The doctor is in. And out. And here and there -- and everywhere but his cluttered Oakland office.
Bruce W. Dixon is no behind-the-desk administrator, preferring instead a whirling-dervish, hands-on approach to his job as head of the largest medical practice in Allegheny County -- the county's Health Department.
If he's not treating patients, he's checking on how they're being treated. Or on the work and morale of the department's 371 employees. Or he's meeting with administrative and medical personnel, serving on various health committees, lecturing doctors at hospitals, talking to the media or visiting the department's divisions on environmental quality or food handling or doing this or that -- always on the run -- during work weeks of 60 to 70 hours. His cell phone rings constantly.
He's been running this place at this pace for nearly 18 years -- the longest director's tenure in the department's nearly 53-year history -- making him the county's longest-serving department director. He's worked at the department for 30 years -- a surprising span in the thicket that county politics can become.
In addition to his day-to-day duties overseeing the health and safety of the county's 1.2 million residents, he coordinates the response when widespread health concerns arise, such as the current spread of the H1N1 virus. He's the media's go-to guy for straightforward, consumer-friendly explanations of what's going on and what to do.
In recent weeks, he's been all over newspaper, TV and radio reports, seeking to calm what he considers undue panic about the effect of the virus. He foresees the net effect will be less severe in symptoms, hospitalizations and deaths than those caused by the seasonal flu.
He's looked the same for decades: crew-cut blond hair, wire-rimmed glasses, black tie and white shirt with monogrammed French cuffs. (On occasion, he'll don a blue or yellow shirt.)
Colleagues, department staff, patients, former students and others call him a "brilliant" physician and teacher -- he technically is employed as a faculty member by the University of Pittsburgh School of Medicine, which the county reimburses for his services.
"He is what a public health official ought to be," said Everette James, secretary of the Pennsylvania Department of Health, who regularly seeks Dr. Dixon's counsel, especially now during the H1N1 outbreak.
"I think he has both the training and experience to make him an invaluable asset in public health's fight to prevent and control disease," he said. "It is impossible to overstate his value to Allegheny County."
Dr. Dixon is a man of compassion and character -- and a character to boot, say the legions who praise him.
Dr. Dixon acknowledges his quirks.
A lifelong bachelor -- "I'd be disastrous in a long term relationship ... The older you get, the more you value your time and the ability to do what you want" -- he eats dinner out every night at favorite, small neighborhood restaurants. His invited dinner guests are an eclectic group of co-workers, patients, reporters and friends.
He's a fast-talking jokester, joshing with employees, patients and anyone he encounters. His interests range from his 60-year collection of doo-wop music to woodworking and metal working to owning eight cars -- most of them vintage, including a 1967 Corvette he bought that year. He's spent 25 years restoring a 116-year-old former steel baron's mansion (it's still not finished) and he collects rare skipper butterflies in the wilds of North Carolina and elsewhere -- in a white shirt and tie, no less. He plays piano and pipe organ.
Dr. Dixon, who splits his time between a Forest Hills home and his North Braddock manse, turns 71 on Tuesday but shows no signs of slowing down. And that's just fine with those who know the man and his work.
"I can't think of anybody in public health who is as skilled and knowledgeable about so many things," said Paul W. Dishart, director of medical education at St. Margaret's Hospital. "We owe him so much for the protection of people in Allegheny County."
'What would Bruce do?'
Dr. Dixon never planned a career in public health, or even medicine.
His father was the Pittsburgh office freight agent for Reading Railroad and his mother was a homemaker. The family lived in Forest Hills. He was an only child.
"My parents said, 'We're not going to do that again,' " he quipped.
He attended Pitt on a full scholarship in the Latin and Greek classics after graduating from Wilkinsburg High School in 1956. He fulfilled the scholarship's requirements but planned to pursue a doctorate in chemistry -- until his senior year when he decided to follow in the footsteps of an uncle who was an ophthalmologist and attend medical school.
"You always were an odd duck," a chemistry professor said of Dr. Dixon's change of plans.
