Lillian Walker was interviewed on August 24, 2005 by Karen Brewster at Lillian's apartment in Anchorage, Alaska. In this first part of a two part interview, Lillian talks about learning to deliver babies and being a midwife, being selected as health aide for Holy Cross, various types of cases she was faced with over the years and how she treated them, communication systems used, relationship between the health aide and the community and the regional health corporation, use of traditional medicine, how she liked helping people, and her retirement.
Digital Asset Information
Project: Community Health Aide Program
Date of Interview: Aug 24, 2005
Narrator(s): Lillian Walker
Interviewer(s): Karen Brewster
Transcriber: Carol McCue
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Her birthplace, childhood, and parent's background information.
When she began her profession as a health aide.
Her patients, health aide assistants, Holy Cross clinic, and medical experiences while she was a health aide.
Her experiences as a health aide and working on writing the health aide manual.
The type of health aide training she received.
Communication technology, management of clinics and medical supplies.
Her work to promote healthy living and discourage the use of drugs and alcohol.
Identifying a rare contagious disease in an infant and keeping the rest of the village from getting sick.
When her husband became ill.
How she started as a mid-wife, and her first experience delivering a baby with her mother-in-law helping her.
Giving birth to her children, and how she gained knowledge in the delivery of children.
Traveling public health nurses who came to the villages, and the limited availability of trained health aides after her retirement.
Why she worked as a health aide, and reflections on her early health care experiences.
The first clinic she worked out of and more of her experiences as a health aide.
Remaining involved with health care services after she retired, and the training she received as a health aide.
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After clicking play, click a section of the transcript to navigate the audio or video clip.
KAREN: Before we start talking about the health aide part of your life, maybe you could just give us a little introduction into when and where you were born and your childhood and your early years. LILLIAN: I was born in Unalakleet and lived there up until I was four years old. And that was in 1924. Probably around '28, I went there and went to my mother who lived in Kaltag then. She remarried after my biological father died. And we lived there up to -- let's see, how long was that now -- up until I was 7 years old. KAREN: So 1931? LILLIAN: Uh-hum (affirmative). KAREN: Something like that? LILLIAN: And then I -- our dad moved us to a mink farm between Unalakleet and Kaltag and called Whaleback. And we lived there with our dad. Our mother died about that year, I -- when I turned 7. So he raised us. And we lived on that farm for six years. And that's when I left -- was -- he sent us to Holy Cross, my sister and I, to go to school. And in the meantime, in I think the year '46, he passed -- passed away, out in Tacoma. And we -- we were both there -- there until -- I was there until I was 18, which that's when I got married. And my sister, I asked them if they could please send her somewhere to work because she was of age to leave. And they wanted to have her marry, and I told them, no, I didn't want that. I was older than she was and I think I had the right to say. And so they sent her to Fairbanks and she got a job up there at the St. Joseph's Hospital. KAREN: Okay. LILLIAN: And she later on went to Seward, about 10 years after that, I think she married. Or less than 10 years. Anyway, it was about that. And she lived in Moose Pass for up until her children were old enough for schooling, or they moved to Portland to where he was originally from, and lived there in all their school years, while I lived in Holy Cross and raised my children there. KAREN: And what was your mother's name? LILLIAN: Katherine Bradley. KAREN: And then your -- LILLIAN: And -- and she -- when she married our dad, he was Fred Labelle. KAREN: Okay. And he was the one with the mink -- on the mink farm? LILLIAN: Yes. KAREN: Okay. Okay. LILLIAN: And -- KAREN: And so when did you get married? LILLIAN: I was 18, got married in '42. KAREN: And what was your husband's name? LILLIAN: David Walker. KAREN: Okay. And he was from Holy Cross? LILLIAN: Yes. Uh-hum. Yeah. He was from there. And then I lived there up until the day or the year he passed away, and I moved over here. KAREN: Which was when? LILLIAN: 2001. KAREN: 2001. And how many children do you have? LILLIAN: Six. KAREN: Okay. LILLIAN: I lost one when he was six years old off -- he had an accident and fell off a truck and -- and the truck crushed him, so I lost him when he was that old. And then all the rest of my children are living. They are spread here and there. KAREN: So what -- oh, go ahead. LILLIAN: I have two that live in Holy Cross yet still, Kathy Chase and Darrell Walker. And Rudy is the oldest one. He lives in Juneau. I have one in Galena. And Mary is now in Chevak teaching. KAREN: She's the one who has been living with you here in Anchorage? LILLIAN: Yes. She went to school for two years, got her masters degree, and went to Job Service here in Anchorage and they offered her a job. Some people asked if she could come to Chevak and teach there, or be their principal. So she accepted. And Chevak is a large school, about 300 children. And they have the principal and the superintendent lives there, too. And it's owned by Chevak and doesn't belong to any of the school districts. So there's a total of about 900 people that live there. And it's a very nice -- from what I heard the principal tell us, former principal, she said that it's just beautiful there. She loved it. KAREN: Okay. LILLIAN: And then Mary asked me what should she do, accept the job? And I told her, go for it. Take it. And if you don't want to go back next year, you don't have to. Besides, she said she wants to come back here and go back to school again.
