John Ronald Brown
Encyclopedia
John Ronald Brown was a United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

 surgeon who was convicted of second-degree murder after a patient died while Brown was practicing medicine without a license.

Early life

The son of a physician,

Dr. Brown was born in 1922. He did well in school, graduating from high school
High school
High school is a term used in parts of the English speaking world to describe institutions which provide all or part of secondary education. The term is often incorporated into the name of such institutions....

 by the age of 16. When drafted by the US Army during World War II
World War II
World War II, or the Second World War , was a global conflict lasting from 1939 to 1945, involving most of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis...

, he scored exceptionally highly on the Army General Classification Test
Army General Classification Test
The Army General Classification Test has a long history that runs parallel with research and means for attempting the assessment of intelligence or other abilities....

, with the result that the Army sent him to medical school.

Brown graduated from University of Utah
University of Utah
The University of Utah, also known as the U or the U of U, is a public, coeducational research university in Salt Lake City, Utah, United States. The university was established in 1850 as the University of Deseret by the General Assembly of the provisional State of Deseret, making it Utah's oldest...

 School of Medicine in 1947, and worked as a general practitioner
General practitioner
A general practitioner is a medical practitioner who treats acute and chronic illnesses and provides preventive care and health education for all ages and both sexes. They have particular skills in treating people with multiple health issues and comorbidities...

 for almost two decades. However, after almost losing a patient during a thyroidectomy
Thyroidectomy
A thyroidectomy is an operation that involves the surgical removal of all or part of the thyroid gland. Surgeons often perform a thyroidectomy when a patient has thyroid cancer or some other condition of the thyroid gland...

, he decided to undertake formal surgical training.

Despite excelling in the written aspects of certification for the American Board of Plastic Surgery
American Board of Plastic Surgery
The American Board of Plastic Surgery, Inc. was organized as a subsidiary of the American Board of Surgery in 1938. The American Board of Plastic Surgery, Inc. was given the status of a major specialty board in 1941...

, he failed the oral assessment (blaming his 'domineering' father).

Later medical career

By the early 1970s, Brown was carrying out sex reassignment surgery
Sex reassignment surgery
Sex reassignment surgery is a term for the surgical procedures by which a person's physical appearance and function of their existing sexual characteristics are altered to resemble...

 on transsexual patients at a small clinic he'd set up in San Francisco. Most of his patients were transsexual people who were too poor to afford the fees of reputable surgeons
. Others were former patients of the university based units at Stanford University
Stanford University
The Leland Stanford Junior University, commonly referred to as Stanford University or Stanford, is a private research university on an campus located near Palo Alto, California. It is situated in the northwestern Santa Clara Valley on the San Francisco Peninsula, approximately northwest of San...

 and Johns Hopkins Hospital
Johns Hopkins Hospital
The Johns Hopkins Hospital is the teaching hospital and biomedical research facility of Johns Hopkins University School of Medicine, located in Baltimore, Maryland . It was founded using money from a bequest by philanthropist Johns Hopkins...

 that offered transsexual treatment during the 1960s. Only a small minority of patients met their exceptionally strict criteria for sex reassignment surgery. The programme at Johns Hopkins, for example, only approved surgery for 24 out of the first 2000 people who approached them with the request for it. Brown, by contrast, freely admitted that he was willing to operate on anybody who would pay him.

In 1977, following the death of one patient and a law suit from another, Brown's medical license was revoked by the California Board of Medical Quality Assurance for "gross negligence, incompetence and practicing unprofessional medicine in a manner which involved moral turpitude". The charge of gross negligence was based on his practice of carrying out sex reassignment surgery in his office on an out-patient basis, rather than in a fully equipped surgical theatre. He was also charged with allowing patients to work as unqualified, medical assistants (allegedly as barter for their own subsequent surgery), failing to hospitalize a patient who had developed a life-threatening infection and making false claims on medical insurance forms. Brown continued to practice medicine outside of California, but was successively barred from practicing in Hawaii
Hawaii
Hawaii is the newest of the 50 U.S. states , and is the only U.S. state made up entirely of islands. It is the northernmost island group in Polynesia, occupying most of an archipelago in the central Pacific Ocean, southwest of the continental United States, southeast of Japan, and northeast of...

, Alaska
Alaska
Alaska is the largest state in the United States by area. It is situated in the northwest extremity of the North American continent, with Canada to the east, the Arctic Ocean to the north, and the Pacific Ocean to the west and south, with Russia further west across the Bering Strait...

 and the island of Saint Lucia
Saint Lucia
Saint Lucia is an island country in the eastern Caribbean Sea on the boundary with the Atlantic Ocean. Part of the Lesser Antilles, it is located north/northeast of the island of Saint Vincent, northwest of Barbados and south of Martinique. It covers a land area of 620 km2 and has an...


