An Astronaut's Guide to Life on Earth

by Chris Hadfield

  Of course, luck has something to do with it, too. I once yanked back on the stick while practicing one-on-one fighting in a CF-18, and accidentally unplugged my g-suit. CF-18s have a heads-up display (HUD) that looks like a glowing, green projection in front of the windscreen; you never have to look around the cockpit, all the key information is there in that display. A video camera films the HUD, and afterward we always watched the HUD tape to see what had happened, so we could debrief. That’s how I know I was unconscious for 16 seconds after my elbow hit the g-suit hose, unplugging it while the plane was pulling all the g it could pull, whereupon the blood promptly drained out of my head and I passed out. When I came to, I thought, “Wow, that was a really good sleep. I feel great. Hmm, that sounds like someone on the radio; maybe I’m still dreaming. Weird—the guy sounds a bit like Denis. Wait a sec. That is Denis. What’s going on? Am I in an airplane?” All this was just rattling through my head until I opened my eyes and figured out that I was indeed in an airplane, and Denis, the other pilot, was practicing gunning me and wondering why I was flying so poorly.

  Those 16 seconds were plenty of time to kill myself and him. Luck is what kept me alive while I was unconscious. Operational awareness—being able to see the big picture and focus on what could kill me next—is what kept me safe after I regained consciousness. I didn’t waste a second thinking about why I’d passed out. In a crisis, the “why” is irrelevant. I needed to accept where I found myself and prioritize what mattered right that minute, which was getting back on the ground ASAP. There would be plenty of time later to try to figure out the why. (And we did: as a result, the g-suit connection in the CF-18 was altered so that it couldn’t be unplugged accidentally.)

  If you’re focused on the wrong things, like the bee in your helmet or whose fault it is that the g-suit came unplugged, you are likely to miss the very narrow window of opportunity to correct a bad situation. In a real emergency in a fighter—an engine failure during takeoff, for example, or a fire in the cockpit—there’s usually just a split second or two when the decisions you make will determine whether you live or die. There’s no time to consult checklists. You need to know the boldface, the actions that are absolutely critical to survival—so called because in our training manuals, they’re written in boldfaced capital letters.

  “Boldface” is a pilot term, a magic word to describe the procedures that could, in a crisis, save your life. We say that “boldface is written in blood” because often it’s created in response to an accident investigation. It highlights the series of steps that should have been taken to avoid a fatal crash, but weren’t.

  In Bagotville in 1986, my best friend, Tristan de Koninck, and I had one of the ultimate male bonding experiences: we went to the base clinic together to get vasectomies. This was a non-negotiable condition for remaining married to Helene after she became pregnant with our third child, Kristin; Tristan was the father of two little girls, about the same ages as our boys, and his wife believed their marriage would also benefit from a little less fertility.

  At the clinic, I went in first and made a point of screaming and carrying on during the procedure, knowing that Tristan could hear everything in the waiting room and hoping I’d spook him. It didn’t work; he had been a Snowbird, an aerobatic pilot, for two years before he began flying fighters, and had nerves of steel. We hobbled out of there sore but laughing.

  About a month later, I was deployed to Bermuda. Tristan, back home in Canada, flew his CF-18 in an air show in Prince Edward Island. It was overcast, about 300 feet of cloud, when he took off the next day to fly back to Bagotville. He stayed low at first, then pulled up into the cloud. About a minute later he came straight back down at 700 miles an hour. The crash obliterated the plane; all they ever found of my friend was a little bit of his heel. It was inexplicable. Tristan was an excellent pilot, a much better formation flyer than I was.

  I flew back to Bagotville for the funeral service, where I played his guitar and sang “This Old Guitar,” which we used to perform together. It was one of the hardest things I’ve ever done. I had to practice singing it a hundred times, at least, until I was able to get through the song without breaking down.

