Janice "Wes" Brown, an infectious disease researcher and physician, has died at the age of 63

Janice "Wes" Brown, MD, a professor of blood and bone marrow transplantation who developed innovative stem cell therapies for immunocompromised patients and helped bring them into clinical practice, died of endometrial cancer on April 14. She was 63 years old.

Brown's research focused on patients who were at risk of developing life-threatening infections after bone marrow transplants, solid organ transplants or other immunodeficiency cancer treatments. Her commitment as a scientist and clinician to alleviate the suffering and prolong the lives of at-risk patients caught the attention of her colleagues.

"Wes Brown embodied the tireless initiative that has made Stanford Medicine a pillar of hope for so many", said Lloyd Minor, MD, dean of the Stanford School of Medicine and Stanford University's vice president for medical affairs. "In the lab, she has been instrumental in developing life-saving treatments for some of our most vulnerable patients, and in the clinic, she has demonstrated her compassionate approach to applying those treatments".

"Wes was a wonderful person", said Irving Weissman, the Virginia and D.C. Ludwig Professor of Clinical Research in Oncology. Brown impressed him so much as an inquisitive rookie researcher in his lab in the early 2000s that he turned to her for help when his mother was recovering from uterine cancer surgery.

"After surgery, she wasn't feeling well, so I called Wes", Weissman says. "She immediately realized what was going on and put her on a new regimen". Weissman's mom returned to her home in Montana - and in good health - and lived another 20 years. "I owe my mom's life to Wes", he added. "She was just a brilliant puzzle solver".

Nose to the openings

During her freshman year at Stanford University, someone told Brown that she looked like Wes, and she didn't argue or take offense, but simply agreed. "Janice never matched her", said her good friend Helen Benedetti.

Brown was born in Worcester, Massachusetts, and grew up in the suburbs of Washington, DC. Her parents were physicians who immigrated from China to pursue doctoral studies. Her husband, Andrew Hoffman, MD, professor of endocrinology, says that watching her parents live a life in medicine was likely an early inspiration that pulled her inquisitive mind in a similar direction.

Brown received her undergraduate degree from Stanford in 1981, then attended medical school at the University of Virginia. She returned to Stanford for her residency in internal medicine. After an internship as a clinical specialist in infectious diseases and an internship in virology in the lab of Ed Mokarski, who was then professor and chair of the Department of Microbiology and Immunology, she turned her attention to the work being done in Weissman's lab with blood-forming stem cells. She soon became a part of it, and that fellowship paved an important path.

She focused on creating stem cell therapies against three specific types of life-threatening infections faced by immunocompromised patients after blood or bone marrow transplants. She examined what Weissman's lab had already established in mouse models and unraveled the mechanisms for avoiding the three deadliest pathogens - bacterial, fungal and viral - that immunocompromised patients face.

"She did it for three major types of infections - and got definitive results", Weissman says. "That almost never happens, especially if someone comes from the world of infectious disease with no experience with blood-forming stem cells".

Brown immersed herself in the scientific literature on the three states, formed hypotheses on how to attack each, and then published papers that proved prescient. "As she predicted, this is how it happened", Weissman says.

She later joined Weissman in a commercial startup to fight a dangerous infection, cytomegalovirus, and became involved in hematopoietic stem cell research. After joining the faculty of the Department of Blood and Marrow Transplantation and Cell Therapy, she continued her laboratory research with clinical studies on immune cells that control cytomegalovirus and other viral pathogens.

Hoffman recalled how Brown had managed to patent the stem cell therapy and get it into phase two clinical trials. But part of her fascination with research was having a practical application she could use herself, and that's what she turned to next.

Puzzle solver

Brown volunteered for clinical rounds in the blood and bone marrow transplant program of the late Carl Blum, MD, and began to learn more about how infectious diseases attack the most critically ill patients. She continued this work with immunodeficient patients, joining the faculty of the bone marrow transplant and cell therapy program, and later helped co-found an infectious disease clinic for immunocompromised patients at Stanford University.

But according to Hoffman, Brown, always a problem solver, didn't forget about the larger research. While continuing to see patients on a daily basis, she conducted clinical trials of antiviral drugs and antibiotics and developed treatment protocols for immunocompromised patients.