KAREN: Okay. So now when did you become a health aide? LILLIAN: My children were still elementary school age, and the youngest, I think, was about 8 years -- 6 or 8 years old. And the people got together and the council, the city council, and they selected two of us. They -- well, they had to vote on which person they wanted for their health aide. And I got the most votes, so I was selected. And -- what year, what year was that. '7 -- did I say in the '70s? KAREN: Uh-hum. LILLIAN: That's 20 -- about 25 years ago. So -- KAREN: So 20 years ago would be 1985, so 1980, late '70s? LILLIAN: Uh-hum (affirmative). Somewhere around there. Anyway, I lived -- well, prior to that, I was -- I learned how to deliver babies with my mother-in-law. So I was sort of a midwife. The youngest midwife that worked within the village, and helped deliver babies. My mother-in-law is the one that worked with me. And after she said that she could no longer -- and she taught me enough that I selected whoever I wanted to help me deliver babies because we had to be two. There could be three or more if they wanted to come and help. But we had to go through sterilizing. We had OB packs from the clinic and all the medication that was there. And the health aide that was working, if they needed any shots, would give the shots. And so I probably worked at least 10 years with that prior to being a health aide. And after I became a health aide, I did deliver a few babies, but not very many. I started sending them to Bethel after I became a health aide. I told them I thought that it would be best that they go to Bethel to deliver. And so -- KAREN: So there was no longer a midwife -- LILLIAN: No. KAREN: -- after you became a health aide? LILLIAN: Well, if we had an emergency, you know, we would have -- the health aide would -- should be the one to assist delivering. And that didn't happen because we -- two weeks prior to delivery or having their child, they had to be at the hospital. And which was good. That was one worry off our mind. Otherwise, we had a few emergencies, very sick babies that we had to escort to the hospital with the mother. And there was one accident we had, bad accident, involved three people. Rolled over in a truck. One had broken ribs, the other one had broken arm. The other one had scalp injury, torn. It was a strange -- her scalp tore back like a cup. KAREN: Across her forehead? LILLIAN: Uh-hum. Complete. When we found her and picked her up, she was unconscious. And it was raining real hard, and it collected water in the portion of her scalp. And when we picked her up and brought her to the clinic, I had to remove that liquid from her head with towels, just press it over, because it was clear rainwater. And she was unconscious up until she -- they medevaced to Bethel. Yeah. The paramedic came from Aniak to pick them up, three of them. Two -- two of the people, the other person had broken ribs, stayed -- stayed home. And his mother being a prior health aide tended to him. They both came through very well. And just in case of infection, and you had no one there, I had to give them each a penicillin shot so they don't get infections. The one that was the worst had multiple fracture on that one arm. And she's the one that I really had to tend to. And my health aide assistant that I had fainted. She looked in her eyes, popping -- I needed someone real bad, so I sent for one of the women in the village to come and help me. And she did. And I kept my assistant with me, but I told her not to look because she watched me work at the woman's arm. And I put -- we had inflatable casts. KAREN: Splints? LILLIAN: Uh-hum (affirmative). Splints like, and I zipped her arm in after I got done. And that was the worst part of it. And she was conscious all the time. In fact, she was the one that come and woke me up. KAREN: Wow. LILLIAN: And told me, said, I broke my arm. And I looked at her. She was holding it, and I had to walk to the clinic with her. She was talking all the time and she was still -- So she didn't feel much pain. And I couldn't give her anything, you know. I was ordered not to give her anything for pain on account of that. The other lady, she just -- we had her in the basket -- we had basket stretchers. She was con -- she was not conscious, but she was -- we know she was -- she was breathing. And they -- that was about one o'clock in the morning that happened. By daylight, the plane came and got them. And we had no communication. So I had to go and no phones, I had to go and get to a radio, and call -- the airline, the airline's phones, call for a plane. I didn't do it, I had somebody else do it for me. And I went back and stayed with my patients until they left. And the former health aide escorted them out, I think. KAREN: Yeah. LILLIAN: Uh-hum (affirmative). Or the paramedic was there. Thank God, he put IVs in them. I didn't know how to put IVs at the time. And I didn't want to. KAREN: So did you call a doctor for assistance? LILLIAN: Uh-hum (affirmative). He came over right away, as soon as he could. And helped me prepare them for flight. KAREN: Was there a doctor in Holy Cross? LILLIAN: No. He was in Aniak. KAREN: Oh. LILLIAN: He lived in Aniak, the paramedic did. And he -- they flew him over with the plane. And they waited until we got them prepared to take off. KAREN: But you didn't get on the phone with the doctor in -- LILLIAN: I did. KAREN: In Bethel? LILLIAN: No. I talked to Aniak. KAREN: Okay. LILLIAN: And he talked to Bethel. KAREN: Was there a hospital in Aniak at that time? LILLIAN: They had a clinic. KAREN: Okay. LILLIAN: They still do. Yeah. And he was -- he was real good. He stayed there in Aniak for about two or three years, I think. Yeah. He -- that's -- he flew from Aniak to the villages in -- in our area, that was four villages, if he had to. KAREN: Yeah. LILLIAN: Uh-hum (affirmative). So --
KAREN: That sounds pretty scary. LILLIAN: I guess I -- I thought it was at the time, but we were -- I was pretty calm about taking care of patients myself, but I -- my assistant wasn't very -- I had to tell her not to look at -- she had to hand me bandages, sponges, sterile water, and all that from the cupboard here. And our clinic was about 10 by 12 size. It wasn't very big. That was before they built a new one. And having her there was good -- I just told -- asked her not to look at the patients, please. Because she looked at me -- I could tell she was going to faint. I told her, get out there on the steps and put your head between your legs and stay that way until you're -- you feel okay. So she did. And I said, okay, now, will you please hurry up and go and get this woman to tell -- wake them up, tell them to come and help me. I think I called for two other women. I wanted their assistance to help because I had to sponge the -- her -- it was raining so bad, her arm's all mud, yeah. KAREN: Yeah. LILLIAN: When she got hurt. And then I had to have that syringe to clean up the wound. Multiple fractures, kind of hard to look at. KAREN: Yeah. LILLIAN: And I did the best I could with her. When she came back, I took care of her. I guess they had to stitch her up and splice her bones back together or something. And there was one opening that I had to keep clean. Used silver nitrate on it, if there was buildup on there, and cleaned it off. Little sticks that you clean through that. They left a place open. And all I did was break the -- break -- break it open and clean it all out. Because there was a little drainage. KAREN: Yeah. What does silver nitrate do? LILLIAN: It -- it cleared the infection. KAREN: Uh-hum. LILLIAN: Helped her with the infection. It was like a -- it was already on a tip, Q-Tip, yeah, they were all in packets. So it cleared up and healed real good. Yeah. And then there -- there was another incident where I had -- there was a stabbing. A stomach. It was just superficial, but some of the intestine came out a little bit. What I had to do