  Afterward, I worked on the accident investigation, but we were never able to figure out why Tristan’s plane had crashed. He hadn’t made a radio call, and the plane’s telemetry and radar data were inconclusive. At the time the CF-18 was having various subtle failures of the displays that show you which way is up; perhaps that’s what happened. There are also a lot of things that occur inside your body during a rapid acceleration; your own balance system may feed you inaccurate information. When you pull up hard into a cloud, you’re relying on your instruments to tell you what to do, so if they lie to you, or if you’re debilitated by dizziness, you might come screaming back down vertically without being aware of what is happening. Or there might have been another cause altogether. We’ll never know. The only thing I’m certain of is that Tristan knew the boldface, and even that wasn’t enough to save him.

  Knowing the boldface improves your odds, but it’s no guarantee. You can be the best driver in the world with the safest car in the world, but if a semi comes through a stop sign and plows into you, none of that will matter. Intellectually, I’d always understood that, but losing a close friend, one I knew to be at least as good a pilot as I was, really drove the point home. Looking on the dark side, sweating the small stuff, viewing your colleagues as the last people in the world, knowing the boldface and recognizing when to use it—in the end, none of it may save you. But in a real crisis, what other hope have you got? The more you know and the keener your sense of operational awareness, the better equipped you are to fight against a bad outcome, right to the very end.

  Tristan was the first close pilot friend of mine who died doing his job; after that, however, I lost a pilot friend almost every year. It’s a part of flying fighters, we all know that going in, but you never get used to it. Each loss is a sharp shock, followed by a wave of grief. I never felt that an airplane had snuffed out a friend’s life, though; rather, a set of unusual circumstances was to blame. So the cumulative impact was not to make me afraid to fly, but to make me even more determined to understand what could be done to enable me and other pilots to work tough problems.

  As a test pilot at Pax River, I spent years trying to figure out how to make fighters safer by thinking through, in a systematic way, what could kill a pilot—and coming up with new boldface to help prevent it. The goal was to give regular fleet pilots who’d just graduated from basic jet training everything they’d need to know to work a problem so that even if they couldn’t save their planes, they could eject and save themselves.

  We did this by putting F-18s out of control, deliberately, and figuring out how to get them back under control. It was a wild experience, physically, a little like getting on a roller coaster at the fair: it’s comfortable enough chugging upward, but when you start whipping down there’s a sense of rising panic and a feeling of unpredictable, external force. Amidst the violent accelerations and nauseating rolling and tumbling, you’re responsible for keeping track of a lot of things, like your altitude and your engines, which may choke because of the changing intake air pressure. Meanwhile, you’re also trying to quantify the experience: What’s the rate of rotation? How hard do you have to grab the stick?

  Working as a test pilot in the “out of control” program reinforced my ability to focus on the essentials even in the midst of chaos. I learned never to give up on a problem and never to assume that everything will turn out fine. It didn’t occur to me, though, that the place where I’d really need to put those lessons into practice was on the ground.

  If I hadn’t understood how to focus and work a problem, I would not have got to space a third time. As it was, I just barely made it.

  In 1990, when I was a test pilot at Pax River, I went back to Stag Island with my family for a holiday in late August. Shortly after we arrived, my parents threw a big party, the
kind of event where people mill around the barbecue playing guitar and drinking whisky and eating their weight in corn and hot dogs. That night I woke up with gut pain. Any time I ate a lot I tended to pay for it, but this was different. I was in agony, and when the morning came I headed to Sarnia General Hospital. They put me on morphine, at which point I began hallucinating vividly about roller coasters and spiders, my dad became convinced that I was dying of cancer and the doctors began talking about exploratory surgery.

  Alarmed, Helene got Charlie Monk, a physician and friend from Stag Island, involved. She explained to him that if I wasn’t back at Pax River in a few weeks as scheduled, healthy and fit, I could lose my flight medical. A military pilot’s career depends on medical clearance to fly; lose that, and you’re toast. Abdominal surgery is particularly problematic: if you’re in a fighter jet pulling g, the added load on your abdomen could rip the stitches open right there in the cockpit. Charlie explained this to the doctors who were treating me, but after three days, when I wasn’t getting better and they still hadn’t figured out what was wrong, they threw up their hands and decided surgery was the only option.

