"We're Traveling with Biological Machinery That Can Melt in Space": Dr. Ekaterina Kostioukhina, Extreme Environments Physician, on Hibernation as the Key to Mars and Why Fish Patents Could Revolutionize Emergency Medicine

Picture this: It's 2030. The International Space Station – humanity's only laboratory where onion cells reveal gravity's hidden influence on life itself – is about to be decommissioned. Forever. Meanwhile, in the remote reaches of New Zealand, where medical helicopters battle weather systems that would ground most aircraft, a physician-researcher has just canceled her Amazon Prime subscription. Not because she can't afford it. Because two-day delivery is a fantasy where she works now. This is Dr. Ekaterina Kostioukhina's world. And she chose it deliberately.

While Elon Musk plans to stuff thousands of people into rockets bound for Mars – despite research showing six is the maximum for psychological stability – Dr. Kostioukhina is asking a different question: What if the human body itself is the technology we need to hack? Here's where it gets weird. An Asian company just filed a patent for hibernating fish during transport. Ground squirrels sleep for months without their muscles turning to jelly. And somehow, 40% of Americans are now obese, up from 30% just five years ago despite more specialists and medications than ever. Dr. Kostioukhina says these aren't separate problems. They're pieces of the same cosmic puzzle.

"We're failing miserably," she tells me with the kind of directness that comes from watching people die in places where help doesn't come. As founder of HIBERIA (Hibernation Intelligence Base for Education, Research and International Alliance), she's lived the extremes – from Harvard psychology to combat medicine with U.S. veterans, from disaster zones to Antarctic research stations. But here's what should keep you up at night: Dr. Kostioukhina believes we're traveling through space with "biological machinery that can melt." Not metaphorically. Literally. The human body can catastrophically fail in space just like any other component, turning a Mars mission into a floating tomb. And unlike a broken oxygen scrubber, you can't just swap out a broken human.

In this mind-bending interview, Dr. Kostioukhina reveals why that fish hibernation patent might save more lives than all the emergency rooms in America, how disrupting your circadian rhythm with your iPhone might be slowly killing you (and why astronauts face the same problem times a thousand), and why NASA's Technology Readiness Level system shows we're stuck at level four out of nine for human hibernation. She's pursuing what she calls her "unreachable star" – driven by a need to leave her children a legacy they can be proud of. The clock is ticking, the ISS is dying, and somewhere in the gap between frozen fish and sleeping squirrels lies the key to making humans an interplanetary species. Or we all die trying. No pressure.

As an Extreme Environments and Space Medicine Researcher, what are the most critical physiological and psychological challenges facing humans in long-duration space missions? How does your research in human hibernation potentially address these challenges?

“Let me be very direct about this: we're dealing with a cascade of failures that the human body experiences in space, and they're all interconnected in ways we're only beginning to understand. The obvious ones everyone talks about are muscle atrophy and bone loss. One month in microgravity causes bone loss equivalent to what an elderly woman experiences in an entire year on Earth. That's catastrophic," she explains. "But here's what's fascinating – hibernating animals don't experience this. Ground squirrels go without movement for weeks and months, and their muscles emerge just fine. There's minimal atrophy."

This observation has profound implications for NASA's current hibernation research programs, including the STASIS (Suspended Animation for Space Travel and Survival) project led by Dr. Yuri Griko, which has demonstrated the ability to suppress metabolism by up to 90% in small animal models. The team is now investigating how to scale these results to larger mammals and eventually humans, focusing on combinations of temperature regulation, bioactive molecules, and tailored nutritional interventions.

"The reason we think hibernation will work in microgravity is because being immobile is actually an analog for being in microgravity," Dr. Kostioukhina continues. "But there's no research yet to confirm if it works in space: that's what we're racing to figure out before the ISS is decommissioned."

