Deadly Silence: How the Inner Circles, Of Medicine and Sports, Failed a Stricken Star
The Wall Street Journal, 03/09/1995 © 1995, Dow Jones & Co., Inc. Reprinted with Permission
After Reggie Lewis Collapsed,
Money and PR Worries
Undermined His Care
NBA: Don't Ask, Don't Tell
BOSTON -- Later this month, in ancient Boston Garden, No. 35 will be retired -- raised high to the crossbeams alongside banners of long-ago champions. But as the crowd pays homage to Reggie Lewis , the dead Celtics captain, certain people will feel a special ache.
The event will be particularly poignant for the doctors and team officials who crowded into a conference room at New England Baptist Hospital two years ago. They had gathered, that early May afternoon, to discuss medical tests taken in the crucial days after Mr. Lewis collapsed during a playoff game.
There was little debate. All agreed that the National Basketball Association star seemed to have a severely damaged heart and that his career was probably over. It fell to Thomas Nessa, the cardiologist leading the medical team, and Arnold Scheller, the Celtics physician, to meet with the Lewis family that evening bearing the awful news.
"I told them what the diagnosis meant," said Dr. Nessa, "and that the next day we'd be pushing him and the Celtics to get to the bottom of the issue of causation. Reggie knew what we meant. We'd been pressing him about cocaine for days."
A few hours later, as midnight approached, Mr. Lewis and his wife, Donna Harris-Lewis, fled the hospital, beginning a bizarre string of events that ended, three months later, with a 27-year-old black hero lying dead on a basketball court.
How could this most highly scrutinized case, involving the nation's foremost cardiologists, one of sports' most venerable teams and a treatable heart ailment, have ended in tragedy? Part of the answer lies in the willingness of family members, lawyers, Celtics officials and some doctors to sidestep the possible cause of Mr. Lewis's collapse.
Protecting the reputation of a hometown favorite provided one motive, but powerful financial interests were also involved. There was more than $15 million in insurance coverage of Mr. Lewis's contract that could be paid out to the Lewis family and the Celtics only if no link to drugs was shown. There was the potential damage to the league and the team if a drug scandal developed. And there was the more specific danger that such a scandal would interfere with a crucial business deal the Celtics were negotiating at that time. Events would show that such considerations, abetted by the NBA's dismissive policies regarding drugs, may have affected human behavior and medical procedure in a fatal fashion.
Whether Mr. Lewis died from a heart damaged by cocaine -- as many doctors suspected then and now -- cannot be definitively shown. What is evident: The official cause of death, a heart damaged by a common-cold virus, is a medically nonsensical finding by a coroner who was under intense pressure from the Lewis family to exclude any implication of drug use.
What is undeniable: Cocaine was a central, explosive issue for the doctors, the Lewis family, the Celtics and the pathologists who conducted his November 1993 autopsy -- an issue that became untouchable because Mr. Lewis was a basketball superstar.
Renu Virmani, the chief cardiac pathologist at Washington's Armed Forces Institute of Pathology, who is familiar with the Lewis case, put it this way: " Reggie Lewis was deprived of proper treatment precisely because he was a superstar. If he was just a guy off the street, he would probably be alive today."
Professional basketball is a predominantly black sport supported by a predominantly white audience, an arrangement that has resulted in stilted silence on some painful issues.
But, in 1984, as newly appointed NBA commissioner David Stern had just begun reviving a sport of dying franchises, fleeing fans and drug scandals, he spoke with bluntness about his sport's crucible.
"This is the first sport," he said then to the New York Times, "where it became fashionable and allowable to talk about race. Our problem was that sponsors were flocking out of the NBA because it was perceived as a bunch of high-salaried, drug-sniffing black guys." The drug taint jeopardized what he described as the league's mission: "the collective business of selling heroes."
It is now a part of American sports lore that the NBA roared forward from those difficult days to become the most successful of leagues: no union problems, no salary problems, no drug problems.
