Dr. Michael Carroll, Transcript Section 10

Community Health Aide Program Project Jukebox

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KAREN: And what about language issues? How did you deal with the --

DR. CARROLL: Well, the older people required translators in some of the villages, but many of the villages, even the older people, had had a long enough contact with English society that they could speak to us without much difficulty.

There was two villages that had very, very traditional language patterns, and the villages of Arctic Village and Venetie in 1970, '71, and '72 were predominantly Indian-speaking villages. And most of the children at that time spoke limited English, and mostly Indian at the time they attended school. And so translators were always needed there.

I mean, I tried to learn a few Indian words of the Gwich'in language, but, you know, never enough that it was more than something that they would smile at. You could always -- you always had a health aide or someone that could help translate, from that standpoint.

By 19 -- the early 1980s, as a product of electrification and television and satellite TV, even those two villages had a huge drop-off in the number of children who spoke Indian.

So one of the most remarkable things was -- was to see that transition from kind of aboriginal language and culture in the early '70s and what had happened just 10 years later.

KAREN: Wow. Amazing. And so the health aides were often the translators?

DR. CARROLL: Almost always.

KAREN: Right.

DR. CARROLL: You know, the health aides usually spoke the languages in those villages that you needed the -- the language. And were good enough at that. And some really excellent at it.

KAREN: Yeah. Because I was thinking that the medical terms and health issues is not something necessarily in somebody's normal English conversational --

DR. CARROLL: Yeah, but the -- you know, the words about fever and pain and feeling sick, those are words that are in most languages.

KAREN: Yeah.

DR. CARROLL: And, you know, you maybe didn't use medical terms.

KAREN: Right.

DR. CARROLL: But -- and usually in the practice of medicine when you're dealing with patients, you -- you have to be careful about not using medical terms.

KAREN: Right. If you're a good doctor.

DR. CARROLL: Well, I think all doctors do that. Plus the health aides, you know, were sometimes very skilled and intelligent people. There was one health aide I could never beat at Scrabble.

KAREN: They had to be.

DR. CARROLL: Yes. You know, I mean. And oftentimes a lot of it was the self-taught, or through observation and learning by experience without somebody there as a teacher.

A few of the villages had a couple people that would function as health aides, and that sometimes allowed them to exchange ideas.

And they would both be there, and if they had a medical emergency, they would both try and sort out whether they thought the patient was really sick enough to need a medevac, or maybe they would be able to stabilize the patient well enough.

But you know, they didn't have IVs, they didn't have things that they could do, really, for much intervention. They could -- they had hot water bottles and blankets and stretchers, and that was it.

KAREN: Right. Well, that's why I find the whole health aide program so fascinating is that it was at a time when there weren't all this -- the modern equipment and they didn't get a whole lot of training. And what those people were able to do is amazing. I mean, they are very special, talented people.

DR. CARROLL: Right. You know, I think sometimes the training wasn't as good as it should be, and, you know, sometimes the conclusions they would draw would be inaccurate, but they were still doing the best they could at the time.

And one of the more humorous episodes I remember getting on radio traffic during that time was a call from one of the health aides saying that this whole family had gotten sick with nausea and vomiting and diarrhea. And they figured that they had food poisoning. Which the conclusion was right, the diagnosis was right.

The health aides had in their stockpile of medications a medicine called Ipecac, which is used to induce vomiting for people who have taken an overdose of pills. And tried to self-poison.

So this health aide took the leap of faith by thinking that food poisoning should be treated the same way as taking an overdose of aspirin or Tylenol. And gave the whole family Ipecac, which took this family that was already sick probably from getting some bad food, and made them throwing up now from the Ipecac medicine. And, you know.

KAREN: And so how did you treat that?

DR. CARROLL: Well, I didn't treat it at all. I just said, have them keep their stomach empty for six hours, and then start them on some Jell-O water or Seven-Up. And they all got better.