BUDGET ACTIVITY 1810: MAINTENANCE AND OPERATION OF MEDICAL TREATMENT

FACILITIES

Medical care in naval hospitals (1810A)

TABLE I. ANALYSIS OF HOSPITAL INPATIENT WORKLOAD

Mr. SIKES. Admiral Kenney, tell us something about the work of the Naval School of Aviation Medicine.

Admiral KENNEY. The school at Pensacola consists essentially of two units, training and research. The real beginning of this school was in 1939. Since that time they have given very active support to the Training Command at Pensacola. This involves not only the selection of individuals for flight training, the recording of certain physiological data during their flight training which continues through the operational phase and throughout their life as an aviator, but additionally includes the actual indoctrination and training of all student naval aviators and various categories of naval aviation observers in high altitude training (including oxygen mask instruction and fitting), ejection seat training, and night vision training.

With the advent of high performance aircraft it was recognized that many factors in human physiology needed to be studied in consonance with the performance of these aircraft. The school, throughout the years, has perhaps been in the forefront in such areas as disorientation, high altitude physiology through the low pressure chambers, safety features through the ejection seat training, and, more recently, participation in the physiology of extremely high altitudes and the biomedical aspects of space.

Mr. SIKES. Do you consider its work is becoming more or less important as time goes on?

Admiral KENNEY. I think it could be said that each year the work of the school has become actually more important. We have had through the years, and continue to have at the school, a staff of very highly qualified and nationally known scientists in their special fields. Captain Graybiel, of course, has an international reputation for his work in vestibular functions as related to disorientation and in the cardiovascular system as related to many of the problems in high performance aircraft operation.

Mr. SIKES. Captain Graybiel is outstanding in this field in the Nation, is he not?

Admiral KENNEY. Not only in this Nation but I think he is recognized internationally as an authority in these two fields of aviation physiology and research.

Mr. SIKES. Is it considered among top level and scientific observers that this school contributes in a major way to space exploration and medicine?

Admiral KENNEY. Yes, sir. The school, through the facilities that were in-being at the time, has participated from the inception of the program and is continuing to do so, in defining the effects of the stresses of all types experienced in space flight.

Mr. SIKES. Is all of the training of medical officers in aviation medicine for the Navy done in this school?

Admiral KENNEY. Yes, sir, all medical officers in aviation medicine are trained at the school.

(Extension of remarks at this point is attached.)

To give an idea of the scope of the training of medical personnel the figures for 1 average year include

In addition, the nonmedical personnel trained for the Training Command included:

1. High-altitude and low-pressure chamber lectures

2. High-altitude and low-pressure chamber runs.

3. Ejection-seat lectures___

4. Ejection-seat trainer shots_.

5. Night vision training lectures_.

6. Night vision trainer demonstrations....

7. Oxygen-mask fitting---.

4,883

3, 867

2,429

2,585

2, 454

2,454

4,806

PHYSICAL FACILITIES OF SCHOOL

Mr. SIKES. Tell us something about the facilities for this school. How is the school quartered? What are its facilities?

Admiral KENNEY. While we are extremely proud of the work that this school has accomplished throughout the years, we are not quite as happy with the physical facilities in which the school has conducted its many endeavors.

A portion of the school, particularly that portion used in the clinical aspects of aviation medicine, both in the training of medical officers as flight surgeons and much of the clinical work done on the pilots, is done in rather temporary buildings which were an unused part of the naval hospital.

The school itself is quite scattered throughout the Pensacola area. It was housed as buildings became available. It is not at all centralized. This has one disadvantage because of the difficulty in communications and contacts between units of the school and the research portion of it.

There are plans in being for the construction of adequate facilities to house both the aviation medicine training section of the school and the tremendous amount of research which the school currently is doing.

Mr. SIKES. As a matter of fact, this school is now scattered in 14 different buildings, and must do its work under difficult conditions; is this not true?

Admiral KENNEY. Yes, sir. It was necessary because

Mr. SIKES. None of the buildings were designed for the purpose; is that correct?

Admiral KENNEY. Buildings were used as they became available and, except for a few small buildings, were not designed and constructed for the specific purpose, so they are scattered throughout the Pensacola complex.

Mr. SIKES. Does this not detract from the efficiency and at the same time add to the operation and maintenance cost of the school? Admiral KENNEY. Yes, sir; we believe so.

Mr. FLOOD. This is at Pensacola, Fla., Admiral?
Admiral KENNEY. Yes, sir.