He excelled in medical school at Pitt, settling on internal medicine as a speciality because "there was a little more detective work trying to figure out what's the matter with people."
He did his internship at Duke University in Durham, N.C., a year of residency at Pitt, a two-year Vietnam-era stateside tour as an Air Force doctor and returned to Duke, where he was named chief resident, a prestigious accomplishment at a prestigious medical school. He then joined the faculty.
His interest in health care for minorities was forged at Duke by the sight of abject poverty and "dehumanizing" racism in the South.
"You can't care for people very well if you don't care about them," he said he learned from a Duke mentor. "That's the problem with health care now -- you become just another patient."
He joined the Pitt faculty in 1975 because his parents were getting older, and "I'm a Pittsburgher." He still teaches at the university.
"He is absolutely the best teacher I've ever had," said Dr. George Brett, who was chief resident at Pitt under Dr. Dixon. "There are probably a couple hundred physicians practicing in Western Pennsylvania who, anytime they come across a difficult case and are not sure what is going on, think to themselves, 'What would Bruce do?'
"It is smart medicine, cost-effective medicine, compassionate medicine," Dr. Brett, medical director for Living Independently for the Elderly in Butler and Beaver counties, said of Dr. Dixon's approach.
Dr. Dixon's foray into public health began in 1979 when Pitt agreed that he could work one day a week at the Health Department's Sexually Transmitted Disease clinic. His workload there increased to three days a week in the mid-1980s with the advent of AIDS; he eventually became head of the county's sexually transmitted disease program.
When then-Health Department Director Albert Brunwasser retired in 1992, Dr. Dixon was offered the job. He was happy teaching and turned it down. But he was summoned to a meeting with the late county Commissioner Tom Foerster, Pitt's chancellor and vice chancellor for medicine, and the head of the county health board.
"You're the new Health Department director," they told him.
Doo-wop and dress shirts
Dr. Brett chuckled, as many people do when discussing the idiosyncratic doctor.
"He's frozen in 1956," Dr. Brett said. "He hasn't changed a bit."
Dr. Dixon doesn't disagree.
"I'm a creature of habit," he said. "Absolutely [I'm a character] because I look at the world differently than a lot of people, I guess. I don't take too many things too seriously. I have a good time. You only live once. You might as well enjoy yourself."
What he doesn't enjoy is watching movies (the last one he saw was 1956's "The Girl Can't Help It") or TV (he watches only the news and some sporting events). He'd rather attend doo-wop concerts by classic groups such as The Five Keys and The Penguins and other artists he knows personally and later watch the recorded shows on tape.
His white dress shirt is legendary -- a former student who hadn't seen him in years was shocked last month to spot him in a yellow one. But longtime Health Department spokesman Guillermo Cole noted, "it's not a stuffed shirt. He differs a lot from the stereotype of a physician. He's very easy-going."
That quality has held him in good stead, with only one notable controversy during his tenure. In late 1995, then-County Commissioner Larry Dunn demanded Dr. Dixon's resignation because the Health Department had allowed Robert Wholey and Co., a food store in the Strip District, to amass 72 food violations over three years without levying fines or downgrading its food-handling rating.
Members of the Board of Health supported Dr. Dixon, who refused to resign.
"Why would I step down? I don't think I've done anything wrong," he said then, noting it was department policy to work with restaurants and food businesses to correct violations before fining them.
The controversy quickly fizzled. It was an anomaly in a public health career that from its onset, colleagues say, has been focused particularly on providing care to those who wouldn't be able to afford it otherwise.
"The reason he's so good is he has the sensitivity and empathy as a human being to relate to problems people have, especially the indigent population who can't pay for good private care," said forensic pathologist Dr. Cyril H. Wecht, who frequently worked with Dr. Dixon while serving as the county's coroner and medical examiner.
Marc Cherna, director of the county Department of Human Services, agreed: "He really lives the Hippocratic oath. He serves the people who others don't want to serve."
