Alums are docs to nation’s astronauts
Posted: June 24, 2011
In orbit or on the ground, our astronauts are in good hands with three ATSU-KCOM alumni caring for their health. Drs. J.D. Polk, Tarah Castleberry, and Scott Savage talk about their journey to NASA and what it means to them – and us. J.D. Polk, D.O., ’93, says his coming to NASA was partly by accident. But follow his trajectory from Kirksville to the space agency and it would seem his success was written in the stars. Attracted to emergency medicine as a teen in Washington Courthouse, Ohio, Dr. Polk started his career as a paramedic and his education at a community college in Dayton. It was then on to New York University as an undergrad before coming to KCOM in 1989. A flight surgeon for Metro- Health Life Flight in Cleveland, where he spent nearly every day for five years in a helicopter, Dr. Polk also has served as Ohio’s EMS director, and has been a Lt. Col. in the U.S. Air Force Reserve and a critical care air transport flight surgeon since 1997. He joined NASA in 2004 as a flight surgeon, was named chief of medical operations and then chief of clinical operations, and was tapped as deputy chief medical officer and chief of space medicine for NASA Johnson Space Center in Houston in 2009. Now the No. 2 doc at NASA’s Johnson Space Center, he had quite a year in 2010. In addition to managing a $45 million budget and providing healthcare for the 17,000-person workforce at the space center, as well as the nation’s astronauts, he accepted another assignment in August that would redirect his focus from 250 nautical miles above Earth to 2,300 feet below it. 
After 33 miners became trapped in Chile’s San José copper and gold mine in the world’s driest desert, the Chilean government contacted a host of experts across the world, including NASA, to ensure their safe rescue. From Aug. 30 to Sept. 5, Dr. Polk and a NASA team consisting of another physician, a psychologist, and an engineer, visited Chile to consult on their physical and mental health, as well as what would eventually be a 13-foot-long steel rescue capsule. Because of the team’s experience in training and planning for emergencies and caring for astronauts in the hostile, distant environment of space, nearly all of its 16 pages of health recommendations were put to use in the miners’ rescue. Recommendations for the miners’ physical health included nutrition and re-feeding, which had to be done slowly and methodically. As Dr. Polk says, “You can’t just shove Ho-Hos® down the hole.” Another recommendation was to offer medical testing – in this case urine test strips – that would provide the easiest and most complete information for targeted therapies. They also planned for a multitude of contingencies concerning the miners’ psychological health, as well as what to do to ensure they were in sufficient health to return to the surface, which they did after 69 days underground. “It was an outstanding challenge, and we were happy to rise to it,” Dr. Polk says. “And happy to use our experience from human space flight in this endeavor. This was something that could showcase for folks that what we do in space flight is immediately applicable and does translate to the ground.” Apparently no one ever told Tarah Castleberry, D.O., ’98, that she couldn’t do something because she was a girl. Not that she would have listened. One of about 25 physicians under Dr. Polk’s direction, Dr. Castleberry spent five years as a flight surgeon for a Marine Corps F-18 squadron and the U.S. Navy Blue Angels before joining NASA in 2009. “I have not woven a straight path to this job. It’s like every other story in my life – it just sort of happened,” she says modestly. In addition to her job as a flight surgeon in the Navy, she earned a master’s degree in public health from Johns Hopkins and spent two years completing an aerospace medicine residency in the Navy, which she left in 2007, and completed a family practice residency at Mayo Clinic in Arizona in 2009. “It’s a matter of knowing what you want and figuring out how to make it happen. This job in particular, but also my job in the Navy have opened a lot of doors and have given me the opportunity to work with a lot of amazing people and get some great experience. And it all started with Kirksville,” she says. “My first two years at KCOM were two of the best years of my life. It was an amazing experience. When we graduated, our keynote speaker said, ‘as good as any and better than most,’ and I couldn’t agree more.” Her first mission at NASA is as the deputy flight surgeon for a chemical engineer who will spend six months on board the International Space Station. Her job is to help prepare him for life on board the ISS as the crew’s medical officer. By the time he launches in November 2011, she will have spent two years working with him, going to his training, and monitoring his health. She then will monitor him throughout his six months in orbit. 