COORDINATION WITH AIR FORCE SCHOOL OF AVIATION MEDICINE

Mr. SIKES. How is the work of this school coordinated with that done by the Air Force School of Aviation Medicine? Is there duplication?

Admiral KENNEY. I would not say duplication specifically as there is similarity in some of their efforts in the strictly training part. Of course, the Air Force School applies to Air Force pilots, selection of pilots, monitoring physiologically throughout their training period, and so on. In addition, the school at Pensacola is vitally concerned with specific problems regarding naval aviation aboard carriers with landings and takeoffs, noise levels, and sudden arrest.

Also the research done is coordinated through several high-level committees so that there is not a reduplication of effort.

I think the attempt in the research field is more to utilize the peculiar facilities of each school toward the study of particular projects.

CONTRIBUTION TO NATIONAL SPACE PROGRAM

Mr. SIKES. I have noted a number of instances where the work of the Naval School of Aviation Medicine has figured directly and importantly in space exploration efforts.

I think it would be helpful for the record if you would enumerate some of those instances and submit the list for inclusion in the record at this point.

Admiral KENNEY. Yes, sir.

(The information requested follows:)

CONTRIBUTIONS OF THE SCHOOL OF AVIATION MEDICINE TO THE NATIONAL SPACE PROGRAM

The research activities of the School of Aviation Medicine, Pensacola, Fla., are oriented toward the solution of the operational problems facing the Navy primarily as regards naval aviation. The location of the school at the headquarters of the aviation training command facilities the necessary interchange between operational elements and the research activities, leading to an optional degree of pertinence of the research studies to the needs of the Navy. The competence which has been developed in aviation medicine research has led to a proficiency in many areas relevant to the solution of problems which will enable man to make useful excursions into space.

The research studies on cardiovascular conditions in aviation and on respiratory physiology led to the development of a degree of competence which was manifested in the successful participation of the laboratory in the missile flights which carried monkeys Old Faithful, Able, and Baker into space (320 miles high and 1,500 miles down range) in 1958 and 1959. These flights were made in cooperation with the U.S. Army. Studies which had been carried out previously on the effects of cosmic radiation, on exotic environments and on the effects of bizarre accelerations contributed to the development of knowledge which made the monkey flights possible.

One of the significant causes of aircraft accidents is the momentary loss of the ability of the pilot to orient himself in space. Random movements of the head while an aircraft is making a turn, even a very slight turn, may produce dizziness, vertigo and, in more severe cases, nausea. This condition is called disorientation. It may last long enough to cause loss of control of the aircraft. To study this problem, in 1947 the Navy began the development of a human disorientation device at Pensacola. In this device a subject may be made disoriented and studied under laboratory conditions. Also, at Pensacola a room 15 feet in diameter has been constructed over the hub of a training centrifuge. This room may be rotated at any desired rate suitable to simulate a rotating vehicle or satellite. Rotation of space vehicles may be necessary in order to generate a centrifugal force in the vehicle to negate the effects of the absence of a gravitational field (weightlessness). Studies using the human disorientation device and the rotating room, although developed for purposes applicable to naval aviation, are ideally adapted to the study of disorientation in space vehicles. Studies to date have led to the description of a condition termed canal sickness. This condition is caused by an abnormal stimulation of the semicircular canals (part of the ear). Studies now in progress should show to what extent human subjects may adapt to such abnormal stimulation if presented over a prolonged interval of time, comparable to a space flight.

Whenever an opportunity arises in connection with high altitude balloon flights, rocket flights or orbital vehicles, the research investigators at the School provide special emulsion packs to gather data on radiation in the upper atmosphere and in space. The School is under contract to NASA to carry out radiation monitoring for the Project Mercury flights.

Capt. Ashton Graybiel, Research Director of the School, conducted the planning phase for the recovery of the Mercury astronaut from the sea upon his return from flight.

The research activities of the School are closely coordinated with the studies being conducted at the other Navy laboratories, particularly the Aviation Medical Acceleration Laboratory, Johnsville, Pa. (principally acceleration studies); the Air Crew Equipment Laboratory, Philadephia, Pa. (principally personal protective equipment); and the Naval Medical Research Institute, Bethesda, Md. (principally electronic monitoring of physiological data). The research activities are coordinated also with those of the U.S. Air Force, U.S. Army, NASA, an FAA through the Bureau of Medicine and Surgery and higher military authorities.