The psychological challenges are equally daunting. "Many times we think of mental health as something invisible, esoteric, that's difficult to pinpoint – just 'toughen up.' But it's very physiological," she emphasizes. "Humans can melt in space just like some materials can melt, and cause lots of damage through their behavior. That's why it's important to consider the characteristics of this component of space travel, because you're not just traveling with metals and plastics and other materials. You're traveling with biological machinery that is an integral component of that entire complex going into an extreme environment."

Historically, several space missions have faced critical challenges due to psychological factors. Dr. Kostioukhina notes, "There have been missions that failed or had to be terminated prematurely because of direct effects from mental health issues." This reality has driven initiatives like SpaceWorks Enterprises' torpor-enabled Mars transfer habitats, which began in 2013 under NASA's Innovative Advanced Concepts program, proposing therapeutic hypothermia to maintain astronauts in torpor during transit.

"Hibernation isn't just science fiction anymore," Dr. Kostioukhina observes. "We see it in every space movie, across cultures, across languages, across time. Part of my work compiling a comprehensive textbook on hibernation concepts includes a chapter on science fiction inspiration, because that's how it starts – first we imagine it, then gradually we make it a reality."

Your medical background spans from treating U.S. veterans to working as an air ambulance flight physician in New Zealand. How do these extreme medical environments on Earth inform your approach to space medicine?

"Extreme medicine on Earth is actually the best training ground we have for medicine in space. It's not just an analog. It allows us to have extensive practice while providing critically needed care for people serving in those extreme environments, whether at an Antarctic base or here in New Zealand."

The parallels are striking. "Everything here is a remote environment because of the nature of this country. It's isolated from the rest of the world. Resources are limited. I had to cancel my Amazon Prime subscription – there's no two-day delivery anymore," she laughs. "But that makes it interesting, because humans have to rely on their own ingenuity, on producing their own resources, and figuring out what we actually need versus what we think we need."

This mirrors the challenges space crews will face. "In space, the main thing is there's no way back. There's no easy way back. Any emergency will have to be solved right there." This reality has informed emergency medicine programs, including a new fellowship in Massachusetts that arose from extreme medicine and is now part of the emergency medicine component.

The integration of AI assistance is becoming crucial in these environments. "Having AI assistance to the doctor, to medical decision making – it's the next frontier being explored," Dr. Kostioukhina explains. "It's quite helpful in environments where you don't have access to physicians themselves. But also when a physician doesn't know everything. If you can enhance that physician by allowing them to have more specialty knowledge and better performance, that's quite helpful."

Her approach challenges conventional medical thinking: "When we do medicine in these isolated environments, we can't just follow best practice guidelines blindly. We need to question: What are the tools for? What outcome do we want to achieve? Can we use something else instead of what's recommended? If a test or intervention isn't going to change my actions, then many times it's not necessary."

With your Harvard psychology background combined with medical expertise, how do you assess the psychological resilience required for space exploration? What screening and support systems should we implement?

“Space medicine is all about preventive care," she begins. "There was a book called 'The Right Stuff' from the early astronaut selection days: those people had to be like Superman. Now we're democratizing space and making it more accessible. But we have to be careful."

She's adamant about the fairness principle: "It's not about human rights and being nice. It's about being fair. You don't want to put a person who's going to fail in an environment that will cause distress to that person, to the people around them, and to all the investments that people, companies, and governments put into that mission."

The screening process goes beyond obvious disqualifiers. "If someone is predisposed to claustrophobia, you're not sending them into a confined space. But also, if they're predisposed to anxiety, depression, and violence outbursts – that's something that needs to be screened for."

Research has identified optimal crew dynamics. "The magic number for a group that they have identified is about six. From there, there's a special combination of personalities that will do fine," Dr. Kostioukhina notes. But this presents a fundamental challenge to current Mars colonization plans. "Elon Musk is aiming to send thousands of people in a big rocket, right? That is much more than six. How are we going to handle it? There's not much research on people in confined environments at those numbers. Hibernation will help with that too, because conflict is quite real."