"She had the perfect background in virology and cell biology to do the job", Hoffman says. "And that was her passion. She looked at a patient's disease as a puzzle that she had to solve. And she did everything she could to make sure she made the right diagnosis. She was tenacious".

Weissman marveled at how Brown put together the whole puzzle of his career. "How often does someone manage to make a discovery and then put it into practice?" - he said. "Helping people live who could have died? That's exactly what she did".

Hoffman recalls how his wife often made house calls to critically ill patients, knowing she could help prolong their lives, or at least calm them down. "She was an iconoclast - not afraid to make a bold diagnosis that others might not", he says.

When her good friend and colleague Judith Shizuru, M.D., professor of blood and bone marrow transplantation and cell therapy, faced a difficult case, Brown always called her first.

"She really went into detail, thought outside the box and had a knack for reaching her own understanding", Shizuru says. "She could guide you like a third eye. I've never met another doctor like her. That takes insight, intelligence and a real sense of courage".

It also helped that she was fully committed to life - both in the lab or clinic and at home. Weissman remembers what she did for his mother during her recovery from cancer, and how she approached the life-threatening mysteries of so many others.

"She was the kind of doctor who considered other people's lives as important as her own family", he said. "And if they're like your family, you don't stop until you deal with it".

Mom's on the stand

Shizuru still doesn't understand how Brown and Hoffman managed to do what they did as full-time researchers and clinicians as well as parents. "Two working physicians who somehow had time for all of their children's activities", she says. "She was the mom who was always on the bleachers and bringing the gatorade".

Hoffman says his wife had a unique ability to apply several passions at the same time. "She loved everything: virology, immune cells, clinical care and research", Hoffman said. "But most of all, she loved being a mom".

While on bed rest at home during her first pregnancy, Brown had time to work on her stem cell research. She then homeschooled her twins through fourth grade while continuing her research.

"While she was doing incredibly important science in my lab, she was simultaneously homeschooling her twins", Weissman says. "I have no idea how she did it all - and did it so well. But that was Wes".

She was in the stands even as the kids got older - at son Jacob's Stanford baseball games, at daughter Samantha and son Zach's lacrosse games, at every Stanford sporting event she could get to.

"She was a very enthusiastic and very loud Stanford fan", Hoffman says. Jacob was able to get the whole family a pass to the Big Game against California last November - exactly the type of meeting "that made her really happy", Hoffman says.

Brown was treating patients in the early months of the COVID-19 pandemic when she was diagnosed with cancer during a routine checkup. She underwent surgery and multiple rounds of radiation and chemotherapy. She and Hoffman spent January through March in Boston at Brigham and Women's Hospital.

"We researched everything we could - she wasn't going to give up", Hoffman says. "All the way until she was admitted to the hospital and learned the life story of every nurse who cared for her".

She was a unique person and her loss is so hard to mourn. It leaves a big hole.

Benedetti was a blood and bone marrow transplant nurse and recalls that she and Brown shared a common commitment to work and family. She remembers her as a selfless caregiver who always took the time to listen and never sought to be the center of attention herself. That was saved for those closest to her. "Family was everything to her", she says. "Wes was a brilliant, humble, loving, family-oriented person".

The biggest disappointment for Brown was that she was too ill to return to work after her cancer diagnosis. But she wasn't about to miss the meaningful family moments that still remained.

In the spring, she attended Samantha's wedding in Los Gatos, California, and then her doctoral dissertation defense at Harvard University. Recently, the entire family spent a weekend at Sierra Family Camp on Fallen Leaf Lake in the Lake Tahoe Basin, a Stanford tradition they enjoyed for many years as the children grew up.

"It was so important to her, and she hung in there", Shizuru says. "She was a unique person, and her loss is so hard to mourn. It leaves a big hole. It hurts".

Hoffman knows. According to him, he finds it hard to accept that his wife died so young. "She was only 63 years old - she still had so much time to live", he said. But he is comforted by the tremendous legacy she left behind. It's everywhere he looks.

"She was known and loved by so many people", he said. "I didn't realize how many people she touched".

Brown is survived by her husband, Andy Hoffman, and their children, Samantha, Jacob and Zachary Hoffman.