Anil Menon, a NASA flight surgeon, felt crushed nine years ago as his hopes and aspirations collapsed around him.

For the fourth time, he had diligently applied to become an astronaut at the US space agency, seeking to fulfill a lifelong dream. Although he made it to the final round, NASA had once again rejected his application at the end of the grueling process.

“I was so sad, and I admitted defeat,” Menon said. “I just did not see a pathway forward. So I pretty much, at that point in time, gave up on being an astronaut. I thought there was a zero percent chance.”

He was 39 years old. In 2017, Menon was already half a decade older than the average age of those selected to become astronaut candidates. He felt a door closing, and looking for a new one to open, devoted time to thinking deeply about what he wanted to do with the rest of his life.

His life was not without adventure up to that point—far from it. An emergency physician by training, Menon had practiced medicine on Mount Everest, provided relief in Port-au-Prince after a devastating earthquake in Haiti in 2010, and flown search-and-rescue missions with the US military in Afghanistan.

As he considered what should come next, Menon journaled daily about his passions, purpose, and principles. Eventually, he settled on space medicine. If he could not go to space, he would help others do so. And collectively, humanity would advance. “I needed that to be crystal clear in my mind,” Menon said.

It had to be, because Menon and his wife Anna were about to make some momentous decisions. Decisions that would ultimately culminate in not one of them, but both, going to space.

Facing a difficult decision

After spending his childhood years in the Midwest, Menon studied at Harvard University (neurobiology) before attending Stanford University to obtain a degree in mechanical engineering and, in 2006, a medical degree. He worked as an emergency physician in Los Angeles. He also joined the Air National Guard, became a pilot, and worked as a physician on search-and-rescue helicopters in Afghanistan.