If you’ve been anywhere near the internet this week, you will have seen that NASA is bringing the Crew-11 astronauts back from the International Space Station early due to a “medical issue.”
No great details given due to privacy rights, so no name, no diagnosis, and no great drama. Nonetheless, this lack of detail always leads to worry, much speculation and many clickbait headlines to boost page visitor numbers. But to be honest, this event holds no great mystery, it’s nothing weird, in fact, it’s probably overdue!

When we think of space exploration, we generally think of it as something heroic - big rockets, brave astronauts floating around and amazing photos of our planet Earth. What we don’t really talk about is that space is quietly hostile to the human body, not in an exploding spacesuit sci-fi drama sort of way, but in a slow, grinding, biological manner.
The simple fact is that microgravity messes with almost everything:

• Bones start leaking calcium.
• Muscles shrink.
• Blood moves around your body differently.
• Immune system gets confused.
• Eyes can change shape.
• Hearts can alter and not work in the usual way.
• Even old viruses that you had as a child can spark back into life again.

​Astronauts are not ‘ill’ in space in the usual sense, but they are also not ‘normal’ anymore. Instead, their bodies are constantly adapting and compensating for the lack of gravity, and slowly using up their safety margins.

NASA has not revealed exactly what happened to the Crew-11 astronaut who needed to come home and they probably never will. However, the important part really isn’t the specific symptom. The important part is that someone’s body crossed a line where Earth became safer than orbit. This is less about a mission failure and more about highlighting the reality of long-duration spaceflight.
The ISS has been permanently occupied for more than 25 years. In that time, astronauts have had all kinds of health issues up there, even if they were rarely described that way, for example:

• Heart rhythm changes.
• Kidney stones.
• Vision problems.
• Blood clots.
• Immune system crashes.
• People fainting and being unable to stand up when they come home.

​Most of it is explained away in polite language like “out of an abundance of caution” or for “operational reasons”, but this time, Crew-11 has said the quiet part out loud.

​Early space missions were short, just days or weeks. You could grit your teeth and push through, and before you knew it you were returning to Earth again. Nowadays, astronauts live on the ISS for six months, and sometimes longer. That turns spaceflight into something very different. It’s no longer a short sprint but more of a long-distance race, with slow exposure to an environment for which the human body was never designed. Astronauts these days are less like explorers and more like participants in long medical experiments, and sometimes experiments can end early.

InnovaSpace Director, Thais Russomano, is a doctor who specialised in space medicine and human physiology, and she will often say that space doesn’t suddenly break you. Rather, it slowly begins to nudge every single body system away from where it is accustomed to being. Most of the time, the body copes and adapts, but sometimes, it doesn’t. So, if NASA says someone needs to come home for medical reasons, it isn’t a mystery. It should be taken as a reminder that although human bodies are incredible, they still come with limits.

Fortunately for Crew-11, being on the ISS means they could come home relatively easily. But what of a Moon crew - maybe not - and a Mars crew - definitely not. There is no quick splashdown from deep space. This story perhaps reflects not so much on one astronaut on one mission, but sharply highlights where we are on a bigger journey.
​We are leaving the era of “Can humans survive in space?” and entering a new era of “Just how long can humans survive in space?”

I wouldn’t consider myself a great poet, far from it, but I would argue the case that poetry (and many of the other arts) have a rightful place in the future of space exploration. Life in space is not only about engineering solutions or medical data. Indeed, many astronauts onboard the ISS have found a need to reflect on and share their experiences, giving us a glimpse of space through human feelings and humour, more specifically through poetry.
Apollo 15 astronaut Al Worden published Hello Earth: Greetings from Endeavour in 1974, a collection of poems about his experiences as an astronaut and the feelings of joy and solitude that being in space provoked. Decades later in 2012, Don Pettit shared his own reflections while on the ISS in a short poem entitled Space Is My Mistress. These examples show that astronauts often look beyond scientific reporting, choosing poetry as a way to express moments that are difficult to put into ordinary words.

​Artistic work, including poetry, helps connect the public with space exploration. Scientific papers and technical reports can feel distant, but a poem sparks curiosity and imagination in new audiences. Some projects have even included artists directly in space-related activities, such as analog missions and exhibitions that mix art with science. These efforts highlight that exploration is not only about technology and survival, but also about culture and community. In the long run, creative expression will be an important part of how people adapt to life away from Earth.

