FINAL SCRIPT Mans ceaseless drive to
explore… Drives medicine to discover
and pioneer new ways of curing the ills of the human body Today medicine is at the
edge ...in space, Preparing the way for a
3 year journey to Mars,. On Mt Everest,
preventing climbing deaths on the worlds highest mountain And underwater, treating
divers for their most feared condition – the bends. Exploring underwater
beneath the sea– its a sensation often compared to floating in outer space
However, the graceful
ease of a diver underwater masks a very real
physical danger. Placed under the extreme
pressure of a deep water dive, the air a diver breathes to survive turns into a
threatening menace – producing nitrogen bubbles in the body - which if
not properly expelled can be fatal. Sean Gregg is a
commercial deep sea diver. 18 years ago Sean left Canada to take a diving contract in American Samoa. He set up his own
commercial dive company and never went home. Sean:
It’s nice down here- the water’s 80 degrees- you do your diving in
t-shirt and shorts..and it’s really nice and comfortable. The
water’s warm- it’s a nice place to live. The American Samoan
capital of Pago Pago
is home to the world largest tuna fishing fleet . Tuna boats like these
are in need of constant maintenance most of which has to be done underwater. It’s Seans
Gregg’s job to keep the boats clean and sea worthy . Most of Sean’s
diving takes place in 15 to 20 feet of water. At this depth he can
work quite safely for hours at a time, because his body is exposed to
relatively little underwater pressure However when Sean has to
work in deeper water his job becomes far more dangerous. Sean:
Once a year we have a contract… …which
is about 180 feet on the bottom…. …At
which point your diving becomes a little more risky at that depth…. …It’s
dark and it’s dirty… ….
and it’s as dangerous as you can make it. At 180 feet, Sean
breathes air at more than six times the atmospheric pressure of sea level. His time on the bottom
is very limited… …and he has to
work quickly, before the high-pressure nitrogen in his breathing air
potentially risks his safety. Nitrogen at depth makes
many divers feel drunk. Known as nitrogen narcosis, it effects crucial
decision-making. . John Duncan is a dive
medicine doctor at the Devonport
Naval Hospital
in Auckland NZ. He regularly takes dive
trainees down in a hyperbaric chamber to show them the effects nitrogen on
behaviour. The chamber is first
taken down…. … to a depth of 60
feet. The trainees behave
quite normally.. When the divers are
taken down… … to one hundred
and fifty feet the nitrogen pressure on the body’s nerves … ….increases
dramatically… … … inducing a narcotic like state Basil: Alright,
fifty metres- All well? John:
At fifty meters we can see them.. they’re behaving like silly
chooks… ….
unable to make simple sentences… ….
Nitrogen- once you’re past thirty to thirty-five meters.. …becomes
just like alcohol…just like an anaesthetic Trish:
Hi my name’s Trish. I’m here because I really want a career in Hollywood. John:
If you take people deep enough it will become a general anaesthetic. The people
on the Kurst… …when
it went down- air at that level would just put you straight to sleep. Nitrogen narcosis goes
away when divers return to shallower water… …..
isn’t that dangerous to you but the effects of it- the fine motor
control- so inflating a buoyancy compensator or adjusting your dive gear will
become difficult. It will affect your judgement and if you’re at forty
metres, or thirty-five metres, the amount of time you can spend there is very
limited. Should you become disoriented and overstay your time there it affects
decompression time and you may well end up running out of air. But breathing nitrogen
under pressure creates another potentially lethal condition, that deep water
divers like Sean fear even more - decompression sickness, commonly known as
“the bends.” When divers dive deep,
the nitrogen in the air they breathe is forced into their tissues. If they ascend too
quickly, or stay down too long this nitrogen can form bubbles… …blocking vital
blood flow to tissues and organs. Bubbles can block blood
getting to any part of the body but are especially dangerous when they form
around the spine and central nervous system. Very quickly a diver can
be paralysed. For most recreational
divers these bubbles are not a problem. They’re small and get exhaled
easily through the lungs. Deep sea divers like
Sean expose themselves to a life threatening hazard, because the deeper you go
and the more dives you do, the more nitrogen is absorbed by the body.. …. they end up diving deeper and longer. A single dive is
perhaps not that dangerous… ….…. but when you’re getting repetitive diving-
diving deep again day after day after day, it definitely increases the amount
of nitrogen that we absorb and it increases our risk. The only way for
deep-sea divers to prevent bubbles is to decompress… ….stop regularly
on the way to the surface, allowing time for any bubbles to be expelled. It’s the same
process as releasing the gas from a bottle of soda –taking the lid off
gradually… ….. prevents many
gas bubbles from forming. But decompressing
doesn’t always guarantee all the nitrogen bubbles will be expelled And last year after
doing ten days of 180 foot dives Sean found himself on the surface, in trouble. Sean:
I got to the surface and…. ….probably
within thirty seconds…. ….