.

During the 1980s Brown began soliciting and advertising surgical services in the USA. whilst performing the surgical procedures in Mexico. In 1986, an article in the magazine Forum reported on his procedure for surgically increasing penis length. The Forum article and an Inside Edition
Inside Edition
Inside Edition is a thirty-minute American television syndicated news program, first aired on CBS on October 9, 1988. It was originally similar to the programs Hard Copy and A Current Affair, but now more closely resembles a condensed version of breakfast television, exclusively with pre-recorded...

 television documentary made several years later ("The Worst Doctor in America") both portrayed Brown as an incompetent and inept surgeon. While some of his patients were satisfied with their surgical results and praised Brown,
he gained an overall poor reputation and the nickname "Butcher Brown" amongst the transsexual community. Despite this, desperate individuals continued to seek him out.

In 1990, Brown spent 19 months in prison for practicing medicine without a license. The charge came after Brown operated on a thirty-year-old male-to-female transsexual from Orange County, California
Orange County, California
Orange County is a county in the U.S. state of California. Its county seat is Santa Ana. As of the 2010 census, its population was 3,010,232, up from 2,846,293 at the 2000 census, making it the third most populous county in California, behind Los Angeles County and San Diego County...


. After leaving prison, Brown worked as a taxi driver for a year before re-establishing himself in medical practice.

Murder conviction

On May 9, 1998, Brown performed a leg amputation
Amputation
Amputation is the removal of a body extremity by trauma, prolonged constriction, or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on individuals as a preventative surgery for...

 on Philip Bondy, a 79-year-old, retired satellite engineer from New York, in Tijuana, Mexico. Bondy was one of the rare individuals suffering from Body integrity identity disorder
Body integrity identity disorder
Body Integrity Identity Disorder , formerly known as Amputee Identity Disorder, is a psychological disorder wherein sufferers feel they would be happier living as an amputee...

 – a desire to have a healthy limb amputated. Very few reputable surgeons are willing to treat this disorder by carrying out such an amputation.

A short time afterwards, Bondy was found dead, in a National City, California
National City, California
National City is a city in San Diego County, California. The population was 58,582 at the 2010 census, up from 54,260 at the 2000 census. National City is the second oldest city in San Diego County and has a historic past.-History:...

 hotel room, by a friend – another BIID sufferer who had traveled with him to Mexico, but had backed out of having surgery with Brown at the last moment. An autopsy showed Bondy had died of gas gangrene
Gas gangrene
Gas gangrene is a bacterial infection that produces gas tissues in gangrene. It is a deadly form of gangrene usually caused by Clostridium perfringens bacteria. It is a medical emergency....

. A police search of Brown's home – a ground floor unit in a San Ysidro
San Ysidro, San Diego, California
San Ysidro is a community in the southern section of San Diego. It is located in the southernmost part of San Diego County, immediately north of the U.S.-Mexico border. It neighbors Otay Mesa West to the north, Otay Mesa to the east, and Nestor and the Tijuana River Valley to the west...

 apartment building – revealed blood-soaked towels, sheets and mattresses, as well as anaesthetizing drugs. Police also discovered video tapes of Brown's operations.

Brown was prosecuted in California for second-degree murder
Murder
Murder is the unlawful killing, with malice aforethought, of another human being, and generally this state of mind distinguishes murder from other forms of unlawful homicide...

 – an unusually severe charge in medical cases. A surgeon, who was a witness for the prosecution, testified that Brown had not left a large enough skin flap to properly cover the bone and stump. The flap was stretched too tightly to allow adequate blood flow and the tissue in the flap died, allowing an infection of Clostridium perfringens
Clostridium perfringens
Clostridium perfringens is a Gram-positive, rod-shaped, anaerobic, spore-forming bacterium of the genus Clostridium. C. perfringens is ever present in nature and can be found as a normal component of decaying vegetation, marine sediment, the intestinal tract of humans and other vertebrates,...

 and producing gangrene. To make the murder charges stick, the prosecution had to establish that Brown had a history of incompetence and recklessness. A number of transsexual women gave testimony of their experiences of Brown's treatment and subsequent medical history. However, he continued to have some supporters amongst former patients, even after his arrest.

Brown was convicted by unanimous decision and sentenced to fifteen years to life in prison.

Illness and death

By spring 2010, John Ronald Brown's health had deteriorated greatly and he came down with numerous health problems, including a severe bout of pneumonia. Treatment for his pneumonia eventually proved useless, his body eventually rejecting antibiotic
Antibiotic
An antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...

medication. While arrangements to move Brown to a rest home in San Diego were being made, he died on the evening of 16 May 2010 at 10:40 pm local time, two months shy of his 88th birthday.
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