Volume 16 Number 3, SPRING 1999

ROPIN’ DOC

Bert Johnson fits the profile

of the quintessential cowboy --

and the ideal physician.

How has this 1952 School of Medicine graduate come to weave

two such distinct career strands into one full life?

POSSIBLY MORE THAN A FEW DOCTORS HAVE SHOWN UP IN A STANFORD HOSPITAL OPERATING ROOM WEARING COWBOY BOOTS. But only one has performed surgery there sporting a ruby-studded, Black Hills gold-and-silver Salinas Rodeo belt buckle. Teaching professor Bert Johnson, MD, won his cherished prize last year in the over-50 team-roping contest. An additional bonus was a new license plate from his wife for his pickup truck. It describes the driver simply as "ROPNDOC."

Wearing a scrub cap (his other hat), Johnson has brought thousands of babies into the world. He launched the Los Olivos Women's Medical Center in San Jose, mentored hundreds of medical students and residents, pioneered techniques for the treatment of female urological conditions, and shared his clinical skills in far-flung locations. Founder of Stanford's Center for Pelvic Reconstructive Surgery and Urogynecology, he continues to make his mark on the medical school as a teaching professor. But Johnson has also kept one foot firmly in the world of ranching. In short, he's as comfortable roping a calf that needs doctoring as he is wielding a scalpel for a pelvic incision.

Gazing out over the roping arena on his 20-acre ranch in the South Los Gatos hills, clad in jeans, plaid shirt, Stetson hat, and boots, the tall, lanky Johnson easily fits the profile of the quintessential cowboy. His face bears the creases of an outdoorsman and his laugh comes easily. But the kindly look in his eyes evokes memories of your favorite family doctor. How did this 1952 School of Medicine graduate come to weave two such distinct career strands into one full life?

The roots stretch back to Johnson's childhood in the Central Valley. His mother and Canadian-born father raised Bert and his younger sister, Nancy, in Modesto. "We had a lot of sickness in our family when I was growing up, and the doctor was always big for me," he recalls. "I wanted to be a doctor from early on, and be my own man." But young Bert was also a wanna-be cowboy. He got his first taste of the ranching life at his favorite uncle's nearby dairy farm. Later, as a teen, he savored long days hunting, fishing, and learning his way around horses and cattle with his friend, Bill Lyons, on the 12,000-acre ranch owned by Bill's uncle.

Johnson bought his first horse, a mustang named Smoky, with $40 he received in worker's compensation when he was hit with a golf ball while working at a driving range. "I was horse-crazy. It's an incurable disease, and I've never gotten over it," he says. His sister, Nancy Gross, recalls that her brother "had an extraordinary way around horses and other animals."

Gross remembers him enthralling her and their cousins with his made-up tales of cattle drives in which they all were assigned imaginary roles. He also showed compassion for people early on, she says, bringing home from school -- during those Great Depression years -- kids who hadn't eaten a good square meal in a while.

In 1944 Johnson enlisted in the U.S. Navy Air Corps, and he was starting to fly planes when the war ended in 1946. Under the GI bill, he jumped at the chance to go to Stanford. Always athletic, he'd played basketball at Colorado College during military training, and he continued the sport as a substitute with the Stanford Indians.

He completed his bachelor's degree in 1947 and, following in the footsteps of his uncle, Don Threlfall, MD, he applied to Stanford medical school. To earn room and board he worked for Russell Lee, MD, rounding up horses on Lee's Borunda Farm (now a Palo Alto city park) along with fellow medical student and close friend, Bill Reeves, MD. Johnson got his start at the Salinas Rodeo when he and Reeves partnered up for the team-roping event. Of their life-long friendship Reeves says, "I can only pay him the biggest compliment one cowboy gives another: Bert would do to ride the river with."

Finishing up his clinical requirements at the old Stanford Lane Hospital in San Francisco, Johnson set his sights on becoming a small-town family doctor. A year into the University of Michigan's family medicine program, he narrowed his specialty to obstetrics and surgery and switched to Northwestern University to train under the well-known pelvic surgeon, George Gardner, MD.

