I work in a brand-new, $2 billion hospital. It sits atop a hill, and, from the resident room on the 6th floor, I can see the vastness and beauty of the downtown San Francisco skyline. In the foreground, however, I can easily retrace the steps I take to work, through an area known as the Tenderloin. My hospital sits in stark contrast to the utter poverty and devastation that I traipse through during my 3-block daily commute. Once recently, I looked down to find a used syringe protruding from the end of my shoe.