“Being in the Air Force and medicine, there’s a lot of opportunities to do weird stuff. I get to have a lot of odd experiences that nobody else really gets to have,” says Dr. Jacob Altholz, chief resident for the emergency medicine residency at the Kirk Kerkorian School of Medicine at UNLV.
Always apt for new adventures and getting into more “weird stuff,” Altholz was thrilled to learn about a clerkship program that lay in the center of the Venn diagram that represents his professional and personal interests.
“Every year, NASA has a clerkship, one in October and one in April. Most participants are medical students, but they accept all the way up to attendings and medical directors too,” Altholz explains. Having graduated with his medical doctorate from the Uniformed Services University’s School of Medicine in 2021, Altholz’s longtime plan to apply to the NASA Aerospace Medicine clerkship was sidelined by the pandemic. However, the wait to apply was worth it when he was one of the 20 clerks accepted into the prestigious, four-week program, which he completed in April.
What do clerks do during their time at the Johnson Space Center (JSC) in Houston, Texas? They play with all of the fun space gadgets, of course. Like taking a turn on the Combined Operational Load-Bearing External Resistance Treadmill – or COLBERT, a treadmill named after comedian Stephen Colbert that’s optimized for exercising on the International Space Station – and a chance to sit in on mission control.
Beyond the tours of the JSC’s cutting edge facilities, the clerkship engages its participants with topical research in the niche field of space medicine. “There’s an entire warehouse that’s just dedicated to audiology … sound dissipation is extremely important (in space),” Altholz says.
Amy Honors, the special projects and flight surgeon training coordinator, says, “The clerkship involves formal lectures on space medicine topics and issues, familiarization with the medical aspects of International Space Station operations, design, and function, as well as Exploration Medical Capability for deep space exploration. Participants are required to complete a research project and scientific poster with an accompanying 250-word abstract in a current focus area of space medicine.”
Honors also notes that Altholz represented his institution with aplomb, calling him a “wonderful addition to the program,” specifically noting his “strong work ethic.”
Medical Mystery Among Astronauts
For Altholz’s research project, he and two other clerks tackled an aerospace medical mystery that has persisted for years: the prevalence of farsightedness in returning astronauts.
A 2017 Atlantic article states that about two-thirds of astronauts report changes in vision after returning from stints on the International Space Station. In an extreme example, astronaut John Phillips, according to Popular Mechanics, found that his eyesight had deteriorated from 20/20 to 20/100 after six months on the ISS.
This field-specific issue is known as Spaceflight-Associated Neuro-Ocular Syndrome (SANS), and, although it may affect a small population, it carries critical implications for the future of aerospace exploration.
“For the last few years, it's been a high priority because we know that astronauts are getting more farsighted,” Altholz says. “We have to correct that, because if we send somebody to Mars and they get farsighted, they can't do anything.”
Conducting research in aerospace medicine presents a unique challenge in that you cannot easily increase your sample size. Therefore, Altholz and his team went through existing datasets hoping explain the likely mechanism (for SANS) a little bit better.
Since the end of the clerkship, Altholz and his co-researchers have continued their work with the goal of having a complete draft of a potential journal article finished by November.
A Future in Teaching and Research
This project, he says, has wedded two of his passions: research and helping patients.
“I've always liked doing and researching very esoteric, specific things,” says Altholz, who spent a summer before entering medical school researching peripheral vision in a psychophysics lab at New York University. Given his penchant for specialized research, it’s no surprise that Altholz's career aspirations include becoming a professor.
A “common thread” that neatly ties up Altholz’s varied professional experiences as a member of the U.S. Air Force, emergency medicine resident, and researcher is the impetus to effect positive change. “For me, it’s taking the breadth of humanity … taking the most indigent patients and helping them up, and then also taking the most high-performing humans on this earth and also helping them.”
Another way Altholz works to make an impact at a macro-level is through his policy work. He has served on the American Medical Association House of Delegates as well as on the American College of Emergency Physicians Council, familiarizing legislators about issues emergency medicine residents face. At this year’s annual advocacy meeting, topics of interest and advocacy included patient boarding, department safety, and Medicare reimbursement.
“My interest in policy,” Altholz says, “has always been my desire to make life better for my colleagues and my patients. I've always been interested in helping make systematic improvements.”
Whether it's lending a helping hand to new residents as the emergency medicine chief resident or helping get to the bottom of an aerospace medical mystery, Altholz undoubtedly lives by his mantra of making life better for all types of people, on this planet and elsewhere.