I looked at my partner and I said there is definitely something wrong… ….
I became very disoriented, dizziness and nausea… ….
kicked in just immediately…. ….The
only thing I could say to my partner….. …. was get this gear off me and get me in the boat
because there’s something wrong… …
And at that point I’d made it to the ladder …. …
of the boat and that is the last thing I remember. Sean was now
unconscious…. … an air bubble blocking
blood supply to his brain. Known as an arterial gas
embolism… …it’s a
common cause of diving related deaths. His dive partner tried
to haul Sean’s180 pounds of dead weight into the boat. He radioed for
assistance but he couldn’t raise the coastguard. Sean:
He physically could not life me into the boat… …
he actually tied me off to the ladder of the boat….. ….Luckily
there was a… …
local fishing boat was going out of the harbour… ….and
he flagged them down and they… ….came
over and they physically…. …pulled
me into the dive boat….. …
and then they proceeded to go to the hospital…. …Whatever
happened to me on that dive- it paralysed me from the waist down …..
It was a sort of a scary moment…. …to
realise that here you are you know, you’ve been diving all your life and
no problems then all of a sudden one day you do everything right but
you’re now going to be in a wheelchair. Sean regained
consciousness on the way to the hospital but he had a serious case of spinal
paralysis, known as “the bends”. Worse still, there was
no hyperbaric chamber on the island to treat his condition. . …..- I would be physically done for for…. …life
if I didn’t get out of this place because they had nothing to offer
me… ….
so I called my wife and I said whatever you do is just get me out of this place. Without treatment in a
hyperbaric chamber Sean would be paralysed for life. He needed to stop the
nitrogen bubbles damaging his spine any further. Sean chartered a plane
to the nearest hyperbaric chamber - 2000 miles away in New Zealand. 5 days after the
incident he arrived for treatment at Devonport
Naval Hospital. John:I
was shocked at how bad his paraplegia was… ….
He had a dense paraplegia from the waist down affecting one leg more than the
other…. ….
With him being so long after injury… …
I sincerely doubted he’d walk out of here… ….
I remember saying if we could get him out of here on… ….a
walker I’d be happy. I’d be ecstatic Sean:John
has seen a number of cases and he told me it was a severe case…. …. I was in deep trouble… …and
– his prognosis- he didn’t know what was going to …. …happen
with this. We were going to try the treatments that he…. ….was
going to offer and we could only take it day by day to see what was going to
happen. Sean was sent
immediately for treatment to the hyperbaric chamber Taking Sean back to
depth, breathing pure oxygen, would recompress any remaining bubbles out of his
spine. But the doctors
didn’t know whether the treatment would be
too late to heal the spinal nerve damage Sean had already suffered Sean’s initial
treatment in the chamber was almost ten hours long…. …but there was no
sign of movement … mean I was still paralysed…. I still
didn’t feel anything… …
so you look at yourself and you say- well this one doesn’t do anything
for me so we’ll start again tomorrow and we’ll continue until
something does change. John:
I spent a lot of time discussing with Sean the likelihood that he would not
walk…. …out
and due to ….. …the
severity of his illness. I mean, he’s a young man married with two young
children. Sean’s 2nd
treatment was his last hope. If there was no
improvement this time, the treatments would be stopped… … there would be
little the doctors could do. For over nine hours
there was again no sign of improvement. In a final attempt to
purge the bubbles and stimulate Sean nerves, the chamber was then taken down to
maximum depth,150 feet. With less than an hour
remaining, Sean’s toes began to slowly twitch. ….are
involuntarily moving which means …. …your
nerves are regenerating and causing your muscles to move… …Your
whole body is jumping- saying like- I’m going to get well, I’m
going to get well Sean continued treatment
in the chamber for another 2 weeks. Each time, more and more
muscle movement returned. He was not yet able to
walk but he was determined to make a full recovery John:He
remained incredibly positive… … …and
with every new improvement ……. ….he
had he regained more and more improvement After the chamber
treatments, Sean was sent to rehab.
