The Artemis II Recovery with Dr. Jesse Wang

In this episode, we interview Lt. Cmdr. Jesse Wang, a Navy EM physician of Explosive Ordinance Group 1, who served as the lead for the dive medical team tasked with the Artemis II recovery on April 10, 2026. 

Transcript

Unknown: 1:02

Anne, Hi everyone. I'm Dr Anne long, and welcome to this episode of the gsacep podcast. You're about to hear my conversation with Dr Jesse Wang, a navy emergency medicine physician with Explosive Ordnance Disposal group one on April 10, he and a team of Navy divers supported the recovery of the Artemis two crew and the Orion spacecraft after their historic 10 day lunar fly by mission, we'll explore his background in emergency and dive medicine, the physiologic challenges astronauts face after re entry, and what it was like collaborating with the many teams involved with the recovery. Thanks for listening. All right. Dr Jesse Wang, welcome to the GS ASIP podcast. Thanks for having me. It's really great to have you here. Your role in the Artemis two recovery is such a unique experience for an emergency physician, and I'm excited to dig into that mission and the path that got you there to start us off. Can you walk us through your journey into emergency medicine, starting with med school residency and then eventually how you found your way into dive medicine and your work with EOD. Sure. Before I say anything though, I have to read this disclaimer. The views expressed are my own and do not reflect the official policy or position of the Department of War or the United States Navy. Perfect. So back to your question about my background in emergency medicine. Let's see how far back do you want me to go? High school, college, just like med school? Probably med school. Yes, I went to St George's University in Grenada, okay, and graduated in 2017 and then I did my em residency at Lincoln Hospital in the South Bronx four year residency program. Graduated in 2021 and joined the Navy straight out of residency. From there, I went to medical battalion, first medical battalion at Camp Pendleton, California, was Greenside for three years. I met umos undersea medical officers while I was at Camp Pendleton, and saw their dive pin on their uniform, and thought that was a really cool device. So I asked him, What was that about? Then they told me about it, and I thought it sounded like a really interesting and unique opportunity that you can only get through the Navy. So I decided to pursue that. And thankfully, the powers that be Let me transfer laterally from the EM community to the undersea medical community, and I was able to go to UMO school, which entails naval undersea Medical Institute training in Groton, Connecticut, and then ndstc Panama City, which is navy dive School. And from there, I was assigned to EOD group one here in San Diego on Coronado Island, and that's where I am now. That's so cool. Definitely not your like typical, you know, military emergency medicine path. So that's definitely neat to hear about. Let's talk more about the mission itself. What exactly was your role during the recovery, and then who else made up your team. And then also, did you have any say in the selection of the team? Or was there like a formal selection process? No, it wasn't formal for me. I just happened to be in the right place at the right time in terms of billets. When I checked into EOD group one, they told me that they're doing the NASA Artemis recovery mission. And I said, Cool. What does that mean? So I was really excited. And my predecessor, who was here before me, I think he's Lieutenant Commander select now caps. He's doing his urology residency at Balboa hospital in San Diego. I want to shout out to him, appreciate him, because I know he did a lot of the training work up to this mission, and I unfortunately he wasn't able to do it due to him being in residency and no longer with EOD. But I definitely wanted to give him credit for a lot of the training. So yes, we were formally tasked with this. I just happened to be the only UMO at EOD group one who could do it. We have a smoke captain, Virgilio, who was gracious enough to let me do it in terms of my teammates, NASA called for one to one ratio of a specialized medic to astronaut ratio. So in this case, we had dive IDCs, which are independent duty corpsman, which are specialized medics in the Navy who practice independently under the supervision of a physician. And so they the dive IDCs, are the ones who did dive medicine and dive school. So they're similar to the UMO, which I am, but on the on the corpsman level, they were with me. So I had hm one, Steven Kapala from mobile unit 11. I had HMC, Vladimir link from mobile unit one, and I had HMCS, laddie Aldridge from ESU one with me on the mission, and I was the medical lead role for that group of four guys. It definitely sounds like they're, like, more senior, right? A lot, yeah, like chief and senior chiefs, that's good to know. Yeah, they've been in the Navy a long time, and they have a lot of experience real world, field environment. And then, looking more broadly, I knew there were a lot of teams involved with this whole mission, like surgical team, flight, medical the ship's medical team. I think there was another emergency physician on board as well, right? Yeah, with the RSS, yeah. Oh, gotcha okay. They were there, I see. And then, so how did you guys fit in with. Them. We were physically and planning wise, somewhat separated from