An Unquiet Death: The last days of Jerome Lackner

Jerome Lackner lashed out at his caregivers, punching and throwing objects.

He was 83, agitated and depressed. But he resisted the flow of morphine intended to ease his passage into death.

“I do not have any pain, go away, get out of here,” he barked at a nurse when asked if he needed more painkillers.

It was the summer of 2010, and Jerome, once the maverick leader of California’s Department of Health, was languishing in hospice in his Davis home. His primary caregivers: his second wife, Rebecca, then 72, from whom he was legally separated; and Joseph Poirier, a 51-year-old recovering addict who, friends and family would claim later, was having a clandestine affair with Rebecca.

In the final days of Jerome’s life, hospice records show, doctors would prescribe multiple vials of morphine. Joseph mixed drops of the bitter drug into Jerome’s beverages to get him under control. To help him die calmly.

Jerome Lackner lived a big life, fueled by relentless idealism. He served as personal doctor to Cesar Chavez, and as a member of Martin Luther King Jr.’s medical staff. Trained in both medicine and law, he took to the streets and Capitol hearing rooms to fight for the downtrodden and mentally ill.

His ethos was individual redemption, his bible the “Big Book” of Alcoholics Anonymous, a tool in battles to save countless addicts. But in his fight against the indignities of old age, Jerome succumbed – some would say to human frailties; others to malign conspiracy, compounded by exceptionally bad luck.

On July 9, 2010, Jerome took his last ragged breaths. The coroner’s pathologist blamed heart disease, with morphine toxicity as a secondary cause.

His daughters suspected darker forces at work, and within weeks Davis police launched a murder investigation.

This is the story of Jerome Lackner’s achievements and misfortunes, and how his painful demise tested the judgment of a DA and coroner, divided a family and forever etched the lives of those who knew him best.

Heal the world

When Jerome was a child, his father, a San Jose doctor, took him on house calls. Silicon Valley was farmland, and patients sometimes paid in vegetables.

Jerome was steeped in a culture of learning. After nearly completing a Ph.D. in cultural anthropology, he shifted to medicine. In 1960, he began practicing in San Jose after his father’s model. Jerome treated the indigent, the disenfranchised and the elderly, often without charge. He also moved on larger ambitions.

“My very first recollection of his involvement in social action issues was during the (1965) march from Selma to Montgomery,” said his daughter, Johanna Lackner, herself a social worker and educator. Her father worked as a doctor for King and the marchers.

“We knew that he had gone somewhere to do something great,” she said, “and that it was potentially dangerous.” He promised to work “in the safety spot.” But they worried. He rarely played anything safe.

Soon after, Jerome began to work at a free clinic in Delano, a Central Valley hub for farmworker organizing. He volunteered on weekends, tending to strikers and their families, making house calls.

“I called to see a sick baby, and I asked the parents to turn on the light in the bedroom so I might see the ailing tyke, only to find that the only functioning light bulb in the entire house was hung from a wire in the kitchen,” he recalled in John Gregory Dunne’s farmworker history, “Delano.” “I was embarrassed by my faux pas and wondered if they were disturbed by my matter-of-factly affluent assumption that every room would have a light bulb.”

Jerome had five children with his first wife, Yetta Lippman. They instilled in their children an ancient Jewish duty about social justice, tikkun olam or heal the world. They never visited Disneyland, Johanna said. “Our vacation was going to Delano – to strike, to picket along with the farmworkers.”

In 1966, they joined Chavez and his legions on the famous 300-mile march from Delano to Sacramento to bolster the grape boycott. A treasured family photo shows Yetta and the five siblings holding hands, standing in order of their size. “Like stepping stones,” Johanna said.

In 1968, in the midst of the grape boycott and strike, Chavez was hospitalized with weakness, according to “Cesar 1968,” a manuscript by documentarian LeRoy Chatfield. One night, a woman called for Chavez’s room number, claiming to represent a doctor assigned to examine him. The operator complied, but with King’s assassination painfully fresh, grew concerned. The operator called Jerome, by then Chavez’s personal physician.

He quickly moved Chavez to another floor and arranged for a police guard. Jerome stayed at his side, monitoring, testing and pleading with his patient to eat, to save his life.

During a 1972 fast, Jerome was asked how long Chavez could continue. He answered as doctor and friend, in comments to a farmworker newspaper: “To look at his cardiograms today and yesterday … brings tears to my eyes.”

Rising to the top

In 1975, Jerome caught the eye of Jerry Brown, full of youthful, first-term charisma, disdainful of conventionality.

Brown’s early appointments included beat-era poet Gary Snyder, and Rose Bird – a brilliant attorney without judicial experience – as chief justice of the Supreme Court. He picked Jerome to direct the Department of Health, despite his lack of executive know-how.

Iconoclastic, uncompromising and idiosyncratic, Jerome wore huelga (strike, in Spanish) and peace-symbol buttons. He sported a handlebar mustache rivaling, for bushy majesty, that of Mexican revolutionary Emiliano Zapata. “We made him an honorary Mexican for that mustache,” said Don Gomez, a longtime friend and retired network TV reporter.

