Reflections on life, death, and Obamacare inside Oakland’s main trauma ward.

Working in the Highland ER means knowing the backstory of a part of Oakland that most of my friends and neighbors will never see. In my car, stopped at a red light, I find myself unconsciously filling in the bios and medical histories of passing pedestrians. A cane, a limp, a cough, a tremor: A city’s problems, often anonymous and impossibly abstract, gain context in the faces and lives of my patients. Urban violence is personified by the 19-year-old boy, shot square in the chest during a drive-by, whom I pronounce dead in the trauma bay. Domestic violence takes the form of a woman coming in for the fourth time this year, now with a dislocated shoulder and a broken wrist. The sexually trafficked 15-year-old, the homeless alcoholic, the diabetic with schizophrenia—the list goes on, and the tapestry of societal malaise is woven tighter and tighter.