In the spring of 1971, Dr. James L. Luke, then state medical examiner for Oklahoma, visted the District of Columbia's morgue operation and said indignantly that it was "one of the best examples of what is wrong with the coroner system in this country."
Working in a cramped building where lack of air conditioning forced them to conduct summertime autopsies outdoors among the bees, the five coroners -- only one of them trained in pathology, the examination of organs and tissues -- functioned with just one microscope and with so few technicians that the telephone often went untended at night. Luke estimated that coroner's offices like the District's allowed at least 2,000 murders to go unrecognized throughout the country each year.
As soon as his comments appeared in print, Luke got a call from a District health official, offering him the job of chief medical examiner. By July, Washington's problems were his problems.
Ten years later, Luke -- a cautious, complusive man who says public attention petrifies him -- is still at a loss to explain why he took the post. He thinks it must have attacted him for the same reason that he later joined the Washington Bagpipe Band.
"I seem to take on things like this," he said. "The bagpipe is the same sort of activity: you have to play a tune, blow on the bag and walk at the same time. There are many easier ways to spend one's life."
Despite his avowed shyness, the silver-haired, pipe-smoking medical examiner has gained a reputation as an energetic advocate for his office and his specialty. By dint of persistence and veiled threats to quit, he persuaded the District government to come through with a new building, new equipment, and the funds needed to investigate deaths in the way he considered proper. He has also staffed his office with pathologists trained in the study of unnatural death, conducted research on such topics as suddent infant death and fatal heroin overdose, and spoken out publicly about problems such as alcoholism and handguns.
During his 10 years in the post, his office has handled about 40,000 deaths, and he said he has not had a single complaint from relatives or others.
Luke's expertise and dedication are applauded by associates inside and outside the office. But his style grates on some. He spits out his sentences in a rapid monotone that a listener must sometimes strain to catch, and he does not mince words.
According to one fellow pathologist, Luke's colleagues in the field "like Jim all right and respect him, but he's a little brusque. . . But he's got that fellow Blackbourne who is just a dear."
Luke acknowledged that he lets his extroverted deputy, Dr. Brian Blackbourne, handle many of the public relations tasks of the office. "There are people doing my job who would be much more flamboyant," he said. "I find it difficult myself. Brian doesn't, and that's a great relief to me."
Luke bemoans the public concept of the medical examiner's office as a "morgue," a word that makes him cringe. He believes the television show "Quincy" -- which he dubbed a disaster when he saw the first episode -- has done more good for forensic pathologists' image than anything they have written or said. Yet, he said, his specialty is ignored by medical schools, and medical examiners' offices are neglected as a research laboratory for learning about communities, because people prefer not to face the reality of death and its causes. It is a reality that he never is allowed to forget.
"Because of having to . . . deal with real-life situations that involve people who had no idea they were going to be killed, or die suddenly . . . you appreciate how fragile it all is," he said. "That makes you appreciate people, value your relationships, realize that time is short and the future is completely unpredictable. . . I'm a better person for knowing that."
Luke got through medical school at Case Western Reserve University without his professors he thought it would be a waste of time, and took an advanced course in anatomy instead.He trained in general pathology, then spent two years doing research at the National Institutes of Health. But it didn't satisfy him. "I woke up one morning about 3 o'Clock and wondered what to do with myself," he said.
At that point, he remembered he had been fascinated by a course in forensic pathology at case. He believes his interest stemmed partly from the fact that his father, a lieutenant colonel during World War II, died in a fire while stationed at the Pentagon. "I've never really understood why he died," he said. "I've never really come to terms with it. It must have something to do with why I went into this field."
He studied for two years in New York City under Dr. Milton Helpen, one of the most famous practitoners of thespecialty. Then he became the first medical examiner for the state of Oklahoma.
"It was me and a secretary and a budget of $100,000 for [a jurisdiction of] 2 1/2 million people," he said. "We had every problem known to man."
According to Sheriff Bill Porter of Oklahoma's Cleveland County, who worked with Luke on local homicide cases, those problems were aggravated by the unwillingness of local police to accept the changeover from the old coroner system to Luke's new one.
"Before he came . . . the sheriff or the deputy or the police would go out on the scene, and if they ruled it a suicide, the body was taken to the funeral home and that was the end of it," Porter recalled. He said Luke required them to wait at the scene of a suspicious death until he could get there to examine the body.
