Vital Sings: Year in Space

Premieres: April 13, 2020.

As run script Distribution Version

Sanjay Gupta: 00:23

What if you had to live somewhere and could never go outside, never experience weather, like a rainstorm or the warm  sun? And what if you had to live that way for nearly six months? Could you do it? This is Vital Signs. I’m Dr. Sanjay Gupta.

Sanjay Gupta: 00:38

Six months is the usual length of time that astronauts spend living on board the International Space Station. Now double that to nearly a year and you’ll have Scott Kelly’s historic mission. It’s the first step in trying to get us into deep space, Mars, maybe beyond. But the biggest variable keeping us from getting there is likely ourselves. Can humans physically and mentally handle it?

Sanjay Gupta: 01:00

A lack of gravity is going to be one of the biggest challenges. As much as two litres of fluid shift from the legs to the head, producing changes in eyesight, while muscles and bones weaken without any force pushing down on them. With so many unknowns, it is risky, but Scott Kelly was up for it, and we went along for the ride.

Sanjay Gupta: 01:27

More than 200 miles above the earth, whipping  around at 17,000 miles an hour, Scott Kelly is on board the International Space Station.

Speaker 2: 01:37

Please stand by for a voice check from CNN.

Sanjay Gupta: 01:40

Station, this is CNN. How do you hear me?

Sanjay Gupta: 01:42

And we’re talking to him live.

Scott Kelly: 01:45

I hear you loud and clear. Welcome aboard the space station.

Sanjay Gupta: 01:48

It’s February 11th, 2016. Scott has already been in space for more than 10 months.

Sanjay Gupta: 01:57

As you travel at a rate of five miles per second,  I understand 200 miles above us, getting close to finishing a year in space. First question, how are you doing? What has surprised you most about any changes in your health?

Scott Kelly: 02:10

I’m doing pretty good. I do feel like I’ve been up here for a really long time. And I kind of knew what to expect going into this because I had flown a long duration flight before. So, overall, nothing alarming.

Speaker 4: 02:32  

Engines at  full thrust.

Announcer: 02:32

And liftoff. The year in space starts now. Kelly, Kornienko, and Padalka on their way towards the International Space Station.

Sanjay Gupta: 02:38

This is Scott Kelly’s fourth trip to space, and by far the longest in duration. In fact, it’s now the longest for any American astronaut.

Announcer: 02:47

Mikhail Kornienko now making his way into the new home that he will occupy for the …

Sanjay Gupta: 02:52

He and Russian cosmonaut Mikhail Kornienko signed on for a year in space. Then Scott and NASA  realised there was a second benefit here as well.

Scott Kelly: 03:05

I’m adjusting to life back on Earth very well. I’ve only been wearing these pants for a month.

Sanjay Gupta: 03:11

You see, Scott Kelly is an identical twin. His brother, Mark, shares the same DNA. And like Scott, Mark too was an astronaut, having flown in space four times. NASA could study one twin in space while the other was back on Earth. I sat down  with the Kelly brothers in San Diego this summer for their first television interview since Scott’s return.

Sanjay Gupta: 03:37

Mark, what was it, do you think, that attracted you to this sort of work? Was it the adventure? Was it the science? What was it initially do you think?

Mark Kelly: 03:46

Certainly, the excitement. But also, being able to serve my country in a different way than I had before. I was in the navy for about 10 years before. Both of us applied to be astronauts. I think I’ve always,  our parents were police officers. Public service was kind of in our family.

Sanjay Gupta: 04:05

Scott and Mark grew up in New Jersey. As kids, they were always active and, in their father’s words, a bit rambunctious.

Sanjay Gupta: 04:14

We had a chance to talk to your father. He said that if you guys were outside playing and he went to go look for you that he was unlikely to find you just sort of looking out, that he’d have to look somewhere specific to actually find you-

Scott Kelly: 04:25

Like on the roof of the building?

Sanjay Gupta: 04:26

On the roof of the building.

Mark Kelly: 04:27

Oh yeah, yeah, yeah, that’s true.

Scott Kelly: 04:29

That is true.

Sanjay Gupta: 04:29

Is that true?

Scott Kelly: 04:29

We’d always  find ourselves on it.

Sanjay Gupta: 04:30

You guys were always playing on the roof?

