Wild Blue Yonder: Med Alumna’s Career in Space Medicine

Rebecca Blue (M'08) practices and teaches both emergency medicine and aerospace medicine.

By Kate Corboy and Jeffrey Donahoe

Imagine riding in an elevator ascending at fast speed. Your body wants to sink low toward the floor to compensate for the upward motion. Your blood wants to sink too. A rush of blood to the feet means a lack of blood flow to the head, which can cause you to pass out.

Now imagine that the elevator that you’re riding is moving as fast as a rocket. What’s the physical impact of that intense acceleration on every part of your body?

With self-described “spacelines” preparing for liftoff in the not-too-distant future, that question is no longer merely theoretical. Companies like Richard Branson’s Virgin Galactic and Elon Musk’s SpaceX have spent over a decade developing ways to carry passengers—ordinary, untrained people—into space.

The new industry’s aspirations are heavenly, but there are earthly issues too, including the health of potential space tourists. Is it safe for average citizens to go into space? How will the everyday ailments of healthy people react?

To find the answers, flight surgeon and space medicine researcher Dr. Rebecca Blue (M’08) leads the largest study ever on the effects of simulated space travel on civilians.

‘NASA Will Come Back’

In January 1986, 7-year-old Rebecca Blue, already obsessed with space, huddled around a TV with the rest of her first-grade class to watch the historic launch of the Space Shuttle Challenger, which turned into one of NASA’s great tragedies when it broke apart 73 seconds into its flight, killing all seven on board.

Later that year, the same class of first graders had to share what they wanted to do as adults. Blue announced that she wanted to work for a space program.

“The teacher said, ‘Becky, I’m sorry, but there won’t be a space program anymore,’” Blue recalls. Blue’s response: “You’ll see. NASA will come back.”

At 11, Blue won a scholarship to attend space camp in her home state of Kansas, making her one of the youngest campers to ever attend. She read book after book about space. She worked odd jobs for two years, and finally, at 14, had saved enough money to attend an advanced space camp at Johnson Space Center in Houston, home of mission control and NASA’s lead program for International Space Station operations and missions.

“I didn’t need to be the one flying, didn’t need to be the astronaut,” she says. “But I wanted to be part of the whole team of people working in space programs.”

For Blue, the answer was space medicine.

Dr. Rebecca Blue (M’08)

Taking a Nontraditional Way

In 2003, with a degree in biology from Truman State University in Missouri in hand, Blue applied to medical schools. She vividly remembers being in Georgetown Medical School’s “fishbowl,” the glass-walled room where applicants are interviewed. 

The speech about cura personalis hit home. “I knew I loved science and could handle the academics, but what I really wanted was to learn more about treating the whole person, not just the disease.”

Blue’s education was unique. In her first and second years, in addition to the medical curriculum, she studied international relations, focusing on how medicine is practiced in other countries and the expectations for care in different cultures.

“One of the things that makes Georgetown Med great is the teaching about cultural differences,” she says. “In our first year, they brought in religious experts from major faiths, including a Catholic priest, a rabbi, an imam. They talked about the major tenets of their religions and what that would mean for a patient’s expectations and needs.”

Blue received a Fulbright Scholarship to study health care differences, which led her to University College of Dublin, Ireland. The Fulbright opportunity required her to take a year off from medical school between her second and third years.

“Georgetown embraced my decision to go to Ireland,” she says. “Everyone at the School of Medicine was so accepting of the nontraditional way. The faculty recognized and encouraged those differences and, in my case, really helped me to explore opportunities that I wouldn’t have been able to explore otherwise.”

The Fulbright gave Blue the chance to design her own study plan, focusing on international health policy and the differences between countries. “At the time, there was a lot of activity in the health policy arena. Ireland had opened its borders as a member of the European Union, and as a result was forced to develop its human protection and health laws specifically for children and immigrants,” she explains.

Blue received her Higher Diploma in Social Policy before returning to Georgetown to finish her medical degree.

Space Patients

“It’s like a regular medical visit,” she says of the experience. “Only the patients are in space.”

Through it all, Blue’s commitment to becoming a flight surgeon had not wavered.  

Knowing that most successful flight surgeons were trained in another field in addition to aerospace medicine, Blue matched for an emergency medicine residency at Florida’s Orlando Regional Medical Center, the level-one trauma response center for any space shuttle launch- or landing-related emergency at Kennedy Space Center in nearby Cape Canaveral.

Blue then completed a second residency in aerospace medicine at the University of Texas Medical Branch (UTMB). Part of the residency was at Johnson Space Center in Houston, training under active flight surgeons. Blue trained with the center’s medical support team for the six astronauts living on the space station year-round. The team had regular private medical conferences with the orbiting astronauts via an earth-bound video link.

