Visionaries: Scott Parazynski practices extreme healthcare in Antarctica

Scott Parazynski in space gear

Meet the South Pole’s top doc. TEDMED 2010 speaker, Scott Parazynski, is the new medical officer and director of the Center for Polar Medical Operations at the University of Texas Medical Branch (UTMB), where he’ll oversee medical screening and on-ice care of all personnel in the National Science Foundation’s United States Antarctic Program.

Parazynski is also a former NASA astraunaut who flew on five shuttle missions and conducted seven spacewalks, a mountaineer who scaled Everest, a pilot, a competitive luge racer and Olympic luge coach.

Q When will you be leaving for Antarctica? How are you preparing yourself and the staff, medically?

SP I’ll be heading down around Halloween and will spend about a month on the ice at McMurdo [Station]. It’s my first time on the ice. In the spring, I’ll go to the other side of the ice, to the Palmer Station. It’s a strange marriage here in Texas, operating all the medical activities in Antarctica from the most sweltering spot in America.

Winter storm in McMurdo. Photo: NSF

Right now we’re sending hundreds of people down to Antarctica, so it’s the busiest time for us. I used to have a career in the space program, and of course we were scrutinized in incredible detail when we were selected, because it costs a lot to train an astronaut for those incredibly expensive missions. They knew everything about us. It’s quite similar in the Antarctic environment, but we can’t afford to do the same level of medical screening. I also suspect that in general the Antarctic personnel are not as physically fit nor quite as young as the astronaut corps. But we do have medical facilities at all three major stations in Antarctica, so we try and get as many folks on the ice as we can safely.

Q What are the working conditions like?

SP We have the wherewithal to handle the likely medical scenarios. We don’t have CT or MRI scanners, or an operating room and ICU, but we have functional urgent care centers so we can take care of problems for a short time. Occasionally, you have to lift someone off, though it’s a very difficult task in the wintertime to actually get someone off the ice. It’s a very risky rescue operation.

I’ve done a lot of things in remote environments, such as the Himalayas, and I always ask the people I recruit, ‘Have you had to MacGyver medical solutions in your clinical practice? We don’t have the range of equipment and medication that you have in your hospital. Are you capable of thinking on your feet and coming up with real-time solutions?’”

However, UTMB is a world leader in telemedicine, so we can guide people through real-time procedures from our base in Galveston. Healthcare delivery in Antarctica is kind of like medicine on Mars. You have a very austere environment.

What are some of the conditions you’re most likely to see?

Standard working gear at McMurdo. Photo: NSF

SP Slips, trips, falls, sore throats and runny noses are the basics. But it’s a unique environment with a higher incidence of orthopedic issues. It certainly does set you up for frostbite, but you get good protection with the heavy uniform. It’s like walking around inside of a marshmallow suit. Snow blindness is a problem. The South Pole station is 11,000 feet above sea level, and people fly there from McMurdo, so you have altitude sickness. We also run dive operations, so there’s the potential for dive injury.

Q Can you talk about ongoing medical research in Antarctica that may have implications for future treatments or interventions?

SP I have to reflect back on my days in NASA as well to answer this. The kind of technologies and solutions that we develop for these extreme environments have great value for general healthcare. For example, the advances in telemedicine that we’re working on for Antarctica may have great potential for family care practice in rural America or remote Africa.

Also, we aim for miniaturization and specificity of medical tools, such as handheld devices for the medical clinics. These will one day be the medical devices for your doc-in-the-box. They’re very expensive at the outset, but with economies of scale they’ll be useful in the general public one day, off the ice.

Another unique element of Antarctica is the isolation component. We send people to these austere environments where it’s dark 24/7 for months at a time, and you’re seeing people day in and day out with no hopes of leaving. So there are longitudinal investigative studies useful for studying seasonal affective disorder.

Q You’ve lived and worked in Africa and the Middle East. Have you taken away healthcare lessons from other cultures that impressed you? Any that might help the U.S. in our current situation?

SP I was going to do a long-duration space flight aboard Mir and I went to Star City, Russia to do my training. I had to go through a bunch of doctors poking and prodding me to see if I was ready for their training program. I’m a pretty fit guy, and I thought it would be a slam dunk.

But a few years prior, I had had a minor ski accident skiing in a whiteout. I hit my shoulder on a snow bank and had to nurse it for several months. In one medical examination, the Russian surgeon noticed a very subtle difference in my [pectoral muscles]. I couldn’t even tell by looking in the mirror, but he knew that I had asymmetry in my muscle group.

