Extreme Leadership Lessons From Astronaut, Antarctic Doctor Scott Parazynski

Former astronaut Scott Parazynski is the National Science Foundation's chief medical officer for Antarctica and the overachiever behind one of the most mind-blowing Wikipedia pages ever written. Here's how he breaks down challenging missions in extreme environments on Earth and in space.

Dr. Scott Parazynski has an intimidating resume. A former NASA astronaut who served on the Space Shuttle, Parazynski now oversees medical operations for the National Science Foundation's (NSF) United States Antarctic Program's bases and outposts on the polar continent. He's also a former Olympic luge coach and an accomplished mountaineer who successfully climbed Mount Everest in 2009. At his current position, Parazynski is responsible for hiring doctors and medical support staff for multiple Antarctic bases and on-ice care for all United States Antarctic Program participants.

Fast Company spoke to Parazynski about his childhood as a Boeing brat, MacGyver-style medical treatments, traveling into space, and the leadership skills he learned along the way.

FAST COMPANY: Can you tell us a little bit about your work at the NSF Antarctic bases?

SCOTT PARAZYNSKI: Absolutely. I am chief medical officer of the Center for Polar Medical Operations, which is in support of the National Science Foundation's United States Antarctic Program, so we oversee all of the medical screening, the provisioning of the major stations on the Antarctic continent, and real-time medical support. This includes providing health care providers as well as telemedical support here from Galveston, Texas and everything in between. So it's a very exciting mission and obviously very challenging. I liken work on Antarctica to being in a station on the back side of the moon...or even what living on Mars would be like. It requires a lot of forethought, a lot of good screening, and then some real MacGyver-type medicine on occasion to handle all the unanticipated things.

MacGyver medicine?

Certainly. A very famous case that you may have read about is that of a physician at the South Pole, Dr. Jerri Nielsen, who self-diagnosed herself with breast cancer in the middle of her stay during the Austral Winter. She had to coach her support staff, none of whom were physicians, to aid her in the breast biopsy and medications were actually airdropped to the station in the middle of winter...you can't land there. They were able to treat her in place until such time as we could get her out.

There are three main stations dispersed around the Antarctic continent. Each of them has the equivalent of what I would consider to be an urgent care center. They have ultrasounds, X-rays, enhanced cardiac life support, but it's not an intensive care clinic and it's not an operating room. If you're really sick, we'll do everything we can to treat you in place and we'll try to medivac you during the Austral Summer. However, there are certain cases where we have to make the best of what we have on the scene and get you off as soon as conditions allow—and that's where the MacGyver medicine comes in.

We make clinical treatments and medical plans without all the bells and whistles taken for granted in the United States.

What kind of backgrounds and skill sets do you look for in Antarctic medical staff?

Having a broad background as well as a procedural background is most advantageous. Emergency physicians and general surgeons with an E.R. background are the most highly sought after. They are jacks of all trades who can handle most emergencies—but not all! That's the advantage of having the background of the University of Texas Medical Branch here at Galveston. UTMB is our parent organization. If I have a vexing problem in the field I can call upon clinical experts and cardiology, dermatology, endocrinology, surgery, and what have you to address those issues. In a team approach, we can handle most things. At the peak of summer at McMurdo Station, which is our largest facility, we have a dentist, a pharmacy technician, and a radiology tech as well as several assistants to help assist the large volume of patients.

You traveled a lot during your childhood, spending time in Lebanon, West Africa, Iran, and Greece, among other places. What was your childhood like?

My father worked for the Boeing airplane company, initially in support of the Apollo project—I grew up in and around the space program. After Apollo wound down, my folks were very adventurous and decided they'd like to live overseas. So we moved overseas, first to West Africa and then to Beirut, Lebanon, then spent some years in Athens, Greece, where I graduated from high school and also several months in Tehran, Iran. That was pretty wild. I lived through the civil war in Beirut during 1975 and then the Iranian Islamic Revolution—we had to evacuate from there as well in December 1978. For me it was an incredible adventure, but I'm sure it was a terrifying nightmare for my folks.

When you're a kid, you're immortal.

When you're a child living in those situations, especially being an American, what was it like?

I didn't have a full awareness of the danger. We certainly didn't have CNN or the web as we've had in recent years where you could follow minute-by-minute happenings. However, there was evidence of war all around. There was sniper fire, we heard cries from the minarets at night spurring on the revolution in Tehran. When we were in Beirut, we were sort of diagonal from an international store, sort of a marketplace. It was blown up in the middle of the night; all of the windows in our apartment building were blown out. We knew exactly what was going on and when it got really intense like that we departed.

Have you been back to Beirut since the Civil War?

I've had several invitations, but it was at a time when there was still some unrest and NASA wasn't comfortable in letting me go. I think that if I had an opportunity to go back now, I certainly would love to go.

I would especially love to return to Iran. It was a beautiful country, and I recall the people as being especially inviting. Unfortunately, it's now impossible for an American to visit. That country has changed in so many different ways.

Does that mean NASA puts travel restrictions on astronauts during their time off?

Yes—this has to do with public relations visits. It would have been a formal invitation to me as an astronaut to go speak. That being the case, they were worried about security issues. They elected—wisely so, in my option—not to have me travel.

What are the places that you have always wanted to travel to but never been yet?