Beyond crew size, there's the issue of circadian rhythm disruption, a factor that Dr. Kostioukhina believes is vastly underestimated. "We evolved for all the time we've been on this planet, even starting from the cells, with the sun, with changing amounts of light at rhythmical levels. The circadian rhythm is quite important to the root of our cells, and in space that is disrupted."

The implications extend far beyond space. "There's lots of fascinating emerging research showing that disruption of circadian rhythms on Earth – because we happen to disrupt them with artificial light that was invented just recently, relatively speaking, like 100 years ago, and then the devices we hold with blue light – directly affects our brain. Apparently that's associated with lots of the chronic diseases that we get."

For astronauts, she explains, "Having developed that proper cycle of lights that will help support and regulate their circadian rhythm is extremely important for their mental health and their physiological health. It's about the kind of strategies being developed that also help us with lots of insights for life on Earth."

Human hibernation research could revolutionize space travel. What is the current state of this technology, and what are the major hurdles we need to overcome?

"To measure that objectively, I like to use the Technology Readiness Level tool," she begins, "which is a systematic metric used to assess the development stage and maturity of a particular technology. It was originally developed by NASA in the 1970s – everything goes back to space, you see – and now it's applied by various US government agencies. It goes from one to nine."

"Right now we're at about Technology Readiness Level four in hibernation technology," she explains. "We almost advanced further with the protocol of targeted temperature management, which was used worldwide on so many people – cooling them to lower temperatures to slow their metabolism after heart attacks. NASA even gave a sizable grant to a company to develop a protocol. They did a great job quantifying things, explaining how much would be saved, how to do it."

"But then New Zealand scientists and others got results back from randomized controlled trials – the strongest level of evidence we have in science – showing that with current technologies and supportive care, cooling people down is not very useful. And here's the minor detail: cooling down a person requires intensive care, lots of specialists, equipment, close monitoring. Things can go wrong that require intervention, otherwise the person can die. That defeats the purpose of what we're trying to achieve – stability and not relying on too much input."

The field is advancing rapidly across multiple fronts. "NASA's STASH project – Studying Torpor in Animals for Space-health in Humans – is based aboard the International Space Station and utilizes rodents to examine how hibernation-like states can be maintained in microgravity," she explains. "They've developed a custom microgravity hibernation lab within the Space Automated Biological Laboratory."

She also highlights the work of Dr. Kelly Drew at the University of Alaska, Fairbanks, who leads the NIH-funded Center for Transformative Research in Metabolism. "Her team investigates the neuroprotective mechanisms of ground squirrel hibernation, including synaptic remodeling and regulation of metabolic suppression. Their research focuses on translating natural hibernator adaptations into practical strategies for human hibernation."

One of the most intriguing experiments involves something as simple as onions. "There's research showing that if you place onion cells in space, they orient themselves differently," Dr. Kostioukhina reveals. "This demonstrates how even at the cellular level, organisms respond to the absence of gravity in ways we're only beginning to understand. It's these fundamental biological responses that we need to comprehend before we can safely implement hibernation protocols in space."

The international landscape is equally active. In 2021, a multidisciplinary Chinese team led by Dr. Zhe Shi at the State Key Laboratory of Space Medicine Fundamentals and Dr. Ti-Fei Yuan at the Shanghai Mental Health Center published groundbreaking research on synthetic torpor. Meanwhile, DARPA's Biostasis program is advancing techniques to slow biological processes without using cold temperatures, aiming to extend the "Golden Hour" following traumatic injury.

"The biggest application of hibernation technology for space travel initially is to save resources," Dr. Kostioukhina explains. "They'll be eating less, needing less oxygen, less carbon dioxide clearance, less waste disposal – and all that is mass. The reason we want to save on that is because to escape Earth, we have to overcome gravity, and that's expensive."

But the challenges remain significant. According to Dr. Kostioukhina's research, current medical technology requires intensive care infrastructure to safely induce and maintain hypothermia in humans, introducing complexity, risk, and dependency on equipment prone to failure. "These limitations underscore the need for safer, drug-based metabolic suppression strategies that can operate independently of hospital-grade systems," she notes.

