Space is no place to get sick, but what happens when you do?
That’s the problem Dr. Dorit Donoviel has spent two decades working on. As Executive Director of Translational Research Institute for Space Health (TRISH), she leads NASA-backed efforts to reimagine astronaut health for deep-space missions.
With a background in pharma, biotech, and ethics, Donoviel is now building frameworks for autonomous medicine, AI-powered diagnostics, and a radically new kind of healthcare system, one that works when Earth is millions of miles away.
In this interview, Dr. Donoviel shares insights from her career path, lessons learned in leadership and innovation, and practical advice for engineers and scientists looking to contribute to space health and beyond.
Interesting Engineering: Could you provide us with an elevator pitch-style overview of your career to date?
Dorit Donoviel: I’m going to give a real high-level answer. Biologist at heart. Passionate about health and healthcare. And viewing space as probably one of the best laboratories for understanding how living things adapt to environmental stressors.
IE: Your career spans pharmaceutical drug discovery to leadership in space medicine. What drew you toward the space health domain, and how did that transition unfold?
So a lot of the best things in life, I’m sure, as you know, and many of your audience know, kind of happened by chance, right?
You just have a chance meeting at a breakfast club where there are people sitting around, and you sit next to this person, and you start a conversation, and two weeks later, you find out that they have a job for you, and they offer a job to you, and you’re like space.
I didn’t even know that there was a connection between healthcare and space.
And you just kind of have to jump in and hope for the best. And then oftentimes these things turn out quite well.
IE: Today, you lead Translational Research Institute for Space Health (TRISH), a NASA-funded initiative. What’s been the most rewarding part of building such a high-impact, cross-sector program?
Seriously, it’s the best place to be, as I’m extremely passionate about biology. I’m super passionate about healthcare and space, which really attracts people who are forward-thinking and are inspired by what’s out there.
And so there’s a natural curiosity for people who become attracted to this field.
So the best part of my job is really the fact that it’s kind of a lightning rod for the
best people in the world.
They’re really curious, really smart and love to solve really hard problems.
And so I get to work with the best and the brightest. And so I’d have to say that’s probably the most rewarding part of my job.
IE: Many engineers and scientists struggle to balance deep technical expertise with leadership. How did you develop your leadership skills while remaining rooted in research?
You know, it’s funny having a basis for science, and excellent research is key because you have to develop an understanding that there are values that remain your core values. For example, being able to reproduce data and always staying open to new interpretations.
For example, today, I can give you my best guess at what a certain scientific result means. But, I must remain open to the possibility that tomorrow there may be a new technology, a new tool, or a new insight that will completely overturn and alter my original hypothesis.
And so there has to be this incredible humility. Anything we do is the best I know right now. And being really honest about it. And I think that that’s a problem where people are kind of losing faith in scientists in that they’re believing that what science is telling them is the truth.
The best we can do with the tools we have and the information available to us. However, we also need to maintain that humility and be honest with people, saying, “That may change tomorrow.” That’s the best guess today.
And so to me, that flexibility, that cognitive flexibility, is absolutely key.
Now, how do you marry that with leadership? You have to be honest enough with yourself to look in the mirror and say, “Okay, I have to speak with confidence.”
But, I must also acknowledge that I may not be right, and I speak with humility.
I may, in fact, be wrong, but I will communicate when I know it, as soon as I become aware, and in an honest manner. And so to me, that’s sort of critical.
Oh boy, it sure doesn’t come easy to a lot of people. And it’s because we’re not trained to do that, right? Like physicians in particular, you know, are really trained to be confident.
Sometimes, engineers, I think, have a sense of what they call analysis paralysis, right? Like you just analyze and analyze, and at some point, you have to make a decision and move ahead. You may only have 60 percent information.
You may not have the complete picture. However, to move ahead, sometimes you have to take action to learn. Therefore, you must be comfortable with the risk of proceeding ahead with a decision based on incomplete information.
And that’s where leadership comes in, recognizing that, yeah, you may be making the wrong decision, but still the decision moves you ahead to develop something, and you may have to backtrack.