​In honour of this blog, I thought I would write a few lines of poetry about spending time on the ISS, though let me remind you I warned in my first sentence that I am far from being a good poet – so bear with me! Here in the UK, I’m of an age that remembers an ITV television talent programme called Opportunity Knocks, decades before Simon Cowell and Britain’s Got Talent appeared on the scene. It was the mid-1970s and onto the stage walked a homely young lady called Pam Ayres, who in a little more than two minutes recited a humorous poem called ‘The Embarrassing Experience With A Parrot’. The audience loved her, I loved her, and my older brother Chris spent the following years of his life reciting Pam Ayres poems as his party trick to impress his friends! Considering all this, and remembering my brother who is no longer with us, I created a short light-hearted ode in the style of Pam Ayres, called Six Months Aloft.

​As we plan for longer missions to the Moon, Mars, and beyond, it becomes clear that astronauts will need more than machines and medicine to thrive. They will also need ways to express themselves and to stay connected with their own humanity. Poetry, along with other forms of art, helps bring meaning to the experience of living in space. Whether serious or humorous, it reminds us that exploration is not only about survival, but also about creativity, culture, and simply being human.

When humans eventually set foot on Mars, they’ll face a medical challenge that rarely needs to be thought about on Earth - TIME. A radio signal between Earth and Mars can take 4 to 24 minutes to travel one way. That means if an astronaut sends a question to Mission Control, it could be more than 40 minutes before they receive a reply, which in an emergency situation is far too long to wait.
To close this gap, NASA and Google are working together on something called the Crew Medical Officer Digital Assistant (CMO-DA), an artificial intelligence system for space medicine designed to support astronauts when Earth is too far away to give immediate help. Think of it as a “medical copilot” that will not replace doctors, but instead will help the crew diagnose and manage problems step-by-step using knowledge adapted specifically to space medicine.

Unlike a standard chatbot, the CMO-DA can work with multiple kinds of input. Astronauts might type or speak questions, upload vital signs, or share images from a portable ultrasound. The system then offers possible causes, highlights urgent warning signs, and suggests treatments that match the very limited supplies they have available to them. The big difference from Earth-based systems is that it’s trained with information that reflects spaceflight medical challenges, such as fluid shifts in low gravity, the increased risk of kidney stones, or how certain drugs behave differently in space.
To test its usefulness, NASA and Google have been running the assistant through structured scenarios. These use the same exam style that medical students face, called Objective Structured Clinical Examinations, where candidates are judged on how well they manage a case. The early results look promising, with the AI decision support tool giving safe, reliable advice, and it helps astronauts approach a situation more clearly under stress.

This project is part of NASA’s broader plan for Earth-Independent Medical Operations. For deep-space missions, it has long been recognised that crews need a much higher degree of autonomy, since communication with Earth may be delayed or even cut off entirely—for example, when Mars is hidden behind the Sun. A tool like the CMO-DA gives astronauts a way to stabilise and treat a patient without waiting for ground communication.
It’s important to remember that the system is meant as support and not as an authority. Ultimately, the astronauts in-situ remain the decision-makers. The assistant provides structured checklists, reminders, and treatment suggestions. It can also document everything that was done and prepare a clear report so that, once communication is restored, doctors on Earth can follow-up what happened and advise on next steps.

The future will bring new features, with researchers aiming to link the assistant to onboard sensors, wearables, and imaging devices, and to test it in Mars analogue missions on Earth. The goal is a complete medical system—crew, tools, and smart software working together to make medical autonomy on Mars a reality.
This technology, however, isn’t just for astronauts. It could also benefit people in remote communities on Earth, where medical access and connectivity are limited. In that way, a tool built for Mars missions medical support might improve healthcare for millions here at home.
NASA and Google’s project shows how AI in aerospace medicine is shifting from science fiction into practical support for space medicine—with potential benefits reaching well beyond Mars.

Microbes are generally associated with infection, and the usual response to their mere presence is to eradicate them as quickly as possible. For example, the “no-rinse soap” used during space travel mainly consist of antimicrobials, i.e. chemicals that kill microbes, with the aim to remove bacteria on the skin.
It is correct that microbes can cause disease, but it is microbes that created an environment and an atmosphere on Earth that allow plants and animals to exist. Microbes are literally everywhere, and we ourselves depend upon microbes to keep our external facing surfaces healthy and to help with the breakdown of food in our gut and production of substances that our body needs. The microbes form actual communities with thousands of species in and on us, for example the gut, respiratory and skin microbiomes, and these communities collaborate with our immune systems.