Scott Kelly: 04:32

We would be out, I don’t know how-

Mark Kelly: 04:35

This isn’t recently. This is when we were kids.

Sanjay Gupta: 04:37

Both brothers were selected for NASA’s elite astronaut programme after serving their country as pilots in the navy. There was always the chance they might fly in space at the same time, but it never happened. That’s okay with them.

Sanjay Gupta: 04:52

Your family, do they worry? I mean how much did they worry for you, Mark, when you were up in space?

Mark Kelly: 04:58

You know, I think our  mother and father would get pretty freaked out, especially on launch day.

Scott Kelly: 05:04

More for me, because they liked me better.

Sanjay Gupta: 05:07

I heard that. Is that true? The rumours are true?

Mark Kelly: 05:09

I don’t know. I’ve never been told. Maybe they told him something and just kept that from me.

Sanjay Gupta: 05:17

A running theme you’ll notice here, these guys are funny and they enjoy giving each other a hard time. It’s part of the close bond they share. A bond that was tested on Scott’s  third mission to space in 2011. Mark’s wife, Congresswoman Gabby Giffords was shot in the head during an assassination attempt in Tuscon, Arizona.

Sanjay Gupta: 05:40

You don’t get a chance to leave unless it’s something like this, no matter what’s happening back on Earth.

Scott Kelly: 05:47 Nope.

Sanjay Gupta: 05:47

And this came up with Gabby, it’s your twin brother, so yeah, I’m sure you call. How did you deal with it then and with mission a year now?

Mark Kelly: 06:00

But first of all, you can’t call. He can only call down. So you can’t even call up. I mean that’s … Send an email say, “Call me, something it’s going on,” but when Gabby was injured he was in space, and you know that’s tough, you know you can’t come home when your sister-in-law is in the ICU. You just, you know you’re there. But it’s something you understand going into it and you, to some extent you prepare for it.

Scott Kelly: 06:26

But that’s the thing I worry about the most when I’m on the space station. It’s not the ammonia leak,  it’s not the fire, it’s not the depressurization. It’s like something happened with my kids or somebody else I care about on Earth and I can’t be there, that’s the biggest concern with being there for a really long time.

Sanjay Gupta: 06:42

It was a concern for his year in space mission too. For 340 days, Scott would not be able to come home no matter what happened back on Earth. It was a risk he and his family were willing to take. And it’s not the only one.

Sanjay Gupta: 06:58

Scott was charting new territory.  No American had ever been in space that long and no one from any country has ever been studied this closely. We have no idea how Scott’s body would react to being in space for that amount of time or what could potentially develop later in life.

Sanjay Gupta: 07:16

Here’s an example of what we do know. A lack of gravity has a big impact on our bones and muscles. According to NASA, astronauts experienced up to a one-third reduction in muscle fibre size in less than two weeks on the space shuttle.  To put that in context, on Earth, post-menopausal women untreated for bone loss can lose 1% to 1.5% of their bone mass in one year, but an astronaut in space can lose that same amount in a single month.

Sanjay Gupta: 07:44

So think about what that could mean for Scott in space for a year. NASA has developed special exercise equipment to help mitigate those factors, proven effective for six months missions, but an unknown in Scott’s case. He would be up there for a year.

Scott Kelly: 08:01

My big lingering effect, I don’t even know if it’s big right now, but just my feet are still bothering me at times. I think it’s probably more plantar fasciitis than anything just from not being on my feet for-

Sanjay Gupta: 08:15

That’s interesting.

Scott Kelly: 08:15

For so long.

Sanjay Gupta: 08:16

So not so much from the fluid shifts?

Scott Kelly: 08:19

Yeah.

Sanjay Gupta: 08:19

More from just not using your feet?

Mark Kelly: 08:21

You say not using your feet. Though not using the bottom of your feet because you use the top of your feet.

Sanjay Gupta: 08:25

That’s really interesting. So bottom, but the top to actually move around. Yeah, you hook the  top of your feet on things.

Scott Kelly: 08:31

You get … I had this kind of patch on the top of my big toes that almost looked like lizard skin because you translate around with your feet and the bottom of your feet are very, very soft. When I got back on my previous flight I was getting a massage at one of these Massage Envy places and the lady goes, she goes, “You have the softest feet I’ve ever felt in my life,” and she did not know I was in space, and I was like, “Thank you. I’m very proud of them.”