A key to victory was a drug policy that Mr. Stern helped craft just before he was anointed commissioner, a policy that has remained largely unchanged. It carries the harshest penalty in sports, a sanction that the league proudly displays: Any player caught in a drug screen will be expelled from the NBA and his contract legally voided.
But of approximately 1,800 players who have entered the league since the drug policy took effect, only six have tested positive in drug screens -- only one in the 1990s, said NBA spokesman Jan Hubbard. The fine print of the NBA policy suggests why. While a rookie can be randomly tested, no testing is allowed after a player's first year unless a team or the players' association finds "reasonable cause" to suspect drug use and then calls in a league "expert" to deem whether a test is, indeed, warranted.
A team doctor who goes forward with a drug test on his own faces possible sanctions. Thus, it is hardly surprising that, under the screening procedures for veteran players, only two have tested positive in the history of the drug policy. While the penalties are less onerous in other sports, the policies are far less legalistic and more widely implemented; the effect is that more athletes with drug problems seek treatment voluntarily.
Top officials and drug-treatment experts from football and baseball say that the NBA effectively has a "don't ask, don't tell policy" that seems rigorous on the surface but is designed not to be.
"A drug program that works is not quiet and neat," said Robert B. Millman, professor of psychiatry and public health at Cornell University and medical adviser to Major League Baseball. "What you want is a fair degree of testing and a program with a lot of players in it. A league needs to be willing to say, `We're secure enough to allow that to transpire.'"
"Obviously, we don't have a lot of drug tests taken," said sports agent David Faulk, who represents 25 NBA players, "but I think that shows that our policy works."
The opening playoff game between the Celtics and the Charlotte Hornets, in a raucous Boston Garden on Thursday, April 29, 1993, might have begun a new era for the Boston team. Reggie Lewis , replacing the recently retired Larry Bird as captain, was setting the pace with sizzling energy, scoring 10 points in the game's first three minutes.
Then, running freely down the court, he fell, for no apparent reason. He sat dazed on the parquet floor, then left the game. At halftime, he was given routine medical tests in the locker room, said he was feeling fine and, in the second half, played again. After a few minutes, though, the lithe 6-foot-7-inch forward felt faint and walked off the court for good.
Early the next morning, Mr. Lewis arrived for an array of tests at Boston's New England Baptist Hospital, where team doctor Arnold Scheller waited with his longtime friend, Baptist hospital cardiologist Thomas Nessa.
By midday Friday, test results were coming in. The two doctors huddled in the office of Charles Munn, the Baptist's staff radiologist, to look at color printouts from a thalium stress test, which illuminates how blood moves through the heart muscle. Dr. Munn guided the others, but there wasn't much need: On the left ventricle of Mr. Lewis's heart were three black patches -- dead spots.
"This was something any third-year resident could have seen," Dr. Munn said. "This was not subtle. This was not esoteric."
Such dead tissue is most commonly caused by arteriosclerosis, mostly in older patients, or by viruses, drug use or a previous heart attack. After considering Mr. Lewis's age, Dr. Munn turned to Dr. Nessa and said, "You see this sort of thing so often with cocaine. Has anyone looked into that?" Dr. Nessa responded that he had already asked Mr. Lewis about drugs in the admittance interview and that, Dr. Nessa recalled, "Reggie said he'd never done any."
But suspicions were growing among the doctors. Mr. Lewis, in that first day at the Baptist, said he could not produce urine, and both Drs. Munn and Nessa remembered meeting Friday evening to discuss ways, through hair or blood, that the player might be tested for drugs.
Dr. Nessa went back to Mr. Lewis's room again and pressed the player to submit to a drug test. Mr. Lewis refused, according to Drs. Nessa and Munn. "Of course, we were suspicious," Dr. Munn said. "If he'd never done drugs, why would he be so adamant?"
By Saturday, though, Dr. Nessa realized that Mr. Lewis's status as an NBA star would alter normal procedures. "I found out that you couldn't just test an NBA player. There are amazingly complex rules surrounding it," Dr. Nessa said during an interview with this newspaper in December, a month before Dr. Nessa's death from a sudden heart attack. "A denial of drug use, of course, is meaningless: Few patients ever admit it. But as a doctor, saying you need this information to help save their life, you can put pressure on them. In this case, though, we simply had no leverage."