Don said Jerome’s appointment appealed to two key constituencies: “do-gooder liberals” and immigrants. “He had a heart of gold and was beloved in the Latino community.”

Jerome promptly got into political trouble with his proposal to decriminalize heroin use, based on the concern that its therapeutic replacement, methadone, was even more addictive. The stance provoked a drumbeat of doubts about his judgment.

But like his patron, Jerome refused to be pigeonholed as a left-winger. He angered feminists by opposing abortion, suggesting that mothers stay home with young children, and by withholding funds for sterilization services. He called it “genocide” for some minority communities.

Jerome fought Medi-Cal fraud, but mismanagement on his watch led to federal and state audits, and attacks from legislators and union leaders.

Better treatment of the mentally ill in crumbling state hospitals became his crusade. The documentary film “Hurry Tomorrow” showed forced drugging and abuse of patients. Activists and former patients used it as an organizing tool. They occupied Brown’s outer office, where Jerome heard their grievances.

He became an interpreter between power and protest. Jerome and Yetta invited the activists to their home for discussion over Yetta’s soybean marinara spaghetti; the Lackners had been vegetarian for years. The governor finally arrived after midnight – in the first hours of the national bicentennial, July 4, 1976.

Jerome screened the film for Brown, with the Lackner family and activists filling the spacious great room. “Can we do this to our citizens?” the governor asked afterward, according to “Hurry Tomorrow” filmmaker Richard Cohen. Kneeling on the floor near the governor, Jerome responded with concern about the excesses of the system.

Zelda Lackner, Jerome’s youngest child, was 13 at the time. “Watching the film, the governor in our home, watching my dad do what only he could – all very powerful,” she said recently.

Brown pledged to investigate. Jerome’s subsequent report prompted reforms – a step toward eventual closure of most of the state hospitals. Yetta said that ironically, Jerome opposed that move, worried that cast-out patients would become homeless.

His concerns proved prophetic. But Jerome faced attacks for lapses in the hospitals that caused deaths and the loss of grant funds. It didn’t help his job security when Jerome bluntly criticized his boss’s signature “era of limits.”

“When Jerry Brown talks about lowering expectations,” he told The American Prospect magazine, “he’s really talking about lowering expectations for the poor, the mentally ill, and the disabled.”

Brown removed him from office in 1978.

Back to his roots

After he left government, Jerome opened a private practice a stone’s throw from Sutter’s Fort in midtown Sacramento, offering medical care to those who could least afford it. He worked late nights and weekends, often treating patients without charge if they lacked insurance.

One patient, Esther Busby, an elderly, fragile woman, suffered baffling ailments. She was a frequent visitor to Sutter General Hospital’s emergency department.

On a house call in early 1980, Jerome met Busby’s live-in caregiver, Dorothea Puente, and noticed something strange about her apparent vigilance. His suspicions peaked when she rushed Busby to UC Davis Medical Center – much farther from Busby’s home than Sutter, which would have called Jerome immediately.

Tests at the medical center confirmed that Busby had been poisoned with a heart drug and a powerful sedative – drugs Jerome had never prescribed, according to William P. Wood, author of a book about Puente. Jerome and a colleague also learned that Puente had solicited money from Busby’s relatives for a nonexistent cancer. They called Sacramento police, who said the evidence seemed thin. At Jerome’s urging, Busby fired Puente, but she was not arrested.

Years later, Jerome’s sleuthing proved tragically prescient. Puente, grandmotherly and diminutive, was found to have poisoned her elderly boarders, cashed their checks and buried them in her backyard. She was convicted as a serial killer.

Jerome continued to work the vulnerable fringes. He walked Sacramento’s back streets to get prostitutes on birth control and protect them against AIDS. No judgment, no charge. A boxing fan, he became a ringside medic. He invited homeless people for dinners out, oblivious to the stares of strangers.

“Son, the only way you can keep what you got is you gotta give it away. Always help that person who puts that hand out,” he told Trino Savala, a former boxing champ, recovering addict and ex-con whom he took under his wing.

Jerome came by his affinity for troubled souls honestly. In the late 1960s and early ’70s, he studied law at night while maintaining his practice during the day – a daunting challenge, despite his seemingly boundless energy. He began using methamphetamine, he would tell some AA colleagues later. Then he moved to painkillers.

“Doc was a stone drug addict,” though he concealed it well and functioned well, Don said. He called Jerome by the name most everyone in the recovery community used for him. “By the late ’70s … it was getting out of control. When Doc introduced himself at (AA) meetings, it was always, ‘Lackner, addict-alcoholic.’ He always said addict first,” Don said.

Most of those closest to Jerome, including his daughters, heard only vague allusions to his long-ago addiction and recovery.

Jerome channeled his personal struggle into another great passion: healing addicts. He added a clinical professorship at UC Davis School of Medicine to his workload in 1979, providing doctors-in-training with a blast of real life: home visits to alcoholics. Helping addicts anchored Jerome and became his tireless mission. He answered the phone, “Lackner here, 24/7.”

