Paranoia can kill, even if there's a good reason for the suspicion.
That's a reality William Minniefield faces every day here as he tries to combat black reluctance to donate organs -- such as the kidney that could have saved his brother's life.
It's a reality that Dr. Clive Callender faces as founder of a national program designed to break down black mistrust of organ donation.
And it's a reality that the Rev. Willie Martin faces every day, more acutely than most.
Martin is waiting for a kidney. The 57-year-old father of four is in his third year on the transplant waiting list. He knows all about the statistics that paint a grim picture of his chances of getting a suitable match because there aren't enough black donors, who offer the best odds of success for the African-American. He also knows the reasons.
"I know my people. They don't trust nobody," said Martin, the plain-spoken associate minister at Mount Olive Baptist Church on East Delavan Avenue.
But he isn't ready to let blacks off the hook for the fear and mistrust that are like malignant tumors resulting from growing up in an environment toxic with racism.
"One day it may be you, or your son, or your daughter, that needs a kidney," said Martin, who has dialysis three times a week.
And that underscores the challenge facing those like Minniefield and Callender: create organizations to compensate for the fact that medicine has traditionally treated blacks like afterthoughts -- or worse. Yet simultaneously convince blacks to participate in that very system because the lives of other blacks are at stake.
Studies show the major problem is "the mistrust of the medical system by African-Americans," said Minniefield, whose younger brother died in 1989 while awaiting a kidney, and whose older brother has been on dialysis for four years.
The reasons for the mistrust are well-known. They're as old as the infamous Tuskegee experiment and as new as studies showing doctors still don't give minorities the aggressive treatments routinely offered whites.
The mistrust is compounded by another fact: Traditional outreach programs fail to adequately utilize minority input.
A white guy knocking on a Fruit Belt door saying give up fatty foods and sign a donor card just won't cut it when residents already believe signing up means doctors will do less to keep them alive in an emergency or will take their organs before they die.
Surveys show that those fears, plus certain cultural beliefs, are behind the minority reluctance to donate.
And the numbers resulting from that reluctance are stark. Blacks make up a disproportionate 25 percent of the nearly 80,000 registrants on the national transplant waiting list, according to the United Network for Organ Sharing. And they account for a startling 35 percent of those needing kidney transplants. It's a similar story in New York State.
Yet blacks accounted for only 11 percent of organs donated in 1999, UNOS data show. With chances of a match heightened when the donor and recipient are the same race, the disparities are like death sentences.
Callender, director of Howard University's transplant center and founder of the National Minority Organ/Tissue Transplantation Program, has proved in Washington, D.C., that the problem can be overcome with culturally sensitive outreach efforts. Now he's in the midst of federally funded effort in 15 cities.
Minniefield, who has lectured and worked on national research projects while pursuing degrees at the University at Buffalo and Buffalo State College, is on the same track here.
He founded the Minority Organ Donation Education Program to compensate for the fact that traditional programs don't reach minorities. MODEP's Web site will be up March 1, and it's working with churches and community groups to overcome the barriers.
Callender sees a two-pronged battle: against medical practices that result in blacks' getting inferior treatment, and against the reaction to that racism that prompts blacks to shun the medical system.
But if one is tantamount to social manslaughter, the other clearly is suicide. And that shouldn't be an option, because it leaves the victims just as dead.
Blacks have to become sophisticated enough to stop taking no for an answer from insensitive institutions, and to stop giving it when someone's trying to help.