Health Department nurse practitioner Charles Timbers, 58, was a young man when he met Dr. Dixon at the department's Oakland clinic. He credits Dr. Dixon with helping him find his way from the dangers of the inner city to a fruitful life.
"He is held in such high esteem because he doesn't care what your financial background is, what your ethnic background is, where you come from. You're a human being. And he treats everybody the same. That's why everybody loves him."
Dr. Dixon is not above dispensing tough love when need be. Once an armed man tried to rob him near his North Braddock home.
"How crazy do you think you are?" Dr. Dixon said, telling him that, first of all, he didn't have any money. "Second of all, obviously you don't recognize me. I'm from down at the Health Department ..."
"Oh, yeah, you're the doctor from the VD clinic," the startled man responded.
"Yeah, that's right, and you've been down there, so don't be screwing around with me."
"I'm sorry, I'm sorry, I'm sorry. I didn't recognize you," the man said before fleeing.
Recently, Dr. Dixon chided and playfully knocked on the head of a young man in the Oakland health clinic who said he just got out of jail for robbery.
"Don't do something stupid like that again, OK? Stay on your medication. You don't want to wear that uniform anymore. You think next time. You take care."
Tea and rare beef
For Dr. Dixon, no two days are the same but Sept. 30 was a particularly busy one. It started with a two-hour meeting as a board member of Tobacco Free Allegheny, followed by a get-together with Dr. Jim Lando of the U.S. Centers for Disease Control and Prevention at Dr. Dixon's de facto office -- the Panera Bread cafe on the Boulevard of the Allies. He ordered cookies to share and grabbed a Lipton tea bag -- he drinks a dozen cups daily -- from a box he keeps there.
"They have great pastries, but I don't like their infused tea, hippie tea, so I just bring my own," he explained.
The rest of the day was a whirlwind. He dealt with an overwhelming crowd of school students seeking required inoculations on the last day before they would be banned from school if they didn't get them.
He conferred with staff about six cases of food poisoning and a weekly review of HIV cases. He checked in at the STD clinic, which he visits numerous time a day. He attended a news conference with Dr. Wecht, who had performed an autopsy of a woman with the H1N1 virus. He visited employees at the Clack Health Complex in Lawrenceville, where the Health Department's laboratory, food program, central supply warehouse, dental program, plumbing and environmental divisions are located.
He made dinner plans with friends at one of his favorite restaurants, Bellisario's Pizza Restaurant & Lounge in McCandless. He picked up a Health Department employee who needed a ride from the county jail clinic to Oakland. And he gave directions to a visitor in the Health Department administration building who was looking for the men's room. "Wash your hands. Be good," he said.
Somehow he squeezed in lunch at the Smallman Street Deli in the Strip District.
"Rare hamburger, Doc?" called out the waitress as he walked in. Yes, that's his order. And yes, the Health Department frowns on ground meat served rare. But he said he knew the meat was ground that day by the restaurant so there was little chance of E. coli contamination.
He doesn't eat vegetables or fruit. "Cows eat vegetables. I eat the cow," he said.
Helping the weakest
Over the years, Dr. Dixon has been offered higher paying jobs at other facilities in the country and even private practices for well-heeled patients. He's turned them all down.
"I could have made a fortune ... but I didn't get into this to make money. I did it to have a good time and hopefully contribute something to the betterment of people. I enjoy taking care of people who are poor. I just get more enjoyment out of that."
He has become a father figure, providing help and guidance, for a number of people. He doesn't like to talk about it other than to say he has "reached out to help people who were not as successful as they could be.
"Hopefully, you leave this world a little bit better place than when you came here. We all have a responsibility to help the weakest among us."
He plans to continue doing just that -- and working on his North Braddock home and reassembling and playing a church pipe organ and collecting butterflies and eating out and wearing white shirts and black ties and teaching medicine and working as Health Department director. The board gave him another two-year contract in June.
"I'll retire when I'm not having fun anymore. I'm having a good time right now. There's a different challenge every day and that's what's fun."
Michael A. Fuoco can be reached at email@example.com or 412-263-1968.