In the space of just a few weeks, he learnt to walk all over again John:
I am sure a lot of it is due to his attitude. The fact that he didn’t
just lie in bed and give up…. …As
far as he was concerned he was going to get better. 3 months after the
incident Sean was back in business with his partner on Pago Pago harbour. He resumed diving
again….. … even though the
doctors warned him he was now even more likely To have nitrogen
problems again These days Sean strictly
limits his deep dives and has longer decompression times in the water to make
sure he’s properly expelled any nitrogen bubbles. …And
if you’re doing recurrent diving- recurrent deep diving- then you need to
play it safe. With each passing month,
Sean’s spinal nerves continue to heal. He now has close to 90%
of his movement back. …and
I truthfully think that I would not be sitting here… … having a smile on my face and… ….be
able to sort of run around a little bit….. …and
back in the diving business supporting my family Underwater - too much
air pressure can be fatal. It’s the opposite
on the highest point on earth - Mt Everest. Here the summit is five
and a half miles above sea level. The air so thin it
barely sustains life. Ken Kamler is an high
altitude physician. He’s been a doctor
on Everest six times including 1996… … when 9 people
died in a single day. Ken:
Everest is a legend. … ….
It’s not just a mountain – it’s a legend. There’s a
tremendous history behind it. It has a mystique … …
and in addition to being the tallest mountain in the world it’s
tantalizingly close to the limit of human physiology… ….
You’re climbing in an area where physiologically your body is not able to
adapt… ….
Human beings can’t adapt to an altitude above 17,000 feet… …
that’s already half the air pressure that you have at sea… …level
and the summit is one third the pressure that you have at sea level… …so
you’re climbing in a range of very much reduced oxygen pressure –
your body’s not used to that. Your body’s not really equipped to
deal with that and can only adapt to a very limited amount Climbing doctors are
however rare. In most cases, its up to
experienced climbers to doctor themselves. Guy:Your
body’s always under stress…. …is
sort of… Guy Cotter guides
clients up Mt Everest. He’s climbed the
mountain four times, summitting twice. His business depends
upon him… …mastering the
physical toll of high altitude mountaineering Preparation for an
attempt on Mt Everest takes many months Yak loads of supplies
and the climbers themselves…. …walk into the
mountain over 10 days This year Guy Cotter has
a… …team of fourteen
going to Everest. At Loborche, the last
village before base camp …his
sat’s are apparently in the nineties- but they say he’s still very
wobbly and can’t stand up on his own. Rachael:
Ciao- how are you? Rachael Bishop is Guy
Cotter’s expedition doctor. As the only doctor in
the village she has to treat a sick porter suffering from
High Altitude Pulmonary Oedema. HAPE is a common and
often fatal illness. The thin air at altitude
has caused the porter’s lungs to collapse and leak fluid. If left untreated
… …. the fluid will
completely fill his lungs and quickly drown him …oxygen but
they’re going to put some dexmethozone into him- which will help
stabilize him to move down to a lower altitude. If he stayed here he’d
probably die. Dexmethozone is an
injectable…. …steroid used to
lessen the effects of… ….altitude on the
body Combined with the
bottled oxygen, it offers a window of relief to get the porter down to a lower
altitude The only cure for
altitude illness is descent.. Recovery can be almost
immediate if a patient can get to a lower altitude and thicker air in time Rachael:People
generally don’t look after their porters… ….
Because someone has taken the responsibility to bring him down and give him
oxygen and drugs- he’ll probably be o.k…. …but
all too many porters just get left and they die. A few days after leaving
Loborche the team arrives at Base Camp, 17500 feet above sea level. Guy Cotter will oversee
the climb from here. His team includes his
main guide Dave Hiddleston …and client Andy Hebson. Andy’s guide Dave
Hiddleston will also be attempting
to summit for the first time An experienced high
altitude guide., it’s his job to not only to help Andy up the mountain,
but also be his doctor if any problems arise. The extreme altitude of
Mt Everest makes it impossible to climb without serious preparation. Before a summit attempt
can even be made… …a month long
acclimatisation programme has to be undertaken - climbing up and down the
mountain to camps at roughly 2000 foot intervals. The first days climb is
to Camp One,1900 feet above base camp. Only a matter hours will
be spent there – just enough time for the body to begin adjusting to the
thinner air. Ken:
Your body’s got to acclimatise- that’s the process that takes
several weeks to be fully completed. It starts out just by breathing
deeply…. ….because
your body brings in other processes such as increasing the number of red
blood…. ….cells
which carry oxygen which makes it easier for you to transport the oxygen to
your tissues. Those processes take weeks On the way to Camp One
the climbers have to traverse three –story high walls of unstable ice. But back at base camp Guy
isn’t so much worried about the ice… …as to how the
climber’s bodies are holding up. …He
picked up a bug just a little while ago so he’s coming back down. Andy:
Even when I left here I felt sick. I didn’t feel good when I left… …..