Porter recalled the time one sheriff found a pile of human bones that was eventually identified as the remains of a homicide victim. "The sheriff got all these bones and put'em in a box and didn't tag'em or anything," he said. When he brought the bones to the medical examiner's office, Luke told him, "This is the worst example of a homicide investigation I've ever seen."
Porter said the sheriff asked Luke who he was, then declared, "I've been sheriff 15 years, and I've never seen your name on my paycheck."
In Washington the problems were different, but the job was no easier. Under the system that he took over, Luke said, coroners maintained outside medical practices, and nobody on the staff was trained to do what he considered a complete, formal autopsy designed to provide evidence in court. Bodies were picked up in dilapidated vehicles and stored on worn-out trays with jagged edges. There was no equipment for X-raying corpses to locate bullets.
"If you want to call it a morgue, that was a morgue," said Rober M. Dix, chief technician at the medical examiner's office, who has worked there since 1961.
Although the number of autopsies done annually was slightly higher then than now, Dix said they were not done with the same thoroughness. He said an autopsy took an average of 30 minutes, as opposed to about two hours now. "If we found the cause of death in the body, a lot of times we wouldn't do an autopsy on the head. Or vice-versa," he said.
Dr. Richard Whelton, who was coroner until Luke arrived and who worked under Luke until 1973, said he had fought for many of the same changes Luke felt were necessary. He lobbied successfully for the 1971 law that replaced the coroner system with the medical examiner system, and pushed for better equipment and a new building.
Joseph M. O'Brien, who worked with both Whelton and Luke as a homicide detective between 1960 and 1977 -- including four years in charge of the homicide branch -- said that from the point of view of homicide investigation he saw no difference between the old and new regimes.
He said the chief improvement he notes is that Luke has better facilities than Whelton had. "Dr. Whelton, who was a pioneer . . . had to beg and borrow to have the same functions performed then that everybody does automatically today," he said.
But Otis Fickling, another detective who worked under both systems, said Luke and the doctors under him devoted more attention than their predecessors to investigating deaths, and to educating police about medical findings. "The system is just much better," he said.
Whelton maintained close relationships with detectives on the homicide squad and prosecutors from the U.S. attorney's office, and said he still serves as personal physician to many policemen and their families. O'Brien said he believed that camaraderie was an advantage, because detectives routinely observed autopsies on every case they investigated.
But Luke feared the close ties with police meant the office was not always viewed as impartial in homicide cases. When he learned a few months after his arrival that attorneys at the public defenders' office routinely hired an outside patholigist to interpret autopsy reports rather than talking to the medical examiners, he wrote to declare his willingness to cooperate with them.
"Jim has always taken the position . . . that they are scientists with scientific information to impart," said Truman A. Morrison, an associate judge of the D.C. Superior Court and former head of the trial division of the public defenders' office. "Tha, in my view, aids the cause of justice. There is a tremendous tendency in other jurisdictions . . . [for] coroners to see themselves as arms of law enforcement and to refuse to speak to defense council."
When Luke arrived on the job in July 1971, he was promised a deputy, a new building and additional technicians. In November, he wrote to the deputy mayor complaining that none of the funds had been provided and that his budget for supplies and equipment had run out with seven months of the fiscal year still ahead. He said he worked seven-day weeks that first year, taking only four days' vacation. Nevertheless, it took several years more to get what he had been promised.
He said he had expected his administrative duties to dwindle in time, allowing him to do more pathology, but instead they have grown.
Since the Department of Human Services' budget cuts last fall, the medical examiner's office has had only two technicians on duty to pick up bodies after 4 p.m. Out of 37 full-time staff positions, seven have been vacant for months, and Luke has been unable to hire applicants because the city administrator's office would not release budgeted funds. The staff shortage at times causes delays in picking up bodies.He said he was told last month that the money would be released.
Luke describes his job as similar to that of Sisyphus, a king of Corinth in Greek mythology whose eternal damnation was to repeatedly roll a boulder up a hill, only to watch it roll down again.
Although Luke is proud of what he has accomplished, once in a while he thinks about leaving bureaucracy behind and going back to research or taking a teaching job. But he said he would never quit to become medical examiner somewhere else.
"I think this is the best place in the country," he said. "I wouldn't want to roll the boulder uphill in some other place."