Nobody's Perfect

Dr. Harry Johnson was flying down the freeway that autumn morning in 1993--his 59th birthday--headed for his lakeshore hideaway with a half-hour to go before Duluth and a truckload of deck furniture, a few bottles of wine, and two valises stuffed with tax papers, when he caught sight in the rearview of the thin trail of black smoke coming from the back of his Chevy Suburban.

Johnson is a cosmetic surgeon, so he's used to noticing the details other men miss. Take actresses on the big screen: He can practically trace the outline of their implants under their blouses. And TV news anchors: The telltale symmetry in their altered features doesn't fool him. Models hawking exercise gear on late-night infomercials he finds himself watching when he can't sleep? Another man might be swayed by their pitch, but Johnson recognizes in their figures the work of a colleague who sculpted away fat with a liposuction hose. He knows the angles, and he sees what's hidden. That only made the business of his truck more troubling.

The smoke, as Johnson veered off the highway, seemed to him some kind of sign--a distress signal, maybe, or an omen. He got out, ran away from the truck, and then turned back, thinking to retrieve at least the tax papers before the vehicle blew. But the Suburban was history. In its place smoldered a pile of plastic dashboard and metal chassis and glass--dissolving in flames that were meant, Johnson is convinced, to kill him.

For 30 years Harry Johnson has plied his trade, cutting, stitching, and reconfiguring the faces and bodies of the Twin Cities' high society. Along the way, he climbed into the upper crust himself, counting among his Wayzata neighbors real estate tycoon Ralph Burnet and Twins owner Carl Pohlad. In the prime of his career, Johnson was a self-made millionaire 50 times over, with ownership in several downtown office buildings. Jaguar, Mercedes Benz SLC, Porsche...why choose? But the man who stood on the roadside and watched his Chevy melt was under siege, and he added the event to a growing list of discomfiting episodes.

There were the lawsuits: They'd come frequently in the past decade, and though he'd been able to fend them off at first, some had begun to stick. There were the millions he owed in back taxes, and his recent bankruptcy. His ex-wife was still dragging him through the courts and had filed for a restraining order. TV news reporters were sniffing around his office asking pesky questions, preparing a damaging report that would air later that year.

As menacing as these matters were, for Harry Johnson they paled in comparison to his exploding truck. The insurance investigator never could zero in on the cause of the fire that totaled it. The ensuing five years have brought other disturbing incidents as well: several break-ins at his Edina office and a rash of stickers bearing a skull and crossbones with his name printed beneath slapped up around town. To Johnson's mind the chain of distressing events since that autumn morning on the highway adds up to one thing: Somebody is out to get him. At this, the cosmetic surgeon narrows his sharp blue eyes, sinks his chin a little deeper into his wrinkled jowls, lowers his voice, and slips into a bitter reverie. "I don't know if you ever saw the movie Dirty Harry..."

Flashback three years: January 26, 1990. John Paulos, then age 32, is driving through South Minneapolis when a Honda buzzes up on his left side. The driver spots a car parked in his lane and muscles the wheel, swerving to clip Paulos's rear bumper. Paulos keeps an eye on the Honda as it weaves erratically through traffic. A block later, at a stoplight, the driver cuts Paulos off, causing him to bump the guy's back end. The man jumps out of the Honda, stalks toward Paulos's car: "What the fuck you hit me for?" Paulos opens his mouth to answer and, in a freeze-frame instant, a baseball bat smashes his face. Out of the blinding pain, Paulos makes out the silhouette of two, maybe three more men coming at him from the Honda. He floors the pedal and swerves into traffic, blood soaking his shirt.

Until that moment, John Paulos had fancied himself a rising star. Though his job consisted of a part-time position in a parking garage, he hoped the modeling work he was doing for magazines would eventually turn into a career. He'd been gifted with good looks since birth--thick, dark hair, a well-proportioned face with a full lower lip, and an aquiline nose, now mutilated.

To some, the injury might simply have meant a crooked nose for life. Not for an aspiring model like Paulos. A month after the incident, he scheduled an appointment with Harry Johnson. Paulos had in mind a round of surgery to rebuild his nose and restore his good looks. Strictly outpatient--a few weeks of healing and he'd be back in front of the camera again, selling his looks.  

Johnson remembers Paulos because he was the last male model he operated on without reservation. "We are very suspicious of male models, especially those that bring their portfolio with them," explains the doctor, adding that men are more prone to fixations when it comes to their looks. In his line of work he's always on guard against clients whose obsessions with their features might warp into obsessions with their surgeon.

