From the Heart
(Page 3 of 3)
A Matter of Trust
In 2007, Landry remembers calling several of the study participants for a follow-up visit. One of the men declined to return. He claimed that taking part was too expensive.
But it's free, she told him.
"He said, 'No, you all referred me to a doctor, and now I've got to take medicine,'" says Landry, smiling. "That was his perception—that there was an associated cost with the study. But of course, it's our responsibility as medical people to refer someone if we find they have a condition that requires treatment."
Clinical trials that focus on African-American populations, particularly in the South, have an added burden of responsibility to bear ever since Alabama's infamous Tuskegee Syphilis Study. Conducted between 1932 and 1972, the study led almost 400 poor, African-American sharecroppers infected with the disease to believe they were being treated when in fact they were not.
Whether Tuskegee's legacy has permanently affected African-American trust of the medical community is a matter of debate. A 2008 study by Johns Hopkins suggested that African-Americans are willing to participate in trials, but are more fearful than whites that they will be treated as guinea pigs.
Dr. Donna Antoine-Lavigne, coordinator for the study's community outreach and partnership office, agrees there is some distrust and emphasizes the importance of a tight bond between the public and the study's administration.
"It's not that black people don't want to be involved in clinical trials," she says, "but certain conditions have to be in place."
The Jackson Heart study has been careful to meet those conditions, drawing in community support and participation from the very beginning. Each of the study's committees includes two local residents, who help guide how the data will be used to benefit the study participants and the wider public. Volunteers suggest and carry out public programs such as weight loss initiatives and cooking demonstrations.
"Trust, truth and honesty," were the study's watchwords, according to Francis Henderson, the study's deputy director. Most participants wanted to be informed immediately if they had a medical condition.
"They wanted black doctors and researchers. It was important that the people on the staff look like them. Most importantly, though, they wanted to know they would be listened to."
With Grace and Gumption
The Kentucky-born mystery writer Sue Grafton said that as a Southern woman, she was taught two things: "Never call attention to yourself, and never make anybody uncomfortable."
It's excellent advice for an aspiring physician who wants to get the most out of the patient-doctor experience, and Landry follows it to the letter. Her voice is one of her greatest assets. Experience and travel abroad and in the U.S. has helped her cultivate an accent that she alters to suit the company and situation—anything from a brisk Boston clip to a leisurely Alabama stroll. It's an instinct rather than an act, and the effect on others is dramatic.
In an interview with one of the Jackson Heart Study participants, Landry senses the woman's slight reluctance to open up about her eating habits. With a bit of conversation about the weather and local restaurants, and a polite sprinkling of "yes, ma'ams" and "no, ma'ams," Landry easily establishes a common language of graciousness. In short order, her subject is smiling and talking about buffet dinners, barbecued chicken and her ongoing struggle for weight loss, which she knows is important if she wishes to stay healthy.
Her clinical experiences in Jackson and abroad have taught her, she explains, that people need to be listened to if you're going to discover how to treat them. Doctors need to be receptive to the fact that circumstances might be different for some patients, and maybe if they asked a few more questions, they would get at something essential.
"An African American from the South might use different words than a Northerner to describe an illness—they might not say 'wheezing,' for example. In some parts of the South, people still refer to diabetes as "the sugar." As in 'I've got a touch of the sugar.' You have to be sensitive to these things."
It's clear Dr. Taylor and the others on staff at the Jackson Heart study value her delicate touch as much as her research.
"Latrice is such a sweet, gracious individual that you are sometimes taken aback by how brilliant she is," he says. "Her work is outstanding, and really poises her for a position of leadership in the field. If I had 10 more like her, I could retire."
But Landry says it's simple stubbornness.
"You remember Ashley's wife, Melanie in 'Gone with the Wind'?" she says, laughing.
"When I was young, I wanted to be just like her, because she so sweet and unselfish and gracious with everyone. But I realized I had a lot more in common with Scarlett. When someone tells me I can't do something, I become twice as determined to do it."
Story and audio slideshows by Claire Vail, Web Communications Manager, School of Medicine. Photos by Melody Ko, University Photography.
This story originally ran on Sept. 15, 2008.