I was nauseated- I almost feel like I got the flu. I didn’t feel good
when I left. Rachel:
There you go- one white one, one green one. Rachael prescribes
antibiotics and a few days rest at base camp –but the lack of oxygen also
makes recovery slower at altitude. He’s also picked
up a stomach bug and a cough While Andy rests at base
camp, High up Mt Everest, Dave Hiddleston is making his own attempt on the
summit. He’s climbing near
to what is called the Death Zone – where the oxygen content of the air is
only a third of that at sea level. Even with the assistance
of bottled oxygen, getting enough of it to the body is almost impossible. With each breathless
step, the climbers slowly deteriorate. …noodles or
continental instant noodles. Normally I’d just go - Right, I want the
tomato- up there it’s like – I’ll think about it for a
bit…. …Now
sure what soup I wanted. Taste factors a major importance up here… …You
actually think you’re quite normal till you see yourself and realize how
you’ve slowed down. I think this is why people get into so much trouble
at altitude. Summit day dawns perfectly … but it’s the first
attempt of the season… …and the climbing
ropes haven’t been properly laid. Dave:..we’ll
try the Hillary step and see what happens. We have limited rope and limited
sherpa power. Guy:
Do you think it’s worth waiting to see if anyone else behind has got some
rope to try and fix. Dave:
It’s going to take us – I’m guessing three hours to reach the
summit. Making life or death
climbing decisions with limited oxygen going to the brain is difficult. Guy
Cotter has been there before. He’s in constant
contact with Dave, using all his high altitude experience to talk him through
the climb. Guy:
Yeah that’s obviously the situation is what is is and you can’t do
anything about it. Most importantly, Guy
monitors Dave’s mental state – because the lure of the summit too
often leads climbers to make a fatal decision. Ken:
Twenty nine thousand foot mountain… …and
you’re 900 feet away – you want to get to the top you’ve been
planning this expedition for months and you can be at the top in two hours so
there is that tremendous lure to not turn around but unfortunately it has cost
many people their lives. Guy: I
tell people you’ve got a tank of … …gas
and once you’ve burned up three quarters of that tank of gas you’ve
got a quarter of that tank to get back… ….down and if people exceed that- if they push
too hard… …and
don’t have the strength or wherewithal to get back down- they’ve
kind of blown it. Dave: South Summit…. ……
believe me its hard work Dave pushes on At the south summit just
300 feet from the top he’s run out of rope again. Dave:
I was getting great feedback about how I was actually doing up there and I
seemed to be doing fine…... …but
something was telling me – no- today’s not the day. Guy: Pushing on at this
stage if its going to take you that long to summit is pushing the envelope just
a little bit too far… …
its one of those things that either on or off even though it’s a
beautiful day it must be very hard for you to make this decision. Dave: yea. We’ll start heading down now. Ken:
Everest is not the hardest mountain in the world to climb but the difference
is….. ….when
you’re doing that climb at 29,000 feet and you have one third as much
oxygen and the temperature is thirty below zero and you’ve been out for
16 hours and you’ve had a half glass of water to drink in the past 24
hours that becomes a daunting challenge. Dave:
We may have got to the summit but I don’t know if we would have
got… ….down
so it’s not really worth it is it? Back at base camp,
Andy’s recovered sufficiently to climb again. He sets off for Camp 2,
2100 feet above sea level. It’s a long climb,
made doubly difficult by extreme variations in temperature. In the Western
Cym, a large valley before Camp 2, daytime temperatures reach 40
degrees celcius. For the climbers dressed
for minus forty and struggling to breathe in the thin air, it’s a hard
slog.. Andy:
When I was very close to camp two I was trying to get four or five steps and I
was actually seeing dots. I couldn’t even hardly breathe I felt like I
had a garbage bag in my left lung. At camp 2 Andy’s
collapsed - short of breath and coughing badly. . At this altitude it
could be the first sign of pulmonary oedema or flooding of the lungs Rachael:
What’s irritating him- is he still breathing quite fast? For Rachael, unable to
physically see Andy…. …it’s a tricky
diagnosis. Rachael:
How about you get the oxygen out…. ….and try him on one liter for an hour with the
thought that if he’s on oxygen he’ll have to breathe less fast,
and if he’s breathing less quickly that might be less of an irritant for
him for coughing over. Dave:
Righto so one litre an hour correct. Rachael:
Yea that’ll be good- that’ll also warm the air he’s breathing
a little bit as well and that’ll be less of an irritant as well. Andy has to spend the
night on bottled oxygen. The thicker air should help him regain strength to
descend the next day. … It was fun.. …It’s an awful long way, even if it is
downhill. …and
often a summit can be lost just through a mere cold…. …or
a stomach bug. The next day Andy
decides his health isn’t good enough to continue… … his Everest dream is over. Andy: It’s a tough mountain… Guy:
Some people never really acclimatise that well to going up really high… …
there’s no real reason for it may be he’s one of those…. ….people
