WALTER:  And I -- and as to the future of the health aides, it's interesting to speculate.  Certainly the rule will have to change, especially with these new clinics that are -- that are equipped in an entirely different way, and people who are being stationed there, such as trained nurse practitioners and PAs.  And the means of communication, Telemedicine and all that.  So the health aide's role, undoubtedly, will change. 

Another aspect is that the whole practice of medicine is -- seems to be undergoing a big change.  And a few decades ago, I think it was still common to think of going to the doctor and do as the doctor says.  And not question it much. 

Now we understand, and I think it's being taught in the medical schools, that the patient is primarily the one responsible for their own health.  And that the doctor is more of a consultant.  And of course, we see that most of the illnesses that people have or the causes that the basic remedy is in their behavior, you know.  And it's not in pills. 

So what they -- what intrigues me is what could the health aide's role be.  Because it doesn't seem to be any doubt that if people would change the way they eat and live, there would be a big change. 
Some of this change is so dramatic.  For example, it's, what, now, 40 years ago, 55 -- I mean, 50 years ago in Bethel, '55 to '05, why, when I was in Bethel, we didn't see any diabetes.  Among the Natives. 

A biochemist, Dr. Scott, came out and looked sedulously for diabetics and could never find them.  Now, it's rampant. 

KAREN:  Right. 

WALTER:  Obesity was -- I remember one obese person.  And now, of course, it's rampant.  And so, you know, how -- how are you going to change people's diet, exercise, and stress management, the factors that would -- of course, could theoretically eliminate the -- all these great problems of obesity, diabetes, hypertension, et cetera. 

So the other observation is that when -- before the snow machines and before the affluence in the villages, when the people lived on fish and berries and beans and rice and had to exercise a lot to cut their own wood, get their fish, they were lean and, in many ways, very healthy, you know, bar tuberculosis and et cetera, but -- and free of these big problems of diabetes, obesity, hypertension, et cetera.  The big culprit back then, of course, was sugar. 

KAREN:  Right.