August 25, 2017 - The boxes stacked in the living room held all the things Joshua Dixon thought he would need in a dormitory. Bedsheets and a matching comforter. Bluetooth speakers, a computer printer and, most important, photos of his younger self.
When the 18-year-old is hundreds of miles away at Maine College of Art in Portland, he'll use the pictures to remember — and to explain to new friends — exactly how far he's come.
Ten years ago, Dixon was mauled by his family's TWO PIT BULLS in his backyard when he returned home from school. The dogs tore off most of Dixon's face — his nose, ears, layers of skin and muscle — all gone in the seconds before his parents made the gruesome discovery and frantically called 911.
Since that snowy, life-changing day in December 2007, Dixon has undergone 59 surgeries to reconstruct a face that people still snicker at, he said. He endured repeated bullying from high school peers, which pushed him to contemplate suicide and hide for years behind the hood of his sweatshirt.
Yet as Dixon and his mom prepared to drive across the country this week to drop him off at the school where he plans to study to be an art therapist — something he discovered in the hospital where he spent much of the last decade — he said he doesn't regret the experiences that led him here.
"I wouldn't take it back," said Dixon, a single tear falling from his one working eye. The traumatic incident that in many ways stopped Dixon's normal childhood in its tracks also gave him an unexpected path forward. Dixon's dream is to become an art therapist, or child life specialist, to help young people recover from crises the way he was helped during his many stays at the University of Chicago's Comer Children's Hospital.
"I met so many people that a regular person wouldn't have met in a lifetime."
Before the mauling, Dixon was a handsome, obedient third-grader who loved basketball, video games and snuggling with his pit bull puppy, Shoop, said his mother, Kimberly Rounds.
Most days after school, the honor roll student would meet his father outside Bennett Elementary in Chicago's Roseland neighborhood for the three-block walk home, or walk to the home of the next door neighbor, who looked after him until his parents arrived.
But on the afternoon of Dec. 5, 2007, after a family miscommunication, Dixon went home alone, assuming his parents would be there soon. Shoop and Bam-Bam, a male dog that his father had brought home six months earlier for breeding, got loose when the 8-year-old opened the door. Panicked, Dixon pulled Bam-Bam's tail to urge him back inside.
In an instant, Dixon slipped on the ice and was lying on the ground. The male dog snapped, tearing at Dixon's face and head, the most accessible body parts not protected by the boy's leather jacket. The female dog, in what Dixon believes was an act of loyalty, tried to pull the boy away, also sinking her teeth into his face as she yanked him in the opposite direction, Dixon recalls vividly.
After initial pain, Dixon said, he became numb as the dogs ripped away his flesh. "I just kept saying to them, 'Stop, stop, stop.'"
Minutes later, his father discovered the boy facedown in the snow, scooped him up and carried him into the house, choking through sobs to call an ambulance. But as the parents waited for what seemed like an eternity for paramedics to arrive, they were amazed that the young boy was still awake and alert.
He told his parents not to worry, and not to let the doctors call him "Josh," a nickname he didn't like, Rounds said.
"It was a trying day, but if you believe in God, it was like an angel was there sitting with him," Rounds said. "His brain was working."
The worst case
It took all night for doctors to clean Dixon's wounds, identify the parts of his face that were gone, and devise a plan for reconstruction. Although his brain was untouched and functioning normally, Dixon's was the worst case of facial trauma Dr. Lawrence Gottlieb, director of the Burn and Complex Trauma Center at Comer, had ever seen.
"It was a tremendous challenge," said Gottlieb, who has overseen Dixon's care for a decade. "All he needed was a complication or an infection and he could die."
Dixon's injuries required so many hospital visits and surgeries that he was homeschooled to accommodate operations or check-ups every three or four weeks. Doctors removed skin from his arm to go to his nose. They took pieces of rib and bone from his head to reconstruct parts of his face. And they created two prosthetic ears — modeled after his mother's — to clip onto the side of his head.
Tracy Lau-Esquibel, a certified child life specialist at Comer who was assigned to work with Dixon, said she worried about how the young boy would cope with his altered life when he awakened after the procedures. Successful recoveries for pediatric trauma patients hinge largely on the child's positive attitude and support from family, she said.
Thankfully Dixon had both, Lau-Esquibel said.
Kimberly Rounds stayed at her son's bedside day and night, reading to him from the Bible and playing uplifting music that she knew Dixon loved.
When Dixon returned to his feet, his mother painstakingly worked to help her son re-learn to walk, talk and write after weeks without using his muscles. Rounds remembers forcing her son to get up and walk the hallways late at night when other patients were sleeping.
"It was hard, but I had the wheelchair right behind him," Rounds said. "I told him, you know we're in this together. Either you use it or you lose it, that's the only way to go."
At the same time, Dixon seemed to have an inner strength that came naturally.