maybe he’ s one of those people- maybe he’ll come back in a couple
of years and be able to do it. Andy:
Alright here we go-See you guys- alright Guy I’ll call you tonight. Andy:
You know I’m disappointed that I didn’t summit but I’m not
done yet… I’ll be back…. …
All I’m gonna do right now is back up and take another run at the hill.
So- that’s my plan. The very name Mt Everest
has come to mean the greatest challenge… …but there’s
another more testing environment for medicine. Outer space and sending
astronauts on a three year mission to Mars The longest any human
has survived in space is just over a year. Before any longer journeys can be
attempted, space medicine has to prepare the way…answering challenges
like How to overcome the long
term effect of weightlessness on the bones, how to perform surgery
onboard the spacecraft and working out how best
to select a crew to get along and work efficiently in a confined space the size
of school bus. A little over 40 years
ago manned space flight was just a dream. The science of space
medicine was in its infancy… …doing experiments
to answer the question… …could man even
survive a few days in space? …- back in the mid fifties when the notion of satellites was
really well known among the scientific community there were panels which looked
at what was likely to happen to humans in orbit.. and the predictions were high
blood pressure, excessive heart rate, nausea, dizziness inability to swallow,
inability to sleep…. ….When
this finally happened and we sent people into space some of these symptoms
occurred… ….but
they occurred to the ground controllers…. ….The
astronauts wee fine and so largely…. …we
found that short duration space flight is not really a problem other than space
motion sickness. Over forty years of
manned space flight, space medicine has never lost a patient. It’s achieved this
by sending only the fittest… …healthiest men
and women into orbit, for only a short period of time. No chances have been
taken with an astronauts health before they takeoff. Prevention of health
problems has been space medicine’s trump card. ….Things
get very different when we get out of lower earth orbit- then going home to the
hospital is hardly the same and we have to have an entirely different approach
to medical care for the astronauts. Jerry:
I always wanted to be an astronaut- looked up at the moon I was actually up in
Canada, lying on a sand dune, looked at the moon…. …and
I said- Man- our guys are up there you know I want to do that some day…. One of only a handful of
American astronauts who’ve spent more than a month in space… …is former Naval
physician, Jerry Linenger. In January 1997 he took
off for a stay on the Russian space station Mir. Jerry:
So as a physician, I sort of used myself as a case study if you will….. ….Psychologically
mentally and psychically, so I tried to sort of peak myself out before the
flight so that I could get a before and after measure if you will on how I
did…. …. Open the hatch and you get the smell of reality. Reality is
sort of a musty damp down in your grandma’s cellar sort of a dirty socks
smell to it- its sort of dark, electrical power margins are always right at the
edge so lights are usually off and even when the lights are on they’re
kind of a dim light. The feel that someone’s lived there Linenger’s stay on
Mir was to last over 5 months. It was to be a test of
both American/Russian relations and his body to withstand the stress of a long
stay in space . Jerry:
I just happen to be fortunate for whatever the physiology that I have,
I’m not exactly sure whatever the factor is but when I’m in space I
fell good from the start. No nausea, no vomiting, no backache- no headache, as
a matter of fact for five months in space I never took a medication at all. Linengers experience on
Mir isn’t normal. Most astronauts report headaches….. …and backaches as
their body fluids relocate from the legs to the chest and head, in response to
their new weightless environment Most of these effects
are temporary, but only10 % of astronauts experience as smooth transition to
weightlessness as Jerry Linenger. Jerry:
Space is just almost hard to imagine how effortless it is... …
But that exactly how it is…. You want to fly, you
take your finger you push and you’re on your way… …
Its just an incredible environment… …All
of a sudden I woke up one day and it felt like I’d lived there all my
life. I was 100% spaceman….You know human beings our adaptability, our
ability to change- it’s immeasurable The human body’s
remarkable ability to change however disguises a very serious health threat. Just as astronauts begin
to enjoy their new-found freedom… … their muscles
begin to rapidly shrink from lack of use. More seriously, without
the support of muscles, astronaut’s bones also loose mass, at a rate of
2% a month. Exercise becomes vitally
important to maintain remaining bone and muscle condition. Jerry: Up in space it
took everything I had to get on that treadmill every day. Painful,
straps yanking into you, feels like someone sitting on your shoulders. Its as
if I say… … go for a run, put me on your back the whole
way for the next hour. That’s about what it feels like. So it’s
very difficult to do it. I did it religiously- again I sort of wanted to study
my own body and in spite of those efforts came back with a 13% bone loss hips,
lower spine, muscle strength about 65% of my pre flight strength level..so
quite a bit of muscle atrophy…. ….
