LINDA:  From a training component, there are lots of things that we looked at in the early years that have changed over time, but all supporting the role of the health aide in this sort of dynamic activity in terms of, you know, a patient coming in sort of to return to the -- the components of it.  I'll give you an example. 

You know, someone who might be allergic peanuts, and this actually was a case where this person knew they were allergic so they have this chronic underlying condition, and went to a potluck, and something was cooked in peanut oil, didn't know it, ate it, and started to have a anaphylactic -- go into shock, and so went from, you know, sort of a chronic to an acute to an emergency situation.  And it's all preventable. 

So it was just one of those moments where this very healthy person sort of collided with, you know, this one -- this one thing called peanut oil for her, and was in an emergency situation.  And all of us, you know, that's just the nature of being human.

KAREN:  Right. 

LINDA:  And so the health aide role to work within that scope and try to deal with all of those sort of issues on a daily basis. 

So -- so if someone comes in with acute otitis media, their role is not only to assess that, do a complete history and physical exam, but also then to treat and try to educate because that's a key part of it is our health care really belongs to the individual. 

We think it's a whole health care system, but it's really the individual, and the health aide role is to assist and to help people to get well.  And that really is through the individual understanding their problem or disease, and following their treatment, whatever that may be. 

And so the health aide link between the physician in Bethel, out to -- and again, my experience, I'm living here in Anchorage, but my home and my life experience is really Bethel and the YKHC region. 

You know, as the health aides over time -- I mean, I'd go back in the early '70s to when it was the CB radio, and there was the radio room and you just, you know, sort of the whole Delta knew what was going on. 

KAREN:  Right. 

LINDA:  It was very interesting.  And then I remember when there was one phone in a community.  And that's, you know, how health care was -- we had talk on the phone. 

And then from phones to multiple phones to faxes and sort of the ability to send things back and forth all the way now to having the computer element or Telemedicine, Telehealth pictures, all of it, technology has been an interesting piece of the puzzle, but I think that it's still about the individual.  It's still about the trained individual who has the human connection with the patient.

And so many folks have said, oh, Telehealth will make all the difference.  I think it has another element -- it's a tool.  It's a tool just like all the tools of medicine.  And we learn to use them appropriately and help to -- again, the goal, what's the goal of this program. 

I think we often lose sight of that and the goal of it is, you know, quality health care for each and every individual living in Rural Alaska.  And that's been my underlying goal in all of the things that I've been involved in. 
And if we don't, if we lose sight of that, then I think we get too wrapped up in other issues, such as, you know, lesson plans or curriculum. 

If we don't remember what the goal is as we do training, and how we need to facilitate the learning within the individual, it's not about standing up in front of the room and lecturing adequately to folks, when we talk about the educational process of health aides, it's different than -- and it is, in the university, and it is given college credit and it is a fully accredited program in that regard, but when you think of it as an educational process, it's very different, I think, than most of us think of college. 

So that in the early years, in putting together, you know, the educational process, I found myself going through a huge evolution and looking at what our goal was and how we could do that.