Sanjay Gupta: 09:01

With Scott in space for a year and Mark on Earth, the idea for a twin study started to take shape. Scott would be the test subject, Mark, the control. It is a one of a kind study that could change the future of space travel. In the meantime, Scott had to make it through the mission, not just physically but mentally.

Sanjay Gupta: 09:23

By the end of the century, 84 years from now, the United Nations projects the Earth’s population will top 11 billion  people. Currently there are 7.3 billion living on Earth, and already there’s a strain on resources for our planet. So where else could we go? It’s certainly part of the appeal of deep space travel. Colonising other planets like Mars has long been the stuff of science fiction, but it could become a necessity with population projections on the rise. It also means Scott Kelly’s year in space is a critical first step in exploring the options of manned missions to deep space.

Sanjay Gupta: 10:00

Year in space, 11 months in, in a place the astronauts can never leave it can be tough mentally. To keep things interesting, Scott Kelly decided to monkey around. There’s no such thing as a true vacation up here, and that can take a toll. Even on a day off, without any scheduled experiments or maintenance work, the astronauts are always on alert.

Scott Kelly: 10:30

You wake up, you’re at work. You go to sleep, you’re at work. You never leave. You’re very busy. I think one of the underlying stressors of being up there for so long is that you’re always thinking, “Okay, if we have a fire, if we have an ammonia leak, if we have a depressurization, I have to be able to respond to this.” And that’s something that’s always in the back of your mind where you never really have a minute off from those kinds of things happening.

Sanjay Gupta: 10:56

In San Diego, I moderated a panel with Scott and Mark Kelly.  Dr. Stevan Gilmore also joined us. He was Scott’s flight surgeon for his past two missions. This lack of a mental break was one of his biggest concerns going into the year in space.

Stevan Gilmore: 11:12

I’d asked a few of the other astronauts that I’ve worked with, what if they could describe what time off would be on station. That’s kind of a difficult thing to do, because for the six-month missions, you’re going up there with an attitude of all the things that you want to get done and it’s a very achievable thing.

Sanjay Gupta: 11:30

The time away was often on Mark’s mind as well. Remember, if anyone could relate to what Scott was going through, it’s Mark. But sometimes he’d need a little reminder.

Mark Kelly: 11:41

I was on the phone with him after he’d been in space about three months. And I was talking about how I’d just been travelling a lot and I was walking down the street in New York city saying, “Yeah, I’m on this trip and I’m not going to be home for like three weeks, and that’s a really long time,” forgetting who I was talking to.

Mark Kelly: 12:00

And he said two words. I’m not going to tell you what they were but the …

Sanjay Gupta: 12:06

Steve, you were also Scott’s flight surgeon for when went up for six months in a prior mission as well. Was there anything that you could share with us in terms of differences? It’s awkward, I know he’s sitting right here, but six months to a year what sort of changes did you notice?

Stevan Gilmore: 12:21

Well, the first thing that I noticed was kind of a day-to-day thing and it was the importance of mindset. I didn’t really think about  this a lot as we were getting ready, but Scott was a great example in just taking things day by day, starting this journey of, I don’t know, hundreds of millions a miles with a staff and not looking too far into the future, because I think if you’re trying to look at the end of things from the beginning it’s easy to kind of get overwhelmed.

Sanjay Gupta: 12:51

If you want to eventually get to Mars, that mission would last roughly 30 months, two-and-a-half years. For the duration of Scott’s year-long flight,  he would have only just arrived on Mars. In addition to being able to mentally handle it, radiation would be a big concern.

Sanjay Gupta: 13:10

Consider this. Beyond low Earth orbit, the protection of the Earth’s atmosphere is gone. NASA says astronauts are exposed to radiation anywhere from 50 to 2,000 millisieverts. A millisievert of radiation is equivalent to three chest x-rays. So add it all up, and that’s an exposure equal to as many as 6,  000 chest x-rays.

Sanjay Gupta: 13:32

I’m curious, with all that you’ve learned, all you’ve seen, do you think Mars is feasible?

