Melinda Sam said she probably started smoking cigarettes around age 7. An older girl taught her how. As a teenager, she started drinking alcohol while she lived in the village of Akiachak on the Kuskokwim River.
But Sam said Tuesday she had given up smoking and drinking after she started playing basketball on her high school team and her friends told her to quit. She was an athlete.
Sam, now a soft-spoken 18-year-old, said she wants to become a nurse to encourage Alaska's youth to stay away from tobacco, drugs and alcohol. She is one of 10 teenagers studying at the University of Alaska Anchorage in the Della Keats summer program, a four-week-long program coordinated by WWAMI, a collaborative medical school of five states: Washington, Wyoming, Alaska, Montana and Idaho.
The long-standing summer program, named after the celebrated Inupiaq traditional healer who died in Kotzebue in 1986, targets talented students from underserved or underrepresented communities who have an interest in health care, said Ian van Tets, director of the program and a UAA associate professor.
"We're looking for a genuine interest in the health profession. We're looking for a genuine interest in serving their community and we're looking for the academic ability that if we do give them the chance they have the ability to take it," he said.
The Della Keats program started more than 30 years ago, while Keats was still alive, and is free for selected students. One of the program goals is to make Alaska's health care workforce more representative of its population, calling on Alaska high school students to earn college degrees and work in their home state. It also aims to diversify the pool of medical school applicants, by assisting students in meeting entry requirements who might be the first in their family to earn a college degree, and whose first language was not English, van Tets said.
"If we don't do anything proactive, then our applicants are going to be almost exclusively students whose parents went to college, whose parents are professionals, who did all the right things in high school, went smoothly into college — and so they've got that transcript of service, GPA and are well-prepared for their exams," van Tets said. "We end up having what on paper looks very Alaskan, but what in reality is only drawing from half the Alaskan population."
To be accepted into the competitive Della Keats program, high school juniors and seniors must meet at least one of six criteria: they must come from an ethnic minority background, live in rural Alaska, be a first-generation American, be the first in their family to go to college, speak English as a second language or come from a low-income household.
In the past year, Sam has moved from Akiachak, where she was raised by her grandparents, to Kwethluk to live with her cousins. She said she realized she wanted to become a nurse while babysitting a 3-year-old boy who cut his finger.
"I didn't even panic, I just brought him to the health aide and they brought him to Bethel," Sam said.
Another student, 17-year-old Heidi Lee, said growing up with a mother with diabetes and a sister with autism inspired her interest in the medical field. She thinks she'll become a pediatrician or go into psychology. As a child, Lee said, she rode the bus with her sister when she first started school and it shaped her perspective.
"When I was in kindergarten I started hanging around with kids with disabilities and handicaps, and for me I didn't really see them as different because I was just used to it," said Lee, a soon-to-be senior at Anchorage's Service High School. "And because of that I want to help kids with special needs."
For four weeks this summer, Sam, Lee and the other students attended classes at UAA in subjects like anatomy and physiology, job-shadowed medical professionals, listened to guest speakers, worked on research papers, took exams, practiced medicine on interactive, robotic mannequins and slept in dorm rooms.
It's a brief window into college life, with some Della Keats students talking Tuesday about surviving on macaroni and cheese and ramen noodles during the past few weeks. Some described a favorite part of the program as spending nights together studying for exams in the dorm's common room.
"It's not the full college experience, but a good intermediate," said Isabel Azpilcueta Balsimelli, a 17-year-old Della Keats student who moved from Mexico to Anchorage with her family four years ago. She said she became interested in medicine when she moved to Alaska and realized how much some people struggled with high medical costs. She hopes to one day open a clinic to treat the uninsured.
On Tuesday morning, she and her peers split into groups for simulation labs, practicing treatments with life-size mannequins controlled by instructors who sat on the other side of a two-way mirror. A few students worked in the area set up like a hospital room, while the rest watched over a closed-circuit television in a separate space, called the "debriefing room."
One of the mannequins, a young boy named Tyler, had supposedly eaten handfuls of pills from a bottle of Tylenol, thinking it was candy. The students told him to say "waffle" if he felt like he was going to throw up, so they could get him a pan. An adult mannequin, Frank, played the role of someone who couldn't breathe. The students checked his vitals and shocked him back to life with a defibrillator once he stopped taking in air.
Later that day the students would take a final exam, identifying body parts on donated cadavers — the same ones used by university students. The next stop for the used bodies: the crematorium.
This year's Della Keats program is smaller than normal. Van Tets said 50 students applied, but he could only accept 10 due to dwindling funds.
Typically, the program can host about 18 students for six weeks. Historically, the program received a bulk of its funding from National Institutes of Health grants, but those are no longer available, van Tets said.
The program now relies on donations from individuals and organizations. Staff with WWAMI and the UAA School of Allied Health and School of Nursing donate their time. This summer's program costs run about $100,000, van Tets said.
After students leave, staff try to track where they end up. Over the past 15 years, Van Tets said 298 of 300 Della Keats students went on to college. The other two couldn't be reached.
"Given our population it's quite a big thing," he said.
Each year, there are at least one or two Della Keats alum accepted into medical school and a couple who have graduated. Last year, three people were admitted to medical school and two others became doctors, according to van Tets.
He added that there's no sign the program will stop since growth of the health care industry in Alaska has long outpaced overall job growth, according to the state labor department. It's just a question of how much funding van Tets can acquire each year to increase or decrease the program's size.
"I'm really proud of students going on into college," van Tets said. "What makes me proudest is whenever I travel or go around the state, I've been involved for over 10 years, no matter which hospital I visit, no matter which community I'm visiting, I will run into people. I will run into nurses or I will run into doctors or I will run into parents who either they or their colleagues or, in the case of their parents, their children went through our program and are doing just great."