The leverage was held by the Celtics, whose chief operating officer, David R. Gavitt, was at the hospital through the weekend and regularly consulted with the physicians about what they were finding and what they might need. Dr. Nessa said that he discussed the drug issue with Mr. Gavitt but that the Celtics chief insisted that "Lewis couldn't be forced into it."
With the assurance that there would be no checking for drugs, Mr. Lewis did give urine and blood by Saturday. The test results largely ruled out a host of possible causes -- including several viruses that sometimes cause heart damage -- and thus further narrowed suspicions toward cocaine.
The failure to look for the drug was based on the Celtics's questionable assertion that Mr. Lewis couldn't be tested without his consent. In fact, the league's requirement that there be "reasonable cause" for mandatory testing might well have been met in Mr. Lewis's case. He had fallen inexplicably; heart damage consistent with cocaine use had been discovered; and he had refused to be tested, despite the medical opinion of his doctors that he should be. If the NBA's expert had mandated a test, league rules would have allowed the Celtics to force Mr. Lewis to be tested or face ouster and a voided contract. But no NBA expert was called upon.
Instead, the doctors struggled. Mr. Gavitt recalled the first mention of drugs on Sunday at midday, when Dr. Nessa asked him if he had "any suspicion that Reggie was involved in drugs at all. I said, `No way.'"
Two hours later, Mr. Gavitt and Celtics executive vice president Jan Volk attended a meeting of a dozen expert cardiologists -- dubbed the dream team by Dr. Scheller -- assembled by Drs. Scheller and Nessa from the area's top hospitals.
"We were very unified in our view that he had a life-threatening risk profile," recalled dream-team member Mark Estes, a cardiologist at New England Medical Center. In interviews, six other doctors who attended that Sunday meeting echoed Dr. Estes's conclusions drawn from medical tests that they reviewed.
The group discussed the possibility that the player would need a defibrillator implanted in his chest to shock the heart when irregular rhythms occurred. For some patients with damaged hearts, use of a defibrillator can free them to live full, active lives, though strenuous exercise usually must be avoided. Much depends on how often irregular beats occur; those with especially weak hearts may become candidates for transplants.
The doctors also talked about how Mr. Lewis might react to the difficult news about his condition and their suspicions about what might have caused it. "We asked about drugs, of course," Dr. Estes said.
Because cocaine acts on the heart in specific ways, cardiologists say it is helpful to know about its use in arriving at a diagnosis and crafting a treatment program. Clearly, too, patients must be steered away from any further cocaine use -- which is especially hazardous to already damaged hearts -- through counseling and rehabilitation.
"One [of the doctors] mentioned drugs, asking if that's possible here, and another one said, `Is doing a drug test possible?'" Mr. Gavitt recalled. "So I told them what the NBA policy was."
Mr. Gavitt said he didn't know who the NBA drug-testing expert was. But, based on his personal view that Mr. Lewis wasn't a drug user, he saw no reason to track down the expert. "You only have to go on your own instincts, your own experience with Reggie," he said.
Shortly after the meeting adjourned, Dr. Nessa related the specialists' assessments to the Lewises, who had been waiting in a nearby hospital room. He emphasized that the possible causes of the heart damage, including cocaine, would be explored in the coming week.
After her husband's diagnosis was described, Ms. Harris-Lewis got on the phone. As the evening waned, she placed calls to representatives of Brigham and Women's Hospital, a renowned Harvard teaching hospital, where she had once worked in personnel. Just shy of midnight, the basketball player checked himself out of his Baptist hospital room, slipped through a side exit and got into a van bound for Brigham and Women's, less than a mile away.
Mr. Lewis's closest friend, Mark Reeves, who was with the couple that night, said that Ms. Harris-Lewis felt they were being excluded from the diagnosis, that the experts met, "passed judgment and didn't even bother to see or talk to Reggie."