Recent breakthroughs offer hope. The Wyss Institute at Harvard, supported by DARPA, used AI to identify donepezil (an FDA-approved Alzheimer's drug), as a potential candidate for inducing reversible torpor-like states. "This repurposing of existing medications for off-label use enables exploration of hypometabolic states without entirely new drug development, which is often prohibitively time-consuming and expensive," Dr. Kostioukhina explains.

As someone who has worked extensively in disaster response and extreme environments, what medical technologies and protocols developed for space exploration could benefit emergency medicine on Earth?

"This is where it gets really exciting," she says, her enthusiasm palpable. "There's a surge in the medical and military communities for finding strategies for lowering metabolism in what's called a temperature-independent way. This directly applies to hibernation research."

"There's this concept called the Golden Hour," she explains. "In casualty care, when a person is injured – be it military in the field during wartime, or in the streets which sometimes can feel like a war zone with stab wounds, gunshot wounds – having them repaired takes time in transport. As time passes, the body deteriorates and the probability of recovery with interventions becomes less and less."

"If we can extend that Golden Hour, that will be quite useful. We have air ambulances that take much less time than ground ambulances, but even with those, time is of the essence. If we can use a strategy to extend it, we'll have better outcomes."

The military implications are particularly compelling. "DARPA has sponsored multiple researchers and laboratories to find these strategies. The Wyss Institute at Harvard – the group that developed the strategy of finding medications already being used by humans – their research was sponsored by DARPA because it has applications for the military field."

She reveals an unexpected angle: "If you have troops on the ground, they're expensive to maintain because they consume a lot of food. If they can go into a state of hypometabolism, like hibernating until they're needed (and hopefully not needed), that's quite useful."

The applications extend to her current environment in New Zealand. "It's not just isolated as an island from the rest of the world, but their lifestyle involves a lot of farming. People are far away, hospitals are sparse. They're far from where injury or heart attack can happen. That makes these technologies especially relevant here."

"I received a notification (I subscribe to the latest research), that somebody applied for a patent for hibernation induction in fish," she reveals. "An Asian company. If you look at it from the perspective of right now, when we get fish, we cool them down or freeze them to preserve freshness. But if we can induce a state of lower metabolism and preserve them during transportation in a safe and effective manner, it can do so much for the industry."

The environmental implications are profound: "There will be less waste and less overfishing, but also more freshness for people. The way it works is with the natural defenses that the fish have against bacteria. It's fascinating how this technology we're trying to use on humans can be applied to so many other industries."

The obesity epidemic connection surprised even her. "Hibernation research, ironically (learning how to lower metabolism), helps us understand how to manage metabolism in general. That way we can also apply it to life on Earth. Maybe it's not just about free will. Maybe there are drivers in our physiology, in the chemistry of our brain that are driving our hands to reach for that extra nutrition, that extra social food that we cannot control."

The challenges in nutrition research illuminate why space-based studies might provide answers Earth-bound research cannot. "It's difficult to study human eating," she explains. "You cannot say, 'Okay, this group of babies we're just going to feed this, and this group of babies, just that.' One, it's unethical, and two, it's difficult to control because humans have their own will. They'll sneak in things here and there."

She points to historical missteps that reveal our incomplete understanding: "Trans fats were initially added for food security when we were starving as a society in certain locations when crops failed. It was great to help preserve food. But then we discovered trans fats are substances we cannot process, and eventually they cause long-term side effects on our health. We're surviving longer but having less quality of life."

The craving for fresh food in space reveals something profound about human nature. "At the International Space Station, the complaint is that there's not enough fresh fruit, fresh food, and the astronauts crave it," Dr. Kostioukhina explains. "It was so intense, this craving, that it made some experiments fail."

