Prof. K. Ganapathy MCh (Neurosurgery), FACS, FICS, FAMS, PhDDirector Apollo Telemedicine Networking Foundation; Director, Apollo Tele Health Services; Past President, Telemedicine Society of India; Past President, Indian Society for Stereotactic & Functional Neurosurgery; Former Secretary/Past President Neurological Society of India;  I wish to thank Dr Thais Russomano for sharing with the InnovaSpace readers my article on “ Technology in Telehealth”, published in the IEEE Computer Society Region 10 newsletter. Also acknowledged is permission given by H.R. Mohan, Editor & Portfolio Member, IEEE Computer Society. The original article was for Telehealth on Terra firma ! How relevant is providing TLC ( Tender Loving Care) when the patient is 600 km above the earth and, perhaps in the future, several hundred million kms away? With failure not being an option in such an environment, both the beneficiary and the health care provider are perhaps only interested in technology per se and rightly so. Is there still a place for virtually empathising and sympathising with a patient, far away from Earth? Should we compound the already complicated milieu by taking into account the extra terrestrial patient’s wants and desires? And should the family also be involved in the decision making process or should we just leave it to an AI enabled algorithm which gives more weightage to the Microgravity environment and takes into account the lack of precedents? A media release said it all “NASA to send humans to the moon once again, – but this time we will stay“. This will also be a forerunner to the manned mission to Mars. With over 600 individuals already having gone into space in the last 55 years and space tourism having just started, extra terrestrial healthcare is now a reality. Bringing Space, down to Earth is not a pun. Representing almost 1% of global economic activity, the multiplier effect and stimulus to health and economic growth is real. There is considerable similarity between probing the emptiness of Space on distant galaxies and getting into millimetre sized capillaries in the heart and brain of the unborn – to go “ where no Man has ever gone before”. Belonging to the BC ( Before Computers - I was the last group of neurosurgeons trained in India when computers were almost non existent in a hospital ! BC is not Before Covid) era, I am Jurassic Park material and old fashioned enough to hope the super sophisticated Flight Surgeon on Earth instructing the on-board robot what to do, would still spare a few minutes and discuss with the family on Earth, the options and its limitations and advantages. Of course, we're not sure yet whether an individual space tourist / astronaut could give an Advanced Medical Directive before he leaves the Earth on a customised Informed Consent form. These ethical issues can no longer be postponed. The future is ahead of schedule. The future is yesterday not tomorrow!
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