Astronauts must be in peak physical condition.

When your body’s constantly subjected to extreme changes in gravity associated with leaving planet Earth, being a poster kid for good health is necessary.

But sometimes, even our top scientists, researchers, and engineers are subject to Murphy’s Law and even astronauts who are perfectly healthy can experience medical issues during spaceflight. When things go sideways, NASA turns to its biomedical engineers, who are responsible for developing systems that safeguard our space explorers in orbit.

Supercluster spoke with BMEs Ria Sadik and Alex Rubin on what the road to such a critical role looks like and what their current human spaceflight duties actually entail.

“As a young girl born and raised in Morocco, I was always fascinated by space. Since I didn’t think it could be possible to work in this industry, I figured I’d go to engineering school to study Biomedical Engineering and then head to medical school,” says Sadik, “It wasn’t until the end of my undergraduate career that I met a professor that changed my life… What was supposed to be a quick six months in Houston turned into the best 5 years of my life and counting.”

For Rubin, NASA’s always been on the radar.

“I went to the University of Texas at Austin and studied aerospace engineering. Following graduation, NASA was an obvious place to apply (and a dream job for anyone in aerospace.) I applied to several positions and got an interview in a relevant aero discipline. I got a second interview, but didn’t end up getting the job,” says Rubin,” A friend told me about a position in Biomedical Engineering as a flight controller and I applied just for kicks. Apparently, I made a good impression among the three A&M graduates interviewing me for the job, because that’s how an aero grad ended up in a biomedical position.”

Sadik and Rubin both work for Kellogg Brown & Root, an American engineering, procurement, and construction company that works closely with NASA on government contracts. Many BMEs at KBR provided essential support for the SpaceX and NASA DM-2 mission in May.

“The BMEs prepared for this mission for many years,” says Ted Duchesne, the Special Assistant to the Chief Medical Officer at KBR, “Additionally, BMEs worked in Mission Control during the flight. Some continue their support of the operations on the International Space Station, but specific BMEs support NASA Flight Surgeons that support the crew onboard Crew Dragon.”

So, what exactly does a biomedical engineer do? What sounds like a STEM field word salad has a pretty intuitive job description.

BMEs create ways of simulating the daily life-supporting activities that we’ve become accustomed to here on Earth. Since humans don’t exactly thrive in the barren, oxygen-less void of low Earth orbit, biomedical engineers have to get pretty creative to make life in space possible.

And they have indeed gotten creative. After all, they’re the folks behind astronaut food.

Besides developing the freeze-dried ice cream that makes every fifth-grader lose their mind when their science teacher brings it for the last day of school, BMEs are also in charge of managing water recovery, atmosphere revitalization (removing carbon dioxide from astronaut cabins), and even waste management. If there’s any universal truth of life, it’s that everybody dies, everybody pays taxes, and everybody poops.

To avoid any zero-gravity bathroom disasters, BMEs have developed some critical innovations. NASA’s latest spacesuit, the Orion Crew Survival System Suit (OCSSS), actually has a built-in toilet. This is a serious improvement from the maximum absorbency garments (MAGS), which are basically diapers that astronauts traditionally wear from launch to landing.

Take it from NASA engineer Kirstyn Johnson, who leads the internal systems design for the Orion launch and suits — an integral part of NASA’s Artemis Program, which plans to send the first women and next men to the moon by 2024. “The MAG may not work 100 percent of the time — you might have leakage — but it gets the job done without us having to put too much effort into design and certification.”

The OCSSS is an even bigger upgrade from 1969 when the Apollo 11 astronauts had to pee in bags and bring feces back home in bactericide. After all, there were no bathrooms on the Apollo spacecraft, and there wouldn’t be any working toilet on any NASA spacecraft until the space shuttle installed the Waste Collection System (WCS) in the 1980s.

All this to say, biomedical engineers do a lot of work in order to keep a certain four-letter-word from literally and figuratively hitting the fan.

BMEs are also responsible for helping to maintain an astronaut’s physical and emotional well-being, by organizing their daily schedules. Alex Rubin gave us a run-down of what that schedule entails.

“Currently, I am the Increment Lead for the BME team (go Expedition 63!). When working on the Increment Management Team, you are responsible for scheduling the crew for all required activities within your discipline. For our team, that includes: all medical exams and conferences; sample of water, air, acoustics, and surfaces; radiation hardware management; daily aerobic exercise and weightlifting; and all maintenance tasks on medical hardware. We also manage any issues that arise, and lately, a significant amount of our time has been dedicated to figuring out how to support all operations with as minimal contact as possible.”

Those activities often include setting aside time for astronauts to connect with their families back home.

"Every now and then, the ISS crew calls down to thank a specific team for their support. One of the tasks the BME team facilitates are the crew’s family conferences. There is nothing more fulfilling than hearing how happy it makes the crew to talk to their family. In this time of quarantine and shelter-in-place, it resonates even more to be able to connect someone in isolation to the ones they love,” says Rubin.

But COVID-19 by no means pumped the brakes on NASA’s operations. At the height of the pandemic’s first wave, Rubin and his team were required to brainstorm unique solutions to cope with the crisis while Expedition 63 prepared to fly to the ISS and Expedition 62 prepared to fly back to Earth.

“We faced a unique set of circumstances in determining our support posture during this time. On top of that, the Russian crewmembers were swapped to the backup crew shortly before launch,” says Rubin, “With such short notice, the crew didn’t receive their full medical training, and we had to scramble to ensure we met our strict requirements. As the Increment Manager for the BME team, I helped to develop a plan to implement mitigation training for the new crew. This included training provided by our doctors supporting the crew in pre-flight quarantine and scheduling onboard training once they arrived.”

Although the pandemic presents its own set of challenges, adjusting to unforeseen developments is nothing new for BMEs. And as we send humans farther into space, new effects of long-duration space travel will continue to be discovered.

These effects could be more significant than initially anticipated. After his year in space, Scott Kelly exhibited significant biological changes, including lengthened telomeres (a region of nucleotide sequences at the ends of our chromosomes) and gene expression. Some of Kelly’s genetic changes persisted for as long as six months after his return to Earth. Researchers also found signs of inflammation of carotid wall thickening in Kelly during and immediately after his mission, which indicates the severe stress that spaceflight puts on our cardiovascular system.

Still, BME teams and NASA’s astronauts find ways to bring moments of levity to long-term missions. According to Rubin, one of these moments was brought on by Kelly himself. “The weirdest thing that I recall was when Scott was on board around Halloween. He donned a gorilla suit and filmed himself all over the station while wearing it and performing various tasks. It was close to the end of his time on board, and this was likely an attempt to improve morale after a long mission,” Rubin says, “Needless to say, a floating gorilla was an odd sight.”

For Sadik, the Foundations of Mission Operations (a sort of vocational oath amongst BMEs and flight controllers), brings a special kind of solace when overcoming challenges. “Specifically, I think of the second statement which reads, ‘To always be aware that, suddenly and unexpectedly, we may find ourselves in a role where our performance has ultimate consequences.’ It acts as an energy shot for me. It instills my vigilance, resilience, and the responsibility I have as a flight controller."