That, however, didn't seem to be the case with John Paulos. He brought his police report to the consultation. He wasn't obsessed; he was injured. Johnson would do the surgery--a cinch, one of a dozen operations that week. "His was no different," the cosmetic surgeon recalls, "no challenge."

On March 30, 1990, doctor and patient came face to face in the operating room. Johnson cut thin slices of cartilage from the inside of Paulos's nose, slid the chunks out of each nostril, and dropped the gristle into a stainless-steel tray. The procedure was over in two, maybe three hours. They didn't know this, but from that encounter forward hardly a day would pass without each man thinking of the other.

Paulos faults Johnson's performance in the operating room for his chronic nosebleeds, rashes, bouts of panic, insomnia, and depression in the eight years since the surgery. Bringing the cosmetic surgeon to justice has become his principal occupation: When he couldn't find a lawyer willing to press his case, Paulos learned the law himself, taking two cases before the state court of appeals without counsel. And like Johnson, he nurtures an obsession with the shadowy edges of his own story. Nights when he can't sleep, Paulos likes to turn his mind to the secret tapes he made of phone conversations with Johnson's receptionist--recordings he regards as evidence of the doctor's campaign of transgressions against him. According to a police report Paulos filed in November 1992, someone broke into his apartment and rifled through the tapes. "Victim thinks his ex-doctor, Harry A. Johnson, may have something to do with it because the victim has some incriminating evidence against him," the investigating officer noted.

When Harry Alvin Johnson, Jr. looks back on his 30-year career in cosmetic surgery, he likes to draw a direct line of descent from his father, Harry Alvin Johnson, Sr., a family doctor who practiced in the same Edina neighborhoods his son does. From an early age, it was understood that Harry Sr.'s only son would follow in his father's footsteps. "When I was 10 or 12 years old," Harry Jr. remembers, "he used to show me films of goiter operations."

When he obtained his provisional driver's license, Johnson was pressed into service chauffeuring his father on house calls. Making rounds at the local hospitals, he'd be introduced to the other physicians by his dad as an up-and-comer in his little white lab coat. In 1965, after Johnson completed his studies at Loyola University's Stritch School of Medicine in Chicago, one of Harry Sr.'s friends who practiced cosmetic surgery arranged a residency focused on fixing cleft palates at Christ Hospital in Cincinnati. Following the two-year stint, he returned to the Twin Cities and went into practice.

At that time there were at most five reconstructive surgeons in Minneapolis and a couple in St. Paul, Johnson says. "The community was really quite filled with general surgeons, so there were also some economic reasons to get involved with a specialty that was known to be vacant."

Thirty years ago, plastic surgeons found the bulk of their practice among accident victims. Along the two-lane highways surrounding the Cities, automobile safety standards were loose, collisions frequent. "Every Friday and Saturday night, I could always count on a couple of cases between midnight and 8 or 10 in the morning," Johnson recalls. Another supply of patients streamed in from the snowmobile tracks just outside the city limits. Johnson remembers them, horribly mutilated by the razor wire strung up across the farm country.

He spent most of his waking hours at the hospital in lieu of a social life. During those early years, Johnson says, he was working his way from the midnight car wrecks toward a career based entirely on elective surgery. Among the handful of surgeons in town, only a few performed a furtive face-lift here and there on the side. Right up through the 1960s, elective cosmetic surgery was a rare and, at least in the public mind, secretive venture--"closet surgery," as Johnson puts it--and he made it his mission to change that, circulating word among his colleagues that he would welcome cosmetic-surgery patients to his office. Over the course of a decade, he built up a caseload of breast implants, face-lifts, and nose jobs among the barbed-wire and windshield operations. By the mid-1980s, he'd nearly weaned his business off accident damage and congenital deformities, and when he moved his office to Edina in 1989, elective operations made up the meat of his practice. "I liked the art form involved with cosmetic surgery," he explains.  

Presumably, he also enjoyed the rewards. Patients pay for their alterations up front, and prices run as high as the market will bear. In 1996 the average face-lift in the U.S. cost nearly $4,000 (Johnson has charged $6,000 for the same procedure), and a tummy tuck about $3,500, according to statistics gathered by the American Academy of Cosmetic Surgery. At the peak of his practice, Harry Johnson performed some 15 operations each week, making him a wealthy man in short order. Annual profits from his practice reached $700,000 by 1990. He plowed his earnings into businesses, investments, and real estate. The year before John Paulos walked into his office, Harry Johnson, Jr., cosmetic surgeon, was the envy of his local colleagues, known by reputation among a clientele able to afford his services, and worth nearly $60 million.