​To give an idea of their importance, data suggest that it is the pollution from antimicrobials that is the primary responsible for climate change because their impact is very broad and reduces the microbial diversity and changes the microbial balance. Similarly, studies indicate that antibiotics have long-term impact on our health, and they have been shown to increase the frequency of cancer, diabetes, asthma as well as functional impairments in children’s development, immune function, and cognition. Poor gut health, which usually means an unbalanced and low diversity microbiome, has also been associated with mental health problems including depression and anxiety as our gut microbiome is responsible for producing substances needed for normal brain function.
On the International Space Station skin issues and problems with wound healing have been reported. Microgravity and radiation have generally been assumed to be responsible for this and the fact, that “no-rinse-soap” is a cocktail of antimicrobials, has received practically no attention. Antimicrobials are traditionally used for treating wounds, but the US FDA reported in 2016 and again in 2022 that they are ineffective in treating wounds, and studies have demonstrated that antimicrobials directly impair healing and that a healthy wound microbiome is required for healing to take place. These novel conclusions banning antimicrobials in skin care and wound healing are further supported by the positive findings with a new technology, MPPT (micropore particle technology), which acts by regulating the wound microbiome without killing anything. MPPT has been able to achieve 100% wound closure rates, including in complicated wounds and in people with impaired immune function. This observation shows that approaches that support the collaboration between the microbes and the immune system can be much more effective than the traditional, old blanket-bombing approach of eradicating all microbes, which renders the skin debilitated and less resilient.

These observations are relevant to space travel, in terms of both the environment onboard and clothing, food and methods of ”washing”. Our bodies have evolved on Earth, where microbes were and are present, and our evolution has benefited from this as the microbes assist in protecting our surfaces and in delivering nutrients and critical compounds needed for our health. This dependence persists, even if we decide to leave Earth for shorter or longer periods of time. It is therefore a necessity, particularly for deep space travel, which does not permit us returning to Earth periodically to update our microbiome, to develop environments and procedures onboard that can sustain our microbial requirements.
These considerations are based on an article recently published in Frontiers in Public Health, which focuses on the role of antimicrobials in causing climate change from severely damaging the Earth’s microbiome. The impact of antimicrobials on the Earth microbiome and the microbiome inside a space station are comparable as they are both closed systems. It is consequently important to consider the essentiality of the microbial environment, when planning human life outside the Earth’s environment.

When scrolling through the endless nonsense recently that appears on Facebook, I came across a rare post of interest detailing the remarkable work of French geologist Michel Siffre, who died a year ago this Sunday (24 August 2024), aged 85 years. In 1972, Siffre conducted an extraordinary isolation experiment in which he lived alone for 180 days in a cave 440 feet underground. He had no sunlight, no clock, and no contact with any other person, having only basic supplies, a sleeping bag, and instruments for recording his activities and observations.
His aim was to study how the human mind and body behave when deprived of all natural time cues. The results of this work, now more than 50 years old, continue to be relevant for research into human endurance, circadian rhythms, and the psychological effects of extreme isolation. They are also especially relevant for human space exploration, with space agencies considering the realities of sending people to live for months, or even years, in sealed environments on the Moon or Mars.

Initially, Siffre relied on hunger and fatigue to regulate his days, but within weeks it was observed that his perception of time changed. He often believed a day had passed when nearly two had gone by. His body abandoned the 24-hour cycle, adopting a 36-hour waking period followed by 12 hours of sleep.
Scientists monitoring the experiment saw this as evidence that humans have an internal clock that can operate independently of the Sun. The changes, however, came with cognitive and psychological costs, like hallucinations, difficulty speaking, memory lapses, and a need to create artificial social interaction, such as talking to insects or to himself. By the time the experiment ended, Siffre believed only 151 days had passed, rather than the actual 180 days.

Life Without a Sunrise - Astronauts aboard the International Space Station (ISS) see 16 sunrises every Earth day. This constant cycling of light and dark is managed by strict schedules, carefully calibrated lighting systems, and oversight by mission control, ensuring that body clocks remain aligned with a 24-hour rhythm. Without such controls, circadian rhythms can rapidly drift, affecting alertness, decision-making, and even physical health.

​Meet MRD-001: The Mars Recon Dog
As part of the StarG2025 platform, the MRD-001 tracked Mars Scout Dog was deployed for its first dual-test mission — one in an urban indoor setting, and another in the field among alpine meadows and virgin forests.

Why "StarG"?

