Mary Roach - Packing for Mars

COMMAND MODULE PILOT DAVE SCOTT: Why don’t you let all the rest of the powering down stuff and all that be ours, and you go get your suit off, clean up, try to eat, and go to bed?

SCHWEICKART: Okay. Cleaning up sounds pretty good.

SCOTT: Get one of those towels and wash and… all that stuff. That’ll make you feel better.

SCHWEICKART: Okay. You want to watch the radio?

SCOTT: Yes, I’ll take it.

For reasons we’ll explore momentarily, NASA goes to great lengths to keep its men and women from throwing up in their helmets during a spacewalk. Schweickart and Scott had a serious talk about whether they should skip this particular EVA and just tell NASA they’d done it. Apollo 9 was a critical step in the race to put a man on the moon. The EVA life support system that Neil Armstrong and Buzz Aldrin would wear on the moon had to be tested, as well as rendezvous and docking equipment and procedures. “This is already March of 1969,” recalls Schweickart in his oral history. “The end of the decade is coming right up…. Is this basically a wasted mission because Schweickart’s barfing?…I mean, I had a real possibility in my mind at the time of being the cause of missing Kennedy’s challenge of going to the moon and back by the end of the decade.”

What happens if you vomit in your helmet during a spacewalk? “You die,” said Schweickart. “You can’t get that sticky stuff away from your mouth…. It just floats right there and you have no way of getting it away from your nose or your mouth so that you can breathe, and you are going to die.”

Or not. U.S. space helmets, including those of the Apollo era, have air channels directing flow down over the face at 6 cubic feet per minute, so the vomit would be blown down away from the face and into the body of the suit. Disgusting, yes. Fatal, no. I ran the whole death-by-vomit scenario past Tom Chase, a senior spacesuit engineer at Hamilton Sundstrand. “There would be an extremely remote potential for any barf to get into the oxygen return duct, behind the astronaut’s back,” he began. “It’s one of five returns, including four at the extremities, so even if one was blocked, it would be unlikely to create a complete system blockage. If it somehow did, then the crew member could shut down their fan and go on ‘purge,’ where they would vent out the Display and Controls Module purge valve and continue to get fresh oxygen flowing into their helmet from their pressurized tanks.” Chase shut down his fan for a moment. “So you see we’ve really thought this one through.”

Even if the vomit lingered in front of your nose and mouth, would it kill you? Unlikely. If you inhale your vomit, or for that matter anyone else’s, it will trigger a protective airway reflex: you’ll cough. If all goes as nature intended, the vomit will be turned away at the gates. The reason Jimi Hendrix died from inhaling his vomit (mostly red wine) was that he was so drunk that he’d passed out; his cough reflex was out of commission.

However. Vomit is a more dangerous material to inhale than, say, pond water. As little as a quarter of a mouthful can cause significant damage. The stomach acid that is a routine ingredient in vomit will handily digest the lining of the lungs. Also, vomit, unlike (hopefully) pond water, often includes chunks of recently ingested food: things to get stuck in your windpipe and suffocate you.

If stomach acid can digest a lung, imagine getting it in your eyes. “Barf bouncing off the helmet and back into the eyes would be really debilitating,” says Chase. That’s the more realistic danger with in-helmet regurgitation. That and vision-obstructing visor splatter.

Visor glop is a serious astronautical downer. In the words of Apollo 16 Lunar Module pilot Charlie Duke, “I tell you, it’s pretty hard to see things when you’ve got a helmet full of orange juice.” (Actually, Tang.) [26] NASA didn’t invent Tang, but their Gemini and Apollo astronauts made it famous. (Kraft Foods invented it, in 1957.) NASA still uses Tang, despite periodic bouts of bad publicity. In 2006, terrorists mixed Tang into a homemade liquid explosive intended for use on a transatlantic flight. In the 1970s, Tang was mixed with methadone to discourage rehabbing heroin addicts from injecting it to get high. They did anyway. Consumed intravenously, Tang causes joint pain and jaundice, though fewer cavities. Duke’s in-suit drink bag began leaking [27] Annoying, but probably less so than when the condom piece of his urine containment device slipped off, just before liftoff from the moon. Duke shrugged it off: “You know, warm stream down the left leg… and a boot full of urine.” during suit checks on board the Lunar Module. (In-suit drink bags are NASA’s version of the Camelbak bag.) Mission Control surmised the problem was zero-gravity-related and that it would “settle out” under lunar gravity. It did not, or not entirely. Here is Charlie Duke in the Apollo 16 mission transcript, driving on the moon, the high point of his life, as a pair of oddly named craters come into view: “I can see Wreck and Trap and orange juice.”