"Being an intern was like being a slave. But it wasn't nearly as arduous as my residency in Chicago," Johnson recalls. The program included running the Chicago Maternity Center, a home midwifery service that delivered about 6,000 babies annually. For a year, Johnson and another resident supervised obstetrics training for students from Northwestern University Medical School, and the University of Wisconsin. "We'd give them a basic course and send them out. It was truly on-the-job training."

For a home delivery in that era, the family would be instructed to boil gallons of water and to have on hand a pile of newspapers a foot-and-a-half high. The medical students would bring only a few simple instruments and basic drugs and would call the resident on duty if they ran into problems. In emergencies Johnson even transported patients to the hospital in his old Ford sedan.

The grueling schedule generated some unique humorous moments. One night when Johnson had been up for two nights and then crashed out, he received a call from an intern in need of assistance with a hemorrhaging patient. "I told him, 'Open the gate and let the cows out of the back pasture,' and hung up on him," Johnson recounts with a laugh. The dismayed intern phoned back the center operator and exclaimed that either he'd reached the wrong guy, or the doctor was totally out of it. A nurse brought Johnson to his senses with coffee, and they went out to help.

At the end of his residency Johnson turned down an offer to stay on and teach at Northwestern and headed back to San Jose to work in the ob/gyn practice of Leon Fox, MD. In 1958, Johnson set up his own office. San Jose was growing fast and his patient load expanded rapidly. Fox and Johnson remained close colleagues. Fox ran the residency program at the Santa Clara County hospital, and Johnson served as the program's vice chairman. "The teaching staff was all volunteer," Johnson notes. "We had the best surgeons in town scrubbing with the residents." Johnson worked in the 1970s with Emmet Lamb, MD, from Stanford to broker the merger of the two institutions' ob/gyn residency programs. The marriage combined Stanford's top-rate academic resources with the county hospital's robust surgery and clinical programs.

In the early 1960s, his practice burgeoning, Johnson's new partner (who happened to be the son of a missionary) lured him on his first overseas medical expedition. Before leaving on the mission to Ethiopia, Johnson received a telegram requesting that he bring a dermatome, for performing skin grafts on children who had suffered burns from falling into campfires. He brought one, but then he couldn't clear it through customs in Addis Ababa without paying an exorbitant duty. So Johnson and the missionary doctor he'd come to assist devised a plan to smuggle in the instrument. At midnight they met at the fence at the airport's outskirts so Johnson could pass the precious dermatome over the fence to the doctor on the other side.

There were other adrenaline-filled moments in Ethiopia. One night as Johnson slept alone in his cabin, he awoke to a scratching at the screen and looked up to see a tall, fearsome warrior with a bone in his nose. Johnson recognized him as a member of the Arussi Galla tribe, which terrorized the region. "I thought I was done for," Johnson recalls. But the man had come for help for his child, who had a seriously obstructed bowel. Unfortunately, it turned out the boy was full of parasites, and Johnson was unable to save him.

In the mid-'60s Johnson spearheaded an effort to build a much-needed hospital on the west side of San Jose. When Good Samaritan Hospital was completed, Johnson became the first chief of obstetrics and gynecology. He and his partners relocated their practice, Los Olivos Women's Medical Clinic, closer to the hospital.

Johnson, who handled the business side of the clinic, sometimes exasperated his partners by taking compensation other than cash in exchange for medical care. "I traded horses, saddles, posthole digging, and even hay," Johnson recalls. "Once I took care of a woman in shock with an ectopic pregnancy. She and her husband had no money or insurance, so I never sent a bill. But he worked for a backhoe company, so to repay me he came out to the ranch with a backhoe and a crew and installed a huge culvert to fix some drainage problems. Problem was the whole bunch got poison oak, and I had six more patients!"

