April 2026 – Maria Yang, MD

Now that the astronauts from the Artemis II mission are safely back on Earth, here are more reactions about what we heard and witnessed:

It’s okay to ask questions. The crew aboard Integrity asked mission control many questions. They ranged from confirmation about what they thought they heard, to where they should store items, to repeating of instructions. They did not hesitate to seek clarity whenever possible. They avoided making assumptions.

Mission control often provided guidance in the form of positive reinforcement. It was a pleasure to watch how to shape conversations with ease in short amounts of time. For example, during the lunar flyby, the Science team said things like, “Thank you! The descriptions of the colors you are seeing are really helpful. We look forward to hearing more about colors.” There’s so much packed into those three short sentences. By frequently saying thank you and offering encouragement, the team on Earth was helping to promote good morale among the astronauts. The Science team was also giving positive reinforcement to the astronauts for something they were already doing (describing lunar colors). And the team was giving clear instructions that they wanted more information specifically about colors. One of the best ways we can improve communication is to point out what people are already doing well when they convey information.

The male astronauts can and should be models of masculinity. It was refreshing to see and hear how the male astronauts were working with different team members, in contrast to some males in high positions within the federal government. The astronauts frequently spoke of love, gratitude, and unity. They did not bloviate. They did not make threats; they did not belittle others. All of this might sound soft and squishy, and maybe it is, but these same people were living in close quarters in space, staying calm and communicating clearly when things weren’t going as expected, and enduring stressors that most of us cannot fathom. To execute this mission they were required to practice physical, mental, and emotional discipline for many years.When they asked to name a lunar crater after Commander Wiseman’s deceased wife, they exhibited a humanity and tenderness that we rarely see in our leaders.

The female astronaut can and should be a model of femininity. She was the one who addressed issues with the toilet! Her hair was always aloft because of microgravity, but it didn’t matter. She and her fellow astronauts seemed to treat each other as equals. She didn’t need to wear jewelry, layers of makeup, or fancy clothes to capture people’s attention and respect. Like her male colleagues, she seemed comfortable with who she was, and her self-confidence made her and her work shine.

These were middle-aged people! While none of the astronauts were old, they also were not young. Brains and minds tempered by time, training, and experience are probably better suited for such a profound mission. Those of us who are similar in age to the astronauts now must confront the fact these astronauts underwent a rigorous experience that we, theoretically, could also undertake. So what’s stopping us?

I wish the astronauts had more time to recover before appearing before the audience in Houston. Less than 24 hours after they took a journey around the moon, travelled nearly 25,000 miles per hour through space, and then landed in the Pacific Ocean, they were expected to say something coherent in front of an audience? I hope someone explicitly told them that this public appearance wasn’t for them. It was for their team and the rest of us; everyone wanted to see them alive and well. But it is sure unfair to ask people who just underwent an intense physical and psychological experience to show up and say something as if nothing major had happened to them or us.

May the astronauts find ways to integrate this experience into their lives and have peace. Commander Wiseman correctly noted that only the four of them will understand the experience they just had. This, of course, gives them a deep interpersonal bond that only they can appreciate. However, this can also lead them to feel grief and isolation. They prepared for years for that experience and now it’s over. Most of the people in their lives will never comprehend what they went through. Words are also often insufficient. Throughout the mission, though most often during the lunar flyby, the astronauts said things like, “This is indescribable” and “There are no words”. When we rely on language to communicate external and internal experiences with each other, what do we do when we lack the vocabulary to describe what happened?

The astronauts are people with their own flaws and foibles. Despite that, they have been sources of inspiration for so many. The purpose of the Artemis II mission was to learn more about the moon. This mission also helped us learn more about ourselves and who we can be.

The Artemis II mission has captivated me. I find myself checking NASA’s Artemis II Live Mission Coverage on YouTube during in-between moments. So much about this mission astonishes me: The fact that a vehicle is hurtling towards the moon! That there are four people inside! All the math used to plan this trip! That those of us still on Earth get to see and hear the astronauts in almost real-time! (This is the kind of reality TV I can support!) It’s all incredible.

(Let us not forget all the other people who have made this trip possible: The janitors who have kept NASA facilities clean so all staff can think and work in sanitary spaces. The culinary specialists who prepared healthy meals for the astronauts. The accountants who ensured that the mechanics got paid for their work. So many people!)

Within the first day or two, conversations between Houston mission control and the astronauts included the phrase “psychological conferences”. I wondered, “What does this mean?”

When I was in psychiatry residency, a Very Important Person with an Uppity Title at the university hospital was a psychiatrist. When he gave lectures, he routinely shared this perspective:

Psychiatrists have one of the most important jobs in the hospital. Say there are three people in the emergency department. One person is having a heart attack. The second person has a gunshot wound. The third person is trying to grab objects, screaming that they want to kill themselves. Which patient will be the top priority?

(dramatic pause)

The third patient will be the top priority. No one else in the emergency department will be able to receive care safely until that person is de-escalated.

The first time I heard this, I admittedly thought it was self-serving. What a way to puff up psychiatry. However, having witnessed and experienced similar situations, there is truth to what he said.

An emergency department is an enclosed space on Earth with exits to the outdoors. What happens if someone becomes escalated in a capsule in space, thousands of miles from their home planet?

My admiration for NASA has only increased upon finding all the published materials they have about cognition, behaviors, and psychiatric disorders, which are part of their compendium of human system risks. There’s a logic diagram:

NASA master logic diagram that describes risk of adverse cognitive or behavioral conditions and psychiatric disorders; open link to see full text

There are likelihood and consequence ratings to measure “Risk of Adverse Cognitive or Behavioral Changes and Psychiatric Disorders Leading to In-mission Health and Performance and Long-term Health Effects“:

chart that show likelihood and consequence ratings for space missions of varying distances and durations; open link to see full table

The accompanying 222-page report describes a “behavioral health and performance operational psychology” group that works along the spectrum of prevention, early intervention, and mitigation for astronauts. It looks like flight crews receive robust training in psychological skills (e.g., conflict management, stress management, education about psychology). Further support happens during flight, which we are witnessing now. These include—ah ha!—private psychological conferences, social support from Earth, cognitive monitoring, sleep and circadian rhythm support, team cohesion and care, and looking out the windows. (The authors included the comment, “NASA flight psychiatrists and psychologists have reported that during debriefings astronauts state that they did not realize how important ‘that psych stuff’ was until after they were on the [International Space Station].” This is the story of every psychiatrist and psychologist.)

Furthermore, there are reports about the intersecting psychological risks of “extended duration of isolation and confinement, greater distances from Earth, as well as increased exposures to radiation and altered gravity”. These are well outside the scope of my expertise, but there are lessons from space medicine (!) that NASA has already encouraged all of us on Earth to adopt:

graphic from NASA that describes the CONNECT acronym about how to cope with loneliness (community openness, networking, needs, expeditionary mindset, countermeasures, training)

I wish we didn’t have to rely on astronauts to make psychological skills like mindfulness, cognitive restructuring, and maintaining healthy routines sexy, but we’ll take the role models where we can find them!

May the Artemis II voyage be safe and successful. May other people in positions of power and authority learn the patience, cooperation, and discipline from the entire NASA team that made this mission possible.