Richard A. Scheuring, DO (left), takes part in lunar simulation on Devon Island in the Arctic Ocean.
Richard A. Scheuring, DO (left)
Office Space

Hero Next Door: How a NASA flight surgeon takes care of astronauts

NASA flight surgeon Richard Scheuring, DO, supports shuttle launches and cares for astronauts—when not practicing space walks with them.

Richard A. Scheuring, DO, grew up wanting to be a physician—and obsessed with space flight, an infatuation that began at age 5, when he attended the Apollo 11 parade in Chicago in 1969 celebrating mankind’s first trip to the moon.

Decades would pass before he would realize that he could combine these two passions. He began his medical career as a family physician in private practice in Galena, Illinois, in 1996, but quickly realized he wanted to learn more. Then one day, he saw an ad for an aerospace medicine fellowship in The New England Journal of Medicine.

“Once I found out that the field of aerospace medicine existed, I got really excited about going out and actually doing it,” he says.

In 2002, he did just that by entering an aerospace medicine residency in Ohio.

“I saw space medicine as a way to combine my fascination with aviation and space with my real enjoyment of human physiology and medicine,” he says.

In the first year of his new residency, Dr. Scheuring landed a one-month rotation at NASA. The following year, he moved to Houston to work for a NASA contractor, Wyle Laboratories, where he conducted research and trained to be a flight surgeon. He hoped the position would lead to a job as a NASA flight surgeon. In the meantime, his job at Wyle helped him achieve a dream he didn’t think he’d ever realize: meeting and working with the Apollo astronauts, the only men who have ever walked on the moon.

In 2005, NASA began its Constellation program, which aimed to send astronauts back to the moon by 2020. At Wyle Laboratories, Dr. Scheuring worked under J.D. Polk, DO, NASA’s chief of space medicine at the time, who assigned him to learn everything he could about human health and performance during lunar missions in preparation for the next moon landing.

“J.D. gave me six months to learn everything I could about the Apollo lunar surface operations, about space walks, about the spacecraft, everything,” he says. “And I came up with about 285 questions that the Apollo astronauts had never been asked before. So I got ahold of all of them and asked if they’d be willing to come to NASA in 2006, and they agreed. We had more than 50% participation in a face-to-face meeting. For three days, I just got to pick their brains and ask them, ‘If you had to do it all over again and had a blank check, what would you do the same and what would you do differently for the next go-round for the moon?’ That was a dream come true.”

Meeting moon men

Alan Bean, John Young, Eugene Cernan and other Apollo astronauts came to the meeting, where they told Dr. Scheuring that the one thing they’d change about the original Apollo spacesuits would be the gloves.

“The gloves only had about 10 or 11 degrees of freedom and the spacesuit’s pressure was 3.75 [pounds per square inch], so the astronauts expended a lot of energy in their wrists and forearms trying to use that glove,” he says. “They said they hoped future glove designs would have more degrees of freedom for the fingers to move and even possibly robotic-assisted joints.”

Dr. Scheuring had noticed in videos that the astronauts wobbled in their spacesuits when they walked on the moon. The prevailing assumption at the time was that the astronauts suffered from neuro vestibular dysfunction, or vertigo, as their bodies adjusted to the moon’s gravity. But after talking with the Apollo astronauts, he learned that wasn’t the case.

Wearing an extra-vehicular activity space suit, just like his patients do, Richard A. Scheuring, DO, trains at NASA’s Neutral Buoyancy Lab. (Photo provided by Dr. Scheuring)

“I asked them, ‘How soon after getting to the moon did you feel like you got your sea legs back?’ ” he says. “They said that actually, they felt that they were stable pretty quickly. It was the center of gravity in the spacesuit that they wore on the surface that made them feel wobbly.”

Dr. Scheuring compiled this information, along with the astronauts’ answers to other questions, in a report, The Apollo Medical Operations Project.

“The report contains a massive amount of fantastic information for the next exploration missions,” says Dr. Polk, who is now the dean of the Des Moines (Iowa) University College of Osteopathic Medicine. “Rick was in charge of putting that report together and chaperoning that process, and he did a phenomenal job.”

Josef F. Schmid, MD, MPH, a NASA flight surgeon, also lauds Dr. Scheuring’s work with the Apollo astronauts.

“Rick was able to extract, in a very gentle way, a tremendous amount of knowledge and experience from the Apollo astronauts on what they experienced on the moon, what they experienced in training, and how they would improve spacesuit design for the future,” he says. “It really was an unbelievable opportunity.”

Shuttle support

A year after his momentous meeting with the Apollo astronauts, Dr. Scheuring became a flight surgeon with NASA at the Johnson Space Center in Houston. He supports spacecraft launches and landings, helps astronauts train for space flight, and takes care of astronauts before and after their missions. In addition, he cares for the astronauts’ families.

“It’s our job as flight doctors to make sure that the families are so well taken care of that the astronauts don’t have to worry about any family problems,” he says. “On one of my colleagues’ missions, one of the crew member’s wives had a baby while he was up on the station. While she was going into labor, my colleague was at the hospital with her, talking to her husband on the space shuttle via a satellite phone.”