was -- that happened because he had to walk over to me. And I bring him to the clinic and laid him on the table there, and cleaned him up. Put a sterile bandage over it so -- yeah, and send him to the -- he went to Bethel. I had to send him out. That happened during the evening, I think. KAREN: And that -- that truck accident, the cause was determined that there had been alcohol involved? LILLIAN: Yes, it is alcohol related. They were running -- driving up and down the airfield. And I guess when he turned too fast or something, it tumbled over and just totaled. They are lucky. One of the -- one of the -- one fell out through the windshield. And she was laying in -- on the side of the road, and we didn't -- I didn't know it when we went to pick -- we had -- we had to go down and pick her up because somebody came and told me there's somebody else on the field. So we went down there and I had -- by that time I had enough men that were able to help and brought her up. KAREN: So the community would come and help if there was an emergency? LILLIAN: Oh, yeah, I knew who to ask. I did. I knew who to ask to help. And they were always there. KAREN: And did you have vehicles at that point? LILLIAN: Uh-hum (affirmative). KAREN: You had -- LILLIAN: We had trucks. Uh-hum. KAREN: Trucks. LILLIAN: Yeah, we had trucks. KAREN: Because you were living out in Ghost Creek, right? LILLIAN: Yeah. A mile up. I wasn't there at the time, this was in during the summer season, and people were fishing, and my health aide helper was in training, so what I did, I moved down from Ghost Creek to stay in her home, and lucky I was there. KAREN: Yeah. LILLIAN: Yeah. KAREN: Because that's what I was wondering was when you lived at Ghost Creek, which was out of town, how did people get to you? LILLIAN: She walked to me, to my door herself, holding her arm. Told me, I got into an accident and my arm's broken. She didn't feel any pain. At the time anyway. Uh-hum. KAREN: Well, in other situations when you were out at Ghost Creek, did you have a telephone out there or people had to walk to get you, or -- LILLIAN: They had to walk to get me. Especially when there was -- I had two deliveries that one day, and I went to my mother-in-law and asked her to come with me. And we had to walk down to the village. And -- or they brought us as far as the beach, and we walked the rest of the way. And just -- we just got done delivering this one baby, and they sent for me and she was up and she was hemorrhaging. And I had to put her to bed and have her husband help me get two blocks of wood to elevate the bed so she would be -- you know, try not to have her hemorrhage too much. She didn't give birth yet. KAREN: Oh. LILLIAN: But -- and by the time my mother-in-law came to me and stuff, I had her all ready for delivery. And after delivery, she didn't hemorrhage anymore. It got daylight, of course, and I had to send -- I sent her to Bethel with the baby. And after that it was all done, somebody else, some -- some woman was having a baby, or she was having -- ready to have the baby, and sent her son up to come and get me. And this was before the plane came in. And I asked my mother-in-law just to tend to her, to the other lady. Because she was resting. And I left her there and then I sent for another woman to come and help me. She didn't know, she said, I don't know what to do. I said, I'll tell you what to do. Just come and help me. And so we delivered her. She delivered real fast all right. And in fact, she had been in labor all while I was down there and I didn't know it. But she had several babies and she knew exactly, you know, when to send for somebody. Well, that's only one time I had to do that. You know. Two deliveries in one day. KAREN: I'm going to take a break here, close your window. All right. It's a little quieter now that the window's closed. LILLIAN: Uh-hum (affirmative). I didn't notice it, yeah. KAREN: Yeah.
LILLIAN: In my experience as a health aide, I -- let's see. They sent for me from -- I came to Anchorage at the old hospital to put together a health aide manual. And I don't know why they chose me but I came over and I was sitting at this big table all these people that were in -- they wanted to know what I thought would be adequate to put in there for training, patients. And first, you set up your clinic, and you had to have how to, oh, gosh, set up all your equipment in your little clinic and stuff and how to keep it clean for -- for the next health aide to -- any new health aides that come along in the village. They had a manual to follow and how to treat different infants and different illnesses, you know. KAREN: Uh-hum. LILLIAN: And what did I think of this and what did I think of that. It was kind of -- I didn't expect to have that done, you know. And I had to answer all these questions. And then we had the health aide manual come out, it was good. Yeah. I guess they -- what they wanted was what a health aide has experienced in their clinic and how did you go about handling it and what -- I thought that was pretty good. And I was sorry I didn't keep that manual. Because I don't know if it's still in that clinic or not. Or -- they may have it in Bethel, if they keep their books and stuff. But it -- and all the different medications you used and what you used them for, how did you use them and all that. It was so interesting for -- in my part, it made me want to learn more. I -- I went to all the trainings I could, whenever they called me. And I enjoyed it.
KAREN: What kind of training did they give you? LILLIAN: Well, they told you what -- how to treat an ear infection, like, you know, children. And how -- what you have to look for, what do you have to do. And, of course, you have to take their temperature, see, you know, how -- how high the temp was. And the doctor told us that when they have a high temperature, that means they are fighting infection. When they don't have a temp and they are very ill, you know they are not fighting the infection because they have no fever. It's one thing I learned about. You know. Working with children. And we had a lot of otitis media there, in all the villages. I think in -- they claim that even here in Anchorage, other children had it, too, so it's something that is sort of still common, I'm sure. I don't find it as bad anymore as it used to be, seemed to me. What I see among my great grandchildren and children. In those days, we used our antibiotics and we had to know that we're giving it for something that's -- that has to be treated and not something that is not -- like a bad case of cold or something, you -- you didn't use antibiotics every time they caught a cold. You had to know what you were going to use it for. And how to distinguish the sounds in the lungs. That was another thing we had to learn. It seemed like it was mostly with children that we had to work with, and of course, the elderly, too. And we always had -- got the radios, after we got the radios, it was easy to diagnose somebody and tell them what you thought was wrong, or -- and if you didn't, you told them what you found and they would -- they would tell you, and tell you what to treat them with and what to give them for discomfort. Yeah. That was a very good, I thought. KAREN: What did you do before there were radios? LILLIAN: We had -- I don't know. By the time I became a health aide, we had radios, yeah. We had the -- we didn't have our own radios in our clinic, but after that, we got these VHF and CBs that we could talk to Aniak and Bethel. And then when we got the phones, which made it good, but in -- in calling, we knew exactly when we had to call when we had cases. We had to have a certain time of the day or -- or hour they would call us. They had to do it that way, call each village if they had any problems, if they needed to talk about. And that made it good. Because in that way, we learned -- we knew what we had to treat them with and stuff. And what, if we had to send them out to the hospital. KAREN: Did you -- were you able to listen on the radio? Were you able to listen to the other villages? LILLIAN: Uh-hum. Yeah. We heard them, they heard us and we heard them. Giving their -- all their little accounts of their patients. And they would give the adult's age, male or female, and talk about whatever illness they had. And we didn't give out names, you know, but we talked about the age. Gave them the age and what was wrong and what symptoms they had. And of course, if they -- they knew a lot of them that I was -- that they -- they would ask how they were doing. Lateral. And we had to keep charts, which was most important because by that, reading their charts, they know how often this illness would occur, like in otitis media and pneumonias and bronchitis and stuff like that. But after they got the phones, they still used the charts. But it was much easier to call on the phone that it was on the radio. Yeah. And so --