Taught me that that environment is one great environment for floating but
it’s not a very good one when you have to transition back from spaceman
to earthling At the National Rehabilitation
Hospital in Washington DC,
bone specialist Dr Jay Shapiro is working with paraplegics to find a solution
to bone loss. Dr Karyn Williams
suffered a car accident 8 weeks ago. Already her bones are weakening, …And
if I’m going to be a candidate for bone loss- which I am- I want every
chance I can get. Without intervention, Dr
William’s bone loss won’t level off until it reaches forty percent. For an astronaut on a 3
year Mars mission this degree of bone loss would be devastating. On reaching the red
planet, they may even be unable to take their first step. Jay:
My feeling is the best hope for the future is to use a pharmacological
agent…. Dr Shapiro is about to
trial a new version of a drug used to treat osteoporosis. It’s hoped that
one 6 monthly injection will significantly reduce an astronaut’s bone
loss Jay:
The first thing we’ll do is put on these goggles which ….. Another approach being
worked upon to counter weightlessness, is to supply the astronauts in space
with a daily dose of artificial gravity Jay:
You’re ready to take your first spin….. Larry: We’re
looking at the possibility of using… ….the smallest possible centrifuge on an intermittent… …basis
to serve as a way of overcoming the bone loss… …
muscle loss and cardiovascular problems associated with weightless ness Dr Young sees astronauts
eventually being able to exercise on the centrifuge for a couple of hours a
day. NASA plans a trial of
the device on the international space station to test how much exposure to
artificial gravity is necessary to maintain bone and muscle condition. Larry:
I
refer to it as a spin in the gym. You go there for a work out, come back, towel
off and presumably the exposure to the centrifugal force will help to keep the
bones, muscles and cardiovascular… Bone loss isn’t
the only medical threat on a mission to Mars. Over three years, any illness or
accident could occur … …and an emergency
return to earth will be impossible. The spacecraft will have to be its own ER. In the 1960’s NASA
pioneered telemedicine - monitoring astronauts vital signs and giving medical
advice in space. Now they’re
working on not just advising, but treating astronauts for any condition out in
space. On the space shuttle, a
remotely controlled robotic arm has long been used to repair and retrieve
satellites… …now NASA is
looking to the same technology to carry out surgery in space. In London Ontario,
Dr Douglas Boyd is using a NASA funded surgical robot called Zeus to do heart
bypass surgery in a way never thought possible. Douglas:
Very nice and as you move down along, you can see it going
down……… ….The
Zeus microsurgical system consists of three components … digitizes
the movements I make at the controller… …and three interactive robotic arms… …one of which is
controlled by voice activation- you can see my microphone here…I address
the robot… …Aesop..move in…. …The
surgical instruments that I hold in my hands control the very fine
microsurgical precise movements… …that
are performed by the small… …graspers
that go into the patients chest, which are only the size of a pencil…. Traditionally heart
bypass surgery has involved splitting the patients chest open and placing them
on a heart lung machine. Using Zeus, Dr Boyd
makes just two 5 mm incisions for the arms of the robot to operate A revolutionary scalpel
uses sound waves to bloodlessly cut away a good artery to replace the faulty
one. The whole operation is
carried out while the patient’s heart is still beating. The minimal impact of
the robotic surgery also has important benefits for space medicine. The Zeus robot is
lightweight and portable. It was developed using
aerospace technology, so that it could potentially perform lifesaving
operations in space while being controlled from earth Douglas:. Aesop..left… …Aesop,
move back move back… …whoever
had the vision of this as a tool to operate in outer… …space
was correct..I believe this is the model T of the final product that will
ultimately allow us to perform operations in outer space. Exploration beyond earth
orbit will undoubtedly involve harnessing all the power of new
technology… …but the biggest
barrier may ultimately be ourselves. . I
would say the biggest surprise of my entire time in space wasn’t Halle Bop comet, it