With the Constellation Program, Dr. Scheuring often supported short shuttle missions to the International Space Station (ISS), which usually lasted about 14 days. But in 2010, the Obama administration cancelled Constellation. Besides meaning the end of NASA’s space shuttle program, the decision put the agency’s lunar travel plans on hold without funding.

Afterward, Dr. Scheuring began assisting U.S. astronauts assigned to longer Russian-supported ISS missions. Although American astronauts now use Russian spacecraft to get to and from the ISS, Dr. Scheuring and other NASA flight surgeons travel to Russia’s Baikonur Cosmodrome in Kazakhstan, the site of the launches and landings, to provide support.

Dr. Scheuring completed ISS Expedition 36/37 last November, and he is now assigned to NASA Expeditions 47 and 48, which will depart Kazakhstan in spring 2016 for an ISS mission led by NASA astronaut Jeffrey Williams.

ISS missions are typically six months long, Dr. Scheuring says, and during that time, he’ll do weekly private medical conferences with the American astronauts via satellite video and telephone. He and his colleagues are on call 24/7, and the astronauts on the ISS can call or email them if they need anything.

Astronauts typically suffer from space motion sickness when they first get to the station, Dr. Scheuring says, noting that the illness is the common cold of space flight. The nausea, headache, vomiting and back pain tend to clear up in a few days, when the astronauts’ bodies adjust to the new environment.

“You get a two-liter fluid shift toward your head when you get into space because gravity’s not pulling the fluid to your legs anymore,” Dr. Scheuring says. “There’s a lot of really dynamic changes that occur in the body.”

Other common health problems for astronauts include bone and muscle loss, low back pain and temporary farsightedness, Dr. Scheuring says. In the past, astronauts would often lose up to 30% of their lower-body muscle mass and up to 20% of their bone density on a six-month mission because the weaker gravity of space doesn’t provide as much resistance to the body.

But in recent years, engineers and physicians have designed exercise hardware to prevent these losses.

“Now we’re seeing astronauts come back much stronger after space flight than previously because we have such robust exercise devices in space,” Dr. Scheuring says. “They really enjoy exercising in space, so they’ll ride on an exercise bike or run on a treadmill or complete a resistive exercise program.”

Training and rehab

To prepare for their space journeys, astronauts submit to rigorous physical training. Dr. Scheuring trains alongside them, which helps him better understand the physical challenges the astronauts are exposed to.

“I can do just about everything with my crew except go into space,” he says. “If we’re flying T-38s, I get to fly a T-38. If they’re practicing their space walks in a neutral buoyancy lab, which is a big swimming pool, I get to dive with them. I really enjoy exercising with the crew, going through all the training with them and teaching them medicine. These are some of the most direct joys I’ve had on the job.”

Following the cancellation of the Constellation program, Dr. Scheuring helped develop NASA’s musculoskeletal sports medicine rehabilitation program, which helps astronauts with post-flight reconditioning.

“Rick brings strength trainers in. He has brought in orthopedic surgeons and residents. And he works with the astronauts directly to identify their risks for injury and reduce them,” Dr. Schmid says. “And when astronauts are injured, he helps them get back to their training. He has probably saved a number of astronauts’ careers from being shortened by an athletic injury or an injury on orbit.”

Additionally, Dr. Scheuring has become certified in musculoskeletal ultrasound, an emerging field in the U.S. that is also the only imaging modality available in space. Physicians use musculoskeletal ultrasound to visualize their patients’ rotator cuff muscles, tendons and ligaments and can also use it to guide injections into the shoulder, knee or other areas.

In the future, Dr. Scheuring says he’d like to serve as a lunar flight surgeon and assist on the first mission to Mars, whenever it should happen.

Renaissance men make good flight surgeons

Dr. Scheuring advises medical students and young DOs interested in aerospace medicine to apply for NASA’s month-long aerospace medicine clerkship, offered every April and October.

“The clerkship is a great way to learn what space medicine is about and learn all the things that we do,” he says. “It’s also a well-kept secret, and I’m not sure why.”

Aerospace-inclined students can also consider becoming pilots and joining the military, notes Dr. Scheuring, who did both.

Dr. Polk says Dr. Scheuring’s well-roundedness—in addition to serving as a lieutenant colonel in the U.S. Army and working for NASA, he is a preceptor and clinical professor for a few teaching hospitals—makes him a better flight surgeon and illustrates his dedication.

“Rick has served his country in the military,” he says. “He has deployed to hazardous places in wartime. He has been the first in after a tornado nearly destroyed a town—he helped lead the mass casualty triage and commanded the incident. And he could easily make twice as much money at a different job. But Rick is truly dedicated to the mission, whether it’s the mission of space flight, the U.S. Army or disaster relief. He is truly dedicated and self-sacrificing to the mission. It runs through the fiber of his being.”

Dr. Scheuring is also dedicated to his patients, notes Dr. Schmid, who attributes Dr. Scheuring’s rapport with the astronauts in part to his backgrounds in family medicine and osteopathic medicine.

“Dr. Scheuring is a full-spectrum family physician,” he says. “Family physicians take care of the person within their family, within their community, and within their work site. DOs are especially trained to take care of people in context of their lives and from a holistic approach. I’ve been very impressed with the way DOs I have worked with do that here. Dr. Scheuring not only takes care of the astronauts, he also takes care of their family members, and he prevents disease and injury from occurring on the job.”