Ms. Harris-Lewis wouldn't comment or respond directly or through her lawyers to a list of specific questions about events mentioned in this story. Mr. Reeves, who stressed that his friend never used drugs, said Mr. Lewis refused to be tested because he felt he was being suspected unfairly.
"I think the feeling was that if this was a white player, that these white doctors wouldn't have been so insistent about cocaine," Mr. Reeves said one December night at a restaurant in Dedham, Mass., down the road from the Lewises' stately home. "The issue of race was definitely there."
The Celtics had additional concerns. In recent years, they had been no strangers to drugs. In 1986, University of Maryland star Len Bias, expected to be a key to the club's future, died of a cocaine overdose a day after being drafted by the Celtics. And just two months before Mr. Lewis fell on the court, Celtics center Robert Parish was busted on marijuana-possession charges when U.S. drug-enforcement officials spotted a Federal Express package of marijuana bound for his house.
Mr. Lewis's collapse, and whispered questions around town about what caused it, seemed to put the team in a double bind. Proof that the athlete had used cocaine would, under NBA rules, release the Celtics from any obligation to pay the remainder of his contract. On the other hand, a positive toxicology test -- a star's career ended by cocaine -- would create a public-relations nightmare and, certainly, spur follow-up inquiries into drug use on the team. The damage might far outweigh any short-term contractual savings.
Team doctor Arnold Scheller publicly endorsed the dream team's findings a day after Mr. Lewis fled for the Brigham, stating that the player's heart was scarred and that he was at personal risk. But the contentious dialogue concerning what caused the heart damage, discussed so often among doctors, the Lewises and the Celtics, never became public. Since then, the NBA has revised its policies and now explicitly prohibits team doctors from talking directly to the press.
Despite the official silence on the subject, the issue of cocaine seemed likely that summer to rise to the surface. The Celtics's remaining obligations to Mr. Lewis -- more than $10 million on his five-year, $16.5 million contract, the team's largest financial obligation to any player -- were covered by a leaguewide temporary total-disability policy.
A feature of such coverage, said Ted Dipple, president of American Specialty Underwriters of Woburn, Mass., which administers the NBA policy, "is that any disability due to drugs is what we call a standard exclusion -- meaning you don't get paid." Experts in disability insurance say even a diagnosis that Mr. Lewis had a scarred heart of unspecified cause would have alerted insurers to contest the payment pending a full drug investigation.
But such a diagnosis, and hence such an investigation, never came. After a week of tests, the Brigham and Women's chief of clinical cardiology, Gilbert Mudge, offered a public statement -- one that was cleared by the Lewis family. Dr. Mudge said his finding so far was that his patient had a relatively benign fainting condition. He added that he would test and monitor the player carefully over the coming months.
Also photographed at the news conference was Mr. Gavitt, then the Celtics's chief operating officer and now its vice chairman. Some Celtics officials were flabbergasted that Mr. Gavitt seemed to be endorsing a diagnosis that contradicted that of the medical dream team. "I was criticized for seeming to back up Mudge, but it was good news and I reacted as anyone would," Mr. Gavitt now says.
A few weeks later, Mr. Gavitt told the Boston Globe that "Reggie is very confident and comfortable with Dr. Mudge's diagnosis. And his prognosis is going forward. We accept that."
Meanwhile, Dr. Mudge was gently constructing a relationship with his skittish patient, trying to prevent Mr. Lewis and his wife from also fleeing the Brigham -- a course Dr. Mudge feared would end disastrously. He agreed with the Lewis family not to talk publicly about the case and, even in conversations with the couple, never mentioned drugs, according to several people close to the Lewises.
While Dr. Mudge has since been faulted by some people for misdiagnosing Mr. Lewis, the doctor has held to his agreement with the Lewis family and has refused to talk publicly about the case. But, when asked specific questions based on Mr. Lewis's medical records obtained by this newspaper, he reluctantly responded.
