Dr. Michael Carroll, Transcript Section 15

Community Health Aide Program Project Jukebox

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KAREN: And when you went there, were you single, were you --

DR. CARROLL: Married.

KAREN: You were married?

DR. CARROLL: Uh-hum (affirmative).

KAREN: And what did your wife do?

DR. CARROLL: She taught school and she was a -- she would substitute at the school. She didn't want to get a job as a teacher in Tanana because she felt that, again, teaching is one of the sources of income in the village, and she didn't want to kind of steal any potential income from people that really wanted to live there.

KAREN: Uh-hum. So were there Native teachers at the time?

DR. CARROLL: Just started the Native program where they were training and so there were a few Native teachers, yes.

KAREN: And did you have children at the time?

DR. CARROLL: We adopted a Native child at that time.

KAREN: So your being gone two weeks out of the month, how did that affect your family?

DR. CARROLL: Well, you know, it was easy. You know, yeah, it's a small community, so you know, yeah, my wife always had things to do and keep busy and it was a wonderful time. I didn't have a radio, I didn't have a television, I didn't have a telephone. See, I didn't have any of these things either.

KAREN: Right.

DR. CARROLL: I mean, we had electricity at the hospital and where I lived, but -- in the quarters of the hospital, but you know, the outside world was truly the outside world, even for me.

KAREN: Uh-hum.

DR. CARROLL: You know, the episodes of coming to Fairbanks and travelling excluded, you know, and you really didn't have to contend with some of the issues that were out there. There's a whole two years that I don't recognize the music. Yeah.

KAREN: It sounds like you enjoyed your time out there.

DR. CARROLL: Uh-hum (affirmative). Uh-hum.

KAREN: And liked it.

DR. CARROLL: Oh, no, it was a --

KAREN: Despite the hardships?

DR. CARROLL: No. The hardships weren't a problem. I never felt that there were any hardships.

It was a great opportunity, you know, to do things that were really wonderful. And so in the wintertime, I'd go to Nulato, you know, for a clinic for two or three days, and then I'd get somebody from the village to take me by snow machine to Koyukuk. And you know, what a wonderful experience to go by snow machine with, you know, to the next village.

In the summer, we would take a boat up to Koyukuk and then to Bishop Mountain and to Galena and, you know, we, you know, did one clinic one summer where we went to Beaver and came all the way down the Yukon River and stopping in Stevens Village in Rampart doing clinics along the way. And how could that be a hardship?

KAREN: Yeah.

DR. CARROLL: Yeah.

KAREN: Were people still using dog teams?

DR. CARROLL: No. Dog teams were really not used for work, but dog teams at that time in the villages were still a part of the sport and recreation. And the Tanana Dog Mushers Association, I think, had probably the third best dog race program in all of Alaska at that point. And, you know, the great mushers like George Attla and Doc Lombard would come out there and race.

But when I say, gee, what would it have been like in the '50s, I think that was before snow machines, so the people were out trapping more at that point in time. And they were living in camps and doing very traditional life-styles.

And -- and doing it oftentimes with dogs and under more difficult circumstances.

That would have been what I meant as a truly exciting time to kind --

KAREN: Right.

DR. CARROLL: -- of see what, you know, the magic of the Bush Alaska was all about.

KAREN: Have you ever thought about the health care -- health aide program as a model for other places for rural health delivery?

DR. CARROLL: Probably not. I guess I'm not quite sure what you mean.

KAREN: Well, do you think it's been a success and that other countries could model this in their programs?

DR. CARROLL: So you mean -- so you mean underdeveloped countries training someone?

KAREN: The idea of training local people.

DR. CARROLL: Well, I think it's a logical sort of thing, and I suspect that's what's done, you know, in some areas.

I don't know that for true, but I suspect that that's what's being done in places like that where, you know, physician access and, you know, more sophisticated health care resources are just not available. You know.

I think the health aides now are far better trained than they were -- than they were. You know, I think they -- they have the ability to deal with medical situations better in most circumstances and health aides now can oftentimes start IVs and do blood tests and send blood in. You know. Which is a different level of sophistication.

The most blood -- the only blood tests we were able to do was a dipstick urine and a hemoglobin, you know, in the villages at that time.

KAREN: So you think the future of the health aide program is, what, strong?

DR. CARROLL: I think that as long as there's -- there is some meaning and purpose to a particular village that's moderate in size, that the health aide program will be useful. You know, if a village gets too small, there is really not a role for a health aide. And if the village gets too big, the needs are too great for a health aide.

And so you're seeing more regionalization, like what's happened, you know, in Fort Yukon is that they've gone from having a nurse, one nurse, who was trained as a nurse, kind of dealing with the health issues of that area to having a clinic and to having two or three PAs, and I understand now having a physician on a regular basis coming up.

Galena, you know, has a -- actually a facility that has X-ray capabilities and can do many of the things that we did at the hospital, one step closer to the villages than the Tanana Hospital was.

And then bringing those people that they can't deal with into Fairbanks. But -- but people also want, in many of the villages, as good a level of sophistication in their health care as exists any place in the state of Alaska.

So what might have been acceptable medicine in 1970 or 1960 or 1950 is not an acceptable level of medicine now.

I mean, you know, you know, I mean, you know, just from the simple fact that, you know, you have lights on the field -- runway. I mean, we wouldn't accept that, you know, unplowed runways with no lights is an acceptable way for people who live in those villages to exist. You know. So I think that just translates into their health care also.

KAREN: All right. Okay. Any other things you could think of, stories or anything else you would want to mention that I haven't asked about?

DR. CARROLL: We've talked about a lot of things, and you know, I think that pretty much covers it.

KAREN: Okay.