So, the way I’ve done it is really just to stay completely humble, curious, and open. And also, you know, a lot of conversations with smart people, a lot of podcasts, a lot of articles, a lot of books on leadership and all of those things, I think, come together to help you kind of move ahead as an individual trying to lead an organization in this highly changing landscape, if you will.
IE: Your team helped establish the first commercial spaceflight human research program. What were some of the biggest technical or ethical hurdles, and how did you overcome them?
So, there’s a whole new field that we’ve created, called Astro-Ethics. This is something we launched as a result of our understanding of some of the hurdles we anticipate will become even more significant moving forward.
And it began with the very first mission, which inspired a completely private space flight, not utilizing the International Space Station (ISS), but rather involving private individuals and a private company orbiting the Earth.
What we saw is that there was a thirst and a hunger to contribute to science, right? These individuals who went up to space, I was thinking of this: they paid privately to go up there.
But really, all the technology and the capabilities that they leverage were paid for by tax dollars, right? Like, you know, decades of work that was supported by governmental organizations.
And so they are kind of resting on the shoulders of giants. In my mind, they have a responsibility to give back to humanity, sharing new knowledge. And there were a lot of ethical questions that came up for one, you know, what is that responsibility?
You’re also a private citizen. And so what is your obligation to participate in health research on your own body? Should we force you to do it? What is the pressure on you as an individual, right?
If you were actually, your seat was paid for by a particular organization or perhaps a benevolent benefactor, what is your responsibility to them?
Is there pressure on you to participate in research that you may not normally participate in? So we needed to create an ethical framework around that. The last thing I’m going to say about that is that not all research is equivalent.
If you go up in space and you do something that is really just to engage students, that is a very worthy thing. But if you truly want to contribute to research, then you need to consult with people who have been doing biomedical research in space for the last, you know, 20, 30 years and really understand where the gaps are.
And if you’re going to contribute, you must conduct the science in a way that adds to the knowledge base, rather than just being a one-off experiment. So we created a whole framework.
We published it in the journal Science, and it is now available online. It’s an ethical framework for space and health research. It provides some guiding principles for people as they venture into space, outlining their responsibilities and what we consider essential information to share as they determine how they will contribute.
IE: What’s something the general public often misunderstands about biomedical research in space, and why does it matter here on Earth?
So we have so few people going to space, right? And so the end, what we call in statistics, you know, those of us who study statistics, the end is very low and stands for number of samples, right, that you’re looking at in terms of biology, et cetera.
So when you have an N of one or an N of four or even an N of 60, the conclusions that you can make based on those low ends, you have to take with a grain of salt. That’s what I said in the beginning as well, right?
This is what we know based on this limited dataset. It could still be informative. There are studies where researchers have examined one person in great detail and gained valuable insights.
The problem is that much of the space research is descriptive rather than analytical. For example, they’ll say, “Well, this gene expression went up, and this gene expression went down, and this protein changed, and that protein changed.”
But it could very well be just a factor of that happening once, but it really has
no impact on real knowledge. It’s a descriptive thing, right? So in biology, you could describe a lot of changes in the human body when you go into a cold room, for example, or if you’re overheated or if you’re in zero G or if you’re in a radiation environment.
And all those changes occur, and they’re very interesting, but until you actually connect the dots in such a way that you could say, okay, this is actionable, this is meaningful, right?
You really can’t overstate your conclusions. For example, I think I saw a headline of some articles that said, well, you know, women have more of an effect in zero G than men do or have less of an effect or something like that.
We just don’t have enough information. One must be extremely cautious when drawing conclusions, particularly with small sample sizes and in such a provocative environment.
IE: For younger professionals (especially engineers) navigating a non-linear or unconventional career path, what mindset helped you most in your journey?
I say the same thing to my kids as well. You just never know when things are just going to click for you. Right?