Antarctica is one! For me, that was one of the real draws in taking this particular job. I have always wanted to visit Antarctica. When I was in junior high and high school, I was a Boy Scout and ended up getting an Eagle Scout award. It was for a national competition when the reward was to go Antarctica as part of a science team. I was a finalist for this thing but I didn't win it. This was one of the biggest regrets of my youth—not getting a chance to go down and visit Antarctica. This is certainly one of the places that's as foreign to our daily existence as anywhere on the planet. I'm really excited to visit Antarctica.

The other big draw for me would be traveling to the Challenger Deep in the Marianas Trench. Jim Cameron recently revisited a spot that hadn't been visited in decades. It was a really audacious accomplishment, technically and otherwise. For some reason, it really didn't raise a blip in the media but I just thought it was an amazing thing for him to do. As an explorer, knowing that only 5% of our ocean has really been mapped and categorized. I think there's a lot to discover in our oceans and I'd like to be a part of that in some way as well.

Do you think the future of exploration is more in the public sector or the private sector?

I think there's going to be a huge role for the public to engage. Commercial ventures, both for human spaceflight and beneath the oceans, are things that really going to open up. I believe that there is a real market as well. I'm very encouraged by the advances in the commercial human spaceflight sector. There are also several submersible companies that are looking to bring more people to the ocean. Also, there are undersea habitats being proposed that would allow more and more people to explore inner space. I hope those things continue to develop and prosper.

Are there any new technologies now emerging that you are really excited about?

I'm drawn to remote and challenging environments—I think they are a very rewarding space to work and study. They are also incredible test beds for technology. They press our limits; the advantage of using these extreme environments as technology drivers is that oftentimes the tech we innovate there crosses over to the mainstream marketplace. I think that the drive toward Apollo and the things we got from the lunar program revolutionized medicine, for instance. The miniaturization of technologies, sensors, and microelectronics that are now ubiquitous in our intensive care units... well, the monitors you see, they're all "space pedigree."

There are a lot of things that we are developing from this now. Telemedicine, and point of care diagnostic and therapeutic devices for use in remote environments where we can't initially get a person in a traditional hospital setting...I think, ultimately, all of these things will be deployed in family doctor offices all around the world.

I'm also excited about advances in microelectronics, nanotechnology, genomics, metabolomics...well, all the "omics." They will allow us to develop capabilities for advanced point-of-care medicine; it's very logical that in places like Antarctica, the International Space Station, and perhaps lunar or Mars expeditions, these things will be used first and then bought "back to earth," so to speak.

I'm also very interested in robotic surgery, telementoring, and telerobotics—the performance of procedures from afar. This means guiding a person at a remote site through a very difficult procedure. By using just-in-time training or actual assistance from afar, we can do procedures that have never actually been done before. Those are some of the areas that I am most excited about.

You're also an accomplished mountaineer. How did you get into mountaineering?

I lived in Athens, Greece as a teenager. I started rock scrambling and climbing, there's actually a lot of great rock climbing in Greece and I ended up going to college in California where there's amazing climbing. During my residency in Colorado I transitioned into summer mountaineering followed by winter mountaineering—there was no turning back from there. The longer you climb, and the more you challenge yourself, you look for harder and higher peaks to climb, The ultimate test piece, of course, is Mount Everest. It's on everyone's to-do list, so I was very fortunate ultimately to climb that as well.

What do you think has been the most difficult thing, careerwise, that you've ever done?

What I've learned by taking on a difficult challenge is that in order to be successful, you have to divvy it up into manageable parts. Using Mount Everest as a simple example, because it's an easy metaphor, if you arrive at base camp and look up at the summit it is two miles or more above you. For many people, it's completely defeating. In fact, I've had many teammates within a week of arrival at base camp turn around, say "I can't do this," and return home.

What you have to do is to take it a day at a time. The important thing is not focusing on the endpoint, but rather at making it through the next rope length without stopping. Then I rest, then I reevaluate. So if you take on challenges of medical training or mission preparation for a particularly difficult mission task, if you can break them down into unique parts and learn as much as you can about what those challenges are and master them, you can get through a lot of big challenges.

In terms of your original question, I think becoming an astronaut and getting selected was a huge objective of mine. I thought I was a longshot, but again, I approached it by asking what the best clinical and engineering background would be. I asked myself how I would ready myself for that position; I spoke with current and former astronauts and got lots of good advice. I was very diligent in my approach; I learned to fly and developed some other skills that I thought would be useful. Ultimately, I was successful in becoming an astronaut.

Could you tell our readers a little about what your daily routine on the job is like?

The only real routine for us is that there is no routine. Every day is different, which is fun but also hugely challenging. When we were awarded the contract to manage all the medical care in Antarctica for the NSF, we began developing efficient procedures to manage the huge workload—the physical screening of thousands of participants, the real-time issues that come up that take up a lot of our time.

We recently had a medical evaluation that I was very heavily involved in. Basically, it was 24/7 operations for several days. I had to continue my day job plus monitor conditions in on the ice and provide assistance to the NSF in regard to the medical evacuation.

There is hiring of health care providers on the ice. We've been involved in standardizing formulas, looking at improving equipment, and facility infrastructure improvements in Antarctica at the three major stations there. It's just nonstop. There are lots of opportunities for significant improvement that we are really excited about; we just have to chip away at it as time allows.

This interview has been condensed and edited for readability.

[Image: Dr. Scott Parazynski]

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