Page 98 - JSOM Spring 2024

for project power and influence, reduce timelines for space op- During this international joint effort, commonalities and po-
erations, and bring focused attention to defending U.S. inter- tential were discovered between SOF and NASA interactions
ests in space. 19–20 Separately, Space Force is an actual military that could possibly support the S/S/C triad and provide quid
service whose job is to man SPACECOM and focus solely on pro quo benefit to SOF and space medical efforts. Further en-
superiority in the space domain; it is presently focused on the gagement between communities in such areas as research and
enablement of unmanned efforts and support systems of space. development, discovery of similarities in operational employ-
Although the crux of the S/S/C triad is SPACECOM, the inher- ment and limitations, and the potential for synergy in feasible
ent, developed, and historical medical support and capability and common lines of effort.
for manned efforts is championed by the National Aeronautics
and Space Administration (NASA). Special operations and space share numerous similarities. Op-
erational commonalities include the sensitivity of mission, the
NASA is the civilian complement to SPACECOM in that its austerity of operation, strategic impact, and public regard.
strategic plan states that NASA is responsible for “strengthening Both communities exercise unique, high-performance selec-
the United States’ (U.S.) global leadership in space and aero- tion for the most demanding of missions and environments,
2
nautics.” This strategy includes establishing a sustainable long- while nurturing uncommon cultures and values owing to these
term human presence on the moon and eventually Mars. This privileges. Both communities esteem and prioritize the need
strategic goal requires operational medical systems and a ro- for emotional intelligence because of the inherent nature of
bust research and development program to ensure that new and our operations and the increasing use of technology and ar-
emerging medical and human performance requirements are tificial intelligence. Both endure high risk and the mitigation
met. NASA established the Human Research Program (HRP) therein that exists in training, sustainment, execution, and the
in 2004 to address a multitude of medical and performance unavoidable consequences of our missions. Inarguably, both
risks associated with human deep space exploration. The HRP communities tangibly contribute to universal research and
is composed of five elements of effort: Exploration Medical Ca- development with beneficial impact across professions, disci-
pability, Human Factors and Behavioral Performance, Human plines, and with international effect.
Health Countermeasures, Space Radiation, and International
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Space Station Medical Projects. Additionally, these programs SOF and space are both required to adapt to change routinely
are designed to directly mitigate the five hazards of space flight: and without expectation. Planning and preparing for contin-
space radiation, isolation and confinement, distance from Earth, gencies are the hallmark of success when plans fail while con-
gravity fields, and hostile or closed environments (Figure 1). 21–23 stantly transforming our actions due to expanding variables.
Lastly, both organizations are relatively young, yet both un-
FIGURE 1 Special Operations Forces in space. derstand, regard, and appreciate that our service stands on the
(Photo by COL Drew Morgan during Expedition 60, 61, and 62 to shoulders of those who came before us.
the International pace Station on behalf of NASA.)
Medical commonalities between SOF and space programs are
just as similar. Shared tenants such as the respect and a quest
for the never-ending objective of evidence-based medicine
while clearly understanding the need to innovate new ideas
and methodology when necessary. Both communities are ac-
tionable first to operational requirements for mission success
while still attempting to deliver the highest standard of care
in operational environments. Principles of care in both arenas
mirror each other as simple, effective, and as expeditious as
possible for the most complicated of problems. The readiness,
performance, and sustainment of operators, astronauts, and
crew members are always a priority.

Both organizations see the value in the direct medical support
The Translational Research Institute for Space Health (TRISH) of medical systems application and, more importantly, that
supports NASA in their human performance and systems de- their integration at every level of mission is as important as
velopment with research and data analysis. TRISH focuses on or more so than therapeutics for operational success. Medical
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both very high- and very low-technology readiness-level solu- support of both organizations is required to be as nested as
tions for crew health and performance in near-term missions possible within missions, knowing that successful operational
as well as innovative and nontraditional solutions for missions medicine must first be located where care is needed (Figure 2).
with unprecedented durations and distance from Earth. As a
translational institute, TRISH supports development and, im- Potential Benefit
portantly, implementation in high-fidelity analogs including
the Australian Antarctic and commercial spaceflight to directly Operational
translate evidence-based medicine into operational impact. A greater understanding of how both communities solve their
respective operational challenges in medical support and
where and how we could learn from each other has mutual
Commonalities worth. Defeating operational limitations, mitigating risk, and
In December 2023, Allied Special Operations Forces Com- optimizing human performance in ground analog environ-
mand (SOFCOM) executed a medical research workshop pro- ments enable our missions. Both communities must adapt to
filing “Technology in Medical Support of Special Operations.” abrupt changes with little or no notice and look to develop

96 | JSOM Volume 23, Edition 1 / Spring 2024