She shares a particularly telling example: "Onions grow relatively well in space. So a team of researchers sent onions to be grown in the ISS, and the astronauts had to supervise. But the experiment failed because the onions were too appetizing – they ate them! Can you imagine? These astronauts are screened for 'the right stuff.' They're very reliable, their performance is good, they're ethical and strong-willed, but they ate the onions. They could not resist the freshness and the smell of it."

This anecdote was later documented in detail by Mary Roach in Packing for Mars: The Curious Science of Life in the Void, where she cites cosmonaut Valentin Lebedev's diary from his 1982–1983 mission on Salyut-7. Lebedev and his crewmate ate the experimental onions "with bread and salt," then had to sheepishly confess to ground control that they had consumed the experiment – a powerful testament to the overwhelming craving for fresh food in space. "The craving can be so strong that you can compromise your ethics and your career," Dr. Kostioukhina observes. "That gives us insight when we tell people who are obese to 'just stop eating' or 'decrease your eating.' Maybe it's not as easy as we think. Maybe it's not just about free will."

Even our relationship with performance-enhancing substances reveals deeper truths about metabolism. "We discovered coffee, and it certainly improves our performance. It changed society from being in the fields doing manual labor to actually being able to work more with the brain and concentrate. It opened up our ability to work longer hours despite our physiology."

Military applications continue to drive innovation. DARPA's Metabolic Dominance program seeks to enhance metabolic efficiency of military personnel through metabolic engineering, aiming to induce hibernation-like states to improve endurance, reduce fatigue, and enhance performance in extreme conditions.

Given your unique position at the intersection of aerospace medicine, psychology, and extreme environments, what do you see as the most underappreciated risks to human health in space? What should policymakers and space companies prioritize?

"The most underappreciated risk is that we're treating the human component as separate from the mission hardware," she states firmly. "You're traveling with biological machinery that is an integral component of that entire complex going into an extreme environment to Mars or other places. It needs to be considered because it's part of it, and space medicine doctors are the ones who can help optimize it so it performs better and doesn't sabotage the mission."

The urgency is real. "With the ISS being decommissioned by 2030, we're losing our primary testing platform. We need to transition to emerging platforms: China's Tiangong Space Station, NASA's planned Gateway lunar outpost, or commercial platforms like Axiom Space's private station or Blue Origin's Orbital Reef."

Her message to policymakers and investors is clear: "Hibernation research is not well known, and my personal mission is to expand that knowledge on how important it is. Besides the applications that are quite important for humans, they're also eventually quite profitable. It's the ground for investment."

She draws a historical parallel: "Just like when we reached the moon collectively by applying all that effort of individual people, to achieve this – to open up the benefits of this technology of being able to manage metabolism either up or down – we need help and investments from a lot of groups and industries."

The cross-domain benefits are crucial for garnering support. "That's what will drive interest and investment from organizations or individuals interested in having that technology in use on Earth. That's how there will be synergy to make progress for the goal of space travel, but also for applications that are extremely important on Earth."

Dr. Kostioukhina concludes with characteristic directness: "In order to send something to space, it needs to be well proven to work on Earth, and people need it. So it certainly feeds a lot of innovation on Earth. There are lots of surprises in the applications. That's why it's important to identify them, explain them, and make sure it's clear there are good applications on Earth. That way there's a mutual buildup of this technology."

Author's Analysis

Close your eyes. You're 100 million miles from Earth, sealed in a metal tube hurtling through the void at 17,000 miles per hour. Your crewmate develops appendicitis. The nearest hospital isn't in the next town – it's on another planet, years away. No medevac coming. No surgeon to call. Just you, five other humans, and the infinite black pressing against the hull. This is the reality Dr. Kostioukhina is preparing for, and her solution isn't better medical equipment. It's to hack our biology so fundamentally that we become something else:something that doesn't need to eat, barely needs to breathe, and can survive catastrophic trauma by simply... pausing. When she canceled her Amazon Prime subscription in New Zealand, it wasn't about saving money. She was practicing for Mars.