Historically, the people who needed to worry about inhaling their vomit were not astronauts, but early surgery patients. Anesthesia, like a gallon of red wine, can both make you throw up and deaden your cough reflex. This is one reason the modern surgery patient is made to fast before the operation. In the rare event of a full stomach making its way into the operating room and disgorging its contents, doctors are equipped with an aspirator. In Hendrix’s case, rescue personnel employed “an 18-inch sucker.”

And you do want the model with the large-diameter suction tubing. In 1996, four physicians from the Madigan Army Medical Center in Fort Lewis, Washington, compared the time it took to aspirate an average mouthful (90 milliliters) of simulated inhaled vomit, using first standard suction tubing and then a new, improved large-diameter model. The latter, as reported in the American Journal of Emergency Medicine, was ten times as fast, and less likely to suck up portions of lung.

Perhaps you are wondering what the doctors used as their “vomitus-simulating substance.” They used Progresso vegetable soup. The Progresso Web site media-mention list includes Food & Wine, Cook’s Illustrated , and Consumer Reports , but not, understandably, the American Journal of Emergency Medicine. Judging from their Web site, the Progresso people would be horrified if they knew. They have a fairly highbrow view of canned foods, even going so far as to recommend wine pairings for their product line.

Has the in-helmet upchuck ever actually come to pass? I was told that it happened to Schweickart, but my source later recanted his testimony. Charles Oman told me he knows of only one in-suit incident, and “the volume was small.” It happened in the airlock of the International Space Station, while the astronaut was preparing for a spacewalk. Oman did not divulge the regurgitator’s name; being sick in your spacesuit retains a stigma to this day.

Though not nearly as powerful as it was in Schweickart’s day. The attitude during Apollo, Schweickart recalls, was that “motion sickness is something that weenies suffer.” Cernan agrees: “To admit being sick was to admit a weakness, not only to the public and the other astros, but also to the doctors….” Who might then decide to ground you. In his memoir, Cernan describes feeling sick during Gemini IX, but not letting on lest his colleagues think of him as “some nugget on a summer cruise.”

Apollo 8 commander Frank Borman covered up his motion sickness. I’ll let Schweickart cast the first stone: “It was well known in the astronaut corps that Frank had barfed more than once, but… for all kinds of reasons which are Frank’s, he wouldn’t really come forward with it.” That left Schweickart to wear the hat that says, as he puts it, “the only American astronaut who had ever barfed in space.” (Motion sickness during the Mercury and Gemini space programs was less common, probably because the capsules were extremely cramped; there wasn’t enough motion for sickness.) Borman much later admitted that he was, as Cernan wrote in his memoir, “sick as a dog [28] And how sick is that? Depends on the dog, and how he’s traveling. According to research done at McGill University in the 1940s, 19 percent of dogs cannot be made sick at all. In one experiment, sixteen dogs were taken out on a lake in rough weather. Two vomited in the truck on the way to the lake. Seven vomited in the boat, and one vomited both in the truck and again in the boat. Though the boat trip rendered these dogs “dejected and obviously miserable”—though perhaps no more so than the owners of the truck and boat—a later experiment with dogs on a large swing elicited much vomiting but “little subjective evidence that the dog finds the experience unpleasant.” Dogs are used to study human motion sickness because the two species are about equally susceptible. Guinea pigs are not used because they, along with rabbits, are among the only mammals thought to be immune to motion sickness. all the way to the moon.”