NOT EVERY city has a good medical examiner. These are the physicians who conduct autopsies and determine the cause of death--a critically important job in public health and law enforcement, but not one that appeals to the average practitioner, to say nothing of the layman.

In Los Angeles, one controversial physician, dubbed "coroner to the stars," has been in occasional trouble for his public pronouncements on the vital secrets of his glamorous, though departed, clientele. In New York, a medical examiner ruled that a health club manager found slumped over a table in his apartment had succumbed because a piece of meat was lodged in his throat. Further examination revealed that a small-caliber bullet had been fired through his ear into his brain. And in New Jersey, one medical examiner was accused of incompetence after he concluded that a 28-year-old man had died of pneumonia when, in fact, he had been shot in the head four times. "It is irrational and inexcusable neglect," said the county prosecutor with judicious understatement, "to confuse pneumonia with four slugs in the head."

In contrast to the slipshod work and taste for sensationalism characteristic of some forensic physicians, there is the career of Dr. James L. Luke, who until recently served as medical examiner in the District of Columbia. Not only did he perform his job with skill and discretion, he brought to the task a humane concern for the victims of crime who were his "patients." Dr. Luke characterized himself as "the last official spokesman for the dead," and his office filled this role in 4,000 cases of suicides, homicides, accidental and unexplained deaths each year.

When Dr. Luke came to Washington in 1971 to become the city's first medical examiner, he found a run-down morgue staffed by non-specialists. Because of inadequate facilities, autopsies were often performed in the back yard. Now the office has a well-trained staff of physicians, modern facilities and a national reputation for excellence. It is also a research facility that has produced studies on sickle cell anemia, sudden infant death syndrome, traffic fatalities and drug overdose. Dr. Luke has been a major force in achieving this excellence, and he will be sorely missed.