Only hours after the autopsy of San Diego City Councilmember Charles Lewis was released last Monday, an unattributed 200-word story was posted on SignOnSanDiego.com, the website of the San Diego Union-Tribune. “Councilman Lewis' liver was damaged by excessive alcohol, autopsy finds,” read the story's headline. The same day, KFMB “Local 8” news posted this story on its website: “Lewis autopsy report reveals alcohol abuse.”
The following day, there was more of the same.
NBC 7/39: “Friends react to news of Councilman's Alcoholism”
KGTV: “Final autopsy: Alcohol led to Councilman's death”
The San Diego Daily Transcript: “Autopsy report pins Lewis death to alcoholism”
And, again, the Union-Tribune, this time in print: “Alcohol use cited in Lewis' autopsy.”
In the stories that bothered to quote Lewis' family and friends, the people who knew the deceased District 4 councilmember best were put on the defensive, responding with surprise to the autopsy's finding that Lewis' death was the result of alcohol-induced cirrhosis of the liver. Indeed, the sub-heading for the NBC news story seemed to sum it up: “Medical report reveals another side to Charles Lewis.”
If that side even existed, apparently no one had seen it. From Lewis' mother, with whom he lived until he was 27, to Mitch Mitchell, the head of the San Diego Chamber of Commerce, to Ricky Laster, a founding member of 100 Black Men United, a civic group with which Lewis worked closely, the autopsy report's apparent conclusion that Lewis had a long-time drinking problem was news to them.
Even over at City Hall, Lewis, who worked for former Councilmember George Stevens for more than 10 years before his election in 2002, maintained a reputation as a clean-living guy. One City Hall staff member, who requested anonymity, said folks on the 10th Floor, where the City Council's eight district offices are located, were “shocked by the medical examiner's report.”
“Having worked with Charles for more than eight years, I can honestly say that I had never smelled alcohol on his breath, he had never appeared inebriated and I don't recall ever having seen him at a social event drinking alcohol.
“Drinking is just not something any of us here would ever have associated with Charles,” he said, “and especially not as a cause of death.”
Other City Hall staffers CityBeat spoke with said essentially the same thing.
Last Friday, Lewis' family held a press conference at the District 4 office in Encanto, where they asked the public not to draw “simple conclusions” about what killed the councilmember. Family members said Lewis worked 12-hour days-a schedule that would be difficult for someone with a serious drinking problem. They believe an undiagnosed medical condition was the cause of his death; a source close to the family said they had not yet spoken to the medical examiner about the autopsy's conclusion. Lewis' medical records have remained sealed.
The press conference received far less coverage than the release of the autopsy report, failing to even make the pages of the Union-Tribune.
CityBeat presented Kelly McBride, who teaches journalism ethics at the Poynter Institute, with a timeline of how coverage of the release of Lewis' autopsy report had unfolded. “I would be hesitant to call a dead guy an alcoholic if he had lived a public life with little evidence of alcohol abuse,” said McBride. “In a competitive [media] market, finding out the truth becomes an urgent task. But if you think about it, the public can wait a week or two for a conclusive story.”
Since Friday, Lewis' family has declined to respond to further media inquiries. Glenn Wagner, the county Medical Examiner who performed the autopsy, who last week told the Union-Tribune that Lewis “clearly started using alcohol and did so over a period of time,” is silent, too, only saying through a spokesperson that he stands by his professional opinion. Letters to the Union-Tribune have challenged both Wagner's findings and that paper's coverage of the autopsy, saying that the latter may have reached an inaccurate conclusion that the former was too quick to report on.
On Aug. 30, retired Salk Institute biomedical researcher and community activist Ian Trowbridge filed a public-records request with the county, demanding written accounts and audiotapes from Lewis' autopsy. In the request, Trowbridge points out that the medical examiner's stated conclusion, both in the autopsy report and in comments to the press, that a drinking problem killed Lewis has been challenged by a nationally recognized liver specialist. He also points out that the autopsy was released before conclusive tests for hepatitis B and C-two ailments that ravage the liver-could be completed. It's possible, says Trowbridge, that the medical examiner “[has] done a grave injustice to Charles Lewis as a result of a sloppy professional job.”
“For Charles' name to be sullied by an incompetent medical examiner is almost too much for me to stand,” Trowbridge told CityBeat.
According to the autopsy report, Lewis was admitted to Kaiser Permanente Hospital in Grantville around 4 a.m. on Sunday, Aug. 8, after repeatedly vomiting blood. At 7:30 a.m., he received a blood transfusion, and three hours later doctors attempted to repair damaged blood vessels in his esophagus. At some point, Lewis became unresponsive, went into respiratory arrest and was pronounced dead at 1:12 p.m.-nine hours after he was first admitted to the hospital.
The day prior, he had been at a class-reunion picnic, where, according to the autopsy report, he drank anywhere from one beer and one Long Island Iced tea to “two-to-three beers.” The report also states that, “the decedent drinks approximately two-to-three alcoholic beverages a day.” The report does not give a source or time period for that information.
Lewis' family hasn't denied publicly that he drank alcohol; it's the suggestion that drinking alone brought about his death that's the issue. As Joel Lavine, a professor of pediatric hepatology at UCSD wrote in a letter to the editor in Saturday's U-T, “The councilman's friends and family may be correct [in saying reports that his liver was damaged from alcohol are unfounded], as there is an increasingly prevalent condition of the liver found in non-alcoholics appearing identical to alcoholic liver disease.” Lavine goes on to say that half of obese people-which Lewis, at 5-foot-8 and 229 pounds, could be considered-develop so-called fatty liver disease. Two percent of that population could develop what's known as non-alcoholic steatohepatitis, or NASH, which, “under the microscope,” writes Lavine, “appears identical to alcoholic hepatitis” (the stated cause of Lewis' death). CityBeat asked Wagner if he had considered NASH but did not get a response.
CityBeat sent the autopsy summary to Stephen Caldwell, a specialist in liver disease at the University of Virginia, who, by e-mail, said that according to the report, “it's not accurate to label [Lewis' cirrhosis] as ‘alcoholic.'” The liver of someone with NASH, he wrote, can look in lab reports pretty much like that of an alcoholic.
Both Caldwell and Lavine point out that it's not uncommon for physicians to misdiagnose someone with non-alcoholic cirrhosis as being a chronic drinker-underlying causes of cirrhosis can be far more nuanced. Both physicians said they are working to increase awareness of the disease. As Lavine wrote in his letter to the U-T, “We should recognize that... obese individuals without a history of drinking significant amounts of alcohol can have a liver resembling that of an alcoholic.”
Staff writer Daniel Strumpf contributed to this story.