all options. Even when we do our best, every procedure has a set of possible complications, which negatively impact both the patient and the care team.
I hope this trip to the moon inspires the next generation of scientists, engineers, and dreamers, and that they will come up with technologies along the way that can benefit all of humanity. If nothing else, a fresh set of photos from a quarter of a million miles away might remind people that we are all in this together, and at least for now, Earth is the only home we have.
How has the current lunar mission impacted you? Were you among those holding your breath during the launch, or did you learn about it after the fact? Leave a comment or email me.
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Sorry to be that guy, but "We remember the loss of Space Shuttle Columbia on its return" - Columbia exploded…