KAREN: Did you miss listening to the other villages once you got the telephone? LILLIAN: Uh-hum (affirmative). Oh. The other villages did we, no, huh-uh. It was direct to the -- KAREN: Right. So you were no longer listening to them. Did you miss, miss that? LILLIAN: Yes. Yeah. It was -- if you wanted to listen in on who -- who was sick and where and what village. Yeah. It was good to know. And after -- I -- I maybe went to Phase 3 -- 1, 2, 3, 4 -- on the Yukon I traveled from Holy Cross, Grayling, Anvik, and Shageluk, and checked all the clinics and talked to the health aides about their meds -- medicines. And go through the medications that were in their -- stacked in their shelves, and teach them how to dispose of it. Take them off the shelves and send -- and pack them up into a package and mail them back to Bethel. It was outdated, it was the best thing to do was to ship it back to them. And we did find -- I did find a lot of things that were -- medication that had to be shipped back out. And -- and tell them how to organize their, you know, medication for different people so we would know exactly ourselves where we put what was sent in from the clinic in Bethel or pharmacy. And, of course, we had to always order refills for a lot of them. And the amount, like, we needed more bandages or we needed more everyday things that we use in the clinic, we would have to order that, put that on order. And call it in if we have to, but most of the time we would send it out in the mail. And that part was -- and then when we know when the doctor or nurses would be coming. And I got to give -- give shots, I mean, flu shots, immunizations to the kids, their polio. They drink their little polio thing or whatever. Give them their shots in their leg for normal baby childhood diseases, measles, mumps, and all that. I did that -- I started doing that before I resigned from there. I didn't want to, but I had to. My husband wanted me home, so it was after he retired from his job. Told me my place -- I should come home and stay home. So I did. And then I had a chance to go back to work, but I didn't. I just told them I didn't think I should. I didn't want to. It was too much of a hassle be coming up and down, driving. KAREN: From Ghost Creek. LILLIAN: We had a Jeep and my husband would drive me down along the beach in the summer over the hill, and in the winter, he would bring me back -- back and forth with a snow machine. And that wasn't easy for him. He might as well have been a health aide with me, be the man to drive. That was quite a ordeal for him sometime. Yeah. Getting me up in the early morning or something like that. He would have to bring me down. And I guess he didn't really want to. Toward the end he wanted me to stay home. But then there was other -- my alternate health aide, she became the health aide after I resigned. Then she would call me up, ask me questions. Should I do this or should I -- so I'd tell her what to do. Then she said, you should come back here and just stay and watch what I'm doing. Because how much you -- until she got sure of what she was doing herself. And of course, there was some people in the village that didn't trust her, but she talked to the doctors, so she -- she did what they told her to do. Yet they would come and call me up and ask me if that was okay. And I told them, well, she talked to the doctor, I don't see any reason why it shouldn't be okay. She was very -- a very nice person. She later died of cancer of the lungs. (Tape change.)
LILLIAN: By going to the schools and talk to the students, and any questions, or talk to them about drugs and alcohol. And let's see. We did a survey, the Browns, there was Jeannie and her husband, and the Browns that came there, and we did -- we passed a paper to all the kids and asked questions about different names of drugs. And, you know, it shocked me how those -- a lot of those children knew. They knew more than I did about the different names of, you know, what they call them. Like marijuana, they -- was it toke, and pill, or whatever. They knew more about those than I did. It was amazing. And you know, it was kind of -- we had IASD school superintendent live in McGrath, and the teachers that were selected to teach in the villages should not have been there. There was one that was bringing in drugs and selling it to the people. And it was -- I don't know. It was -- it wasn't very good. KAREN: Is IASD, Innoko Area School District? Iditarod. LILLIAN: Iditarod. Iditarod Area School District. And they had to get them out of there. KAREN: So when you -- you mentioned being at Phase 4 when you went to the villages and checked the clinics and their medicines. LILLIAN: Uh-hum (affirmative). Uh-hum. KAREN: What is that Phase 4? Phase 4 health aide? LILLIAN: Yes. KAREN: And what is that? LILLIAN: That is that you know enough about medication and what they are used for. And -- well, just to make sure that the health aides knew how to dispense their medication to their patients and to make sure that if they had a certain kind of medicine to take, to go into the homes and make sure they take them. KAREN: Does Phase 4 refer to the training, level of training? LILLIAN: Yes. And then what else did we do. I know I went up there to make sure -- oh, tell them how -- as when they run low on certain bandages and whatever they needed, make sure they -- they had to make an inventory of their supplies they have, and such as OB packs and -- and suture kits. Not that they did -- some did suturing, but not -- in an emergency, you could, but some were trained in that. And -- and they did well. I never did have to suture anybody. KAREN: Oh, you didn't? LILLIAN: I learned -- I learned it, but I didn't never had to. And this one time one of the teachers brought his dog to me, wanted me to sew up something that he had, and I -- I didn't want -- I refused to. I told him, why don't you try it. Actually, I was afraid of the dog, but he said, I'd watch, and I said, no. I didn't -- I didn't think I had to do that. Bring him to Aniak or some other more -- a person that wouldn't hesitate to do it. And of course, when the -- the team that came to vaccinate dogs and give them their rabies shots and stuff, you had to make sure that the whole village knew so they would bring their -- their dogs and young, you know, six month olds, I think, or four month old dogs had to have all -- all those shots. And if they didn't get everyone, they would leave the -- some with you, and you had to give it to them. KAREN: So you -- LILLIAN: Yeah. KAREN: You were sort of the -- you put the word out that the vet's coming, everybody? LILLIAN: Uh-hum. Yeah. Yeah. And then if there was an emergency, if I couldn't leave, I'd let my alternate take the patient. But most of the time when an emergency came up, both of us were in the clinic. We both helped each other. Yeah. There was sometime -- if we had to bring children, we had -- the mother had to be the escort. Yeah.