  After opening me up, they did find the problem: a single strand of scar tissue, formed after my appendix was removed when I was 11 years old, had bridged onto my intestine and, like a drawstring, was pulling it closed. The surgeon snipped that strand and sewed me back up, leaving an impressive, jagged 8-inch scar across my belly. But I felt just fine. Two weeks later I was riding horses, and when we got back to Maryland, the U.S. Navy doctors checked me out and cleared me to fly. A month after being released from the hospital, I was back in an F-18.

  At the time, it seemed like a little too close a call. But that medical emergency turned out to be a really lucky break. Had the constriction not been addressed it would likely have been discovered in 1992, during the astronaut application process, and I would have failed NASA’s medical exam. A problem I wouldn’t have even known I had could have finished my chances of becoming an astronaut. Applicants are regularly ruled out for more minor medical conditions.

  Over the next two decades, my most serious health problem was a head cold. I passed the physicals for my Shuttle flights, no problem, and in 2001 I passed the most stringent medical exam in the world and was certified to go on the ISS. Then in the late fall of 2009, the crew for Expedition 35 was selected and I was told I’d be commander. It was something I’d been working toward my whole adult life, and I was both proud to get the assignment and humbled by it. I wanted to be worthy of the honor, to vindicate NASA’s trust in me and the CSA’s investment in me—it was the first time a Canadian would command the ISS, and only the second time that the position had been assigned to an astronaut who wasn’t American or Russian.

  A crew is trained to look after everything on board, from the potable water dispenser to all systems in the Japanese module, but there are varying degrees of expertise. Being certified as a user means you have basic knowledge and can turn things on and off; operators can run a module or system unaided, and know how it works but not how to fix it; specialists can do it all—operate, understand and repair. Becoming a specialist in all modules and systems would require considerably more travel and hundreds of hours of extra training, most of which I would in all likelihood never need to put into practice on the ISS. But that was all right. I decided to try to be designated a specialist in as many modules and systems as possible. This was my last chance to make a real contribution to the space program, since I would never get another opportunity to leave Earth.

  By October 2011, I was a specialist in almost every ISS system, experiment and module. I’d been training hard for two years, regularly working nights and weekends, and spending 70 percent of my time either in Russia or elsewhere on the road. I was happy to be back in Houston with Helene for a few weeks, only my stomach didn’t feel quite right. She was recovering from the flu, so I figured I’d caught it too but decided to go to the NASA clinic, just in case. The doctor there didn’t think my problem was the flu. He sent me to the hospital, suspecting an intestinal obstruction. An MRI confirmed it.

  This was not good news, but sometimes a blockage will clear on its own. That’s what I hoped would happen, but it was one of those hospital stays where everything that could go wrong, did: they accidentally wound up dehydrating me, and then after three days, when I was much sicker than I had been when I was admitted, the surgeon assigned to my case announced that he’d be operating on me the next day. He wanted to do what the surgeon in Sarnia had done back in 1990: make a big incision in my abdomen, open me up and see what the problem was. In the intervening two decades, however, laparoscopic procedures had become much more common; these involve a tiny incision and the use of a laparoscope to transmit images to a video monitor. Because laparoscopic surgery is minimally invasive, there’s a much lower risk of complications than with traditional surgery, and recovery time is also minimized.

  Given what I’d just been through there, the prospect of having an operation at that hospital didn’t appeal to me. Furthermore, I knew that if the surgeon operated the conventional way, with scalpel and large incision, I would not be going to the ISS in 2012. I would be medically disqualified. But I might still have a shot if I could get a laparoscopic procedure—and if it turned out that the issue was in fact minor. We had 24 hours to work the problem and I was, by this point, really feeling ill. Helene got on the phone and in short order I was moved to another hospital where I received excellent care. I was soon scheduled for laparoscopic surgery with Dr. Patrick Reardon, who’d treated Barbara Bush.