wasn’t lightning storms on the earth for thousands of miles , it was that
we got along…. On a 3 year Mars
mission, astronauts would have to get along for much longer than has ever been
attempted before. Choosing the right
person for the job is critical. Jerry:
I think most people think you want the most friendly person- the guy that
really gets along with everybody- sort of the life of the party but
I’m not sure that the right person now that I’ve had the experience
I’ve had. I think the right person is sort of the Einsteinian person that
goes into his laboratory and shuts the door and puts out the do not disturb
sign, and say leave me alone, I’m really interested in what I’m
doing, and they get lost in their work and their work means a lot to them. At the
end of the day that sense of satisfaction- of accomplishing some good science-
getting some good work done is the thing that keeps you going. After 5 months aboard
Mir, Jerry Linenger packed his bags pleased to be heading home. However the transition
to being back on earth was not as easy as going into space. Jerry:
Earthling to spaceman- easy transition, spaceman to earthling…. To regain his pre flight
physical condition Jerry embarked on an extensive exercise programme –
starting out in the pool. … the water just felt so heavy to me being used to floating
for five months.. …Actually
I was amazed at how difficult it was to get back to my base line… …and
it really took about a year and a half to do that , but I think I did it the
wise way by going in the water, low impact, low risk of injury, because you
definitely are at risk of getting a stress fracture if you go at it too hard
early on. Three years after Mir,
Jerry has a permanent 3% bone loss from his lower spine and hips. It’s a
lasting legacy from his time in space, making him more vulnerable to bone
fracture in old age. Scientists will report
within 5 years on whether the human
body can survive a journey to Mars. …and
the human body can adapt- we can adapt- it’s going to be a challenge but
we can do it- so just like the guys sailing in the ocean thinking they’re
going to drop off the end of the earth… …we
take those risks along the way but I think we’re learning that the human
being is one heck of an animal…. …and
we can do things that you know- we can only dream about. MEDICINE AT
THE EDGE
Narration
…with the local canneries to clean and maintain
their pipeline….
Sean: It can make you disorientated when you actually
don’t know what you’re doing…
…. You think you’re
doing something… but your movements are a lot slower and it really affects
your mind and how you perform under water.
John:The hyperbaric chamber is a pressure chamber….
… or pressure vessel. It effectively lets us – to- dive
people or put them under pressure without getting wet or leaving the surface.
…laughing- giggling…
…Behaviour changes instantly back to normal again.
John: Nitrogen narcosis in itself probably…
John:I think commercial divers have to be very careful
because they end up doing diving that a lot of us don’t do….
Sean:I realised that I had to get out of this
place…..
Sean:My first treatment- I mean, nothing changed. I
…
Sean:Sensations of touch and feel are still there-
it’s just that your muscles…..
Sean: For me it’s like one of the greatest
things in the world. Like – you know- for the rest of my life been
– wheeling around in dock and watching everyone else run around when
instead I’m going to walk out of here.
Sean: It’s like falling off a horse – you
climb back on it- I said…
… you know it’s not going to bother me.
It’s -that accident- was something that was out of control, whatever..
We did an excessive amount of diving and it was something that just happened so
you just take it more careful.
John: Sean had been diving again and again and again
for ten days- so at the start of the next day he hadn’t cleared the
nitrogen from the day before……
Sean: The greatest decision I ever made was going to
New Zealand, and having all my treatments and the rehabilitation down
there…
…Climbing up high…
…like having a hangover and a flu at the same time.
Your body can feel absolutely awful at times. But as you acclimatize you adjust
to the thin atmosphere and you perform much better.
they’re reminded of the danger ahead.
Actuality – sick porter
Guy: He’s on oxygen and responding well to the …
Rachael: He doesn’t need a doctor, he needs someone
intelligent who I can explain too how oxygen works..
