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A DOSE OF TRUST IN HELPING MINORITIES

Shervaughn Turner defies all the national studies showing that African-Americans receive unequal treatment for heart disease and stroke.

The latest studies, 17 in all, released recently by the American Heart Association in a special issue of the journal Circulation, detail the problems.

Members of minority groups often don't get the latest drugs and interventions. They don't see heart specialists as often as white patients. They aren't offered the chance to stop smoking as often.

There are a slew of theories and just as many proposals to make a difference:

Establish more community programs to educate people in their neighborhoods about healthful eating and exercise as long-term solutions to heart health.

Train more minority heart specialists.

Enroll more minorities in studies so experts know for sure whether approaches that work for whites work for others.

Use computer programs to send patients reminders for follow-up care once they leave a hospital after a heart attack. Before they leave the hospital, devise checklists to guarantee that patients get the right drugs to prevent another heart attack.

But most experts agree one common-sense strategy -- one that's simple yet all too often overlooked -- trumps them all: Doctors and the health care establishment need to break down the walls that make people distrust physicians. Only then can their doctors do a better job.

Dr. John Flack, one of the nation's few black cardiologists, calls it "the soft side of medicine."

"We can't care for patients until they understand you care about them," says Flack, professor and associate chairman of the department of internal medicine at the Wayne State University School of Medicine, where he is training the next generation of heart specialists. He tells them to answer patients with "yes, sir" and "yes, ma'am" and "to convey to people we'd care for them like a member of their family."

Once patients trust, they'll listen, he says.

They'll ask questions.

They'll want to learn more.

That's how Dr. Hank Rosman, director of the cardiology fellowship at St. John Hospital, helped Turner understand her lifelong history of heart disease.

Turner, 49, had rheumatic fever as a child that left her with a damaged heart valve. In her teens, she developed heart failure, and her active life as a high school cheerleader was over. She has been on a blood thinner and medication to prevent heart failure ever since.

While others planned their futures, Turner wondered how long she'd live.

When she moved to Detroit in 1977, she met Rosman at Detroit's Henry Ford Hospital, where he worked at the time.

He listened to her story, took out his stethoscope and asked her to listen to her heart.

Three beats. Then an open and snap sound, he told her.

Turner heard the sound. To her, it sounded like boop-brooom, boop-brooom. It was the sound of her heart valve fluttering open and shut to let out blood to the rest of her body. The exercise helped her trust Rosman.

She stayed healthy, exercised, even rode a bike around her northwest Detroit neighborhood when she wasn't busy as a computer specialist for the Midwest region of the federal Food and Drug Administration.

Last year, she got a chance to retire early and took it.

Two children. Ten grandchildren. Too many grandchildren, she says with a laugh. Too many to baby-sit. She's always in demand.

Rosman has taught her how to relax and not to lose her temper. He has encouraged her to take vacations. Now she goes each year to Virginia Beach, Va., and swims in the ocean.

Rosman says the health care industry needs to start thinking differently, beyond its walls, beyond its comfort levels.

"Health care isn't just about when you're sick," Rosman said.

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