"Clearly, there was an abnormality in the function of his heart, but it's not one we could reproduce in any of our tests," Dr. Mudge said. So he resorted to a program of what cardiologists call "watchful waiting," which involved carefully monitoring the player's activities as testing continued. After a few weeks, he said, he directed Mr. Lewis to consult a third team of specialists far from the medical tempest that swirled in Boston around Mr. Lewis's diagnosis.
After this new group of doctors, who were from California, sent their findings to Dr. Mudge in mid-July, he and his star patient had a sober meeting in Mr. Lewis's Range Rover in a Brandeis University parking lot near the Celtics's training gym. Dr. Mudge recalled that he told Mr. Lewis that the California results, combined with the tests he had conducted at the Brigham, indicated that Mr. Lewis appeared to have both a damaged heart, as initially found by the dream team, and a fainting condition.
The latter -- called neurocardiogenic syncope -- can also be caused by cocaine, according to a number of specialists on the condition. Francois Abboud, director of the cardiovascular research center at the University of Iowa, who recently wrote about the fainting condition in the New England Journal of Medicine, said generally that the malady can be "brought on by excessive stimulation of the heart, a kind of reaction you find with cocaine."
Now that Dr. Mudge had won Mr. Lewis's trust -- able to speak to the player alone, without his wife present -- the doctor laid down his hand: Mr. Lewis's career was almost certainly over. Then, Dr. Mudge recalled, he finally bore in on the cocaine issue. He told Mr. Lewis flatly, he said, "that [cocaine] is the only thing that would explain what we're seeing" and that if the player "was still doing it, he has to stop, immediately."
ABOUT 10 days later, Reggie Lewis called a recently reformed cocaine addict in Baltimore.
It was his mother.
Inez Ritch, 48 years old, was part of a past that Mr. Lewis had fled once he had found his professional success. But now, facing a life crisis, he had felt a tug.
He was raised with his three siblings in one of Baltimore's bleakest, most drug-infested slums by a single mother and went on to play basketball at Baltimore's Dunbar High School, a training ground for many NBA players. By the time he was playing on scholarship at Boston's Northeastern University in the mid-1980s, his mother was already using cocaine. She said emphatically that Reggie never did. In his second year at Northeastern, Reggie met his future wife, Donna Harris, and they were soon a team: She was smart, pretty and determined; he was an affable, gangly youngster, just then discovering his potential.
After Mr. Lewis was drafted by the Celtics in 1987, Ms. Harris became something of a business manager as well. They were married in 1991. Recalled longtime friend Andre LaFleur, "She'd take care of him completely -- breakfast, lunch and dinner -- and every day she'd make a schedule. Today, you'll be doing this. He liked that, I suppose. This is the life he chose."
In those early years with the Celtics, said Ms. Ritch, relations deteriorated between her son and herself. A seminal event occurred in 1991, when Ms. Ritch called her son to say she was ready to quit cocaine and needed money to enter a treatment facility. By then, Mr. Lewis had signed his lucrative five-year contract.
"First, Reggie and Donna said OK, and we set up a great place for me to go. Then they backed out, saying I needed to quit my job and go on welfare so I could get publicly funded for the treatment," Ms. Ritch said. The reason, she added: "They didn't want Reggie to pay for it, because people would find out I was his mother and it might link him, taint him, you know, with drugs."
Soon, Ms. Ritch said, she had quit cocaine, found a new job as a security guard and begun lecturing to drug-prevention groups. But relations with her son remained strained.
By early 1993, said Mark Reeves, best man at the Lewises' wedding and godfather to their son, Mr. Lewis "knew a lot of people, but I was the only one of Reggie's old friends that Donna allowed to remain really close to him."
Mr. Reeves said, as well, that "Reggie never did any drugs, but, in the end, I suppose no one could ever really know that except maybe Donna."
Indeed, during that last summer, the protective qualities of Ms. Harris-Lewis -- long a topic of discussion among friends -- had become fodder for doctors and Celtics officials, who often found themselves forced to deal with her rather than her husband. Even Mr. Reeves said that, in the last weeks of Mr. Lewis's life, "Something was going on. I couldn't seem to get through to Reg. It was like he wasn't available, even to me."