“The space suit itself can be hazardous, and space and its pressure are hard on the suit,” Blue says. “The crew can easily have the minor but frustrating injuries that we all get in normal daily life—a scratch or a bruise or bump—but in space, these issues can have greater consequences.”

“It’s like a regular medical visit,” she says of the experience. “Only the patients are in space.”

A Ticket to Ride

For all of its 70 years, the U.S. space program has been solely a government operation, with NASA providing strict controls and protocols. Astronauts go through four to six years of intense training before they go into space. They are in peak condition, and their health is continually monitored. Worldwide, astronauts make a tiny group: fewer than 550 people have gone into space since Yuri Gagarin’s first trip in 1961.

Enter private enterprise.

When commercial spacelines like Virgin Galactic, where Blue is a consultant, start operating, they will upend how we think of space flight—and what we think of as space travelers.

“This new consumer-oriented industry and the coming space tourist is a huge change from a NASA model,” Blue says.

More than 75 people bought tickets on Virgin Galactic, founded in 2004, when it was still an idea. No one yet knows when the first flight will be; nonetheless, more than 700 people have paid as much as $250,000 for a ticket to ride. (Ticket holders include Stephen Hawking and Lady Gaga.)

Breaking the sound barrier is no easy ride—not even for trained astronauts. There’s the pull of gravity, rocket-propelled accelerations, supersonic speeds, deceleration, and re-entry into Earth’s atmosphere, to mention just a few of the physically demanding events to overcome.

There is almost no information about how persons other than career astronauts can tolerate the stressors involved in spaceflight. Blue’s research is beginning to fill that gap.

“Now that I have the position, everyone who told me not to do it has begun asking how to get into the field.”

The Next Best Thing to Being There

Since last fall, Blue has been leading a study with Principal Investigator Dr. Jim Vanderploeg of UTMB. The study, sponsored by one of the Federal Aviation Administration’s Centers of Excellence for Commercial Space Travel, is trying to determine the physical standards, medical history, screenings, and training necessary for a space tourist to be cleared for a suborbital jaunt.

The FAA study, granted to the UTMB, is conducted at the U.S. National Aerospace Training and Research Center (NASTAR), just north of Philadelphia. Blue brings the study volunteers to NASTAR for two days, placing them in a large, high-fidelity centrifuge model that simulates the accelerations profiles of commercial spaceflight vehicles and induces several types of G-forces, placing stress on the heart and internal organs.

Add sound, video, and anxiety, and—while it’s not space—it is the next best thing to being there.

In the study, the team spun 77 volunteers, ages 20 to 88, of “all shapes, sizes, and medical histories,” Blue says, including a below-the-knee amputee.

“Name a common ailment, one of them had it,” she says. By common ailments, Blue means everyday afflictions: heart and respiratory problems, diabetes, high blood pressure, and musculoskeletal problems.

Blue and the research team gradually increased the G-forces to let the study participants adjust. The team monitored vitals before during and after the centrifuge simulations and watched them over video.

Blue's research uses a large, high-fidelity centrifuge model that simulates the G-forces that future space travelers will experience. Photo credit: Chris Crisman Photography

The first study showed that the volunteers tolerated the centrifuge model of acceleration forces well, regardless of age, sex, medical history, or medication use. A second study tested 86 volunteer subjects with the same common health issues. In spite of their ailments, “they all did fine,” Blue says. “It was intense, but they all made it.” For some, anxiety proved to be a larger problem than physical symptoms.

The best part of the simulation? “No one puked,” Blue says. “That’s what they worry about most.”

A third study, currently underway, has doubled the number of volunteers.

Unmasked Excitement

“My favorite part of my job is the number of incredible opportunities that have been given to me—even the training I have received,” says Blue. “I’ve been put into spacesuits, space capsules, centrifuges, and simulators. I’ve undergone various water, winter, and heat survival courses, as well as parachute and flight training. Not to mention being sent all over the world for support and operational events. In this line of work, we often catch ourselves saying, ‘I can’t believe they let us do this!’” she says with unmasked excitement.

In 2015, Blue started as a full-time emergency physician and educator at Upstate Medical University in Syracuse, New York, working with emergency medicine residents. She’s also an assistant professor in the UTMB Preventative Medicine & Community Health Division, where she mentors residents in the aerospace program and runs her research.

“People throughout my career have told me that space medicine was a silly dream, that I should grow up and focus on getting a real job,” Blue says. “Now that I have the position, everyone who told me not to do it has begun asking how to get into the field.”