For me, it was a lot of chance and just really being open to any opportunity that came my way and kind of jumping in and even if it doesn’t seem exactly perfect, as long as you’re going to learn something and make connections and grow, and it’s a place where you can develop your curiosity and be in a place where you can cultivate a growth mindset.
That sounds like a good place to stop for a while and learn. And you know, none of it. I mean, if you had asked me when I was a child or even a college student, I would have ended up doing space medicine.
I would have gotten what space medicine is, like what the heck, right? Just as we never know where we’re going to land, we should be open to it. To me, the best advice for all young people starting out today is to stay curious, stay open, and maintain a growth mindset.
IE: Looking back, was there a pivotal failure or detour in your career that turned out to be a gift in disguise?
A couple of failures come to mind. This all goes back to grad school. I had a graduate student advisor who had a pet hypothesis. And when my data generated evidence to support his pet hypothesis, he was really pleased
with me.
When my data generated evidence to the contrary, he didn’t want me to publish that. And so that was a really key moment for me, where I understood how much we are victims of our own biases and how sometimes we’re blind to evidence right in front of us.
I think that’s what started my journey with the concept of humility in science: we have a result today, and this is the hypothesis based on that result, but we have to stay humble in the sense that tomorrow we may have an opposite result.
And so to me, that was a pivotal moment in my career. And then I would say the second piece was that I was part of a layoff in 2008 when the economic downturn in the United States caused massive layoffs.
You know, there was a crash in the stock market. The entire research division of the pharmaceutical company I was working for was laid off in a single day, and 230 people were looking for a job on the same day.
And that’s how I ended up here. So and it’s been a fantastic ride. I’ve been doing this since 2008, and I would never have come across this amazing opportunity if that layoff hadn’t happened.
I am aware that layoffs are occurring today in the US, resulting in significant cuts and funding reductions. I just want to give all those people who are part of those experiences a perspective that it’s not you.
And you know, you’re going to land just fine. You will land on your feet. And what you may do may turn out to be even better than what you did before. So, really, try not to lose hope, I guess, is my message to folks.
IE: What future space health challenges do you believe today’s engineers and scientists should be preparing to solve, and how can they get involved now?
In the sense of being off-planet, we will have to adopt a do-it-yourself model of healthcare. And AI or a medical decision support smart system is absolutely going to be key because, as you know, we might have communication delays or disruptions with, you know, on an exploration
mission to Mars.
So, we’re going to have to figure out how to handle healthcare completely on our own, integrating with a smart system, and building trust while maintaining healthy skepticism. Okay, this is what the AI is telling me.
Does this drive align with what I’m seeing in myself? And you know, that is a really complex question. And I think that all of us will struggle with this moving forward. In all decisions that we make, we will be increasingly dependent on AI.
But we can’t forget that those ais are have their own biases, right? And sometimes they hallucinate, and sometimes they’ll tell us something that’s completely wrong.
So, maintaining a certain level of trust, while also being skeptical, and not forgetting to check in with ourselves as well. Does this really make sense is really key. So that’s one thing that I think, you know, young engineers today and scientists should be contemplating.
What does that future look like, right? But in my heart, I’m a biologist, as I said, and I am fascinated by engineered biology. In particular, the ability to manipulate organisms, such as yeast, bacteria, and fungi, to produce food products.
And the reason I’m interested in this is, of course, that for an off-planet sustainable presence, we cannot rely on continued resupply from Earth (which is really expensive).
And so to live off the planet, we have to figure out how to make food for ourselves off the planet. You know, for those who have watched “The Martian,” love the scenes where, you know, he’s growing potatoes and using his own feces to feed them, to feed the potato plants.
But you can’t live off potatoes alone, you know. And so we have to figure out a way to feed ourselves. And what’s exciting for me is learning how to do that, which will also solve some of the world’s hunger problems in places where there are supply chain issues.
In places where there is no land to grow crops or no water, how do we maximize our resources and feed people in a sustainable way? So space is an incredible place to push us to innovate because you have to.
There’s no other way around it. Food is absolutely an essential resource that I think space can help Earth by allowing us to innovate and create a new system for the future.