Medical Monitors

As early as October 29, 1959, Dr. Stanley C. White, STG, had noted in a memorandum for the Project Director that as Mercury moved into actual manned operations, there would be "fairly con-siderable requirements for additional medical support in monitoring recovery, and post-flight research and support." 8

A plan of action was offered which envisaged using medical personnel from the various Federal medical services, particularly the Department of Defense. Basic assumptions were that appro-priately trained personnel from all branches of the service would be used; that Mercury was sufficiently important as a national effort to justify unusually extensive medical support, that most personnel would be obtained for training and duty on a tempo-rary basis; that whenever possible, personnel would be assigned at or near their normal duty station; that although Space Task Group, NASA, would prefer to request certain persons by name, this was not always practical; that STG should reserve the right to review records and qualifications and to interview persons to be assigned in direct support of Mercury; that STG would supervise training, with the right to delegate much of the work; that monitoring personnel would be responsible to the Project Manager; and that whenever possible, Mercury would attempt to accomplish other national objectives as a byproduct of the mission.
The following day, October 30, a detailed plan for medical monitoring of Project Mercury was forwarded to the Project Director by Dr. Augerson, then on duty with the Life Systems Branch, of which Dr. White was Chief. The purpose of the medical monitors for Project, Mercury would be to preserve the health of the pilot by providing remedial advice during the flight, evaluating the current medical status of the pilot, and correlating spacecraft data and physiological data with the mission profile. The medical monitors also would provide medical advice to flight directors, station directors, and recovery commanders as appro-priate; provide preventive medicine advice and medical care for personnel at remote sites; gather research information in space medicine; and train personnel for support of future space projects. A schedule was outlined for individual and team training.

By mid-November 1959 these preliminary discussions were in the process of being formalized. On the 13th of that month the newly appointed Associate Director of Project Mercury (Opera-tions), Walter C. Williams, who had been designated the single point of NASA-DOD operation contact, requested that General Yates assist in making the necessary arrangements for obtaining medical support for Project Mercury.9

Recognizing that it would not be feasible to detach medical personnel from their present duty station and assign them full time to Project Mercury, the Associate Director of Project Mercury suggested that they be assigned on temporary duty for training and actual operations.

Requirements for recovery medical personnel, it was noted, would have to await a more detailed analysis of the recovery system. It was contemplated, however, that the Department of Defense would be asked to deploy one or two field medical units or to augment certain existing facilities. Capt. Ashton Graybiel, USN (MC), Director of Medical Research for the Naval School of Aviation Medicine, was mentioned as being "eminently desirable" as head of the medical recovery and research program.

A summary of the monitor plan was enclosed in William’s letter to General Yates. (See app. B) Certain questions, however, remained to be answered. For example, the Associate Director of Project Mercury asked if it would be feasible to train and deploy physicians on a temporary basis. How would medical support be controlled and administered? What additional personnel in excess of NASA requirements could be trained? What were the estimates of the cost? Could it be assumed that NASA would be required to pay only the travel and per diem allowances of assigned officers? Could some assignments be integrated with other Service medical plans and assignments? Would it be possible for NASA to express a particular interest in certain personnel by name? These and other details had yet to be worked out.
On December 11, 1959, a little more than a week after Dr. Knauf was officially designated the Assistant for Bioastronautics for DOD support of Project Mercury, the STG aeromedical team met with DOD representatives, including him, to brief them on the medical requirements for Project Mercury. Earlier concepts were clarified. The medical monitors, it was reiterated, would preserve the health of the pilot, and correlating spacecraft data on physiological data with the mission. They would provide medical advice to the flight director, station director, and recovery commander as appropriate. They would also provide preventative medical advice and medical care for personnel at remote sites, gather research information in space medicine, and train personnel for future space project support.10

Medical monitors obviously would require a detailed knowledge of the Project Mercury mission and spacecraft. They would also require personal knowledge of the astronauts and their physiological responses in stressful training. Further, they would need experience with Mercury monitoring equipment as well as experience in missile or other analogous monitoring. Finally, they must have the professional capability to correlate psychological, environmental, and physiological changes indicated by instrumentation. A list of qualified military medical personnel to be used was proposed by the Space Task Group. In addition, it was proposed that entire classes from the USAF School of Aerospace Medicine, Texas, assist in the monitoring operation so as to provide more depth for continuing space flight, operations.

There would be two types of monitoring stations for Project Mercury: The purely monitoring stations which could make medical recommendations to the pilot or assist the control center in decisions, and the command stations which, together with certain launch and control central positions, were to be regarded as key sites. The monitors there should be the most familiar with Mercury operations. Assignments of the "key site"medical officers, would be as follows:

1. The astronaut flight surgeon would be with the astronaut to provide preflight examination, preparation and installation of the astronaut in the spacecraft, and emergency medical coverage near the launch pad. Following successful launch, he would fly downrange to the normal recovery base.

2. The blockhouse monitor would monitor the countdown, serve as tower rescue physician (should there be prelaunch difficulty in the gantry), coordinate the medical aspects of near-pad aborts, and relieve or assist the control central monitor.

3. The control central flight surgeon would be in the. Command Control Room.

These requirements were already clear, STCT reported. Still to be determined were the medical requirements for the Bermuda station, the normal retrofire command station, and possibly the Canary Island station.