• Star Guardians – Youth as defenders of ecosystems and the universe
• Star Generation – Representing the next wave of interstellar humans
• Star Growing – For ecological restoration and space biospheres
• Star Genesis – For future planetary transformation and space colonization

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Learn more about Chris Yuan and his activities at LinkedIn
or contact him via ​[email protected]

The Ursa Minor Interstellar City (UMIC) project was born out of the need to create accessible and sustainable space simulation environments on Earth. Inspired by NASA’s Neutral Buoyancy Laboratory (NBL) and NEEMO underwater project, as well as ESA’s CAVES programme, UMIC reimagines these concepts to provide affordable, eco-friendly simulations that bring space exploration closer to ordinary people, considering the following scientific principles:

• Low-gravity simulation: Using underwater neutral buoyancy environments to replicate microgravity for astronaut training.
• Closed ecological systems: Conducting oxygen regeneration and resource recovery experiments to simulate living conditions on the Moon and Mars.
• Human adaptation studies: Exploring human survival in extreme environments, akin to ESA’s cave studies, through underwater confined space experiments.

A Journey of Innovation
​In 2020, collaboration with Professor Thais Russomano on the Evetts-Russomano (ER) CPR method sparked the idea for UMIC’s Underwater Space City. Over four years, UMIC has developed the complete underwater space city elements: EVA training spacecraft, animal spacecraft, lunar commuter motorcycle, space farm, the world's largest astronaut helmet, and the smallest underwater cafe - Galaxy Cat Cafe (see videos below). We can even provide astronauts with a cup of hot coffee underwater, and broadcast space education for young people around the world, truly realizing the popularization of space exploration education.

​Mission and Impact
UMIC’s goal is to train commercial astronauts to thrive in space and on alien surfaces while establishing ecological, multi-species habitats. By fostering collaboration and resilience, it not only advances humanity’s path to becoming a multi-planetary species but also strengthens our ability to protect Earth and preserve its ecosystems

The webinar, organised by InnovaSpace Director Prof Thais Russomano, was presented by 4 students from the Remote Medicine iBSc program, National Heart & Lung Institute, Imperial College London, and in association with the MVA (Moon Village Association). The focus of the event was on one of the most critical aspects of future lunar habitation: human health.
Join the student panel as they explore the unique environment of the Moon, the history of its human exploration from NASA Apollo Mission first steps to future Artemis plans, its potential impact on human physical health and mental well-being, Moon research and Earth-based space analogues, and research limitations and gaps in the knowledge.
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Congratulations to the presenters - Manvi Bhatt, Nareh Ghazarians, Diya Raj Yajaman, & Elvyn Vijayanathan - and good luck with your future careers. 

​I became involved in Space research whilst my husband was completing his PhD in the early 90s, acting as ‘flight nurse’ for several parabolic flight human research studies. I went on to co-develop the Evetts/Russomano (ER) technique for basic life support in space, while continuing to work as a renal specialist nurse in the UK.

​In 2011, I became the sole flight nurse for the European Astronaut Centre in Cologne, Germany. I enjoyed two successful years working closely with the flight surgeons within the Operational Space Medicine Unit (OSMU), as it was called then. I was part of a team responsible for the day-to-day management and administration necessary for maintaining ESA (European Space Agency) Astronaut health. One of my key responsibilities was to track and retrieve data from medical events related to ‘pre’, ‘in’ and ‘post’ space flight activities.  
 
The role also involved working as the interface between OSMU, NASA, the ESA flight clinic and occasionally the Russian Space Agency, coordinating somewhat complex planning to ensure all flight medical examinations were completed within a rigid timescale from an Astronaut’s initial mission assignment, 18 months before they flew, to two years post-mission. The examinations took place at the locations of all 3 agencies to accommodate an Astronauts packed international training schedule. Astronauts who weren’t assigned to a mission, also required coordination of annual medicals locally.

​I particularly enjoyed good relationships with the NASA flight nurses who I had the pleasure to meet when visiting the Johnson Space Center in Houston. It was a great opportunity to meet all those I had been communicating with by phone and email, to cement our good working relationships.
 
I represented OSMU at weekly events such as the astronaut training coordination meetings, where planning and updates on training schedules and upcoming flight assignments would be discussed. Each team involved in preparing an Astronaut for flight was granted a certain number of hours of the astronaut’s time from a packed pre-mission schedule, to complete the necessary training and preparatory requirements. Arduous negotiations were required with other departments and the agency central mission organisation authority, should a team think they needed extra time to complete their activities.
 
As the Flight Nurse I was responsible to lead weekly clinical meetings to update the flight surgeons on any new information and issues relating to an astronaut’s health and the work underpinning their welfare.