In the end, though, Mr. Lewis seemed to be reconciling himself to a future that neither he nor his wife had planned for, a future without basketball.
Ms. Ritch, recalling that mid-July phone call -- her last conversation with her son -- said that Reggie "told me that no one or no thing is going to control him any more and that nothing would come between him and me any more. He said I shouldn't worry, that he's got to take control of his life, and all he cares about now is just making sure he's OK, even if it means that he won't be playing basketball any more."
Five days later, on July 27, as he lightly tossed basketballs into a hoop at Brandeis University -- a gentle off-season exertion, though not one cleared by Dr. Mudge -- Mr. Lewis fell to the court. Soon he was short of breath and, in moments, paramedics were struggling futilely to raise a pulse.
The next morning, a great outpouring of grief had begun to wash over Boston. Soon, notables from sports and politics -- from NBA Commissioner David Stern to Sen. Edward M. Kennedy and the Rev. Jesse Jackson -- were arriving from around the country to eulogize the fallen hero. On Aug. 2, nearly 15,000 people crowded an arena at Northeastern University and lined roadways to pay their last respects; the funeral service was carried live on television and radio. Mr. Lewis's many good deeds were recounted -- his gifts of turkeys each Thanksgiving to needy children, his tireless work with inner-city children -- along with his gentleness and his wide, easy smile. Ms. Harris-Lewis, holding their one-year-old son, Reggie Jr., and pregnant with another child, became a symbol of courage and pain. It was the largest funeral service, according to a local historical society, in the history of Boston.
Meanwhile, the tension was palpable at the medical examiner's office.
According to Jeffrey Isner, a cardiologist at Boston's St. Elizabeth Hospital and the sole consulting cardiologist called in to assist with the preliminary autopsy, a lawyer for the Lewis family told pathologists working on the case that if anything came out about drugs, the Lewis family would sue the city for damages. A lawyer for the family denied that any such threat was made.
In the highly charged days after Mr. Lewis's death, one reporter -- the Globe's venerable sports reporter and TV commentator Will McDonough -- wrote a column saying an imminent drug-toxicology test by the medical examiner's office is the "possible time bomb in the Reggie Lewis story." A follow-up column by Dan Shaughnessy suggested that "self-abuse" may have played a role in the tragedy. The Globe was flooded with angry calls and hate mail.
A few days later, a preliminary autopsy report found that Mr. Lewis's heart was "abnormal, enlarged and extensively scarred" and that "preliminary drug screenings show no evidence of drug abuse."
Mr. Lewis's heart, which was removed before his burial, was then examined by Dr. Isner and another consulting pathologist, John Fallon of the esteemed Massachusetts General Hospital. Both said in interviews that they found scarring that they described as "consistent with a cocaine cardiomyopathy" -- a cocaine-damaged heart. They said they passed their findings on to deputy medical examiner Stanton Kessler, who handled the final autopsy report. A third consultant called in on the case was Jesse Edwards, a Minnesota pathologist who is former president of the American Heart Association. He told this newspaper that he could not comment on the specifics of his findings other than to say, "Drs. Isner and Fallon are both extremely fine diagnosticians."
Despite the clues of possible cocaine damage, though, the two doctors said they agreed that more was needed to list the cause of death as a cocaine cardiomyopathy. The toxicology test would have to turn up positive for drugs or there would have to be circumstantial evidence that Mr. Lewis had used cocaine. Otherwise, the possibility would remain that a virus, medication or poison had made the heart look as though it had been damaged by cocaine.
Neither Dr. Isner nor Dr. Fallon was surprised, they said, that the toxicology test on Mr. Lewis's body was negative. It was unlikely that the athlete had been using cocaine, which is difficult to detect more than three days after use, while undergoing extensive medical testing. "Beyond that," said Dr. Fallon, "we can only do so much. We can't launch an independent investigation into whether he used cocaine" some time in the past.