them, because we were the dive recovery team. Is what we were tasked with. We were the medical component of that. So we're the team that is actually out on the water in small boats, ribs and cricks, which are glorified rafts without boards on them, to recover not only the astronauts, but the capsule so we did have a dive, a regular dive team with us that we fell under to recover, because that spaceship is billions of dollars, so they want to make sure they get it back safely, and they also want to make sure that it's handled well, because if it gets damaged or anything like that, it could skew their interpretation of collection of data for how it fared in space and so forth, we integrated with the medical teams on the ship, mainly through communication. Was the most key component. They wanted to know what was going on in the water as we recovered the astronauts and in the process of getting put on a inflatable front porch out in the water, outside of the capsule, and then lifted via hoist into a helicopter, brought back to the LPD ship, where the other medical teams were waiting, yeah, it definitely sounds like highly coordinated operation from the medicine standpoint. You know, I was, I was definitely curious what the expected physiologic effects on the astronauts are after reentry, and then how is that similar to what you would see in like dive medicine? So there is some overlap. But to be honest, we took this course called space medicine, 101 on Jko, which is and it was kind of mind blowing, because you never learn these things in medical school, right? It's very niche, specific to astronauts. I would say it falls more into the realm of flight medicine than it does dive medicine. I was learning new things, and the treatments are very unique, too. So in terms of physiological effects on astronauts, it's it's very unique. They that when it's almost the opposite of motion sickness that you get here on earth when you're sea sick or car sick, because the visual system where your vision doesn't track what your vestibular system is inputting when you're in the weightlessness environment of space, and it causes disequilibrium, nausea and vomiting right when they come back to Earth, because after a certain amount of time they've been there, the brain has become accustomed or sensitized to that disequilibrium. They have the same effects now that they're on earth of when they went into space. So there's a period of readjustment, definitely with a lot of nausea disequilibrium. It's made worse with head motion. So again, the vestibular system. I thought it was interesting that Zofran wasn't really effective in treating the symptoms. They seem to rely more on fanner again. Oh, interesting. Okay, yeah, because I was hoping ODT Zofran, you know, fixes everything in this case, and especially when they're wearing spacesuits, because you can't have you have limited access to right routes of administration of medications, right? Exactly. It's not optimal placing an IV in the dark in the interact. Other than that, they get atrophy in space. They have some interesting cardiovascular symptoms when they're in the weightlessness environment of space. You no longer really need the vascular tone in your legs to maintain a blood pressure. So the body in well third space, and then diurese that off in urine, a lot of your blood volume. So they come back hypovolemic or volume down, and as soon as they get back to environment with gravity, they get some edema in their legs, and they have orthostatic signs and symptoms. And that's just normal physiologic adaptation to being in space that they have to recover from once they're back on Earth. Muscle Atrophy is also a huge one, and bone atrophy, but bone density, I mean, but they did bring an exercise machine with them, and luckily, they were only in space for 10 days, so I watched a lot of videos of them working out on space. It was, yeah, whole gym in the International Space Station, because they're out there for much longer. So let's talk about how you prepared for something like this, how much of your training was simulation based versus in person, and then when you got to the real event, did it feel like the training translated? Well to that absolutely, the training had been ongoing years prior to my arrival to EOD group one, there was multiple underways. They call them ur teas, which we actually go out on the full LPD and do the full mission profile with the mock up of the capsule that's put out to sea and we recover it, along with the astronauts and the helicopter squadrons and the FST and the RSS and the ship's medical all involved. We also went to Houston twice, more than twice for the team as a whole, but twice for me, for the NASA Neutral Buoyancy Lab, which is a really cool D POOL they have there in Houston with spaceships down in the bottom where astronauts can practice working in somewhat of a simulated weightless environment underwater. And they have, they had the capsule floating there, and it even has a wave machine. It's very neat. You can practice rough seas in there and recovering astronauts. So the training was extensive. I went to Cape Canaveral, saw plant there, and saw some things I can't talk about. And also a SpaceX launched. It was cool. Got to see the rocket, the actual Artemis rocket, before it launched. Amazing, gigantic hanger they have there. So we did a lot of training. We went to Denver. There's a lot of proprietary equipment that needs specific training on