By Mark Couch  

(October 2018) Bottle rockets and daydreams about space flight fueled Ben Easter’s childhood imagination.  

These days, Easter, MD, is an emergency physician who spends his spare time designing Mars simulations in the Utah desert where he teaches others how to handle medical emergencies in an extraordinarily austere setting.  

These are not simple flights of fancy. The Mars simulation is a Wilderness Medical Society-endorsed continuing medical education course that is taught by experienced scientists and physicians using a habitat developed by the Mars Society, a nonprofit dedicated to promoting exploration of the Red Planet.  

And Easter, an assistant professor of emergency medicine at the CU School of Medicine, isn’t pursuing the project as a hobby. He’s laced his education with aerospace medicine to cultivate his longstanding interest in space.  

As a fourth-year medical student at Harvard Medical School, Easter participated in a clerkship at NASA’s Johnson Space Center, where he and five other program participants spent a month learning about manned space flight, toured the facilities, and took turns flying the space shuttle simulator.  

One day, the group was looking at the Mars Rover when a non-descript man asked who they were.   

“We say, ‘We’re medical students and we’re interested in space flight,’” Easter recalled.  “And he says, ‘Oh, this is the Mars Rover. I’m the lead engineer for the project. You want to go inside? So we go inside and he’s describing it. Then, he looks over and says, ‘Do you guys want to drive this thing?’”  

The correct answer would be YES!  

“He gets out, opens up the huge hangar doors,” Easter said. “We all pile in and he takes us out on the test field and we’re driving around. It was a very cool experience.”  

Also while a fourth-year medical student, Easter rotated at Denver Health.  

“I loved emergency medicine out here. We loved Denver. We loved Colorado. So I was fortunate to match out here for residency.” 

After moving to Denver as an emergency medicine resident, Easter had another fortuitous encounter.  

“When I was down at NASA, they had given us all NASA space medicine division fleeces. They have a logo and patch. So one day, as an early second-year resident, I was wearing this fleece coming in to a shift. Jay Lemery [an associate professor of emergency medicine and the head of the section of Wilderness and Environmental Medicine] was the attending and Jay says, ‘Hey what’s that?’ I told him and he said, ‘I did that rotation as a medical student.’”  

That was the fleece that launched a new course to explore.  

“Jay and I batted around a lot of ideas,” Easter said. “We wanted to do some kind of space medicine simulation program, but the barrier for a number of years was the venue. Where are you going to go do that? And then I was just following a rabbit hole on Google one day and found the Mars Society.”  

The Mars Society operates the Mars Desert Research Station outside Hanksville, Utah, that generally had been used for basic science research, such as geology, robotics, and biology.  

Searching the Mars Society website, Easter found a team member who was a physician. “I showed Jay the website, and told him that I think this person might be our in and Jay says, ‘Not only do I know this guy, I know this guy really well.’”  

It really is a small world after all.  

Lemery’s connection helped make introductions to the Mars Society. Then, Lemery and Easter began to develop a continuing education program that they hoped to offer through the Wilderness Medical Society.  

That wasn’t such a hit though. Easter said the immediate reaction from the society was skeptical: “Do you really think anyone who’s interested in the wilderness and being outdoors is going to lock themselves in a tin can? We think you’re not hitting the right market.”  

So Lemery and Easter decided to trek to the site.  

“My wife never lets me forget this,” Easter said, “because the week before our wedding, I drag her about six and half hours out into the middle of nowhere. Hanksville’s a town of about one motel and three gas stations. It’s mostly a gas stop, so I’m driving to Mars, Utah, and she’s doing the seating chart to our wedding in the passenger seat.”  

While the habitat itself wasn’t the highest fidelity, the surroundings were perfect for designing a rugged course about surviving in a remote environment.  

“It is barren,” Easter said. “It is desolate. It’s red. It’s dry. It’s a place that looks like it is shaped by water, but there’s no water out there anymore. You can get incredible winds coming across the desert. One time we were doing one of our sims and a big storm blows in and there’s lightning while we’re exposed on the top of a cliff. It’s pretty impressive. So I said to Jay, the living conditions may leave a bit to be desired, but the outdoor experience is absolutely incredible. I think we do it.”  

