A 79-year-old Lake Elsinore man spent decades obsessing over a routine surgical procedure that he claimed left him impotent and incontinent until his “descent into madness” led him to gun down one of the doctors he held responsible in the physician’s Newport Beach office, the defendant’s attorney told a jury Thursday.
Stanwood Fred Elkus is charged with murder and faces a special circumstances allegation of murder by lying in wait. He has pleaded not guilty by reason of insanity, so the trial will be in two phases, with jurors first determining his guilt or innocence. If he is convicted, they will be asked to consider whether he was legally insane at the time he shot and killed Dr. Ronald Gilbert on Jan. 28, 2013.
If jurors find that Elkus was legally insane, meaning he did not know the difference between right or wrong or did not comprehend the consequences of his actions, he would be sentenced indefinitely to a mental health hospital and would have the right periodically to petition for his release if he believed his sanity had been restored.
If convicted and found sane, the defendant would be sentenced to life in prison without parole.
Elkus had a “nice” childhood aside from being diagnosed with dyslexia, and spent five months in the U.S. Marine Corps in 1956, which allowed him access to Veterans Administration healthcare, “which he took advantage of a lot,” Senior Deputy District Attorney Matt Murphy said.
The barber by trade was also a successful landlord who managed up to eight rental properties at one point, the prosecutor said.
In 1992, when he was 54, Elkus made appointments with multiple doctors, complaining of urinary problems, Murphy said. One of the doctors he consulted with was Gilbert, who was a young resident at the time, he said.
Elkus was diagnosed with urethral stricture, a narrowing of the urinary tract, so doctors recommended a routine surgical procedure to correct it, Murphy said. Part of the procedure involved the placement of a catheter so that the urethra could heal around it. Elkus, however became so “fixated on the idea he may die” during the procedure that a social worker was assigned to talk to him, the prosecutor said.
The surgical procedure went “smoothly,” but Elkus refused to leave the hospital and threatened to pull the catheter out if he was forced to go, Murphy said. He finally agreed to leave on Sept. 3, but then returned a couple of days later to demand the catheter be removed even though he was told it must stay in place for two weeks.
The doctors finally complied with his request, but it led to Elkus “blaming all of his problems on this procedure” for decades afterward, Murphy said. Though Gilbert wasn’t one of the doctors who performed the surgery, he was listed as the doctor responsible for the patient on hospital forms, the prosecutor said.
The defendant went to doctor after doctor, complaining about how the procedure ruined his sex life, and also wrote letters to doctors saying he wished they would die, the prosecutor alleged.
In 2010, Elkus “begins making plans,” Murphy said, telling jurors that the defendant created a living trust to benefit his sister should he die, become incapacitated or “becomes incarcerated.”
In December 2012, Elkus bought a Cobra Patriot, but returned the 45- caliber handgun because he said it wouldn’t fire correctly and instead purchased a Glock handgun like the ones police officers use, Murphy said.
In early January 2013, Elkus went to Gilbert’s office at the Hoag Medical Group building located at 520 Superior Ave. and was told he had to make an appointment, so he filled out forms using a fake name of Allen Gold and included other false identifying information, Murphy said.
On the day he returned, he was ushered into an examination room to await the doctor. When Gilbert walked into the room, Elkus “pulled out the gun and proceeded to shoot him 10 times,” continuing to fire even when the physician was on the floor, Murphy alleged.
When other doctors and employees burst into the room, Elkus said, “I’m insane. Call the police,” according to the prosecutor.
Tapes of Elkus in the squad car capture the defendant crying for 30 seconds to a minute, but then later calmly discussing the shooting. He complained to the officers about the surgical procedure in 1992, Murphy said.
“We get a taste in the back of that police car of what everyone else has heard for the last 20 years,” he said.
Elkus’ attorney, Colleen O’Hara, said her client’s brain has significantly deteriorated to the point that he is at one percentile of the cognition of others his age. In a hearing in January of this year, Elkus told the judge presiding over his case that he has a brain tumor.
“His mental health issues started when he was young,” O’Hara said, telling the jury that her client had polio when he was 7 and was not the same afterward.
The surgical procedure in 1992 was the “final trigger … into his eventual descent into madness,” O’Hara said.
Doctors have diagnosed damage to parts of his brain that control inhibitions and behavior, O’Hara said. Symptoms of his brain disease include “a feeling of unreality and fluctuations in consciousness,” she said.
Depression is a common symptom of polio survivors in middle age, and Elkus was diagnosed with chronic depression, O’Hara said.
Elkus was doing fine until the surgical procedure in 1992, and he felt the doctors “pushed” him into doing it, she said. Later, he visited multiple physicians over the years who told him his prostate was damaged in the “botched” surgery and that it was unnecessary, O’Hara said.
Elkus found out too late that the statute of limitations prevented him from suing, so he began years of pursuing claims with the VA, not so much for the money but to have the government acknowledge its mistake, O’Hara said. One of the claims was that the errant surgery caused erectile dysfunction and the other was for bladder-control issues, she said.
Elkus said after the surgical procedure that his erectile dysfunction problems led to the breakup of a longtime relationship with a girlfriend he had planned to marry, O’Hara said.
At one point, as he threatened suicide, he was committed at a VA facility and was prescribed Valium, which he took for 21 years, which may have also contributed to his brain damage, O’Hara said. Instead of calming him as the drug is meant to do, it can cause “aggressiveness” in someone of his age group, she said.
In 2005, Elkus asked Gilbert at a forum on prostate issues if he would write a letter for him to help with his government claim and the physician brushed him off, O’Hara said.
–City News Service