Dr. Michael Carroll, Transcript Section 5

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KAREN: And as a physician not being able to communicate or not communicate with your patients and people in the villages, what was that like?

DR. CARROLL: So, what you'd do is you'd reach a village health aide and ask her if she had any radio traffic. And she would say, yes, Dr. Carroll, I have Mr. So-and-So or Mrs. So-and-So, or an 8-year-old boy, and then they would relate the vital signs they had taken, the symptoms that they had taken, and sometimes would help you with the diagnosis of what was going on.

Sometimes it would be a matter of relaying symptoms to you without getting a clear-cut picture diagnosis. And as a physician, you'd try to come up with what your impressions were and then make some recommendations as to what you thought would be the treatment.

The stockpile of things that were available for the health aides in 1970 were pretty limited. They had some injectable penicillins, they had some sulfa, you know, they had some aspirin, they had some Tylenol.

They may have had a little bit of Darvon as far as the pain pills. They may have had some medicine to help with diarrhea, they had some Ipecac to help if you thought somebody had accidentally or intentionally taken an overdose of something. But you know, I think the list is probably no more than 20 to 25 medications.

And so your diagnosis and therapy pretty much had to limit itself with dealing with those issues. If you felt that the patient was sicker than what could be dealt with, then you could authorize the health aide to send the patient in.

If it was an emergency, it would -- you would frequently arrange for a medevac. And at that time, a medevac would be, you know, a local bush pilot flying either out of Galena or Fort Yukon without the -- any help to pick up the patient, and then bring them to Tanana.

If it was appropriate, you would sometimes fly the airplane from Tanana to the village. And occasionally, if we thought that it was a situation that a physician needed to go to, we would jump in the plane with the pilot and fly to the village and pick up the patient.

If we had -- if they were a stretcher case, we had some steel wire baskets that we would put them in that would fit in the back of a 206 or a 185 or a Cherokee 6, and bring them back. If they could sit up, they would usually sit up. You know, we could deal with IVs to a limited extent, but it was always difficult trying to maintain an IV in a small plane like that.

KAREN: Yeah.

DR. CARROLL: Because it was bumpy. And back in 1970 we just didn't have the same venous access devices that we now take for granted.

KAREN: So were you ever called out to a village that there was an accident? Were the doctors called out to --

DR. CARROLL: Well, oh, there was -- you know, one of the most memorable ones is one we didn't get to go on. And this was a particularly snowy winter in 1971 at Christmastime.

And at that point, one of the villagers had become depressed, and depression is a big issue, even in the '70s, and had tried to commit suicide by shooting themselves.

They had not succeeded in killing themselves right off, and so this was Christmas Eve, and we then spent the next four hours trying to arrange for some sort of medevac, but because the snow had been so heavy and the snow removal was not very good at that time, the state had not assumed much of a responsibility in this particular village, we could not get a pilot to fly in.

The villages did not have electricity, and of course, that meant they didn't have lights on the runway.

KAREN: Right.

DR. CARROLL: And -- and so we would get reports every 30 minutes from the village health aide about the vital signs, and over a period of a number of hours, this patient that might have been saved, had we been able to get in there and get some medical help to them, gradually went into shock and died.

Yeah, so that's, I think, a particularly difficult and always unsettling sort of memory from what health care was at that point in time.

You know, I can remember having episodes where people would have seemingly minor accidents and I may have been at a location where I'd sometimes fly out and suture them up there. Most health aides at that time didn't have the skills or the tools to do any suturing, and sometimes it was easier to go out and suture them and let them stay home rather than have them fly in and then have to fly them back, you know, a day or two later.

You know, there were examples of infants and children getting burned, there were examples of bad dog bites, you know, people being sick as far as bad pneumonias that required, you know, young mothers pregnant, and having seizures. Occasionally getting caught in delivering babies on kitchen tables in the villages. There was a whole spectrum of that. Gun shots of other types, accidental. You know, lots of different stories.

KAREN: Uh-hum. You were -- that one you talked about, you know, other harrowing flights or close calls or particular memorable cases that come to mind?

DR. CARROLL: Well, one time I was going to one of the villages and we were to land on the river with skis. And as we were setting down, the skis caught some gravel and -- and the plane crashed. No one was hurt, so you know, that worked out fine.

I can remember going to -- great story is going to one of the villages for a field clinic and having worked there all day and was supposed to be picked up in this particular village, again, didn't have a runway, so in the wintertime we landed on skis on the river, and in the winter [summer] on floats on the river.

And so the plane to pick me up was supposed to -- they only got mail service twice a month at this village. And they were supposed to pick me up the next day, and I'm all ready to go, and a wonderful blue sky in the middle of March, and the plane flies over and circles a couple times.

The pilot opens the window and throws out this yellow mail sack to me down on the ground, and inside is a note saying that the skis are broken, I'll pick you up tomorrow.

You know. There weren't -- again, no telephones, no electricity in that village, so you know, it was an era where this village didn't even have a single-sideband radio, so they were without communications, other than what happened when the pilots would land and tell us what it was.