The pursuit of physical perfection can lead to strange places. Down through the ages, people have been willing to exchange suffering for beauty (or some approximation of it)--foot binding, female and male circumcision, ritual scars, tattoos, corsets. Today's cosmetic surgery brings the age-old quest into the offices of modern medicine.

But if the basic procedures resemble other minor surgeries--sterilized instruments, anesthesia, scrubs, sheets, a mask--the similarities end there. "Usually in medicine, doctors say, 'I can go ahead and expose you to risks because there's a medical benefit,'" explains Margaret Little, a senior research scholar at Georgetown University's Kennedy Institute of Ethics who studies cosmetic surgery. And it's easy to argue that a child born with a deformity or an adult injured in a car accident enjoys advantages from plastic surgery. A woman desiring the illusion of youth or a model wanting the camera to smile on him are another story. "Cosmetic surgery imposes medical risks with no medical gains in those cases," Little argues.

Cosmetic surgeons are quick to point out the psychological benefits of their work. If a woman is depressed because she looks old, a face-lift might relieve her despondency. The alternative, of course, might be to examine why she's upset about aging. America's pet procedures--liposuction, breast implants, face-lifts--tend to mirror the nation's most rampant obsessions: perky bods, buns of steel, ample busts, eternal youth. "People who seek surgery recognize something about themselves they want to change because they think it will make them feel better," says Dr. Bruce Cunningham, director of the University of Minnesota Medical School's Division of Plastic and Reconstructive Surgery. Spend a little time studying pictures taken before and after cosmetic surgeries and you'll soon realize that a lift doesn't make a plain face pretty, implants don't give a woman the come-hither allure of a vixen, a nose job won't dramatically alter an obnoxious man's demeanor. In other words, Cunningham says, it's unlikely that cosmetic surgery will bestow on patients the elusive qualities they may have thought they'd purchased--charisma, charm, social grace, serenity, youth. At most elective surgery simply alters the small, nagging details about which patients obsess.

Some clients, pleased with their original revision, become addicted to cosmetic surgery: first the tiny bump on a nose, then that wart behind an ear, the loose skin on the thigh--feeding what Margaret Little calls a "roving dissatisfaction with the body," which can add up to decades of serial operations. They make the error, Little says, of locating in various parts of their anatomy the failures life hands out. One blames a troubled marriage on her sagging breasts. Another faults the bags under his eyes for his dead-ended career. The complex interplay between individuals' insecurities and the cultural ideals of beauty and worth can lead, Little has found, to chronic obsessions mapped onto the smallest of bodily details: the crease in a thigh, the hem of spare skin on an eyelid, the slightly crooked angle of a nose--minutiae noticeable to no one but the face in the mirror, and of consequence only to the surgery client.

And the client's surgeon. The cosmetic surgeon enters this equation as a legitimate medical doctor, a voice of authority with an interest in confirming a client's fixation. It makes a world of difference to the distraught patient, Little concludes, "when medicine says, 'Yes, I'll take your money and make you look like a Barbie doll.'" Some surgeons broadcast such promises explicitly. Ads for elective surgery often feature airbrushed, doctored photos of sculpted supermodels. One of the nation's principal cosmetic-surgery associations selected for its phone number 1-800-A NEW YOU. Principled doctors ignore the chance to profit from clients' insecurities, argues the University of Minnesota's Bruce Cunningham. "What it really does boil down to is ethics. Their duty is to do the best by the client--not to sell a product, not to enhance the bottom line."  

Still, says Little, "There are those who are just hawking this stuff, and trying to create dissatisfaction among their patients. In some clinics a patient goes in wanting one surgery and comes out with two. The doctor says, 'I think I can help you with your nose.' Well, if this expert on beauty says I have a problem with my nose, it must be true." Cunningham too recognizes this phenomenon, allowing that the industry is open to--and perhaps, by its lack of strict regulation, invites--abuse. "Cosmetic surgery is dealing more with the emotional hopes and fears of an individual, and maybe it's a little easier to manipulate those things than the common sense of somebody that's got a medical problem," he says.