how to use it. And. Act with it. So let's shift to the actual day of the mission. Can you walk us through what that day actually looked like for you? And then what kind of equipment did you guys bring with you on the small boat? And then what did it feel like, terms of like teamwork, and then being part of something that was that high stakes teamwork, working with NASA and debt three from the Air Force, was amazing. Anything we asked for, we got it. It was, I've never experienced that before, great. Yeah, that's super nice. And they were very open to anything critique wise. In terms of the gear that we were provided, we could modify it or lose some parts we didn't think they were necessary, and replace it with some other equipment if we wanted that. In terms of what we brought, we brought a whole, I would say, approaching er level capability with us out on the water. We had two prolonged Casualty Care bags for T Triple C bags, everything from ATLS or T Triple C we had covered, including blood products in the water, not needed, yeah, but we had the capability in case they landed far from the ship, and we had to sit on them for a while out at sea on a casualty. Thankfully, again, not needed, but we were ready for advanced level resuscitation from multiple angles. That's really great to have, and it really speaks to how well you guys prepared for that day. Sounds like it was kind of a long day for you, right? I think I heard it was like over 12 hours because of the capsule recovery. We're part of the dive team, so we stay out there until, uh, everything is back to the ship and button, yeah, we, I think we left mid afternoon, and we didn't get back until, I mean, 230 in the morning. Oh my gosh, wow. You know, I think overall, probably just an incredible experience. How did you feel your background in emergency medicine prepared you for this kind of mission, and then did going through it change anything how you think or practice in the ER, so the mission, I think it was well suited for an emergency medicine physician. Luckily, I just happened to be one of them, because it was only tasked to a UMO, which could be a GMO, or a non residency trained physician or other specialty. I think emergency medicine is very applicable in that situation, specifically pre hospital medicine. So someone who would have been EMS fellowship trained would have been really adept at that situation, or even wilderness because of the environment that we were in the ocean and in the dark. Yeah, even flight medicine would have been applicable just because of the nature of being in space. How would it change the way I practice? I don't. I don't think it's Apple it's apples and oranges. I don't think something you would encounter in your day to day shift, totally. Yeah. EMS is bringing you an astronaut, and he's been in space. Gone wrong, if they're bringing you an astronaut to your Er, yeah, yeah, I don't think it would change the way I practice too much. It definitely solidified my desire from working with so many incredibly intelligent positions from NASA and the Air Force and and the other Navy physicians on board from the ship, surgical teams and such. My desire to get back in the ED and keep those skills up, because they are perishable. Did this experience kind of reveal to yourself or teach you anything about yourself as a doctor? It made me realize how much we rely on the hospital systems that we take for granted in place when you're on shift. Those things, I know that we complain about them at times, but they are so much better than doing everything by yourself in a raft, right? Because you have a nurses, you have techs, pharmacists, lab, all that is on you when you're isolated out there at sea. So it made me realize that we shouldn't take those things for granted. Appreciate your your colleagues in the hospital, totally, yeah, yeah, cold, in the dark, getting rained on by the waves. You're just like, oh my gosh, yeah. I mean, just even, you know, mixing meds and drawing up meds and stuff like that, oh my gosh, yeah. A lot of nursing things you take for granted. To close on a bigger picture note, after being part of something like this, has your perspective on emergency medicine changed at all? Or what does the field mean to you now? Oh, I love emergency medicine. I feel it's my calling. Sometimes I feel like that. I have imposter syndrome just from being around so many inspiring physicians that I've met over this mission. And I'd like to get back into the ER again, because I said, you know, it's perishable skill I feel. And sometimes, when you're out on an operational billet like this, doing a different thing like undersea medicine, you realize that you don't get the opportunity to practice medicine in the way that you'd like, sometimes, in terms of being in the ER, more I'd like to do that we find ourselves sometimes in roles that that aren't what we were training to do, but you learn on the fly. And think a lot of the admin things that I learned while being here at EOD can take back to the ED and give me a broader scope of understanding of how systems work, and just kind of in your one. Around it, I feel, yeah, yeah. It's, it's definitely, you know, like I said, a unique experience that not a lot of other ER doctors get to be a part of. It's, it's so neat. And thank you so much for taking the time to share this with us today. And congratulations again on a successful recovery mission. Oh, my pleasure. Thank you for having me. You.