We’ve become too focused on technology in America, and there is still an art to medicine that many people in the world practice, certainly in these remote environments and in rural America. Perhaps now with the financial pressures upon us with healthcare reform, we’re going to need to get back to that and look for subtle findings, make better clinical judgments, hone our skills, and MacGyver solutions using the equipment available.

Q You’ve been an astronaut; you’re a diver and a mountaineer. It seems that many of your career choices are driven by the desire to explore limits and to tap the unknown. Is this a conscious choice?

SP Life is an adventure, and the people that inspired me the most when I was growing up were all scientists, engineers and creative, inventive people. But they also had skin in the game. They were also out there doing things, participating in discovery. I like to build new things in challenging new environments. I’m not much of a steady state person.

Q Are you taking anything special with you to the Pole? Any special plans to mark the visit?

SP Yes, you do want to bring some bling with you to these places. For this, I’ve been training myself to do a good handstand. I really want to get the bottom of the world and do a  handstand, and have an Atlas photo.

Q Have you had to conquer fear, and if so, what’s the one thing you always tell yourself?

SP I have been fearful at times that I wouldn’t succeed. I had this spacewalk on my last mission [STS-120 Discovery], and it was very high stakes, and if I hadn’t succeeded there would be huge repercussions for the program, and it was up to me to finish the job.

Scott Parazynski, the first astronaut to summit Mt. Everest

Also, there was summit morning on Everest. The experience is weird — you leave your tent in the middle of the night. And you do think, ‘What’s this day going to be like?’ There are doubts: ‘Am I going to summit? Am I going to make a round trip out of this?’ I’m hoping I’m worthy and strong enough and that I’m going to make the right decision. I had various doubts along the way, but I just focused on the fundamentals: Buckle in carefully, listen to your body and stay hydrated.

Q Countless kids all across the U.S. want to grow up to be just like you. Who were your idols as a kid? Who are they now?

SP For me it was John Glenn, Yuri Gagarin, [Edmund] Hillary, [George] Mallory and [Andrew] Irvine, Lewis and Clark, Jacques Cousteau — folks who were explorers, scientists and who really had skin in the game. Sir Roger Bannister really amazed me, and he was a physician as well. He broke the mile down and said, ‘I need to run at this pace, at this or that piece.’

I still think space is the place. I hope kids still want to grow up and become astronauts. It’s a different environment now. I grew up in the shadows of Apollo, and now kids have computer games with space planes and all kinds of wild stuff. Can they suspend belief and go out and actually do these kinds of things? I’m the chairman of the board of the Challenger Center for Space Science Education. We hope to inspire kids to go out and explore.

I really admire the commercial space flight industry. These are folks that are so passionate that they’re willing to spend their own time and energy to make this happen.

Also, Jim Cameron’s descent in Challenger Deep was an amazing technological feat. Only a couple of guys have been down there, and the last time was decades ago. It was really an audacious accomplishment.

–Interviewed by Stacy Lu

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For more about practicing medicine in extreme environments, watch Scott Parazynski’s TEDMED speech.

This interview has been edited for space and content.

To create a better retinal prosthesis, first crack some neural code

Making blind mice see: Researchers at Weill Cornell Medical College, including TEDMED 2011 speaker Sheila Nirenberg, have cracked the neural code for retina-to-brain communication to create a better prosthetic retina. Their study has just been published  in the Proceedings of the National Academy of Sciences. Read more about the breakthrough here, and check out her talk for the fascinating backstory.

New map of health risk: Obesity rates top 30 percent in 12 states

More than one third of U.S. of adults are obese  — with a BMI of 30 or higher — but some states have a bigger problem than others. According to a new analysis of CDC stats from the Robert Wood Johnson Foundation (RWJF) and Trust for America’s Health (TFAH), obesity rates vary among states and regions, with twelve states having an obesity rate exceeding 30 percent. Mississippi’s is highest at 34.9 percent; while Colorado’s is leanest, relatively speaking, at 20.7 percent.

The costs in terms of chronic disease and healthcare burdens are virtually incalculable.  What’s to be done to stem the epidemic?  Later this summer, RWJF and TFAH will release the 2012 edition of “F as in Fat,” an annual report that analyzes state obesity rates and policy efforts to address the epidemic, and provides policy recommendations to accelerate progress.

Read more about the report here, and details on the CDC statistics here.

New animated videos explain EHR benefits to consumers

Although the technology is becoming more widespread, only 10 percent of Americans have downloaded a health application on their smart phone to manage their own health.  And only 17 percent of Americans have asked their provider for electronic access to their medical record.

What’s available to help consumers manage their own healthcare? And what’s in it for them?  The ONC has created two animated videos to explain. They’ll also be available in Spanish in a few weeks.