Two physicians are assigned to each three-person crew for the six-month mission to the ISS. Each year, at least four of these international crews launch on board the Russian Soyuz Space-craft from Baikonur, Kazakhstan. These crews spend two years in training before flight, not only at Johnson Space Center in Houston; they also typically spend up to 12 months training on Russian systems in Star City, Russia, where Tarah spends two to three months each year working with U.S. astronauts. While her crew member is on board the ISS – manned by three to six American, Russian, Japanese, Canadian or European astronauts 24 hours a day, 365 days a year – her job is to monitor their overall health, such as oxygen and carbon dioxide levels, temperature, nutrition, sleep, hygiene, morale, and exercise, the latter of which takes up nearly two hours every day. When her crew member lands in Kazakhstan after six months of flight, she and another flight surgeon are there to pick them up and accompany them back to Houston the same day. She then spends three to four months with the crew member as they complete postflight rehabilitation and testing. “I think the neatest thing is seeing the international partners and how well we all work together,” she says. “And it’s not just the physicians who coordinate, but the operations from NASA in general and the governments and agencies that all have to work together.” Despite the international intrigue, the job isn’t all that glamorous, she insists. “When you get up close, you see that it’s a lot of hard-working people who have a common goal working together as a team. Most people would be amazed that astronauts are just like you and me. They’re regular people who have worked really hard, and most of them feel really honored to be in the position they’re in and able to represent us.” Although glamour might be debatable, “It’s a pretty cool place to work,” she says. “I think a lot of us here are attracted by the awe-inspiring job that is exploration – who we are as humans and where we are in the universe.” [cincopa AEOAVoa6GttQ] When Scott Savage, D.O., ’87, got a call from a company that contracts NASA physicians, he entered his application but didn’t think he had the right stuff to be hired. Despite being certified in emergency medicine, wound care and hyperbarics, and prison medicine, he wasn’t certified in aerospace medicine. Then the offer came. “After I regained consciousness and they picked me off the floor, I said, ‘Sure,’ and here I am.” He just finished his first two years of training and his first tour in Star City, Russia, as the physician for a crew member of the International Space Station. “It’s great,” he says. “It’s the best job I’ve ever had, and I’ve had some good jobs.” 
Some of those jobs include spending 12 years in the military, some of which involved serving as a U.S. Air Force flight surgeon for F-15 and T-38 squadrons; spending a number of years in emergency medicine and police medicine; and working in prison medicine in Ohio before taking what he calls a research job at St. Mary’s Hospital in Knoxville, Tenn. He also has taught on the national teaching circuit for the National Procedures Institute and has just published three chapters in “Pfenninger and Fowler’s Procedures for Primary Care, 3d Ed.” These days, he’s working with an emergency operations group of engineers from all disciplines that runs through emergency procedures on the International Space Station and makes sure equipment there keeps pace with technology and that procedures work. “The space station is an active laboratory,” he says, “and we’re finding out new things every day we didn’t know before, which we hope will eventually make it into medicine.” His favorite aspect of the job is working with a talented group of people, from astronauts, to physicians, to engineers. “One of my favorite crew members has flown 95 different types of aircraft,” he says. “Another speaks five languages, is an engineer, and a test pilot.” Of course, Dr. Savage himself is no slouch in his list of accomplishments. His internal drive, he says, comes from a near-death event as a teenager. Since then, his motto has been carpe diem. He says, “I got the chance to understand that at some point, the days come to an end, and you don’t get to pick what day it is. And so ever since then I’ve just tried to make the best of each and every day.” One day he’ll never forget is working in the neutral buoyancy lab, the world’s second largest pool, watching astronauts dive in space suits to practice the things they will perform in outer space. “It’s one of the coolest things I’ve ever done,” he says. No matter what ‘s on his plate on any given day, thoughts of his medical training, which he began with the intention of becoming a plastic surgeon, are top of mind. “The philosophy we trained under at KCOM was more holistic than standard medicine, and that just works well here,” Dr. Savage says. “We deal with people who are healthy who want to stay healthy, so a background in dietary, nutrition, osteopathic medicine, and rural medicine is what you need to do that well.” 
In regard to training in rural medicine, “A space station is about as remote as you get – you can’t exactly get an ambulance out there. When you’re out there on your own with very few resources, you still have to do the job. KCOM trained me very well for those sorts of challenges.” Something else he values is osteopathic manipulation, which he has used throughout his career and continues to employ at NASA. He also appreciates KCOM’s approach to regional anatomy rather than systems anatomy. “I can’t tell you the number of times I’ve been grateful for that approach,” he says. “Knowing not just the separate systems but where they’re located and how they relate has been very, very useful. I still push that to students.” “People always ask, ‘Didn’t you want to be in the space program since you were a little boy?’ And I say, ‘No. It just kind of happened.’ And I’m ever so glad that it did. I certainly am now and will be the rest of my life.”