Testing the Limits: Aviation Medicine and the Origins of Manned Space Flight (review)

In Testing the Limits, Maura Phillips Mackowski tells the exciting story of how American and German physiologists and physicians in the 1930s–40s learned to protect the health of aviators as they exploited unprecedented heights in high-performance fighter aircraft and long-range bomber aircraft (Part I, chapters 1–3, “Aviation Medicine”). Using a narrative style that favors the lay public yet is also appropriate for an ardent physiologist, she tells how an aviator’s maximum altitude was no longer restricted by the performance of the aircraft. Now the pilot was the weakest link, unable to survive in the cold, rarefied oxygen-deficient atmosphere beyond eighteen thousand feet without a reliable oxygen mask, protective flight clothing, and, later, pressurized aircraft cabins and flight suits. Accelerative g-forces generated by violent flying maneuvers during dogfights, or the decelerative g-forces of the parachute opening shock at high altitude, could leave the World War II aviator incapacitated.

All of these medical problems had to be understood, and protective equipment and procedures devised, so that American and German aviators could effectively wage warfare from 1939 to 1945.¹ In the process, these scientists laid the foundation for the new discipline of space medicine in the postwar era (Part II, chapters 4–7, “Space Medicine”). Many of the physiological challenges were the same, but they were now compounded by higher altitudes (and the near vacuum of space), greater speeds, and longer periods of solitude. The book ends with a cogent discussion of the political struggles between the U.S. Air Force and NASA for oversight of America’s new space program.

Much of the story focuses on the interactions between American and German physiologists and how they dealt with all of these foregoing medical problems. To her credit, Phillips Mackowski uses a modest level of technical detail complemented by an excellent selection of illustrations that together facilitate comprehension by a broad audience. Although not all of the significant American and German physiologists are considered, she has identified many of the key personalities, including Armstrong, Lovelace, Dill, Stapp, Strughold, and Benzinger, to name a few. Insight into their personalities is provided through the author’s exhaustive research of oral histories, original written documents, and interviews with the scientists’ family members and former colleagues.

In particular, Phillips Mackowski is to be commended for the comprehensive, detailed summary of the important contributions made by German aviation physiologists that would establish them as the leaders in aviation medicine during the prewar period and the early days of World War II. All too often, the German aviation physiologists, as a group, have been condemned by association for the despicable, unethical actions of a few of their colleagues. Phillips Mackowski highlights this issue by concluding that “a few scientists took advantage of the wartime environment to do research on human subjects that went far beyond the boundaries of science and into sadism. Most, however, could do nothing more than hunker down and work as best they could” (p. 69). She addresses the sensitive topics covered at the Nuremberg trials and the evidence for the debate that continues today regarding the actions, or lack of action, of Hubertus Strughold. She provides an excellent account of the postwar period and the interactions between the Germans and the Americans, beginning with the organization of the U.S. Army Air Forces Aeromedical Center in Heidelberg (1945–47). This effort evolved into Project Paperclip, the American program that recruited German physiologists, scientists, and engineers to the United States and prevented them from going to Russia. Thus, America’s former enemies would play a significant role in the early days of America’s space program. In fact, the first Department of Space Medicine was organized at Randolph Field in San Antonio in 1949 and was staffed primarily by German physiologists.

Testing the Limits is an excellent read...