It was noted that, by the time manned operations were begun, five Air Force officers and one Army officer would have detailed knowledge of the astronauts and Project Mercury, and it was recommended that they be considered key Space Task Group personnel. Already detailed to STG were three Air Force officers: Dr. White, now chief of Crew Systems Branch, STG; Dr. Douglas, Flight Surgeon, assigned to the astronauts; and Dr. Henry, on duty with Dr. White (as coordinator of the animal program). There was also Dr. Augerson, of the Army, who had been on of the original aeromedical consultants for Project Mercury. In addition, Dr. Knauf, the assistant for Bioastronautics, and Dr. Rufus Hessburg, and Air Force colonel assigned to Holloman AFB but working intimately with the Space Task Group in support of the animal program, should be considered part of STG at the time of launch. This was later to become fact.
It was suggested that three cardiologists serve as consultants: Dr. Larry Lamb, on duty in a civilian status at the School of Aviation Medicine; Dr. Per Lanjoen, cardiologist at the William Beaumont Army Hospital in California; and Dr. Samuel M. Sandifer, Chief of Cardiology, Tripler Army Hospital, Hawaii.  Alternate personnel included Dr. Clyde Kratochvil, a USAF flight surgeon holding a doctorate in physiology, and Drs.Charles Berry and William R. Turner, both USAF flight surgeon and Board certified in Aviation Medicine. Finally, a tentative list of other proposed medical monitors was attached. (See app. B).

Training and indoctrination for the medical monitors envisaged a 5-day tour of duty during which the monitors would become acquainted with the astronauts. Also, they would be briefed on such topics as Mercury spacecraft mockup, environment, monitoring equipment, full-pressure suit, recorded reviews of simulated missions, systems, and reserve objectives. They would visit the Navy installations at Johnsville and at Philadelphia as well as Holloman AFB (where the Air Force was carrying out the Mercury animal program for NASA). Team training would follow individual training, and shortly before an actual mission there would be an extensive team drill at Cape Canaveral.

Following this briefing, DOD representatives and the NASA Space Task Group consolidated a suggested list of military person-nel for submission to the Associate Director, Project Mercury. The individuals named-military and civilian-were those suggested by the three military service representatives11 at the close of the Space Task Group briefing on the medical requirements for Project Mercury support.

During the next few days the Space Task Group considered these individuals in the light of the background material submitted by the Service representatives. Also, STG attempted to correlate, insofar as possible, the, professional and technical skills of the individuals concerned with the type and magnitude of the medical responsibilities envisaged for each global range station at which it was planned to conduct aeromedical monitoring during Project Mercury flight operations.12 By late December 1959, STG had completed its review of the list of recommended medical personnel.13 It was planned that the proposed training program would got underway by March 1, 1960.

Since the medical monitors would be receiving telemetered information from the astronaut in flight, they had to be indoctrinated in the techniques to be used. Special mention should be made of the four 3-day refresher courses that were subsequently given at the USAF School of Aerospace Medicine by Dr. Larry Lamb, who was to serve as a consultant to STG. Since a major portion of the medical monitoring would consist of the interpretation of telemetered information from the astronauts in orbital flight, NASA requested that he develop a course to train monitors in the electrocardiographic and cardiovascular aspects of space flight.

In September 1960, as a first step, he recorded important biological variables of the seven astronauts. Together with information gained through aeromedical evaluations of the Air Force flying population over a period of years, this information formed the basis for the courses given to medical monitors in December of that year.14 Mention should also be made of the 59-page guidebook entitled, "Medical Problems at Tracking Stations Supporting Project Mercury" prepared by Col. Harold. V. Ellingson, USAF (MC), for use by monitors stationed at telemetry and tracking stations for Project Mercury.15

8.  Lt. Col. Stanley C. White, Head, Life Systems Br., Space Task Group. Memo for Project Dir., Subj.: Medical Support for Project Mercury, Oct. 29, 1959.

9.  Walter C. Williams, Assoc. Dir. of Project Mercury, Ltr to Maj. Gen. Donald N. Yates, DOD Representative, Project Mercury Support, AFMTC, Patrick APB, Fla., Subj.: Medical Personnel to Support Project Mercury Flight Operations, Nov. 13, 1959.

10.  NASA Space Task Group Briefing, "Medical Monitoring for Project Mercury," Dec. 11, 1959.

11.  The three Surgeons General had designated the following officers to serve as their representatives for Project Mercury: Army—Lt. Col. John A. Sheedy, USA (MC) Navy—Capt. Vance E. Senter, USN (MC) Air Force—Col. Karl Houghton, USAF (MC).

12.  As described in Ltr from Col. George M. Knauf, USAF (MC), to Hq. USAF, Office of the Surgeon General, Attn.: Col. Karl H. Houghton, USAF (MC), Subj: Medical Support of Project Mercury Flight Operations, Dec. 21,1959.

13.  Robert R. Gilruth, Dir. of Project Mercury, Ltr to Maj. Gen. Donald N. Yates, DOD Representative, Project Mercury Support Operations, Hq. AF Missile Center, Patrick AFB, Dec. 18,1951). See also Ltr, Knauf to Houghton, cited above.

14.  Col. George M. Knauf, USAF (MC), Asst. for Bioastronautics, DOD Representative for Project Mercury Support, Ltr to Maj. Gen. Otis 0. Benson, USAF (MC), Commandant, Aerospace Medical Center, Brooks AFB, Tex., Jan. 12, 1961. Further Information obtained in interview with Dr. Lamb by the author in Oct. 1963.

15.  Also consultant to STG, Dr. Ellington was at that time Commander of the Gunter Branch of the USAF School of Aerospace Medicine. He later became Commandant of the School of Aerospace Medicine.

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