Scott Kelly: 13:38

Yeah, I think it’s definitely feasible. I think there are certain challenges. The radiation environment between the Earth and Mars is something that we’re going to have to figure out because we get protection here on the space station, although we get a lot more radiation than you do on Earth, you’d get much, much more on your way to Mars. So that’s a challenge.

Scott Kelly: 14:01

The systems, the life support systems are on one hand a challenge, but we’ve been maintaining these systems here for the last 15 years now. We can get resupply quicker, but there’s a lot we’ve learned here from operating the space station that will help us go to Mars.

Sanjay Gupta: 14:18

Another aspect of being in space for so long, nutrition. In 2014, I visited NASA’s Johnson Space Centre and got to taste some of the food. I got to tell you, it’s come  a long way. I tried a crab cake and some fish curry. Even so, though, I’m not sure I could eat out of a bag every meal for 340 days, let alone the time it would take for a Mars mission.

Sanjay Gupta: 14:46

For the twins study, NASA monitored everything Scott ate and drank, while Mark continued his regular diet back here on Earth. They also closely monitored Scott’s heart. In space, body fluids shift from  the legs to the head and upper body, as much as two litres of fluid. NASA says a natural reaction to this is a decrease in the total amount of circulating blood in the body. That can result in low blood pressure. Upon reentry back to gravity, some astronauts experience fainting until their blood pressure normalises.

Sanjay Gupta: 15:20

That reentry is the last piece of the complicated coordinated effort for safe space travel. It is the riskiest, most exciting element, and it just  happens to be the final part of the mission.

Announcer: 15:32

Scott Kelly back on mother Earth after 340 days in space.

Sanjay Gupta: 15:39

Back in 2014 when I visited Johnson Space Centre in Houston, Texas, I first met Julie Robinson. She is the chief scientist of the International Space Station with a critical hand in the science experiments happening during Scott Kelly’s year in space. Another element to consider about living on the space station that long  is your personal space.

Julie Robinson: 16:02

These are the sleep quarters. So this is your personal space.

Sanjay Gupta: 16:05

This is it?

Julie Robinson: 16:06

This is it.

Sanjay Gupta: 16:07

Julie showed me around the mock-up of the station, which has 935 cubic metres of livable space.

Julie Robinson: 16:14

You’ve got some real nice fans blowing on you at night so you don’t suffocate.

Sanjay Gupta: 16:18

Can I step in here?

Julie Robinson: 16:19

Yes. Don’t tell anyone. Go on.

Sanjay Gupta: 16:21

Scott slept in this small compartment every night.

Sanjay Gupta: 16:24

You strap on them?

Julie Robinson: 16:25

So basically you have a sleeping bag that’s velcro-ed to the wall.

Sanjay Gupta: 16:29

NASA  says astronauts sleep on average less than six hours a day, and before critical mission operations, it’s even less. Today, I met up with Julie again, this time in San Diego, for a look at what has changed since we last saw each other.

Sanjay Gupta: 16:46

Last time we talked, it was before this year in space. I’m just wondering, from the chief scientist perspective, what’s the year been like for you?

Julie Robinson: 16:55

It’s been an amazing year. I’ve never had so much public interest in  what we’re doing in space from people. A lot of times people don’t even realise that the space station is up there all the time. And suddenly everyone’s aware, little kids, older ladies. I’ll meet someone at a party and they’ll say, “Oh, how about Scott Kelly?” So it’s really caught people’s imagination. But I think it helps people see how the space station connects to Mars, and it helps people see how the space station connects to health. And those themes are so important. They really capture  everything that we’re doing on the space station.

Sanjay Gupta: 17:32

A lot of times you’re talking about stuff that’s already in textbooks, is already published. But this is happening in real-time.

Julie Robinson: 17:37

Yeah, yeah. We’re really solving problems real-time, things that we really don’t know. There’s no analogue on Earth. There’s nothing that looks like the vision syndrome on Earth, and so we’ve got to solve a brand new medical problem.

Sanjay Gupta: 17:49

You just got this fast laboratory where it’s happening.

Julie Robinson: 17:51

Right. You’ve got these incredibly healthy people that don’t have other diseases and they have it, this problem, and then it reverses. So the power of things like,  the twin study is if you can understand the genetics that was turning that problem on and turning it back off, then you’ve suddenly got a window into health on Earth that you wouldn’t get anywhere else.

