'One Boston' or two? Hospital wants to be strong for all victims of violence.

Boston Medical Center, which treated 28 Boston Marathon victims last year, is the city's busiest trauma center all year long. Officials stress that violence is an everyday problem for Boston.

Brian Snyder/Reuters
Pedestrians are reflected in a 'Boston Strong' t-shirt displayed in a shop window, as they walk past the site of the first bomb blast from the 2013 Boston Marathon bombings in Boston, April 16, 2014.

As Boston remembers the bombings that ended three lives and forever changed scores of others, a city hospital is reminding the public – and, perhaps, itself – that the events at the Boston Marathon finish line were not the only test of the city’s strength: In some neighborhoods, such tests, if often less graphic and less public, are a wrenching norm.

Officials at Boston Medical Center (BMC), which treated 28 marathon victims on April 15th, 2013 and is also Boston’s busiest trauma center all year long, emphasize that the hospital is by no means downplaying the enormity of the tragedy at last year’s marathon.

But while acknowledging the ugliness of what happened last year, as well as the long healing process still ahead, BMC officials have also emphasized that violence is an everyday problem for Boston. To that end, the week of commemorative events that the hospital began on Monday with a flag-raising ceremony is dedicated not just to the victims of the attack at the marathon, but to “all victims of violence.”

“We were all very moved and touched by all the support, but it was also important not to forget that we deal with violence every day,” says Andrew Ulrich, vice chair of emergency medicine at BMC. “It put a light on something that happens all the time, and it does allow an opportunity to spread that light around.”

Last year, on April 15th, a pair of brothers placed two pressure cooker bombs at the Boston Marathon’s finish line, prosecutors allege. That afternoon, the bombs ripped through the busy scene on bar and restaurant-packed Boylston Street, where spectators had gathered for one of Boston’s most celebrated events. Three people were killed and at least 264 were injured.

Within 45 minutes of the bombing, BMC received 23 people from the finish line and took in five more as the day unfolded. The surgeries were often complicated, the recovery times long. Well-wishers, some of them with bona fide movie star grins, offered support. Actor Bradley Cooper popped in for a visit. So did Sen. Elizabeth Warren.

Meanwhile, BMC was still Boston’s de facto city hospital – it was, in fact, the formal city hospital for more than 100 years, until it merged with the Boston University Medical Center Hospital in 1996.

In the week after the bombings, BMC took in nine shooting victims. Those high numbers were not flukes: BMC sees over 1,000 incidents of “intentional violence” a year, including victims of gun violence and beatings, says Mr. Ulrich, and it gets between 70 and 80 percent of all gunshot and stab wound victims in Boston, according to BMC statistics.

“Unfortunately, intentional violence is something we know very well,” says Ulrich.

But, though first responders know that violence well, much of Boston does not.

“You don’t often hear about gunshot and stab wounds in this city,” says Lisa Allee, the director of the BMC Community Violence Response Team, which provides free mental health support to violence victims and their families. “But there are hundreds and hundreds of violence victims out there, people who are a part of the community, and who are neighbors, and all of them deserve recognition.”

Jamarhl Crawford, a graphic designer who recently ran an unsuccessful write-in campaign for a city council seat, has over the last year tallied the number of shootings in Boston since the Boston Marathon on his blog and online forum, Blackstonian.com. The number, updated daily, is emblazoned on a graphic design that mimics a marathon bib, in a pointed attempt to call attention to violence that happens all the time off the marathon route, he says.

As of Thursday, there had been 235 shootings since last year’s marathon, according to Blackstonian.com. Ten of the 15 shootings since Jan 1st have happened in just three of Boston’s 12 neighborhoods, according to Boston Police Department data: Dorchester, Roxbury, and Mattapan.

Indeed, a painful point is that such little noticed, everyday violence is not experienced evenly across Boston, but hits black and Hispanic communities concentrated in low-income neighborhoods the hardest, says Mr. Crawford, who lives in Roxbury.

“This is a tale of two cities,” says Crawford of the post-bombing rallying cry “One Boston,” referring to a schism that is not unique to Boston, but divides cities across the country. “There are most definitely two Bostons, maybe more.”

Of the 234 people treated for gunshot wounds at BMC last year, 184 of them were black, according to hospital statistics that Ms. Allee says show “an off-the-charts, clear disparity” in how different racial groups are affected by violence in Boston. Another 28 of those patients were Hispanic, 15 were white, and three were Asian. Five did not specify race.

For the BMC staff, the weeks after the bombings were spent in a constant effort to ensure that the influx of Boston Marathon bombing patients would not split the hospital into haves and have-nots – those that had lightly-bearded movie stars at their bedsides, for instance, and those who did not.

“It was difficult, but it was clear and evident to us that we needed to provide that high level of support to everyone,” says Allee. “Every single person who comes though the hospital doors is just as important as another.”

These days, the sense of community palpable at the hospital just after the bombings have heightened BMC staff’s expectations of themselves, says Allee.

“Doing this every day, you get into a pattern,” she says, “but then something highlights for us that we can do better, that we can do even more, and that we can do it every day.”

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