Each time Lau-Esquibel asked him to explain what the plan was for a hospital visit — a strategy child life specialists use to gauge a child's perspective — Dixon matter-of-factly, even humorously at times, explained grisly procedures such as a skin graft or a collapsed cadaver nose repair.
When kids in the hospital playroom asked Dixon what happened to his face, he answered without shame or bitterness.
"He wouldn't skip a beat. He would just give the answer, just like, 'This is what happened to me,' Lau-Esquibel said. "That resilience just carried over with him through his whole hospital experience."
Dixon said he had many moments when he felt angry about his situation. His family members were consumed with their own guilt about the attack: His mother, for being bedridden after an operation and not able to pick him up from school. His father, for thinking that breeding pit bulls would be a good idea. Dixon, for pulling the dog's tail, something he knew better than to do.
But with counseling, difficult family discussions and time, Dixon and his parents were able to let go of the bad feelings and concentrate on moving forward.
"We still sit around today and say it was all of our faults," Dixon said.
Healing through art
Along the way, Dixon found an outlet that helped him to cope with his challenges. At the hospital, staff introduced him to art therapy, which allowed him to express himself using colorful paper, crayons, paints and eventually computer design.
Shortly after the attack, Dixon, still 8 years old, drew a gingerbread-like man wearing a button-down shirt, tie, slacks. The figure's eyes were symmetrical and his mouth was smiling. Next to the figure, Dixon drew the same gingerbread man with a missing eye and a sad face. His dress shirt was replaced with a hospital gown.
"Joshua consistently engaged in art as a method for self-expression," said Sue Yoghihara, the art therapist at Comer. "Art provided a source of hope and healing."
The escape through art was especially helpful to Dixon when he began high school — his first time in a classroom setting with peers after being away for five years.
Outside of home and the hospital, which became like a second home, life became more difficult for Dixon. When classmates refused to let him sit with them at lunch, called him "scar face" and tripped him down the hallways, Dixon hid behind a hooded sweatshirt and retreated to his computer-art programs.
Using photography, digital manipulation and digital illustration, he created pieces to describe his battle with self-esteem, how he felt about hateful comments directed at him, and his struggle to recognize himself in the mirror.
"It took my mind off the pain sometimes," Dixon said. "It really helped me to face my fears in a psychological way."
Rounds also did her part to help her son to push forward. When she heard of bullying incidents, she insisted on meetings with the high school principal, counselor and teachers to ensure the perpetrators were confronted.
When Dixon was a freshman in high school, he posted a heartbreaking update on Facebook: "I step out of the house every day wishing I can stay home forever or die and be relieved from all this pain."
After that, his mother insisted on regular appointments with a therapist. When they arrived, the mother told him to leave his hoodie in the car.
"I said, 'Stop hiding yourself. You're beautiful. Accept who you are. And once you accept who you are, no one can touch you,'" Rounds said.
In time, doctors and medical staff at Comer saw a noticeable difference in the way Dixon carried himself. They marveled as he went out of his way to talk to new patients at the hospital, encouraging them through their own crises by talking about his own.
He welcomed questions from medical students, who studied his case in books about facial reconstruction. Looking on proudly, Dr. Gottlieb came to think of Dixon as another child of his own.
"He's a pretty amazing kid," said Gottlieb. "He was grateful, he was accommodating. He never gave us a hard time, and he always wanted to help other people."
Pursuing a dream
In March, Dixon had his 59th surgery — to fix a collapse in his nose and make other small adjustments — which doctors believe will be his last necessary reconstructive procedure. By then, he had made up his mind to study art in college and was applying to schools in Chicago, Maine, Tennessee and Massachusetts.
Today his face appears similar to that of a burn victim, with an uneven surface and discoloration. His left eye, which is only able to detect some light, is covered with a protective plastic cover. His nose, lips and cheekbones have all been reconstructed. The final surgery also helped to pull his smile up.
Rounds hoped that her son would land at the Art Institute of Chicago, so she could continue to look after him, even if from across town. But after a visit to Maine, and a significant scholarship offer, she knew he would be leaving home.
Earlier this month, in a break from packing for his big move, staff at Comer Children's Hospital threw Dixon a surprise going-away party. It had cake, balloons and hugs from nurses and doctors, and the art therapists and child-life specialists who had been there since Day One.
"You never want to say this was good for him, because it's such a devastating, terrible thing that you don't want to wish on anybody," Gottlieb said. "But in reality...without this terrible tragedy, I don't know if he would be going to college."
When Dixon and Rounds arrived at his dormitory in Maine on Thursday, the mother helped her son to install closet organizers and space savers. She made his bed, set up his TV — and helped him hang his photographs over the desk in his tiny room.
"I feel awesome about it and proud to make it this far, because it took a lot of hard work and determination to get here," Dixon said.
His mother said she is dreading her solo drive back to Chicago on Monday. But she has told her son to remember she's just a phone call or a plane ride away.
He knows how proud she is of him, she said.
"It's going to be like I'm leaving my baby behind," Rounds said. "But I know he's going to do great things."