One entity that, in August 1993, had begun to investigate Mr. Lewis's death was the Equitable Cos., a lead insurer of Mr. Lewis's life through a huge policy taken out by the Boston Celtics. Total coverage with Equitable and possibly other insurers exceeded $15 million.
Financially, the Lewis crisis couldn't have come at a worse time for the publicly traded company that owns the basketball team: the Celtics Limited Partnership, listed on the New York Stock Exchange.
Calendar 1993 had begun as a troubled year on the balance sheet of the partnership, said chief financial officer Joseph DiLorenzo. The partnership had decided to buy back a television station, WFTX-Channel 25, that it had spun off a few years before, and in January it had borrowed $30 million from banks to help finance the deal. Because of the transaction, by midsummer the partnership found itself with a capital deficit of $28.1 million.
The death of Mr. Lewis in July "was a devastating blow to the franchise," Mr. DiLorenzo said. The only thing that could have been worse, one Celtic official conceded, was if the announced cause of death had been drugs. After repurchasing WFTX, the Celtics began that summer to negotiate with Fox Television Stations Inc., which was seeking an option to buy the station. WFTX televised Celtics games, and a drug scandal might have endangered the negotiations.
Any hint of drugs also would have jeopardized the Celtics's huge life-insurance policy on Mr. Lewis. "This was never an insurance issue, it was an issue of human tragedy and that was the only way we looked at it," said the Celtics's Jan Volk. "We never focused on it from any other perspective."
Equitable, meanwhile, was focused on obtaining Mr. Lewis's medical records in the weeks after his death, according to people close to New England Baptist Hospital. These individuals say Ms. Harris-Lewis complicated the inquiry by refusing to release to insurance investigators the records of Mr. Lewis's crucial first days at the Baptist.
Said Mr. Lewis's former agent and family confidant, Jerome Stanley, "Some of the things Donna has done might at first glance seem sinister or even conspiratorial. But being an insider, I can tell you that is not the case."
If Equitable could prove that Mr. Lewis used cocaine before the issuance of the policy -- for which he had filed a medical disclosure stating that he had never used drugs -- then the insurer could refuse to pay the claim on the ground that it had been lied to. If it could prove a wider conspiracy by potential beneficiaries to conceal drug use, it could file civil fraud charges.
While Equitable searched, Dr. Kessler, the deputy medical examiner, was searching as well: for a single, definitive cause of death. On Nov. 19, nearly four months after Mr. Lewis died, a death certificate was quietly filed in Waltham City Hall, not far from the Brandeis University basketball court where Mr. Lewis fell and died. It listed the cause of death as adenovirus 2 -- a common virus that causes the common cold -- that led to inflammation of Mr. Lewis's heart, widespread scarring of tissue and, ultimately, a fatal cardiac arrest.
The filing of a definitive cause of death -- rather than a more cautious statement that Mr. Lewis had a damaged heart of unknown cause -- meant any insurance investigation would now have to take on the office of the chief medical examiner of Massachusetts. Then there was the likely public backlash if the insurer revealed that it didn't want to pay the hero's widow. People at Equitable will say only that their investigation has been closed.
More than a year ago, in February 1994, after the death certificate was finally uncovered and newspaper stories appeared, Dr. Isner attempted to contact Dr. Kessler.
"The adenovirus 2 finding was wildly improbable. I helped with the autopsy. I wanted an explanation," said Dr. Isner, who called steadily for a week until an official at the coroner's office said they "couldn't even talk to me about it -- and then they hung up on me."
Jangu Banatvala, a researcher at St. Thomases Hospital in London and one of the world's leading experts on heart viruses, agrees with Dr. Isner that the listed cause of death was absurd. "I've never, ever seen adenovirus 2 used as a cause of death like this. If you have a common cold, or sore throat, like most of the population you could have a dormant trace of one or more adenoviruses," Dr. Banatvala said in an interview.
"It's more than just very flimsy as a cause of death," Dr. Banatvala added. "There's simply no hard science, no evidence, linking adenovirus 2 and a myocarditis" -- the technical term for an inflamed heart.