LILLIAN: There was just one case where one of the two year olds had meningococcemia, they called it. KAREN: In English? LILLIAN: Uh-huh. Yeah. That's what it was. And when the -- I -- I escorted the mother and the baby. And when I went back, we had to take antibiotics. We had to give antibiotics to the rest of the children and to the mother and father, and ourselves, we had to take, because it was contagious. Just for -- we -- none of us got sick, but just in case, you know. That was the thing we had to do in that case. And this -- this Japanese doctor was one of them assisting there, and when I -- he said, what's wrong with the baby, or the little one? I said, she's got meningococcemia. He said, how did you know? I said, well, I study books. And that she broke out with purple spots all over her body. It was that -- I don't know what they call it, but anyway, that was one sign that that's what she had. And she was very constipated. And I tended to that part, got her doing okay, but I had my assistant with me. And when we did go and take care of, we learned how to use the gloves, you know, so we don't get contaminated, or contaminate them even. That baby, at the time she was just a baby. She's a woman now and she's got children. Every time I see her, I see her as a baby being so very ill. And Theresa and I were trying to figure out what happened. What's wrong with her. And then we looked in the books and here's a picture of that baby with this sickness in her. And that was a type of meningitis, I think, huh? That's what -- KAREN: I don't know. LILLIAN: I think so. KAREN: Right. LILLIAN: And anyway, that was one time, that was the only incident we had, a real serious incident where we had to take antibiotics, too. KAREN: Well, it sounds like you saved her, though. LILLIAN: Yeah, we did. KAREN: By diagnosing -- LILLIAN: Uh-hum. We -- two or three o'clock in the morning, she called because her fever was real high. And the both of us went there, and she told me -- I don't know exactly -- (Tape change.) LILLIAN: -- home and tending to the baby. And she was dehydrated, for one thing. That's why she got constipated. And by morning, I went down -- I escorted them down, both down to the doctor. And then I came home the next day. We would escort and bring -- and come home the next day. KAREN: Uh-hum. LILLIAN: To be the best thing to do. I didn't mind escorting patients. And if we had a friend to stay with -- at the time they didn't have a -- a place to keep health aides, so we had -- I know I had friends that I stayed with. KAREN: This was in Bethel? LILLIAN: Just for the night. Yeah. And if you didn't have a place to stay, they would find a room, vacant room for you. But it was good to have somebody to stay with so you can have a cup of coffee when you wanted to. Have something to eat. Yeah. So --
KAREN: Well, what -- LILLIAN: I know my own husband, I had to run up to him. I left for work and he wasn't feeling good. And -- no, this was after I -- I sent for the health aides to come and help me. I had my own blood pressure cuff and -- that I got for myself. And he all of a sudden fell down and he might have had a little, like, stroke maybe. KAREN: Uh-hum. LILLIAN: Because he fell on the floor and he was spinning, he said. I can't -- I can't get up. So I took his blood pressure and it was pretty darn high. And I had to send my -- my son down to go and get the health aides. And I can't remember, I think I escorted him to Anchorage here, to get seen by a doctor. KAREN: Uh-hum. And that's when they diagnosed him as being sick? LILLIAN: Pardon? KAREN: They did -- what was the diagnosis? LILLIAN: He had a -- a slight stroke. And he had to have a patch on his eye because he couldn't see straight or something. KAREN: Oh. Making him dizzy. LILLIAN: Uh-hum (affirmative). And then I -- we stayed with him here, my daughter came in with me. And that's when he had -- I guess he had a slight heart attack and we didn't know it. But he was okay after he -- we came back, we went to a wedding and we came back here, then after he was well enough, we thought. And this was caused by consuming alcohol, too much alcohol in his system. And they took X-rays of his -- his head to see -- I know, they were looking for something, I guess, to see if he had -- if he did have a stroke. But he also -- that's when he also found out the back -- the back of your head here, the bottom part of your brain, it shrinks up. And that's for years of drinking alcohol. Yeah. I tried to tell him about it and he didn't want to hear it. I guess -- and then it affected his heart because he had -- he was not too -- the heart muscle is affected. KAREN: Right. LILLIAN: Uh-hum (affirmative). He was not to do any heavy lifting and all that. But I don't know why they didn't do anything more. I really don't. I -- he was told not to lift and not to overexert himself, don't do any shoveling, don't do any. I think he hated that. He couldn't do work around like he used to. And if you told him, he didn't -- he would get mad. He'd say, I could do it if I want. I said, no, you can't. So we would sit there and argue about it for a while, and then he would think about it and then he would say okay. He was not well for quite awhile. KAREN: Uh-hum. LILLIAN: But at least he could walk around and go to church and stuff like that. He wanted to do things almost, always wanted to. KAREN: And you both -- you continued to live out at Ghost Creek during that time? LILLIAN: No. KAREN: Oh. LILLIAN: I had him come live with us down in Holy Cross. KAREN: Okay. LILLIAN: Because I moved down there with Mary when she -- she had to go to do teaching. She was working is her -- she had her BA in education. Yeah. She -- she caught there for 10 years before she came back to get her degree. KAREN: Oh, I see. LILLIAN: Yeah.
KAREN: So why did you start as a midwife? What did -- how did you get into being a midwife? LILLIAN: Oh. My in-laws, my sister-in-law and both sister-in-laws were pregnant and they were going to have a baby. Okay. My mother-in-law said, would you come over and help me deliver. She's in -- she's ready to deliver. I said, no, grandma, I don't want to. I'm afraid to. Anyway, she came and they were -- I didn't know exactly how long they had to be in labor, stuff like that. And didn't know what -- how to tell that they are going to deliver soon or -- they were themselves ignorant of it, so okay, as soon as they started having labor, as they -- come and had to be around there. And then she says, I'm so hungry, I'm going to go home and eat, do you want to stay here for a while? And I said, yeah, I'll stay here, grandma, but don't stay too long. I always called her grandma. And she went out and Irene said, oh, I'm having another pain. It's just -- it was hurting so bad. So I opened the door, grandma, she's having a pain. That was funny after you start thinking about it. And the other, though, Mary, she was married to the other brother, she was having her labor pains, and she -- she delivered, -- she knew when to, you know, call for -- get us. And so we delivered her. I helped grandma, she told me what to do, and I helped her. And then Jimmie, her -- her other son's wife, was going to deliver and she was having a problem. And then I went down there to help her. And I was -- she was seeing to the mother on this side, I was down where -- you know, where the birth canal is. And here comes the baby, blue. I said, grandma, the baby's face is blue. She said, take your finger and go this -- the cord is around the neck, take your finger and slip it out. So I did. Everything she told me to do, I did. And we had to -- he was such a tiny baby, I had to wrap him in a blanket and put him near -- we didn't have furnaces at that time, just wood stoves, and kitchen stove, the oven door, I opened the oven door and fixed a place to keep him there warm, keep him warm while she worked at the mom. And I had to kind of watch him because he -- he was blue. He was kind of a blue baby from that cord around his neck, I guess. But that was -- that was my first experience delivering a baby and my first lesson, always look to see if the cord is around the neck. As soon as the baby is born, remove the mucus from the baby's throat. And make sure he's not going to choke, you know, he would be crying. And you had to kind of tap him a little bit, take him by the feet and just give him a little tap so he would start crying and get that mucus out. She told me everything what to do. It's a wonder I did it without getting to where I was afraid. I wasn't. I -- KAREN: That's what I was wondering, how -- how you had the courage to go and stick your finger in. LILLIAN: She said, take your finger and do this. She said, take and put it over the chin. Yep. That's the right way to do it. So I did and -- and then he was born. KAREN: But you weren't afraid? LILLIAN: No. I couldn't -- I couldn't. This was life and death, you know. I couldn't be afraid. The only time the first delivery I helped her with, every little pain I had her saying Hail Mary or saying a prayer so she would hurry up and deliver the baby without any incident or something. And then grandma come up after she ate her breakfast and she -- we had to wait a while before the baby came. It was kind of -- to think of it is kind of funny. Irene and I laughed about it. Her name is Irene. We laughed about it after everything was over. I told her, well, you know, I was so scared I was ready to cry. I was. KAREN: How old were you? LILLIAN: I must have been 28 or 29, yeah. Because I had babies about that time myself. Uh-hum. Yeah.
