One Giant Step for Physicians: A Texas Physician’s Role in Space-Race Medicine
By Nancy Semin Texas Medicine August 2019

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This summer marks the 50th anniversary of America’s Apollo 11 Lunar Mission – the first time humans set foot on the moon. Across the world, the event was heralded as a milestone of scientific achievement, and its three-man crew – Neil Armstrong, Col. Buzz Aldrin, and Lt. Col. Michael Collins – became American heroes.

Laboring behind the scenes were swarms of unsung individuals whose expertise made the enterprise possible, including Texas cardiologist Lawrence E. Lamb, MD. His 2006 memoir Inside the Space Race: A Space Surgeon’s Diary remains a vivid account of the essential role physicians played in the race to reach the moon.

Among his duties, Dr. Lamb “developed a team of scientists and physicians who carried out the medical evaluations for the selection of the astronauts, participated in training the medical monitors for the first manned space flights, and was a key scientist for the Air Force and NASA’s man-in-space program.”

For Dr. Lamb, it was a career filled with triumphs, setbacks, and unanticipated moments. “Those eleven years required all my ability and time to cope with the events. … Much of this remained hidden from public view. … It was a tumultuous time.”

Entering space medicine

When Dr. Lamb graduated from the Kansas University School of Medicine in 1949, the field of space medicine didn’t exist. “I just wanted to be a doctor,” he explained.

But after rotating through different disciplines during his residency, Dr. Lamb was drawn to cardiology. During that time, he befriended Kurt Reissmann, MD,  a German physician who eluded Soviet capture at the end of World War II. Dr. Reissmann piqued Dr. Lamb’s interest in aerospace medicine, prompting him to enlist in the Air Force to assess the medical status of flight crews.

Dr. Lamb’s career took another turn in 1957 after the Soviet satellite Sputnik I was launched. The American government was shocked into action. Determined not to lose the “final frontier” to communism, Congress appropriated $100 million to create its own aeronautic program the following year: NASA.

Dr. Lamb had the necessary credentials for an assignment within NASA and was appointed chief of the clinical sciences division. There he was tasked with developing a program to medically evaluate selected astronauts. It was an onerous job, requiring careful monitoring of data collected from equipment designed to test endurance to gravitational forces, weightlessness, and other anticipated rigors of space travel.

On May 5, 1961, NASA’s first flight, a 15-minute suborbital launch into the atmosphere manned by Rear Adm. Alan B. Shepard, was a success. Two months later Lt. Col. Virgil I. “Gus” Grissom completed a second suborbital flight.

The third Mercury launch was designed to push even greater boundaries, and plans were made for a capsule to orbit the earth three times before reentering the atmosphere. Deemed a risky mission with too many unpredictable outcomes, NASA decided first to send a trained chimpanzee named Enos into orbit, but his mission did not go smoothly. Enos had been outfitted with three venous catheters, restrained in a chair, and launched into space where he circled the earth at 18,000 miles an hour. He grabbed at levers and pushed buttons as he had been trained to do, but an equipment malfunction administered 76 painful, though nonlethal, jolts of electricity into his body. When he was retrieved from his capsule in the bobbing waters of the Atlantic Ocean, he was experiencing atrial fibrillation.

Dr. Lamb was asked to evaluate him. That Enos would have good cause to be distressed seemed to have escaped Dr. Lamb. He grumbled that Enos was a poor flight school candidate to begin with and complained that he was uncooperative during his exam. He dismissed the chimp as “a little monster” but could at least report that a catheter had slipped from the pulmonary artery during the test launch, so Enos’ heart troubles were not due to the flight itself, but instrumentation failure. The space mission would go forward.

Maintaining medical judgment

Enos’ difficulties paved the way for Col. John H. Glenn to enter orbit next. In February 1962 he orbited the earth three times for a space flight that lasted nearly five hours. The next scheduled three-orbit flight was to take place on May 24, 1962. That’s when the pressure of being a NASA physician mounted.

The mission had been assigned to Maj. Deke Slayton. During a centrifuge test administered a few weeks prior, Mr. Slayton developed atrial fibrillation, a condition that could disqualify him from further participation in the program.

Aug_19_TM_historyofmedicine_lambDr. Lamb obtained an EKG and performed a physical exam. But it was Mr. Slayton’s medical history that raised sufficient alarm bells. The astronaut confessed that he had experienced fainting episodes in the past and admitted he was familiar with the symptoms of irregular heartbeat, a fact that suggested his condition was not a recent onset. It was clear to Dr. Lamb that Mr. Slayton was medically unfit to fly. His atrial fibrillation could result in a blackout behind the controls, which would be disastrous for both Mr. Slayton and the space program. Mr. Slayton’s wings would be clipped.

Or so Dr. Lamb thought. He had failed to take into consideration bureaucratic wrangling and internal rivalries within the space program. It turned out that Mr. Slayton had allies within NASA, many of whom still wanted to see him fly. A fierce debate soon unfolded within the organization, and the story was eventually picked up by the press. Before long even President John F. Kennedy was asked to weigh in. The pressure was intense, but Dr. Lamb was resolute in his opinion: He did not believe Mr. Slayton should fly.

Two months prior to the scheduled launch date, Mr. Slayton was medically disqualified and scrubbed from the mission. In his place astronaut Scott Carpenter completed the mission.

Unfortunately, the fallout from that event resonated for years within the agency, but Dr. Lamb still had much work to do. A whole host of biological variables still needed to be researched, including the accumulation of fluid in tissue, calcium levels, and circulatory status. And it was not just gravity and weightlessness that affected the human body – mobility and immobility made a difference as well as the position of a body prone or upright in an aircraft. These were but some of the many questions Dr. Lamb helped find answers to. By 1966, a wealth of data had been collected, and NASA was now tantalizingly close to reaching its collective goal to place a man on the moon before the decade ended. 

From tragedy to triumph

And then, another shock. During a test for the launch of Apollo 1 in January 1967, a faulty wire produced a spark and caused a fire that engulfed the spacecraft, which was completely filled with oxygen at the Earth’s atmospheric pressure. All three astronauts on board died.

Dr. Lamb had befriended all the men, and the loss was devastating. But he also knew all astronauts would want the space program to go forward, a sentiment Dr. Lamb heartily agreed with.

“The catastrophe would delay the man-in-space program,” said Dr. Lamb, “but it would not stop it.”

The NASA team hunkered down. A new spacecraft was designed. More unmanned flights were launched into orbit, followed by missions with three-man crews. By the summer of 1969 the time had come to put astronauts on the moon.

Dr. Lamb knew the selected candidates well. Neil Armstrong, an engineer, was quiet and unemotional, with a face so smooth Dr. Lamb almost wondered if it was made of plastic. On the other hand, Col. Buzz Aldrin appeared “alive and active.” Lt. Col. Michael Collins, the third astronaut, had a personality somewhere in between.

On July 16, Apollo 11 was launched into space. Three days later, the astronauts reached lunar orbit. As Mr. Armstrong and Mr. Aldrin at long last touched down on the moon’s surface, more than 1 million Americans listened in. Dr. Lamb was one of them.

Of his involvement he noted he was not in the spacecraft, but “in the trenches.”

“The conquest of space was the greatest adventure of the 20th century, and I was along for the ride. … I was, so to speak, on top of a rocket when somebody lit the damned fuse. And it was a bumpy ride,” he wrote. But all in all, Dr. Lamb said, “I was part of that exciting adventure.”

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Tex Med. 2019;115(8):32-35 
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Last Updated On

August 02, 2019

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