Dick Fine, a lifelong San Francisco doctor who advocated for underserved patients and found respite sailing on Tomales Bay, died last month at age 75.
“He could work within the system to find the solutions, or buck the system when it wasn’t allowing him to do the right thing,” said Dean Schillinger, a colleague and friend.
Dick grew up in Cincinnati; his father owned a few movie theaters and his mother stayed at home. He aspired to be a doctor since his childhood, perhaps in part because he caught pneumonia at just five years old. He was the first child in Cincinnati to receive penicillin.
Dick attended college and medical school at Cornell University and started his residency at San Francisco General Hospital in 1966. He worked there until his retirement.
During his years at the hospital, Dick spurned the traditional white doctor’s coat, instead opting for jeans, cowboy boots and a mechanic’s shirt with his name embroidered on it.
“I think it was about relatability,” said his daughter, Sarah Fine. “It was a way of being more approachable. He didn’t care about formalities… What mattered to him was doing the right thing, however it needed to happen.”
Dick understood the terrible health effects of poverty and other social ills in the city, and he took a personal approach to outreach.
Sarah, recalling a walk with her dad in the city when she was young, said she saw evidence of that care: “A homeless guy popped out of a sleeping bag and said ‘Yo, Dr. Fine!’ He said, ‘Hey Jimmy, how’s it going?’”
In 1970, Dick founded the General Medicine Clinic, an outpatient clinic at the hospital that provides health care to underserved populations. He ran it for 25 years. In August, the clinic was renamed the Richard H. Fine People’s Clinic.
“I was able to use S.F. General and UCSF as a springboard for demonstrating new ways of care,” he told the San Francisco Chronicle in an interview earlier this year.
Mark Dowie, a friend of Dick’s who lives in West Marin, said that when he was helping prisoners in San Francisco, he would send them to the clinic for medical attention. “[Dick] was a really good guy, and very generous,” Mark said.
San Francisco General was at the forefront of AIDS care as the crisis emerged, and it formed the first dedicated AIDS ward in a public hospital.
But some patients, fearing the stigma of AIDS, did not want to be seen at the ward. Dick—often out and about talking to people in the clinic and on the street—was the first to realize the problem. So he secured federal funding to create an AIDS treatment area within the hospital’s General Medicine Clinic, since no one in the clinic’s waiting room would know what ailment other patients had.
“Because of his close connections to the community, he was able to hear about this subset of people who weren’t showing up,” Dean said. “What that showed me was how Dick was always able to make visible what was invisible to many of us, with respect to disenfranchisement and marginalization.”
Dick, aghast at the treatment of inmates in local jails, sued the city over the issue, which led to many reforms. Along with a colleague, he also won grant funding to create a health center for inmates in San Francisco.
“The health care for county inmates was abominable,” said his wife, Kathleen Campbell. “You were basically handcuffed to a bed. I mean, people were dying in jails because of that.”
Dick also tended to members of the Black Panther Party.
Sarah said that one time at a party when she was a teenager, a member of the Black Panthers came up to her, shook her hand, and said, “Your dad saved my life.”
Though he took his work seriously, Dick wasn’t averse to using a flamboyant costume to make a point. Once, upset about a city program that provided broad health coverage but had a loophole that left the very low-income without care, he asked for a meeting with some government officials.
He showed up wearing a cape and devil’s horns. They asked him why he was wearing such an outfit.
“Dick said, ‘Because with every policy, the devil is in the details,’” Dean recalled.
Despite his busy work life, he made time for his wife, whom he met when she was a secretary at the hospital, and his twin daughters, Sarah and Lynn.
“He was a phenomenally involved father,” said Sarah, who also works at San Francisco General, as a project director for the university-run Center for Vulnerable Populations.
She described a childhood full of swimming, biking and sailing around Inverness, where the family had a second home. “When I think back on my childhood, I think of Inverness and Point Reyes,” she said.
Dick was introduced to West Marin by a member of a Berkeley commune he spent time with in the 1960s, who often stayed in a house in Bolinas. Dick ended up renting a cottage behind Manka’s Inverness Lodge in the early 1970s, and he and his wife bought their home in Seahaven soon after.
Dick loved to sail, and he would take his daughters out on Tomales Bay on his sailboat, which he named Shiksa (the Yiddish word for a non-Jewish woman).
He purchased the boat with money he and his wife’s parents had given the couple to start a college fund for their daughters. “The way he tells it, he asked our four-day-old daughters what they’d like us to do with that money, and they said they really wanted Daddy to buy a sailboat,” Kathleen said.
He also would take hospital interns and others sailing. He could be a bit bossy to his makeshift crews, but for Dick, the bay represented an important respite from a stressful job.
“I think that Tomales Bay, to Dick and to many of us, signified a refuge from the really tremendous burden—you could call it trauma in many ways—of what it’s like to be a caregiver at a public hospital,” Dean said. “It certainly requires a place to reconnect to another part of life.”