The brilliance of her approach reveals itself in layers. That fish hibernation patent she mentioned? It's humanity's first commercial success at pausing life itself. Those ground squirrels that hibernate without muscle atrophy? They're mocking our million-dollar ICU beds that can't prevent a human from wasting away after a week of immobility. The obesity epidemic (40% of Americans despite more specialists and medications) suddenly makes sense not as a failure of willpower but as proof we've never understood metabolism at all. When Dr. Kostioukhina describes humans as "biological machinery that can melt" in space, she's not being poetic. She's stating engineering fact: our bones dissolve, our muscles vanish, our minds fragment. We're bags of salt water trying to survive where water boils and freezes simultaneously. In space, we are the weakest link.

Here's what keeps me awake: If Dr. Kostioukhina succeeds – if we can dial down metabolism like a thermostat, pause our biological clocks during trauma, turn death into a temporary inconvenience – what are we anymore? The person who enters hibernation for a three-year Mars journey won't be the same person who wakes up. They'll have aged differently, dreamed differently, existed in a state between life and death that we don't have words for. Ground squirrels don't contemplate their existence during torpor. But humans are conscious beings. What happens to consciousness when you pause the machinery that creates it? What dreams come in that deep, cold sleep between the stars?

The circadian rhythm disruption she describes isn't abstract – it's happening to you right now. That blue light from your screen? It's scrambling biological programming that took millions of years to evolve. Now imagine the ISS, orbiting Earth every 90 minutes – 16 sunrises and sunsets per day. No wonder astronauts' bodies rebel. No wonder we need to become something other than human to survive out there. The ISS decommissions in 2030, and with it goes our only laboratory for these questions. Dr. Kostioukhina isn't waiting. At Technology Readiness Level four of nine, she's racing against time to answer the ultimate question: Will we still be Homo sapiens when we wake up on Mars, or does leaving Earth require leaving humanity behind? And maybe that's why she chose the edge of the world – not to escape civilization, but to prepare for what comes after it.

About Dr. Ekaterina Kostioukhina

Dr. Ekaterina Kostioukhina is a medical doctor with postgraduate studies at Harvard University. As founder of HIBERIA (Hibernation Intelligence Base for Education, Research and International Alliance), her current research focuses on exploring hypometabolic states, including torpor and hibernation in humans, through international and multidisciplinary collaborations.

She has served as a guest lecturer at MIT, teaching Space Medicine and Crisis/Disaster Management, and has provided training to military and intelligence agencies of various countries on critical global matters. Her expert opinions have been featured on TV, radio, and in prominent publications, including Forbes, Crisis Response Journal, and military journals.

Currently stationed for a medical assignment in New Zealand, she continues her contributions from a remote environment while balancing her roles as a wife, mother, educator, and mentor. Her comprehensive textbook on hibernation concepts, currently in development, will provide the first systematic compilation of evidence from diverse disciplines to guide future investigations in this rapidly evolving field.

Further Reading and Resources

Dr. Kostioukhina's Hibernation Textbook (Draft)
Access the working draft of the comprehensive hibernation textbook that synthesizes research from multiple disciplines:
https://docs.google.com/document/d/12thkZnZvxG3LOEtKNjo4yL2e-mOLudQWnwJut3tObYE/edit?usp=sharing

Free Online Course: Hibernation Science
The University of Alaska Fairbanks offers the first-of-its-kind free course on hibernation, serving as a bridge for emerging scientists to understand this topic:
https://www.edx.org/learn/biology-life-sciences/university-of-alaska-fairbanks-hibernation-science

Current Human Hibernation Research Videos

TRISH and University of Pittsburgh Research:
https://youtu.be/XEUmjjRGOds?si=2l1froKHFfkRicBy

Russian Hibernation Research (Enable English subtitles):
https://www.youtube.com/watch?v=ED_0Dg_r7tk&list=PLwdgnB16N8M8uK-DiYjhCrYdWn0UKLJnX&index=135