Not the actual surgeon
Charges Against Doctor Bring Ire and Questions
By ISABEL WILKERSON
December 11, 1988
Relief, shame and anger were being expressed today in this central Ohio city where for 22 years Dr. James C. Burt performed what experts say was crude experimentation on hundreds of women without their consent.
This week the Ohio State Medical Board formally charged Dr. Burt with ''gross immorality'' and ''grossly unprofessional conduct'' in surgery he performed to restructure his patients' genitals, procedures that the board said often caused permanent physical damage. Dr. Burt, 67 years old, who is still practicing out of his office here, has 30 days to request a hearing, which could be scheduled as early as next month.
The doctor, who detailed some of his procedures in a 1975 book, did not return repeated phone calls to his office this week. But he has said in recent months that he was confident of vindication.
Concern About Other Doctors
In Dayton, many people are relieved that charges have been brought against Dr. Burt by the medical board. But heartbroken patients here and incredulous physicians elsewhere are trying to figure out why it took so long for his practices to attract the scrutiny of medical investigators and wonder whether other doctors are trying out unproven techniques on their patients.
Janet Phillips went to Dr. Burt with complaints of cramps six years ago and was one of hundreds of patients who ended up with her anatomy changed. ''You're raised to trust your minister, your policeman and your doctor,'' she said. ''He was the one with the degree on the wall. He knew medicine better than I did. I didn't think he would hurt me.''
In all of the soul-searching and finger pointing, the state medical board is now looking into the role and responsibility of his colleagues who, board officials say, silently watched as many of Dr. Burt's patients suffered permanent physical damage.
''There is a great deal of concern about the breakdown in the reporting system,'' said Lauren Lubow, an attorney and spokesman for the board. ''The doctors in the Dayton medical community are under investigation for what they knew.''
Some doctors say they repeatedly told medical board investigators about Dr. Burt but say the board did not take action until Gov. Richard F. Celeste wrote it about the case. The board has said that the physicians did not submit written complaints against Dr. Burt and that their reluctance slowed the investigation.
Physicians across the country said they were astonished and outraged that Dr. Burt had operated outside recognized standards for so long. ''It's a disgrace to all of medicine,'' said Dr. Sidney M. Wolfe, an internist who is director of the Public Citizens' Health Research Group, a consumer advocacy group in Washington. ''His procedures were several standard deviations from what is acceptable. And only now are people who should have spoken up 20 years ago slowly, timidly coming out of the closet.'' Surgery Prohibited
The procedure has not been performed since January 1987. Last month, the board prohibited Dr. Burt from surgery pending its investigation, but it has not revoked his license.
Dr. Burt, once a well-regarded physician, considered merely eccentric, began the special surgery in 1966. Explaining his philosophy in his 1975 book, ''Surgery of Love,'' Dr. Burt wrote: ''Women are structurally inadequate for intercourse. This is a pathological condition amenable to surgery.'' In franker terms, he also said that his surgery would turn women into ''horny little mice'' and asserted that ''the difference between rape and rapture is salesmanship.''
In the book, Dr. Burt admitted to performing reconstructive surgery on ''many hundreds'' of women without their consent, usually after the birth of a child. ''The patient,'' he wrote, ''had not been informed that anything more had been done to her than delivery and episiotomy and repair, or ''Yes, you had stitches with your delivery.' ''
The surgery often included removing the hood of a patient's clitoris, repositioning the vagina, moving the urethra, and altering the walls between the rectum and vagina. It was intended, the doctor wrote, to redesign the vagina to increase sexual responsiveness.
Instead, the surgery caused sexual dysfunction, extensive scarring, chronic infections of the kidney, bladder and vagina and the need for corrective surgery in many patients, according to the Ohio medical board. Although some of the patients have expressed satisfaction with their surgery, at least one patient suffered phlebitis, blood clots and a heart attack, the board said, and several have permanent disabilities.
The procedure is not recognized by the American College of Obstetricians and Gynecologists, the standard-setting organization for gynecology, nor taught in American medical schools.
Gynecologists have told one former patient, Cheryl Sexton, that corrective surgery will require four specialists and cost $25,000. 'Dissatisfied Women'
Dr. Burt told The Dayton Daily News on Nov. 20 that the criticisms came from ''dissatisfied women who may have had complications, who may be lying, who may have had positive feelings turn negative when forced to pay the bill and women who stand to make a lot of money from the lies.''
Dr. Burt began his medical career in 1945 when he graduated from the University of Rochester Medical School. He is neither a fellow of the American College of Obstretricians and Gynecologists nor certified by the American Board of Obstetrics and Gynecology.
Mrs. Phillips was one of the many women who went to Dr. Burt for a relatively minor physical problem. She was told she needed a hysterectomy because her Fallopian tubes were ''rotting.'' Now, she suffers chronic infections, extreme difficulty urinating and excruciating pain if she attempts intercourse. The strain eventually destroyed her marriage, she said.
Seven hours of surgery completely changed her life. ''I feel like a freak,'' Mrs. Phillips said. ''I can't date. I can't ride horses. I can't urinate like normal women.'' She characterized the surgery as a form of sexual abuse and said, ''He stole parts of my body.''
Gynecologists knew about Dr. Burt's surgery and recognized it when they examined his former patients. ''Doctors would say, 'Dr. Burt's done surgery on you, hasn't he?' '' said Joy Martin, on whom he performed his surgery after delivering her son in 1974. She recently had corrective surgery. Mrs. Phillips and Mrs. Sexton have filed lawsuits, seeking $6 million, against Dr. Burt and St. Elizabeth's Hospital, where he performed most of his surgeries. Thirty-five other former patients are expected to sue in the next few weeks, said Lee Sambol, the lawyer for the women. Ten malpractice suits against Dr. Burt over the past 12 years were dropped after other physicians refused to testify.
''We've all had Dr. Burt's patients, and we've tried to undo the work he has done,'' said Dr. Robert Hilty, a gynecologist who was chairman of the Department of Obstetrics and Gynecology at Kettering Medical Center in Dayton for 18 years. ''But we need the freedom to openly criticize without fear of legal retribution.''
Some doctors also point to the patients, who they say did not question Dr. Burt enough or consult other doctors, and to St. Elizabeth.
The hospital, which does not permit elective abortions, allowed Dr. Burt's ''love surgery'' to be performed for 12 years before it began requiring special consent forms that, it says, left the responsibility to the patients and the physician. A spokeswoman declined to comment further while the case is under investigation.
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