The number of doctors performing elective surgery, along with the demand for their services, has never been higher. According to statistics gathered by the American Society of Plastic and Reconstructive Surgeons, liposuction surgeries performed by its members have increased by 215 percent over the past five years. During the same period, and despite widespread publicity about the risks of silicone implants, breast augmentations have increased by 275 percent. The number of face-lifts has risen by 52 percent. New-sprung and less-popular procedures alike are on the rise, too: breast reconstructions, breast reductions, chin augmentations, cheek implants, breast lifts, buttock lifts, forehead lifts, thigh lifts, upper-arm lifts, collagen lip injections, eyelid surgeries, hair implants, nose jobs, scar revisions, tummy tucks. Name a body part and chances are it is being sculpted, snipped, suctioned, injected, implanted, and coaxed into a new configuration on a cosmetic surgeon's operating table. One Los Angeles physician, on the cutting edge of the business, is now offering "female genital cosmetic surgery" for women "troubled... about the appearance of their inner vaginal lips."

Looking back on it now, Harry Johnson divides his life into two epochs: Before John Paulos's nose, his world seemed, if not perfect, then perfectly manageable; after the nose, in the doctor's calculations, everything started going to hell. When Paulos arrived in Johnson's office in 1990, the surgeon examined him and concluded that there was, he says now, nothing special about this nose. It looked like any of the hundreds of noses he'd operated on.

John Paulos, for his part, separates his life into similar periods: before and after Johnson. The version he tells of his surgery begins and ends in an agonized nightmare. After the operation, according to one lawsuit Paulos filed in Hennepin County District Court, he sat bleeding in the recovery room for two hours. "Plaintiff felt a 'pop' in his head and blood started gushing out of plaintiff's mouth," the lawsuit alleges. "Plaintiff immediately started choking on his own blood and started uncontrollably convulsing and coughing up blood." When Johnson was alerted to the problem, the complaint continues, he "placed his hand over the ice pack sitting on the plaintiff's face and started pushing and grinding it... with significant force. [Paulos] could feel the bones in his nasal and eye area being crushed and ground." Paulos claimed that for several weeks after the surgery, he had to be fed Gerber baby food, and that when he returned for a follow-up visit three days after the operation he was "so bruised and swollen that the Defendant's office staff did not recognize him until he identified himself with a piece of paper." (Paulos declined to be interviewed for this story.)

Paulos represented himself in court, stating in one document that he "tried approximately 10 medical malpractice firms who all claimed to have a conflict of interest with Dr. Johnson. It seems Dr. Johnson is well known and protected among the medical malpractice community." His case was summarily tossed out on the grounds that state law requires malpractice claims be reviewed by an expert witness (usually another doctor)--which Paulos had failed to do. He took the matter to the Minnesota Court of Appeals, which upheld the ruling.

John Paulos was by no means Harry Johnson's only legal problem. Over the past two decades, the surgeon has been taken to court by no less than 14 different patients angry about the outcomes of their surgeries. (When City Pages checked Hennepin County District Court records for 35 local plastic and cosmetic surgeons whose names were obtained from the American Board of Medical Specialties and the Plastic Surgery Network, none during that same time period had been sued more than four times.)  

The first suit was filed in 1978. Lois Iepson had visited Johnson for consultation a year earlier and eventually paid him $1,500 for a face-lift, according to her complaint, which goes on to report that she spent 12 days in the hospital suffering complications from the surgery at an additional cost of $3,000. "Now, in the center of my chin it's very tight and on either side there's gross, hanging tissue," Iepson says today. "I have an unsightly face." Iepson says she dropped her suit when she learned she would be liable for Johnson's attorney's fees if she lost in court.

Barbara Wirkula sued Johnson that same year. The surgeon had removed cysts from her breasts in 1975 and implanted silicone gel. Afterward, according to her complaint, her breasts grew tough masses of scar tissue around the implants. One method of treatment involves breaking up the tissue either manually or with a wooden instrument shaped something like a nutcracker. In her complaint, Wirkula alleges that during a post-op exam Johnson began "manipulating her breasts so harshly, while she was conscious, and did continue the manipulation despite her outcry and protests so vigorously that he caused a rupture in her right breast." But Johnson's attorney entered medical records from Wirkula's stay at a chemical-dependency treatment center and succeeded in convincing the jury that her mental anguish sprang from her alcoholism.