Amid that obsessive commitment, Jerome’s world shifted. He ran with a new crowd. Not the activists and professionals of his farmworker and government years. People who lived hard lives battling personal demons. Redemption became his core principle.

Jerome and Yetta separated in 1988, after he began an affair with Rebecca Steinke, a slight woman, 11 years his junior, known for persuasive determination and theatrical flair. Everyone called her Becky. After their divorce, Yetta eventually moved to Santa Cruz near their daughters; Jerome and Becky took up residence in the Lackner family home with its backyard pool on a peaceful, tree-lined Davis street.

The two became partners, in life, the AA community, and ultimately in marriage.

“I met my husband because I was a drunk. He saved me,” Becky said. His friends and patients spread their love to her.

“I never had anything but a fondness for Becky. She was ‘Mrs. Doc,’” Don said. “She wasn’t anybody’s Einstein. … But what the hell, she was Doc’s old lady. I’d give her all the respect in the world.”

Jerome, so successful as activist and health leader, proved less deft in melding his families, his old world and new.

Jerome’s grown children loved their mother and were protective of her interests, so the split was not easy for them. But they loved their father, as well, Zelda said, and respected his choice. When Jerome married Becky in September 1995, Zelda attended the reception, where a photo shows her and her father locked in a warm embrace.

“My dad seemed happy. And I believed that he was, and that he was well cared for and well loved. And that was all the mattered to me,” she said recently. “When I look back on that day, it was a very happy memory.”

Becky’s son Donald Steinke, a tree-service operator whom Jerome helped fight alcoholism, nonetheless saw tension. His mom – a party girl in her youth, charismatic survivor in later years – didn’t fit into Jerome’s old life of pedigreed professionals. Donald thought Jerome’s kids disliked his mother, and maintained they later would try to cut her out of Jerome’s estate for a key reason: She wasn’t Jewish.

Recently, Donald sat on his porch on the outskirts of Woodland, facing cropland and a prized muscle car he was rebuilding in the driveway.

“They were always better than. Snooty,” Donald said.

“They were all, ‘We just came from Jerusalem.’ And, I don’t know, like my mom wasn’t worthy. My mom was a good person for Dr. Lackner. She took good care of him.” He called Jerome’s daughters “evil.”

Doubts and decline

In 1997, at age 70, Jerome shuttered his practice. His penchant to give away care, and miserly insurance reimbursements for those who paid, forced his hand. He went to work for the state, as a doctor at Solano State Prison. His outside patients pooled modest resources to create a small nonprofit where Jerome continued to treat addiction, free of charge.

To relax, they took drives, Becky said. Jerome rode shotgun as she took the wheel, following weaving drunks. When the driver stopped, Jerome walked over. “I expect you to come to the Friday night meeting at Sutter General,” Becky recalled him saying. “They always came.”

Jerome’s “Gottawanna Group” at Sutter – where he led AA meetings for decades – still meets weekly. “Hey Doc. It’s been over eighteen years since you told the one thing I needed to hear most – ‘You’re going to be okay,’” wrote one of Jerome’s disciples in an online remembrance.

But as he advanced in age, a combination of physical ailments restricted his enterprises and reach. In 1998, he injured his leg during a fall at his prison job. Hip-replacement surgeries made things worse, hampering his mobility. He suffered chronic heart disease and amyloidosis, an ailment that can further weaken the heart. As he entered his 80s, he was easily fatigued and often in pain.

The caretaker role took a toll on Becky as well. The drives and pleasant dinners out became much less frequent. “He was very sick. I just couldn’t keep up,” she said.

Becky, who had taken over management of the family finances, said the cost of Jerome’s care made it hard to get by. Yetta’s alimony checks stopped arriving, and Jerome and Becky filed a court motion to end the spousal support.

Increasingly, Zelda said, she and her siblings were having difficulty getting in touch with their father. They believed Becky was a primary factor. In an email string from October 2009, Zelda and her sister Sara expressed frustration and concern at his failure to respond to repeated phone calls and emails. The daughters said they were getting snippets of information about him falling or needing intensive physical therapy, and were having trouble getting details about his whereabouts or condition.

Sara, a doctor who had been counseling Becky on Jerome’s care, said that following one call to check on her father’s well-being, Becky had accused her of interrogating him on behalf of Yetta and abruptly cut off contact.

“It seems to me that if Becky is not there, Dad is comfortable talking to me,” Zelda wrote her siblings. “If she is there … well, the last time Dad was on the phone with Becky there, he was very strange and stiff and handed her the phone. … Becky took the phone and promptly hung it up.”

She tried for days to reach him again, Zelda wrote, leaving multiple messages and emails. When he finally answered his phone, she said, he told her he had never gotten them.

“Because of Becky and her actions, it is becoming increasingly difficult to have a normal relationship with him, and that worries me,” Zelda wrote. “What is she doing? What is she hiding? Is she caring for him properly? …”

“I think it has come time to talk to someone else about how we can protect Dad.”

Charles Piller: 916-321-1113, @cpiller