KAREN: So did your mother-in-law help you deliver all your own babies? LILLIAN: No. There was two other ladies that I sent for from the village to come up and help me. Yeah. Grandma get too excited. So I didn't want to hear her. And they helped and -- and they came just about the time babies want to be delivered, so -- KAREN: It's interesting that in Holy Cross, you continued to use midwives even when there was a health aide. LILLIAN: Uh-hum (affirmative). KAREN: I wonder why that is? LILLIAN: Well, I don't think the hospital wanted them to come down to the hospital to deliver -- deliver, but most of the time the -- the mothers wouldn't want to leave because of their other children she would have to leave. And it was just in that time, day and age, I guess, they were still delivering at home. KAREN: Uh-hum. LILLIAN: And I refused to deliver after my alternate aide, she was a health -- she was not a health aide then, but she hemorrhaged, she was hemorrhaging before I got to see her. But I knew what was happening, so I -- I put her to bed right away. I was already knowing what to do, I was in health aide training. And they always gave us a lot of books and stuff to study. Any kind of -- anything to teach -- to train. We did a lot of reading. I did. And that's how I learned how to take care. And then I talked to the ladies before it was time for them to, they would come to me and they would say, I need to kind of know when they are going to deliver their first, or their last period they had. KAREN: Uh-hum. LILLIAN: And count. Take some days away from that, add it up. And then I'd tell them when you're going to deliver, I want you to go to Bethel Hospital. Some didn't want to, but they had to. I told them I refuse to. I said, after I seen that woman hemorrhaging like that, and it made me think if anything like that happens again, you know, we might not be as lucky. But after I became a health aide, I was not a health aide -- let's see, he's 20 -- I think he's 28 years old now, that was about 28 years ago I delivered him. The health aide was there. I -- it's after I retired. She -- she said to -- she said -- Judy told me, when I have my baby, you're going to deliver me. I said, no, I'm not. Yes, you are. And she said, nobody's going to send me out of this village. She already had had one child before some years before that. And she said, and when I call for you, I want you to come to me, so okay. And the health aide that I worked with was -- was the primary health aide then, and she said, I told her, you're going to come up and help me. And she said, I am? And I said, yes, because I am no longer a health aide, and it's -- they -- I can't do it if there's a health aide there. She has to be with me. And the Public Health nurse was there at the time. They still had traveling nurses. Diane was her name. And I said, Diane, when she's going -- thank God you're here. I said, when she's going to deliver, you're going to come with me. She said, I'll go and I'll -- I'll observe you. I said, okay. That would be fine. And if you really need help, I'll help you, but I didn't need any help. I just told her what to do and told Theresa what to do. And after she had the baby, Judy, after she delivered, she said, well, you see, you did it. I told her, it wasn't -- it had been awhile since I had delivered a baby. But that young man went to the -- he was in the Marines, I think he was in the Marine. Maybe in the Navy. And he came back home and he's now about 29 years old. Yeah.
LILLIAN: So he's the -- KAREN: How -- how did that work with the traveling doctors and nurses? Did they come and visit Holy Cross? LILLIAN: They did in -- every fall, they would come. The nurses, Public Health nurse, used -- would come in beginning of school year. And what we had to do was weigh all the children and update their charts, I mean, their records on their shots. And give shots to those that needed it. And after Diane, I worked with her and she said, I don't think I need to come here anymore to do this because I think you can do it. So I told her, okay. That's fine with me. And after I resigned from there, nobody else ever did it. I don't know what the reason was, but maybe the amount of training you had and -- and they themselves decided, Theresa, I taught her how to give shots. And she -- she was so afraid to. I said, you can do it now. I told her, you do it -- do this and do that. Just my grandson she had to give a shot to. I was holding him and I told her what to do. I said, you saw me do it before, so I'm sure you can. So she did. And I taught her what they taught me, their little buttocks, their little fat butt here, you take and you divide that. And up here where there's no muscle, you give the shot. And I told her, don't hesitate and don't push it in slowly, do this right away, fast. That way, they wouldn't -- it wouldn't hurt, if you put in too slowly. And then when you push the syringe, do it slowly, don't do that. Yeah. Just do it slowly, let the medicine go in slowly. That's when we still gave penicillin shots. KAREN: Oh. LILLIAN: After some years, we didn't do that anymore. Unless it was necessary for -- for -- for VD cases. Yeah. Yeah. You had to do that, most of the time, they would send them to the clinic in Aniak, but while I was a health aide, they refused -- they let me do it. They wanted me to do it, so I did. And I -- they still didn't -- they still gave shots for that because it was just kind of a serious thing. Yeah, that was -- KAREN: Who was the health aide after you, Theresa somebody? LILLIAN: Theresa Demientieff. KAREN: Okay. LILLIAN: Uh-hum (affirmative). And she was a health aide until she could no longer be. After that, it was awfully hard to get health aides. We got Arlene, she married one of the men in Holy Cross, she lived in Anvik. She already had had health aide training and stuff. So when she moved down there, they built a room there. We hired her for a health aide because she already had a lot of training. She was one of the best. And then after that, there was some that would work for a while, a lot of them had alcohol problems, so they had -- they would be off -- on and off thing, like. KAREN: Yeah, I was wondering why do you think that -- you know, you did it for 10 years and -- LILLIAN: Uh-hum (affirmative). KAREN: -- now if the people -- LILLIAN: They have a -- KAREN: -- stay and do it for that long. LILLIAN: Arlene has been on there and she resigned for a while, then she went back to working again. And as far as I know, she's still working there. She -- she's very good. KAREN: What's her last name? LILLIAN: Turner. Arlene Turner. KAREN: Okay. LILLIAN: And there was some other younger aides that came on, they didn't last.