Model and television-commercial actress Carol Collins thought she needed the skin tightened up around her belly. Johnson gave her a tummy tuck in February 1977. After the operation, according to the lawsuit she filed in Hennepin County in December 1981, the right side of her abdomen began to swell. When she brought the problem to Johnson's attention, she says in her affidavit, he brushed her off. According to a Minnesota Court of Appeals summary of the case, "Collins testified that she has sensations of pain and numbness in her abdominal area, that her stomach is extremely sensitive, that she can not sleep or tolerate shower spray on her stomach, and that she cannot engage in sexual relations that require contact with her stomach." Johnson blamed any complications on Collins, arguing that "she did not return for the full course of postoperative treatments." In the end, the judge dismissed the case, citing the fact that it hadn't been filed within the two-year statute of limitations period for medical malpractice suits. Collins's appeal also failed.

Two other lawsuits against Johnson were likewise dismissed. A patient named Harold Johnson (no relation) sued the surgeon in March 1980, claiming his eyelid surgery had rendered him unable to secrete tears. Johnson countered that his problems were "due to a natural aging process." The plaintiff failed to produce an expert witness, and his case was dismissed. In 1984 Diane LaPorte, a flight attendant for Northwest Airlines, claimed Johnson took too much cartilage out of her nose when he removed a cyst. Again a judge nixed the suit, which had been filed more than two years after the surgery.

Suzanne Cwik arrived at Johnson's office wanting a new nose and came out scheduled for a chin implant to go with it. After the surgery in June 1982, Cwik claimed she "experienced nothing but pain and misery": Her dentures didn't fit properly and she couldn't eat. She developed sores in her mouth, and a dentist eventually recommended that an oral surgeon reverse the chin implant. By then, her complaint continues, massive scar tissue had to be removed and a skin graft cut from her leg. A jury handed down a split verdict in November 1987, awarding Cwik $13,000 but also finding Harry Johnson not liable for negligence in his care and treatment.

Bruce Kolby sued Johnson in December 1987. Kolby had scars on his face he'd asked Johnson to fix; at the same time he wanted hair transplants to mask his baldness. According to his complaint, "Johnson actually worsened several of plaintiff's facial scars, created additional facial scarring, [and] created scars and lumps on plaintiff's forehead and head." Kolby's lawyer says Johnson agreed to a $10,000 out-of-court cash settlement in October 1989.

Johnson had difficulties apart from the lawsuits. The late-'80s real estate bust, along with the savings-and-loan crisis, had devastated his fortune. He filed for bankruptcy in 1989, listing more than $50 million in liabilities, most of them in taxes. His wife filed for divorce shortly thereafter; wrangling over the settlement kept him in and out of family court for years, and cost him thousands. He was seeing all too much of the courthouse in downtown Minneapolis--if not for the divorce matter, then in response to more patients who'd filed suit--a bad situation made worse for Johnson when the plaintiffs began winning.  

At first he didn't notice any sea change. John Paulos, for instance, hardly made it to the judge's bench in 1992 before being ordered to pay Johnson's $521 in court costs. Another patient, Suzanne Wolf, sued Johnson that same year, claiming he'd botched her breast implants. She called no expert witness and the statute of limitations had run out. Johnson prevailed again, and Wolf was required to pay him $950 in court costs.

But the Janice Dircks verdict was inescapable. She'd been happy enough with the breast-reduction and eyelid surgeries Johnson had performed on her over the years. So she scheduled a $6,000 face-lift in late 1989. "He just told me not to worry, that I would look wonderful and would be extremely happy with the outcome," Dircks explained in a lawsuit she filed in April 1992. "Dr. Johnson became concerned because the sides of my face were not healing," the document continues. "He prescribed some medication for those areas and had me put warm compresses on them. After a time I developed thick scabs on both sides of my face." Today Dircks bears a visible patch of scar tissue on either side of her face. "My grandchildren say, 'Grandma, what happened to your face?'" she says. "I have numbness. It's like there's insects crawling on my face. It kind of just feels like little bugs." Though Johnson blamed Dircks's scars on the hot packs she used contrary to his advice, a jury in September 1993 found him negligent in failing to disclose the risks of the surgery and awarded Dircks $279,552 in damages.