In mid-July of last year, a dozen eminent cardiac pathologists from the Northeast met at Boston's Deaconess Hospital to discuss the issue of sudden death and athletes' hearts.
Leading the group was Renu Virmani, of the Armed Forces Institute, who has collected nearly 150 slides of heart tissue from athletes such as Len Bias and Hank Gathers, a star basketball player at Loyola Marymount College in Los Angeles who died in 1990 due to a damaged heart. There was no link made to drugs in the Gathers case.
As tissue slides of athletes, both famous and anonymous, flashed on a screen, the doctors discussed the heightened risks for athletes who may, at one time, have used cocaine. A small tissue scar caused by such use, which may not cause problems in an average person, can enlarge in a large, muscular athlete's heart, upsetting the electrical responses of heart muscles and causing cardiac arrest. They spoke of the frustration of how the stilted dialogue concerning athletics and drugs, laden with public relations and financial interests, prevented the issue from being studied with scientific rigor.
As the lights came up, talk shifted to some famous cases, and the group turned toward a short, heavyset man with unruly gray hair and a tweed jacket: Stanton Kessler. One pathologist mentioned the adenovirus finding and actually began to laugh. Others wanted the coroner to discuss his conclusions.
Dr. Kessler squirmed. Looking down, he told the group there had been legal threats made by the Lewis family and that he was bound by Massachusetts law not to discuss the case.
The meeting adjourned and, as he walked to his car, Dr. Kessler reiterated to a Journal reporter that he was unable to discuss the matter. He again cited pressure from the family and other "Boston institutions."
Charles McDonald, spokesman for the Massachusetts Office of Public Safety, which oversees the medical examiner's office, said that his office is "investigating the very serious issues" raised by this newspaper's reporting but that he could not comment about any specifics related to the Lewis case.
In a recent telephone interview, though, Dr. Kessler said, "I stand by the scientific basis of my diagnosis. If I need to, I can back this up."
When asked if he understood at the time that his diagnosis would have a financial impact on both the Lewis family and the Celtics, he answered that he did, and then added, "I can't say any more."
For the year ended June 30, 1994, the Celtics Limited Partnership posted record earnings, even though the team itself had just ended a rare losing season. While revenue was $82.8 million, up slightly from $80.7 million in the previous year, net income surged to $23.8 million, up from $5.2 million in the previous year. A key was a net gain of $13.7 million from the sale of the TV option to Fox, announced on Oct. 1, 1993, two months after Mr. Lewis died and six weeks before the death certificate was filed.
The other financial boost, SEC filings state, was $5.6 million in proceeds from life insurance on the life of Reggie Lewis in excess of obligations paid to the Lewis family.
Mr. DiLorenzo said the obligations to the family are "above $10 million." Ms. Harris-Lewis, he added, receives her share over the normal course of her husband's contract "as though he were still alive." At this point, she has apparently received at least $4 million, based on how the insurance is structured. Ms. Harris-Lewis still lives in the family's house in Dedham, Mass., with her son, Reggie Jr., 3, and a daughter, Reggiena, 1.
Ms. Harris-Lewis is continuing her husband's work with inner-city kids. She gave a commencement address last year at Northeastern University and expects to participate in ceremonies to retire her husband's number on March 22.
"At this time of Reggie's Celtic jersey retirement, she declines to be interviewed," said her lawyer, Susan Shapiro, in Ms. Harris-Lewis's sole response to questions for this article.
One night recently, Inez Ritch was sitting in the cold headquarters of the Bell Atlantic Co. tower in Baltimore, in her blue guard's uniform, her legs close to a space heater. That day she walked and bused between state offices to see if she could get public aid to cover bills from medical tests. She has been having chest pains that are growing increasingly severe.
She has seen a doctor, who says it's imperative he do more tests. But, based on her conversation with the physician, Reggie Lewis 's mother thinks she may know the cause: that her heart was damaged by years of cocaine abuse.
"If I don't get help," she says gently, "I know I'm just going to die -- and I'll join my Reggie."