Where are the answers if doctors can't agree? THE REGGIE LEWIS CONTROVERSY

March 10, 1995|By JOHN EISENBERG

Reggie Lewis died on a basketball court in Boston largely because the opinions of some of the country's best heart doctors were ignored.

The lesson was as obvious as it was tragic: A consensus of top medical experts shouldn't be refuted.

Twenty months later, as Lewis' death hits the front page again thanks to a Wall Street Journal story suggesting possible cocaine use, we face the same dilemma Lewis faced as we try to discern the truth in this sad mess: Should we believe the doctors?

The problem is it's not nearly so simple this time.

Because there is no consensus among the doctors this time.

After Lewis fainted on the floor of the Boston Garden during a playoff game in 1993, the Celtics assembled a "dream team" of cardiologists who concluded that Lewis had a damaged heart, a life-threatening condition, and should never play basketball again. The Celtics and Lewis found a doctor who disagreed, saying that Lewis had only a fainting condition.

Lewis began working out again.

And died.

So the dream team was right. Not that that was any surprise. Twelve of the country's best cardiologists aren't going to be wrong.

But the issue now is what caused Lewis' heart to stop that night at Brandeis University, and the problem is that there is no medical consensus on which we can rely this time. There is just a loud, angry debate.

And there is the inescapable truth that we will never know for sure why it happened.

According to the Journal, tests revealed that the left ventricle of Lewis' heart was scarred in three areas of dead tissue. The four most common causes of this condition are arteriosclerosis, a virus, a prior heart attack or drugs.

Lewis had not had a prior heart attack. Arteriosclerosis exists mostly in patients older than Lewis, who was 27. The Journal quoted the only cardiologist who examined Lewis' heart after his death, as well as a pathologist consulted on the autopsy, saying that the scarring was "consistent with a cocaine cardiomyopathy" -- a cocaine-damaged heart.

Several other doctors quoted in the Journal strongly rebuked the medical examiner in Waltham, Mass., who signed a death certificate claiming that a virus, not cocaine, caused the abnormality in Lewis' heart.

Yet Dr. Michael Gold, director of cardiac electrophysiology at theUniversity of Maryland Medical Center, told The Sun yesterday that the virus could indeed have caused the damage -- and that, in fact, the virus is "the most common cause of unexplained heart damage in young, otherwise healthy people."

Dr. Kenneth Baughman, professor of medicine and chairman of the division of cardiology at the Johns Hopkins School of Medicine, told The Sun, "I have many, many examples of patients like that who had a relatively sudden onset of a viral inflammation of the heart and went on to have either sudden death or sudden heart trouble."

And Dr. Richard Evans, the chief medical examiner in Massachusetts, told the Associated Press that any claim attributing the scarring to cocaine use is "a garbage diagnosis."

In other words, we're right in the middle of a huge, cloudy medical gray area.

And right back where we were the day Lewis died.

We don't know what happened.

The Journal's story was pointed, explaining that the Celtics and Lewis' family would receive more than $15 million in insurance payments -- payments that could be canceled if a link between Lewis and drugs was proven -- and that the Celtics are paying Lewis' wife the entirety of a multi-million dollar contract Lewis signed, a contract from which the Celtics can escape if drug use is proven.

Without question, a lot of people have a lot to lose if it turns out that cocaine contributed to Lewis' death. The NBA has spent years overcoming the notion that it was tainted by drugs.

But there simply is no evidence that Lewis used cocaine. The autopsy showed no drugs in his system.

The Celtics called the Journal story "racist" and threatened to file a $100 million lawsuit. Of course, these are the same Celtics whose CEO at the time, Dave Gavitt, gladly endorsed the ultimately fatal medical opinion contrary to the dream team's two years ago.

Way to stand by your man, guys.

Amid all the mud that is going to fly, maybe for years, there is this truth: The doctors are the only people in this mess with no personal stake. There is no compelling reason for them to offer anything other than what they believe is the truth.

They are the place to find the truth in this thing.

But when they don't agree, we can't find it.

And we never will.

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