Cynicism is the easiest of all reactions, right? But it's also so disappointing and self-defeating.

Spacewalking trumps everything. Viscerally, it is a phenomenal place to be; to be able to glance right and see the world, glance left and see the universe, and realise for a moment that you're holding on to your known existence with one hand. That's the thing.

The Nile, draining out into the Mediterranean. The bright lights of Cairo announce the opening of the north-flowing river’s delta, with Jerusalem’s answering high beams to the northeast. This 4,258 mile braid of human life, first navigated end-to-end in 2004, is visible in a single glance from space.

The world, when you look at it, it just can't be random. I mean, it's so different than the vast emptiness that is everything else, and even all the other planets we've seen, at least in our solar system, none of them even remotely resemble the precious life-giving nature of our own planet.

Life off Earth is in two important respects not at all unworldly: you can choose to focus on the surprises and pleasures, or the frustrations. And you can choose to appreciate the smallest scraps of experience, the everyday moments, or to value only the grandest, most stirring ones.

Our role is to develop techniques that allow us to provide emergency life-saving procedures to injured patients in an extreme, remote environment without the presence of a physician.