KAREN: Why did you stick with the job so long? LILLIAN: I liked working. I liked working as a health aide. Up until my husband told me that he didn't want me working no more. KAREN: What did you like about it? LILLIAN: Just to help people. I enjoyed helping people. It was -- I was used to it since I start -- I was young -- I started to helping my mother-in-law deliver babies and stuff. And then if somebody got sick sometime, they would call and ask me if I could come down and see them. And I did. There's a health aide there, remember? No, we would like you to. And -- and if so, we'll let -- I know there's one girl that didn't want, she had infection of the kidneys. And it -- it turns in -- they lose a kidney, you know, if they don't get treated right away. Because it's -- she had strep. And strep can cause them to get kidney -- bad kidney disease. And if they don't get treated, they lose a kidney. They have to go -- go on dialysis. And this is from the strep germ. And while I was in training, gone -- I was here in Anchorage, and I was in emergency care training. And I -- and during that training, I worked at the ANS, they had me there in the ER. Then I had to go to Providence and work in there. And this is where I watched. I could do suturing if I want -- had to, because I watched them. You learn by watching. KAREN: Uh-hum. LILLIAN: You don't learn by -- I thought that's the only way I learned. And during that time, she had strep, that young lady had, and she would not let my alternate give her a shot. No. By the time I got back there, it was too late. It had already went to her kidney. And then she later had to go on -- had to have her kidney removed and go on dialysis. And she didn't get no donation -- nobody to donate her a kidney. At the time, I don't think they started that yet. Yeah. KAREN: Well, how did you manage the long hours of being a health aide and coming to Anchorage for training? How did you manage that with your family? LILLIAN: Oh, I had my -- my kids were pretty -- teenager. They were grown up, quite grown up by then. And Mary was the youngest, and she had -- their dad was there, when I came in for that. I let him come in with me for one of them that I came here for. And he was back in my room where I was. I was gone all day. And I found him down in the local bar. And I made him come home with me. And I told him, you're never coming with me again. That was -- poor guy. KAREN: Now, was he supportive of you taking a job initially? LILLIAN: Yes, at the time. Uh-hum. He was. But after he resigned from his job as a captain, he was a pilot on the boats. KAREN: Barge captain? LILLIAN: Yeah. He came home and I guess, I don't know, he just didn't want me to work no more. KAREN: Uh-hum. LILLIAN: In the village. Because I -- I'd be long hours, sometimes I'd stay over in Marie's place, if there was some -- some seriousness. And when this -- let's see. Before I became a health aide, I had to take care of an elder. She was real -- quite old. And she was so sick, I don't know why the health aide didn't take her and bring her to Bethel. And the health aide would not stay with her while she was. So I told Genevieve, she was my friend, I told her, could you bring a cot into her little place and I'll take care of her. So I did. And here she was bleeding from her stomach. And next morning they had to bring her out. And they called for a plane and the health aide that didn't want to stay with her escorted her to the hospital. I wasn't -- I wasn't the health aide, I just offered to take care of her. KAREN: That was nice. LILLIAN: Yeah. She was such a nice old lady. I learned a lot from her. KAREN: And who was that? LILLIAN: Irene. Her name was Irena Woods. I-R-E-N-A, Irena Woods. She taught me a lot about how to sew skins. I made jackets for my two daughters, or three daughters -- two, actually. The other one was gone and married. And I went down to her and asked her how to cut -- cut it out, and she taught me how to hole. I had to use a little ulu, you know. And how to sew it and how to match it with the fur. What to do, I did. She helped me a lot. She was a very learned person. She was probably almost 90 when she died. KAREN: Wow. LILLIAN: Uh-hum (affirmative). Irena was -- everybody called her grandma. Yeah. She was a good lady.
LILLIAN: I know I don't know what else, is there any other things? KAREN: Well, were there ever times when you were doing your health aide work when you wanted to quit, you've said this is -- I've had enough? LILLIAN: Was there. I don't think so. I -- I -- I always enjoyed working there. You know. When the new clinic came, I was there. That -- they -- now, they have another clinic there, but the first new clinic, first real clinic, in fact, I worked in a little room, it wasn't very big. We had a -- all the cupboards on one side and the -- they called it -- I can't even -- those stretchers that you -- the tables. KAREN: The examination tables? LILLIAN: The examination tables. We had one of those. And it was very -- very little space. But we managed. Yeah. I thought about it. And I used to have to weigh the kids, take their weights and do all kinds of. And then if they needed shots, I'd give them their shots. And I was -- it was easy for me to do, I thought. KAREN: Uh-hum. LILLIAN: I -- I mean, I was confident in myself that I could do this. I did one draw -- blood draw, and I was all alone. I didn't have a nurse or doctor looking to see if I was doing it right. I had to do it because I had orders to draw blood because they said I could do it. But to do it without somebody supervising you, I didn't let that man know I was pretty shaky. I was pretty nervous. But after it was done, it -- it was -- I was okay. But that was the one and only one I had to do. KAREN: Hmm. LILLIAN: Yeah. I don't know what, they got orders to get blood draw on him. I don't know where he was from, but -- I mean, where he worked before that, but they were suspecting syphilis going around. And he didn't -- he didn't have any. But they wanted to make sure. KAREN: Well, yeah, it sounds like you had a number of scary times, and you somehow just did it. LILLIAN: Yes. I did. But there was always somebody there to help if I needed them. KAREN: Uh-hum. LILLIAN: No matter what, it seems that I had always someone to help me. Which I was very happy to. I could depend on. KAREN: How did you deal with issues of privacy and confidentiality? LILLIAN: It was easy. If you had a patient come in, you had to chart their illness and stuff and -- and your findings. And then report it to the doctor. It -- there was never anyone around when you use the phone or the radio. Too small to be in there anyway. And -- KAREN: And people in the village couldn't listen in on the radio? LILLIAN: No. This was on a different radio band, you know. KAREN: Oh, okay. LILLIAN: Uh-hum. Yeah. And on the phones, I didn't have any phone. Now, I take that back. When we got the new clinic, yeah, we did. Uh-hum. Yeah. I liked talking on the radio -- on the phone better than I did on -- on the radio, though. It was easier. The other one you never knew if you were going to get through. On the phone, you could. KAREN: Right. LILLIAN: Uh-hum (affirmative). KAREN: Well, what about also in terms of privacy, just knowing all these things about everybody in the village, was that ever a problem? LILLIAN: No. KAREN: No? LILLIAN: Not with -- not with me, it wasn't. We had locked chart cabinets and lock for our medicine. And so -- Whenever they came to us, it was in privacy. They didn't -- there was no one around to be there. KAREN: Did you ever find it difficult treating or caring for close friends and family? Being from a small village and being -- LILLIAN: Huh-uh. I didn't. I had to give shots to my own grandchildren and treat them for strep throat. And then I discovered, why were they having strep all the time? I cultured the whole family, they all -- the one that was carrying was their dad. He -- the one that thought he never get sick, he had the strep germ. And when I told him I had to give him a shot, a Bicillin shot, why? And I told him why. I am -- I'm not sick. I said, you're not sick but it showed up in your culture. Gee. And he said -- I told him, you have to come to the clinic so I can give you that shot. He didn't want to come down there, so I brought it up. And I told him, okay, now, let me give you that shot. And I said, that was not that hard, was it? And I told him, this is why your children were getting strep all the time. I said, you know, if one has strep in the family, the whole family has to get cultured to make sure they don't have it. Using their same towels and stuff, it's pretty easy to, you know, spread. KAREN: Yeah. LILLIAN: Yeah. Uh-hum. That same thing in the school, if there was a student that came down with a sore throat and was -- it was positive, I'd -- I'd have to send the -- the culture to Aniak and they -- there they had it, and he'd call me and tell me within a few hours if, you know. So I'd have to treat him, bring -- send him home for the day. He can go home -- go back to school tomorrow. But I -- there was a lot of that. And then, one other thing, there was in the spring would be impetigo. KAREN: Okay. You were talking about impetigo? LILLIAN: Uh-hum (affirmative). KAREN: Which is what? LILLIAN: I cultured it and it was strep. Strep germ. That's from -- strep comes from uncleanliness, you know. KAREN: Uh-hum. LILLIAN: And I told them that they had to wash with soap and water at all -- all the time, in order not to get that, because it spread fast. Especially in schools. And I was so shocked that -- that impetigo was strep. KAREN: Hmm. Is impetigo a skin thing? LILLIAN: Yeah, skin lesions in the skin. But they get these about the time the gnats come around, and you know how when they are playing outside and they are scratching. KAREN: Right. LILLIAN: It's in the fall time when you get -- well, that's how it developed. It hurt. That -- that was kind of not so common after some time, after they learned how to take care of them. KAREN: Yeah. Did you have to deal with patients of yours dying and not making it? LILLIAN: Did I? I don't think so. I don't believe I ever had anybody that died while I was -- I -- before they get too sick, you ship them off to the hospitals, you know. KAREN: Uh-hum. LILLIAN: I never -- no. KAREN: All right. LILLIAN: I was fortunate enough not to have that. KAREN: Or during an accident? LILLIAN: Uh-hum (affirmative). No. Not that -- KAREN: You couldn't save somebody? LILLIAN: -- many accidents. KAREN: Okay. LILLIAN: That accident I had, I think, was the biggest accident they ever had there. Aside of my son when he got run over. KAREN: Uh-hum. LILLIAN: He was six years old. And that was when the mission was there. They moved out of there after that. But -- KAREN: So you weren't health aide at that point? LILLIAN: No. I was -- I was having babies. KAREN: Yeah. LILLIAN: Yeah. And so --
KAREN: Now, after you retired as a health aide, did you continue -- did you continue to be involved in regional health care? LILLIAN: Uh-hum (affirmative). KAREN: How? LILLIAN: Just -- just by them calling me up on CB and telling me how -- what's wrong with their child, what should I do. Just go to the health aide and tell them, I think that's what's wrong with them, you know. KAREN: So you weren't involved with the health board or health corporation? LILLIAN: I -- no. Huh-uh. I wanted to be, but they had one, somebody on the health board that just didn't do much, but at that time, they just let it ride that way. And anyway, I -- I did go to some meetings. As a health aide, we had -- we formed a health aide association, and we had meetings -- I had -- down the Kuskokwim area, we would have health aide meetings. And there were a lot of health aides. And the -- the health aides from the Kuskokwim area were Yup'ik speaking. They would have their meetings and they would be talking. Our meeting -- we would have our meetings and they would be talking Yup'ik because they didn't know how to speak English too good, maybe. And I didn't mind. I didn't understand half of what they said, but I didn't mind it. It didn't bother me. And Clara Morgan and I -- Clara knew how to speak Yup'ik and I didn't. And but I'd understand. I wouldn't know how to respond to them, though, because I didn't learn the language. And that -- we didn't have too much of a problem there. But then if we had meetings, nowadays they -- when we go to meetings in Bethel, they speak in Yup'ik, the majority of the people do. And we have a translator and we have these headphones that we hear, it translates to us. KAREN: So as a health aide in Holy Cross, you worked for the Yukon Kuskokwim Health Corporation? LILLIAN: Yes. Yes. And I got my training through the -- KAREN: Through them? LILLIAN: Through them. KAREN: Okay. LILLIAN: And there was a few times I went to Tanana Chiefs in Fairbanks. And we had a health aide gathering there, too. Because politically, we belonged to the Doyon region. Medically, we belonged to YKHC because that's the closest hospital to us. Fairbanks is far away. Their service unit couldn't train us because it was easier for us to go to Bethel. We're closer than we -- so we belong to their unit. And when TCC had meetings and they -- they started gathering health aides together, I went up there to the meeting. And up there it was -- most all of them could speak good English and they -- they spoke their language, too, you know. KAREN: Uh-hum. LILLIAN: And -- and at our meetings, they spoke English, but among themselves, they spoke their language. I didn't -- I didn't know or anybody had to translate for us. But that was just more like, I don't know, just something that they wanted to see how -- what kind of training we had and what kind of training they were giving theirs, health aides. KAREN: So Holy Cross -- Holy Cross, Shageluk, Grayling, Anvik, you're all YKHC. LILLIAN: Uh-hum (affirmative). KAREN: For medical. LILLIAN: Uh-hum (affirmative). KAREN: And right on the boundary, I guess, of the two. Yeah. LILLIAN: Uh-hum (affirmative). And McGrath was with TCC. KAREN: Uh-hum. LILLIAN: And we had TCC meetings up there, I'd go up there to attend them if I was asked to. KAREN: And what about Aniak? That's -- LILLIAN: Aniak? KAREN: Is that YKHC? LILLIAN: Aniak was with YK. Uh-hum. Uh-hum.