The ink barely had time to dry on the verdict before Shelly Armstrong filed her claim in December of that year. She'd sought out Johnson for eyelid surgery and to fix scars left by three cesarean deliveries, at a total cost of $5,500. "I wanted a scar revision," Armstrong recalls. "My husband didn't know anything about it. I thought it would be a surprise for him." In the end, she maintains, the surprise was on her: "While she lay on the operating table, and after she'd been pre-medicated for the surgery, defendant for the first time discussed additional work that had to be performed," her lawsuit alleged. "He did not state the nature of that 'work.' He did tell plaintiff it would cost $3,000 over and above the $5,500 she had already paid, and had his nurse get her purse, extract her checkbook... and had her write out the check." The new surgery she paid for was a tummy tuck. "I was 97, 98 pounds!" Armstrong says, and adds that she was so drugged-up she couldn't even spell Harry Johnson's name on the check. Johnson's attorney denied her allegations and tried to introduce evidence suggesting that Armstrong had a drug-abuse problem. A jury awarded her $89,950 in damages, finding that she hadn't consented to the tuck.

In 1994 a 12th malpractice suit was dismissed for lack of an expert witness. The next, filed in federal court by a patient whose breast implants had ruptured, was put into indefinite limbo until other implant suits in the federal system are adjudicated. Finally, in 1996 Cyndee Lee sued Johnson, alleging that the implant surgery he'd performed left her with "dimpled, rippled, and saggy breasts." These complications, she claims, sabotaged her career, rendering her "unfit for certain modeling positions she aspired to, specifically, for certain nude modeling and photography such as Playboy magazine... where the requirements are that the model not have disfigured, displaced, asymmetrical or other disproportionate nipples and breasts." Johnson and Lee reached an out-of-court settlement this past November, the terms of which are confidential.

Adding to his troubles, Johnson says, was a spate of break-ins at his Edina office during 1994 and 1995, in which money and other property was stolen. Soon after, stickers began cropping up around Minneapolis--mainly in bathroom stalls downtown--printed with a skull-and-crossbones emblem and bearing his name.

In the meantime, John Paulos hatched a plan to take the surgeon back before a judge. Early this year he found an opening and an attorney to state his case. The malpractice statute of limitations has run out since his nose surgery. But the statute on fraud is more lenient. His new case, filed in Hennepin County in February, claims the doctor lied about his credentials on the telephone, in person, in newspaper and Yellow Pages ads. Paulos, if he had his way, would have his day in court.

Reflecting on Paulos's latest legal action and the 14 others against him, Johnson insists his record is a good one. He points out that only two jury awards have gone against him, and neither called into question his ability to wield a scalpel. And he asserts that cosmetic surgeons get sued more often than do regular doctors--a situation that makes him an easy target for disillusioned clients. Still, to the University of Minnesota's plastic surgeon Bruce Cunningham, Johnson's 15 suits "sound like a lot. If you heard that a guy was being sued that much, you would really wonder--there must be something there," he says. "All you're seeing is the smoke. But there must be some fire."  

In 1993 WCCO-TV (Channel 4), the local CBS affiliate, went in search of the fire. A "Dimension" station report titled "Scarred for Life" featured interviews with Janice Dircks, Shelly Armstrong, and other former patients of Johnson. A segment shot with a hidden camera in Johnson's examining room captured him on tape from an unflattering angle. Paulos, who'd tipped off the station to the story, also made an appearance, complaining about Johnson's surgery: "Aesthetically," he told the interviewer as a glamour shot of the former model filled the screen, "it pretty much destroyed my face."

In June 1995 Johnson took a page from the book of his agitated clients and sued WCCO and CBS in Hennepin County court for trespass, interference with prospective business relations, and deceptive trade practices, seeking damages in excess of $50,000 on each of three counts. (The suit later moved to federal court.) Johnson maintains that "Scarred for Life"--with Paulos as its source--destroyed his practice. In the three months following the broadcast, his suit claims, nearly two dozen patients canceled their surgeries. "It's like someone threw the switch," the surgeon says. His lawyers say the case could come to trial this year.

In defense of its broadcast, CBS collected nearly 20 sworn affidavits from former patients of Johnson. None has ever sued the surgeon, but they cite a litany of complaints about the doctor's modus operandi and post-op care, alleging that he failed to inform them of the risks of surgery, that he sold them on more surgery than they wanted or needed, and that he offered exaggerated promises about the results. "I felt as if I had had Dr. Frankenstein working on me," one former patient stated in an affidavit.

Johnson filed a response this past month. That document is under seal, but in a version prepared by his attorneys for City Pages that omits off-limits patient information, Johnson accuses CBS of "character assassination." Referring to his patient files, he highlights the consent forms all of his patients are obliged to sign and notes that some of these patients agreed to recommend him to prospective customers. In some cases, he disputes the conversations reported in the affidavits.

