Practically everyone in the South Bronx knows about the place at Grand Concourse and East 173rd Street. You can pick up scratch-off lottery tickets there. You can grab a bacon, egg and cheese on a roll on your way to work. You can go to Sunday Mass.



You can also go there for medical care, whether it is an emergency, a kidney treatment or a checkup for your 1-year-old daughter.

These are just some of the ways that residents of one of the most poverty-stricken communities in the nation interact with the roughly 4,000 doctors, nurses, cafe countermen and others who work at Bronx-Lebanon Hospital Center, one of the biggest employers in the Bronx and the scene of a horrific rampage last week when a disgruntled doctor who had worked previously at the hospital killed another doctor and wounded six other people with an assault rifle before shooting himself.

Towering over the Grand Concourse, the 972-room hospital is enmeshed in the daily lives of those who live around it in ways that hospitals in more affluent areas tend not to be, from the cafe and the gift shop to the chapel and the emergency room. If the neighborhood is a varied mix of nationalities and backgrounds (one in three was born elsewhere), the staff is even more diverse. The physicians alone represent about 40 countries.