  He made two very small incisions in my abdomen and, using flexible snake-like devices just 3 millimeters wide, quickly located the problem: the surgery back in 1990 had created a 1.6-inch adhesion—a glob of sticky scar tissue, basically. The vast majority of abdominal operations result in adhesions, and adhesions are in turn one of the most common causes of obstructions because they can twist or pinch the intestines closed. That was exactly what was going on here: this adhesion, likely inflamed by the flu virus, was essentially gluing my intestines to my abdominal wall. When Dr. Reardon released the adhesion, everything sprang back into its proper place. After carefully inspecting my insides, he closed me back up and told me I should have no further trouble.

  I knew this wasn’t accurate, though. Now there was a whole new problem to work: convincing the powers-that-be that I was healthy enough to go to space. On the plus side, I didn’t have a chronic condition and one of the top surgeons in North America thought I was good to go. However, if I had a recurrence in space, our mission would be cut short and we’d have to fly home early. Another crew would have to launch earlier than planned to replace us. The cost would be astronomical.

  Before I could persuade anyone else I was fit to fly, I first had to convince myself. I wanted to go to space again, of course, but if there was any chance of getting so ill that I’d need to be evacuated from the ISS, I had a responsibility to withdraw from the expedition. I needed to find out what the risk of a recurrence really was, so Helene and I started researching and talking to doctors. In the meantime, I felt perfectly fine and was cleared to go back to training—but I wasn’t cleared for space flight. Every country that funds the ISS would have to sign off on that, which would be a tall order given the stakes.

  Over the next two months, a panel of experts—surgeons, military doctors, authorities on the medical aspects of space flight—considered the issue in order to make a recommendation to the Multilateral Space Medicine Board (MSMB), which includes representatives from the U.S., Canada, Europe, Japan and Russia. In order to decide whether I was a good statistical risk or not, they needed statistics. So a medical doctor was hired to review the research on the likelihood of another obstruction after surgery. But as it turned out, most of the studies had been conducted before laparoscopic surgery was common; many of them lumped together people who’d had minor procedures like mine with people who’d had really serious problems like massive internal tra
uma after car accidents or operations to remove tumors. And these studies did show that the risk of a future problem was unacceptably high: 75 percent.

  I’m no medical expert, but common sense told me that that data had little bearing on my situation. My problem had been minor, and it had been repaired using the latest and least invasive technology. Dr. Reardon had told the MSMB that the risk of me having another intestinal obstruction while I was on Station as just one-tenth of one percent. The chances that we’d have to evacuate the ISS to get me home were, in other words, significantly lower than the chances that an astronaut would have to be evacuated for a tooth abscess.

  I felt it was important to put even that very minimal risk in context; going to space is inherently dangerous, and activities such as spacewalks compound the danger. Seen in that light, the risk of a recurrence was inconsequential. I made my case directly to the two Canadians who served on the MSMB, presenting as much information about laparoscopic procedures as I could so that they were well prepared for the meeting. When the members of that international panel convened in November 2011, their ruling was unanimous: they cleared me for space flight, though they wanted to see some of Dr. Reardon’s studies.

  Phew. All’s well that ends well. Only, it wasn’t really over. Two months later, I learned that some doctors at NASA hadn’t been satisfied that I really would be all right, and had gone to their Canadian counterparts asking for more proof—but like a lot of top doctors who are in demand, Dr. Reardon hadn’t had time to publish his results. He didn’t have a neatly printed academic journal article to show them, just his own expert opinion based on extensive experience. So, unbeknownst to me, a new panel of four laparoscopic surgeons had been asked to consider whether it would be a good idea to have what they kept calling “a quick look inside”—in other words, to perform exploratory surgery to see whether I really was okay or not.