John McFall is a para-astronaut and hopes that the first person with a disability will enter the International Space Station by 2030 – before the complex is decommissioned that same year.
McFall, a reserve astronaut with the European Space Agency (ESA), was selected for the program in 2022 because of his experience as a trauma and orthopedic specialist, surgeon and sports scientist. McFall also has experience with a disability, having regularly used prosthetics since having his right leg amputated at age 19 following a motorcycle accident. (He even won a bronze medal in the 100-meter sprint, class T42, at the 2008 Paralympics.)
A recent study called “Fly!”, in which McFall was instrumental, found that missions to the International Space Station would not have major problems if an astronaut used a prosthetic limb on board. There is still a lot of work to be done, but the goal is that eventually “someone with a physical disability” will be flown to the ISS, McFall said in an exclusive interview with Space.com on August 8. “Hopefully by the end of this decade, that will be happening.”
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Before McFall was selected, ESA and NASA worked on Phase 1 of the ‘Fly!’ study in 2022 to discuss the range of physical disabilities that could be accommodated on the ISS. For example, they examined case studies in the military literature that detailed how members with physical injuries returned to active duty.
The authorities decided to conduct a feasibility study on lower limb disabilities because they saw it as an easier first step toward inclusion than considering visual and hearing impairments or upper limb disabilities, McFall said. That led to the call for para-astronauts that resulted in McFall’s selection. McFall and other team members then moved forward with the feasibility study, which was discussed publicly last month. (The study is not yet available for publication but is expected to be ready by spring 2025, McFall added.)
McFall is not a full-time astronaut and has not completed all the required training. But he has completed some training and is ready if ESA needs additional help in space at short notice. (A reserve astronaut from McFall’s group, Swedish Marcus Wandt, has already flown to the station. He flew to the ISS earlier this year on the private Axiom Space Ax-3 mission, which lasted several weeks.)
The “Fly!” study examined all the requirements of astronaut activities from launch to landing, as well as tasks on the ISS that would require a prosthetic, such as exercise. McFall also worked with SpaceX simulators and tried on spacesuits as part of the process.
“My background has been incredibly useful,” McFall said, explaining that he uses at least three prosthetics on Earth regularly: one for everyday activities, one for cycling and one for running. “As an athlete and of course an amputee, I’m not really a passive amputee. I’m very involved in the care. I know how my prosthetic works. I’m a technology demonstrator.”
McFall’s medical background also includes a master’s degree in biomechanics and gait analysis, which was an advantage in bringing experts from engineering, medicine and other fields into the study. (Prosthetics for future spaceflight, he said, would likely be a commercially available option for convenience.)
“I think it’s about being a conversationalist and people asking questions that they understand in their world,” McFall said. “They have their point of view: ‘This is what’s happening in my world. And I don’t know what your world is like, John, but… I’m wondering if your situation might be a problem in my world.’ And I say, ‘Okay, cool, let me understand your world a little bit better.’ And we have that conversation and kind of pick it apart.”
Among the questions the team considered, McFall said, was how the volume of his stump might change during spaceflight. Fortunately, fluid shifting in the simulations showed no obvious differences. The spaceflight prosthesis will still have a “volume adjustment” in case there is an unexpected increase in volume during orbit, he said.
McFall also tested whether he could perform cardiopulmonary resuscitation in weightlessness without a prosthesis, as this is one of the basic requirements for ISS operations. Tests on a parabolic flight went perfectly, he said.
Future research could involve certifying a particular prosthetic device for space travel, McFall noted. But he said the work the team has done so far is monumental: “This hasn’t just been superficial… It’s been really systematic, logical and very thorough – and I’m very, very proud of everyone around me who has done this.”
“I’m just a subject matter expert,” McFall continued. “Yes, I’m the one we’re talking about (for a spaceflight), but there’s a team here that has worked really hard to deliver this. There’s a core group of people in this small team that we have. We’re just five of us on this team that really had this vision of what we want to prove and demonstrate to ESA: It’s a groundbreaking, world-first study that really pushes the boundaries of human space exploration.”