In his attorney's office last month, Johnson hotly denied his former clients' testimony. "There's no doubt in my mind that I have thousands of patients that are very grateful," he said. "The fact that there are a few disgruntled--it's like a popularity contest! Maybe they didn't like my bedside manner. I'm a gregarious individual, an honest individual. There's a transference: They blame me because I didn't create a whole new face. But I don't have a magic wand!"

John Paulos first learned from the American Medical Association that Dr. Harry Johnson is not a "board certified" plastic and reconstructive surgeon, which Paulos claims he had been led by Johnson to believe. It happens that there are two competing organizations that certify cosmetic surgeons. Both require medical and surgical residencies and a certain amount of specialized training. But only one, the American Board of Plastic Surgery (ABPS), is recognized by the American Board of Medical Specialties (ABMS) and the AMA. The other, the American Board of Cosmetic Surgery (ABCS), has applied without success to be recognized by the ABMS and is considered less prestigious by those in the medical field.

But if the distinction sounds confusing, it should. The two groups represent doctors competing for the same set of clients. "What you're really getting into is the murky state of [cosmetic surgery] business and designation in the country," says the University of Minnesota's Cunningham. According to Cunningham, who sits on the ABPS, a certificate like Johnson's from the competing ABCS is far from a stamp of approval. "Many people feel it's not part of the mainstream medical education process," says the surgeon. "It has always been regarded as a route that people took who couldn't or wouldn't go through the full training and certification process so that they would have something to call themselves."

When it comes to touting his credentials, Johnson has a record of, at best, imprecision. He has testified under oath, for example, that he is "certified to practice" in "plastic and reconstructive surgery"--a distinct specialty requiring training over and above his own--when in fact he's certified (by the ABCS) only in cosmetic surgery. At the time of Paulos's surgery, Johnson's advertisements in the Yellow Pages further clouded the matter. He listed himself as "certified by" a number of organizations including some, such as the American Society of Liposuction Surgery and the Lipoplasty Society of North America, that have no certifying board. He has also claimed membership in a variety of professional organizations including the International Academy of Cosmetic Surgery--a group that, according to one doctor associated with the ABCS, hasn't collected dues in more than 25 years. "You can get certificates from any of these fucking groups," asserts the doctor, who asked not to be identified. "There's no credentialing. These are self-made groups. You just give them a registration card and you can get [a certificate] one, two, three."  

In August 1993, Paulos, his patience unraveling, brought copies of Johnson's Yellow Pages ads and letters clarifying the surgeon's credentials that he'd received from the ABMS, the AMA, and the ABPS to the judge in his dismissed malpractice suit. She denied his request to reopen the case. But when he supplied the material to the Minnesota attorney general's office, Paulos got a warmer reception. An investigator summoned Johnson into the AG's office, the cosmetic surgeon recalls, and told him, "You, Dr. Johnson, don't do it anymore: Don't advertise--or do it in such a way that there's no question.' I said, 'I'm sorry that's misleading. It will never happen again.'"

Today, of the 60-plus ads for plastic and cosmetic surgeons in the Yellow Pages, Johnson's full-page listing seems downright modest. Amid a slew of ads for surgeons with credentials such as "International Award Winning Teacher and Author" and featuring buff, half-clad models as visual aids, Johnson's appeal features only a photo of the smiling doctor in scrubs beside a list of the organizations he actually belongs to: the American Academy of Cosmetic Surgery and the American Society of Liposuction Surgery.

With a public scolding of his nemesis on his side of the ledger, in September 1994 Paulos fired off a letter to Johnson. "Now that my findings have finally been confirmed by the attorney general's office that you have been misrepresenting your medical credentials and more importantly that you misrepresented your medical credentials to me and thereby obtained my consent to surgery," it read, "I am willing to settle this matter for the formulated sum of $12,450,521." If Johnson failed to ante up, Paulos threatened, he'd sue.

This past February Paulos followed through and launched his new suit in Hennepin County District Court, asking for a minimum of $50,000 in damages on each of eight counts. The claims--fraudulent and negligent misrepresentation, negligence, consumer fraud, breach of contract, false statements in advertising, principal-agent misrepresentation, and deceptive trade practices--add up to one basic argument: Johnson lied. He represented himself, Paulos argues, as certified by the prestigious, AMA-recognized American Board of Plastic Surgery, when in fact the doctor is certified by the American Board of Cosmetic Surgery.