Johnson bought his 20 acres of brush-covered hills near Los Gatos in 1958 and over the years created a working ranch. When he met his wife, Gretchen, 23 years ago, he taught her to ride and rope, and soon had her turned into a full-time cowgirl. Together, they've managed three ranches. Their spacious, rambling house, embellished with tasteful Western-style art and furnishings, reflects a shared affinity for the ranching life. "It's been hands-on," Gretchen says. "We're down to 50 cow-calf pairs now, but we managed 250 pairs at one time, without any outside help." How does Gretchen see her husband? "He's a man who wears two hats, and wears both well," she says. "He has the full respect of his peers in the medical community, as well as the respect of the ranchers and cowboys he knows."

Characteristically, Johnson's involvement in ranching has extended to a larger community. He's chairman of the California Beef Council. And, in recent years he's shared his expertise and advice with the ranching industry, helping the industry respond to consumer concerns in the wake of the outbreak of bovine spongiform encephalopathy in Europe and the E. coli crisis at fast-food outlets.

In 1980 Johnson stopped doing obstetrics to focus exclusively on the emerging field of urogynecology. He boned up on the latest findings and techniques and began definitive testing of patients for incontinence, to better determine the appropriate course of care. To bring state-of-the-art urogynecology to the ob/gyn department at Stanford (where he had been a clinical professor since 1970), in 1994, Johnson started Stanford's Center for Pelvic Reconstructive Surgery and Urogynecology. He soon recruited Stanford graduate Bertha Chen, MD, as co-director.

Chen describes Johnson as "a Renaissance man. He's a venerable professor, a kind of walking history book of obstetrics. But he's also very contemporary and open to trying new things. As a teacher, he has a way of making surgery seem easy, interesting, fun and relaxed. As a colleague he's very nurturing and supportive," she adds.

Johnson's dedication to his patients has often made him a hero. Three years ago, bucked off by a rambunctious filly, he separated his pelvis. "He'd lost a lot of blood and we told him to just stay home and recuperate," Chen recalls. Less than two weeks later, he operated on a patient who was especially counting on him. "We sent the university presidential limousine to pick him up and bring him to the OR and he maneuvered himself into surgery in a wheelchair."

And Johnson remains dedicated to far-flung medical missions. Since 1989 Johnson has participated in more than a half-dozen medical teams that travel by bus to the remote mountain town of Nuevo Progresso in Guatemala. Chen and several other Stanford residents have accompanied Johnson to the Hospital de la Familia there. They set up a "MASH"-like operating arena and power through three weeks of nonstop surgery. Johnson typically performs up to 40 major procedures, treating uterine prolapses, large tumors, and bladder problems. On one visit, the team was packed up and ready to leave when a young woman they had expected sooner finally arrived after an arduous journey. She'd had a Caesarean delivery that had left a hole in her bladder causing urine to leak down her legs. "We unpacked everything and did the surgery," Johnson remembers. "Then she rode on the bus with us, holding her catheter, and we dropped her off close to her village. Happily, she's been dry ever since," he says with a laugh.

On another trip, Johnson brought Stanford resident Dennis Siegler, MD. Witnessing Siegler's remarkable progress while there prompted Johnson to lobby the Stanford Residency Review Committee to grant academic credit to residents who participate in the missions.

Siegler, now in private practice, has become a regular team leader for missions to Hospital de la Familia. He's "eternally grateful [to Johnson] for hooking me on working down there. It reminds you of why you got into medicine in the first place," he says. For Siegler, Johnson is "the single greatest mentor I've had in my career. He's a positive influence emotionally, academically, and clinically. He cares about the whole person." In 1994 the residents named Johnson "Outstanding Teacher of the Year."

Reflecting on his life and the dual careers of medicine and ranching, Johnson finds strong parallels. Many of his ranching friends share the same values that contribute to being a good physician, he says. "There's a reality to being outdoors and ranching that gives you common sense, honesty, and openness -- a real foundation to work from in medicine as well." Johnson draws on these values in advising Stanford residents. "I teach my residents to direct their energies toward the real focus of medicine, that of building an honest, open, and caring relationship with the patient. The bottom line is to take care of sick people." SMD