Andy:Truthfully I would like to summit- it’s-
I’ve trained for two years to get ready for it. I’ve done a bunch
of preliminary climbs. I’ve climbed in Latin America
and in Shoyu trying to work up to this point. But I would be- as long as I put
out – and it’s my best effort- whatever- as far as I get is as far
as I get…But I really would love to summit this thing.
Dave:People are misunderstood about guiding in the Himalayas. We are there to give our best knowledge and
medical advice and I make sure people understand that once we go into the 8000
death zone that if they do have a problem then they have to go down. If they
don’t and then they do collapse- basically they’re on their own.
…and gasping for air- that’s when people
feel short of breath because they’re trying to get more oxygen. And after
a while you get used to that and you begin to breath easier….
Guy:Just got a radio call from….
…David up on the ice wall- they just left an hour ago.
He informs me that Andy is still feeling tired…
Andy is suffering from headaches and nausea –common complaints as
climbers adjust to thin air.
Andy: Your medicine is better than David’s medicine.
Dave:At South Cole, 7,900 meters - stoked to be
here…
…. Everything’s just so slow- choosing whether
I’m gonna have tomato instant…
Radio call
Dave: And he just became slower and slower- to the point
where we’d walk twenty feet and he’d rest for a few minutes. I
think that was the moment when he started to realize what altitude climbing was
all about. I mean he’s a very physical person and likes to challenge
himself, when- all of a sudden- wham, he hit the wall, and he was thinking what
is going on with me.
Andy: No nothing to it- piece of cake…
Guy: Health is very important up high and if you’re
unhealthy your chances of doing well at altitude are reduced severely…,
…. I don’t want to try and climb this thing
unless I’m a 100% and I’ve got all the foundation laid to climb it
otherwise you’re wasting your time and risking your life.
Larry: The predictions about sending people into space and
how they would fare were really dire before we had any experience…
Larry: Going on a space shuttle in terms of the
medical threat is a bit like going on a sailboat. You carry an emergency kit,
you probably have one person who is either a physician or who is trained in
emergency medicine and the best you can hope to do is diagnose and
stabilise… .
… and when I finally made it, you know it was a great
moment in my life….
…and when they called me and said come on down to Johnson Space Center
for training, I just- literally dropped the phone. Just jumping up and down
– this is great.
…We’re flying in looking out there and this
thing is just going off in all directions- big solar panels. And you get a wow-
perched above the earth; It’s just majestic….
Jay: People who have sustained spinal cord injury
…
… have a pattern of bone loss which is very
similar to what we see in patients who are exposed to micro-gravity that is to
say in the astronauts.
so she’s taking part in a bone loss drug trial run by Dr Shapiro
Karyn: This guy is the best transfer guy in the
world….
…Believe me anything that could help prevent any loss
I’m all for it and I think we need to push it to make sure it happens..
….in order to cut down on the rate of bone loss. We know a
lot about the use of pharmacologic agents nowadays because so many people with
osteoporosis in the older age groups are treated with these agents.
…system from undergoing the negative effects of the
adaptation of weightlessness.
Larry: Likelihood of needing some medical care if we
have a crew of six that is going to be travelling for three years is greater
than 50% so we will probably find in practise that the onboard physician is
going to have something to do and it will be more than trivial.
… the surgeons console which I’m sitting at here
….
…the computer controller which
…This robotic system is actually allowing
surgery to be performed that up to this point was beyond human manual dexterity
Douglas: Patients heal a lot faster and have
substantially less pain. Patients are very comfortable after the surgery..very
often they move themselves from the operating room table onto the bed
... Aesop..left….
…As early as a week ago we are able to manipulate this
robotic system from London Ontario
to Santa Barbara California which is about two thousand five
hundred miles away. We’re able to very accurately manipulate this robotic
arm from a very remote distance…
…Aesop- In…
Jerry: I think it’s very hard to get along with two
other people for five months in a school bus
, and I saw people not doing well toward the end and going
down a downward psychological spiral ..cut off, isolated.
…a year and a half later, I still didn’t feel
exactly right when I’m out running…
…It’s a tough process – spaceman to
earthling – that transition was a tough one- big surprise to me.
Jerry: Tell you the water felt like mud when I first started
swimming- I dove in … l
…trying to get up to the surface…
That will be ultimate challenge for medicine at the edge
Jerry: We are space-farers, we can do it…