Sanjay Gupta: 18:11

The twin study is really the crown jewel of this mission. 10 studies with 10 different groups of researchers are happening almost simultaneously, using the samples from Scott in space and Mark on Earth.

Andrew Feinberg: 18:25

This is what we can see.

Sanjay Gupta: 18:26

Dr. Andrew Feinberg is a researcher with Johns Hopkins. He’s also  one of the principle investigators of the twin study. His focus is genetics.

Andrew Feinberg: 18:36

If you think about the area that the twin study was involved in, things like, say, identifying what might be epigenetic damage to the genome that might precede the development of mutations, it could lead to cancer risk that might open the door to ways to mitigate that damage. That has practical implications for here on Earth.

Sanjay Gupta: 18:55

By studying Scott and Mark, scientists will be able to identify any links between the environment  and human health. But there is another downside in addition to the potential long-term health impacts for Scott. Because genetic information is a part of this study, privacy could be an issue for the Kelly twins and their families. So before anything is published, they will have the option of withholding certain information.

Sanjay Gupta: 19:19

Your study is going to become a well-known study. This data is going to be out there. And obviously people are going to know it’s you two because the only twins that have been in a study like this at that time.  The security of that information, just the privacy of it, how much do you worry about that?

Scott Kelly: 19:35

I’m not worried about it for me. I’m worried about it more for my kids. They could potentially see that I’m susceptible to having this disease and based upon the person and what kind of person they are, that could have a significant effect on them or not. Maybe they would just like to know.

Sanjay Gupta: 19:53

Did you have any reservations, Mark, about being in a study like this?

Mark Kelly: 19:57

I realise the significance of  putting that information out there. In flying in the space shuttle, there’s a lot of risk involved, and it’s a risk versus reward thing. And the reward is really for our country and for our nation. Same thing with the science. There might be a little bit of a downside for us. But the benefit to the space programme and to the American people is enough to make it a pretty obvious decision.

Announcer: 20:23

Getting ready to depart the International Space Station again, wrapping up 340 days on board the orbiting laboratory.

Sanjay Gupta: 20:31

As Scott’s mission in space came to a close, there was one big part left, reentry.

Announcer: 20:37

And undocking has occurred, seven-

Sanjay Gupta: 20:40

Perhaps the riskiest part of space flight happens at the very end.

Sanjay Gupta: 20:45

You described it as going over Niagara Falls in a barrel that also happens to be on fire.

Scott Kelly: 20:50

Yep.

Sanjay Gupta: 20:50

It’s pretty scary. I watched the video and, first of all, you seem remarkably composed.

Scott Kelly: 20:57

You actually think about it, so I’ve made it all  the way through this whole year, the launch, spacewalks, the risk of being up there for a really long time. I’ll tell you what, one of the riskiest parts is at the very end when you come blasting back into the atmosphere and you’re relying on this parachute to open in this Russian Soyuz, and everything goes well when there’s stuff flying by and hitting the windows, part of the insulation that comes off and it gets hot inside. Then as soon as the chute opens  and the motions stop and you realise it didn’t kill you, it’s the most fun you’ve ever had in your life.

Announcer: 21:38

Scott Kelly, back on mother Earth after 340 days in space.

Scott Kelly: 21:43

I said, even if I hated being up there for six months, maybe not a year, but even if I hated being on the space station for six months, I’d do it all over again for the last 20 minutes. It’s a wild ride.

Sanjay Gupta: 21:56

When it was all said and done, Scott Kelly spent 340 consecutive  days in space, from March 27th, 2015 to March 2nd, 2016, the most of any American astronaut. He travelled more than 143 million miles and saw nearly 11,000 sun rises and sun sets. In that same time period, you and I saw just 684. He also returned home five milliseconds younger and two inches taller, though gravity soon weighed in to shrink him back down to normal. And he shared it all with us along the way through these stunning photos on social  media. And he’s going to continue to share with a book coming out next year.

Sanjay Gupta: 22:34

The results from the twin study will begin coming out early next year as well, and then we’ll truly begin to see the impact that this historic mission could have on all of us.

Sanjay Gupta: 22:43

For Vital Signs, I’m Dr. Sanjay Gupta.

Sanjay Gupta: 22:43

(silence)