The next step was to enlist additional expertise in space medicine, so they contacted NASA Astronaut Kjell Lindgren, a 2002 graduate of the CU School of Medicine.  

“We said, ‘Kjell, we’ve got this crazy idea to take groups of doctors, live in simulation in the Utah desert like a Mars crew for seven to 10 days at a time, teach about aerospace medicine and then put them through EVAs (Extra Vehicular Activities), the term for whenever you’re leaving your space craft.’”  

Lindgren helped them contact Rick Cole, an emergency medicine physician who also does aerospace medicine. Turns out, Cole was Easter’s mentor during Easter’s rotation at the Johnson Space Center.  

“Kjell gets on the phone with me and Rick and I said, ‘Rick, I don’t know if you remember this. . .,’ but when I mentioned it, he put two and two together and he remembered the exact research project I had worked on and everything.”   

Cole, who is a flight surgeon at NASA and has sat on Mission Control, became a core partner as Easter and Lemery developed the program. “He really had a sense of what it should feel like,” Easter said.  

With a site for the program and with a team to design it, Easter and Lemery went back to the Wilderness Medical Society. Despite concerns, the course was posted on the society’s website.  

“And, of course, it sold out in 24 hours,” Easter said. “So we actually had to pull this thing off.”  

The first time the program was offered, in November 2015, it was for six participants. They offered a curriculum, with a few hours of lectures each day on topics relevant to space: radiation, hyperbaric medicine, contingency planning, and psychological challenges of long-term space flight.  

Using all-terrain vehicles, they developed “sims” – simulation challenges for the EVAs when they are outside the habitat, or “Hab.” 

One of the first challenges is to handle communications outside of the flight vehicle. On the rocky, hilly terrain it is easy to lose contact with one another on the two-way radios.  

“If you’re not in the line of sight, you completely lose communication,” Easter said. “So we tried to integrate all this story into a coherent theme. On the first day we send them out, it is a very simple EVA where the biggest problem is communication with the Haband that’s a key part of what goes wrong.”  

On the second day, the EVA project is to set up repeater stations on high points near the Hab to keep connected even when they aren’t in direct sight of it. Dividing the spacesuited crew into two groups, one climbs a steep crag, while the other ventures into the field.    

“The group on top basically acts as a repeater, transmitting signals between the field crew and the Hab,” Easter said. “The group on the far end is mapping. ‘OK, we’ve got a signal here. OK, we don’t have a signal here. OK, we have a signal here.’ So that it feels like you’re doing something that an actual crew would do.”  

Then, on the way down from the high point, one of the crew members has been pre-selected to act out a slip-and-fall scenario. That crew member ends up with a tear in the back of their suit and a simulated femur fracture.  

“The crew has to come back together and they have to figure out what to do,” Easter said. “If they don’t find this tear in the back of the suit, the person gets decompression sickness, and even if they do find that, they have to figure out how do you splint andevacuate this crew member with a femur fracture and get them all the way back to the Hab.”   

Subsequent “Martian Medical Analogue and Research Simulation” (2MARS) courses were offered in 2016, 2017 and this year, with one scheduled for November.   

And it remains a popular course.   

“Probably one of the best compliments we’ve got about the course was from a doc from Australia,” Easter said. “We were asking, what made you sign up for the course and he says, ‘I didn’t sign up for the course. My wife signed me up for the course as an anniversary gift.’ He and a group of other physicians flew halfway around the world to spend time in the Utah desert. To us we thought that was the best compliment you can get because CME courses can be so dry,” Easter said.  

Easter was appointed in September as the Deputy Element Scientist for NASA Exploration Medical Capabilities. He will be detailed to the Johnson Space Center for the majority of his work and will continue to have a faculty appointment with CU and do clinical time in Colorado.   

He also continues to tweak the 2MARS course. This year, he wanted to simulate a fire in the Hab.  

“So this is how, a few weeks ago, I found myself with a friend in my garage with a smoke machine, trying to smoke out my own garage. And it worked well enough that we had to buy goggles and masks for the whole crew. But I never would have anticipated what happened in the actual sim: The fire looked so real that a crewmember pulled a fire extinguisher to actually put out our simulated Martian fire.”