In the meantime, the Minnesota Board of Medical Practice appears to have launched an investigation of Johnson. The board is a group of licensed physicians appointed by the governor to enforce the minimum standard of medical practice as defined by state law, and its members exercise a range of sanctions against doctors, from issuing warning letters to permanently revoking licenses. Robert Leach, the board's executive director, would neither confirm nor deny that Johnson is under investigation, and Johnson himself refused to answer questions about the inquiry. But several former patients told City Pages they'd been contacted about their experiences with the surgeon by investigators from the attorney general's office, which handles complex investigations for the board. Many say they plan to testify against Johnson at a hearing they've been told is scheduled for this fall. According to Leach, at any time during an investigation the board may suspend a physician's license "if we feel the individual is in violation of [law], and that continued practice constitutes a danger to the public." Much to John Paulos's dismay, the board has not taken that step with Harry Johnson.

Still, all this activity has given Paulos a flicker of hope in his dark world. In the eight years since his nose surgery on Johnson's table, he has often sought the professional help of a registered nurse at the Hennepin County Medical Center's Crisis Intervention Center, a counseling service. The nurse's notes from his home visits have been entered as evidence in Paulos's latest suit against Johnson--whom he believes, as Johnson believes of Paulos, "ruined my life."

His first visit with the nurse occurred in June 1993, after his initial lawsuit sputtered. The nurse noted that Paulos seemed "knowledgeable and creative... with a gracious manner" and that he "goes out mainly to work or conduct legal business. Friends shop for his groceries. John lives with five cats whom he rescued from the Humane Society and the street. He lives a simple life.... He has a girlfriend, but few other friends... who seem to have drifted away with exposure to his obsession with medical and legal problems."  

After appeals of the ruling in that first suit failed in 1994, Paulos phoned the nurse again. The complications he traced to Johnson's nose job--recurrent bleeding, aggravated pain, vomiting, hives, insomnia, anxiety--were getting worse, he reported, and his faith in the legal system was shaken. "Other than working two hours a day as a parking-lot attendant, John is reclusive," the nurse wrote after their second visit. "John's nose bleeds at night. He sleeps poorly and feels 'hot and nervous' and anxious and depressed. [He] admits to often feeling suicidal. Sleeps with a loaded gun under his bed."

Soon after Paulos mailed his letter seeking $12 million from Johnson, the nurse paid a third call. "John remains frustrated over past medical care and distrustful of all professionals," he wrote. "John's battle with the plastic surgeon... is apparently dead-ended." The nurse also noted increased vomiting and nasal bleeding and characterized Paulos as "anxious, depressed, discouraged, but not about to give up his five-year battle." By then Paulos was practically housebound, spending whole days in solitude, despairing of any remedy short of a court victory against his enemy, Harry Johnson. "He rarely leaves his apartment," the nurse's notes read, preferring instead to lie on a mattress in his living room "with a cold pack of frozen beans on his forehead."

During the same sleepless nights that John Paulos spends agonizing and strategizing over his legal files, Harry Johnson lies awake, too. After midnight he often flips on the TV and surfs for round-the-clock infomercial stations, trying to rid his mind of his troubles. Johnson is as obsessed with his legal battles as is his nemesis. Perhaps more to the point, Johnson is as obsessed with Paulos as Paulos is with Johnson. Both have become, by chance or by choice, arbiter of each other's fate.

It appears for Johnson that the high times are over. He claims that his career, his finances, and his professional reputation are in tatters. (Attorneys from the Minneapolis law firm of Best and Flanagan are handling his still-active lawsuit against CBS on a contingency basis.) "I can't tell you how many times I've been in the doctor's lounge and there will be an empty seat on either side of me that no one takes," he says. "I've sat down at doctors' tables who I've known for 25 years and one or two of them will get up and walk away. In a group of friends, you know that you're being shunned."

The cosmetic surgeon's phone rings less and less frequently at his Edina office. "At my peak," Johnson reminisces, "I had maybe three or four cases four days a week--15 cases a week! I used to do three or four face-lifts a week! Two or three eyelid blepharoplasties! Now I have maybe two or four cases a week total."

Johnson says he has pressed the attorney general and the Edina city attorney to prosecute Paulos for sending the $12 million demand letter--an action the doctor says merits a charge of criminal harassment or blackmail. Short of that, Dr. Johnson complains, he has no means to put an end to what he sees as his ex-patient's ceaseless persecution. "That's what's so tough," he laments, "about being a victim."

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