Five months into his fourth International Space Station mission, veteran NASA astronaut Mike Fincke was having dinner the day before a routine spacewalk. Suddenly, he found himself unable to speak. The episode in January lasted just 20 minutes and while Fincke felt no pain, he became agitated.

“It was completely out of the blue. It was just amazingly quick,” Fincke recently told the Associated Press.

“My crewmates definitely saw that I was in distress. It was all hands on deck within just a matter of seconds,” he said.

Fincke’s fellow astronauts and a series of emergency protocols kept him safe, but NASA still made an unprecedented move: The agency cut short the SpaceX Crew-11 mission, returning Fincke and three of his fellow astronauts to Earth a month early and leaving the station staffed by only three people. Now, this event might play a role in how future missions are designed.

Jared Isaacman, NASA’s administrator, said in a post-splashdown news conference that the early return was due to a “serious medical condition.” He added that while astronauts receive extensive medical training, there are circumstances in which the option to come home is the best one, and that’s why that possibility is built into the agency’s flight plans.