Health IT for You: Giving You Access to Your Medical Records When and Where They're Needed (3 min)

Read more about the videos on the HealthIT Buzz blog.

Climber Hugh Herr’s robotic legs help him scale new heights

Amazed by Oscar Pistorius?  Watch another incredible story by TEDMED 2010 speaker Hugh Herr, head of biomechatronics at Massachusetts Institute of Technology (MIT) Media Lab, a champion rock climber who uses prostheses that he designed following a calamitous climb in 1982.

Hugh Herr at TEDMED 2010

XX in Health: Let’s bring in women mentors from all fields

As part of Rock Health’s Women in Health Week, we’re talking to one of our own leaders, TEDMED Chief Marketing Officer Shirley Bergin, about how to get more women to the top in health and medicine.

Q Do you think that there has been more of a buzz recently about women leaders in healthcare? It seems that we have a unique opportunity here.

SB Absolutely. Healthcare is a dynamic industry to be in right now, period.  It’s an area that is personally interesting to many women, and once you start working in an area that you’re passionate about, one that includes making real contributions to the world today and in the future, that translates to success. I sense that women are starting to see a field in which they can come together and leverage their personal experience and perspectives to make a difference.

Shirley Bergin at TEDMED 2012

On the flip side: To date, women comprise 73% of medical and health service managersbut only 4% of CEO’s.  What’s up with that?  What do you see as major hurdles?

SB  I spent some time with Halle Tecco and her team at Rock Health this week and was surprised to hear that in their recent survey the number one obstacle according to women interviewed was a lack of self-confidence. This, we can overcome. There’s no reason to settle for any kind of pre-defined limitations. Knowing that kind of effect is happening is the first step toward changing it.

We also need to connect talent across fields. Mentorship is critical to seeing more women CEO’s and senior leadership in healthcare, and until that strength is widespread within this industry, we’ll need to tap top leaders from others. At TEDMED we strongly believe in a horizontal approach to better understanding the challenges we face in health and medicine today. We believe that connecting people from diverse fields who would not normally meet leads to great things. Using this same approach toward mentoring young women is a must. Women leaders across all industries should support up-and -comers in health, medicine, life sciences and the like. The results will be amazing.

Q What are some of the unique attributes women bring to healthcare?

SB Women are able to apply their personal journey and experiences to the way we view and address challenges in healthcare. I don’t mean that we’re soft or overly emotional; it’s just that we wear many hats, and not only as business leaders. We’re mothers; we’re daughters, we’re patients; we’re caregivers. Women make 80% of the healthcare decisions in their families and are the majority of caregivers. We’re deeply engaged in health.

Women are sensitive to working together to achieve shared goals, they are team players, strong collaborators, multi-taskers and good listeners. And sure, we tap into our innate nurturing abilities. When it comes to an industry that’s all about healing, that can only be a good thing. We’re just as energetic when it comes to nurturing new ideas and businesses.

Left to right: Halle Tecco and Leslie Ziegler of Rock Health, Shirley Bergin, and Clare Wylie of Rock Health

Q TEDMED had more women speakers than ever before in 2012 and half of the Great Challenge Advocates were women. Is this a conscious effort to promote diversity?

SB  We are making an effort to include more diverse perspectives in our program and our community, and women are part of that. With challenges as complex as we’re facing in healthcare today, there are no easy answers and straightforward solutions. We need every point of view we can get. Having Rebecca Onie talk about ground-up solutions like getting volunteers to help patients with basic needs – that’s the kind of upheaval in thinking that we need.

Q  Which female TEDMED speakers have particularly inspired you?

SB TEDMED has been fortunate to have a number of amazing women grace the TEDMED stage. I’ll never forget Billie Jean King calling women “she-ros.”  Diana Nyad making the most of every second of her life.  Frances Arnold talking about designing new DNA to do miraculous things. Reisa Sperling trying to head off Alzheimer’s before it starts. Freda Lewis-Hall saying, “I don’t want any more ideas. I want some i-doers,” and Sheila Nirenberg’s amazing work on neural coding and treating blindness.  Powerful women doing incredible work!

Q You’re a healthcare exec; you’re a wife, mother and daughter.  How do you manage to accomplish it all?

SB That’s a loaded question! At the end of the day my family is happy and healthy, and I’m doing work that I’m passionate about and that makes a real difference.  I’m collaborating with smart, talented, inspiring people.  Life is good.

–Interviewed by Stacy Lu

For more about women in health, join the conversation at Rock Health for reports and features all this week – and be inspired by the video below:

XX in Health: Women Leading Healthcare