On August 26, 2011, 68-year-old Vernon Traversie was admitted to the Rapid City Regional Hospital in South Dakota for emergency double bypass surgery. After his operation, Traversie, who is blind, discovered that he had been brutally mutilated while under anesthesia. In addition to the surgical scars, his torso was covered in gashes, with the letters KKK carved into his stomach. Traversie is a Lakota Sioux who lives on the Cheyenne River Reservation.

“They’re squeezing us, just like they were before Wounded Knee,” said Guy Dull Knife Jr., who lives on Pine Ridge Reservation. Along with Cheyenne River, Pine Ridge is one of over a dozen territories scattered throughout the Dakotas, Nebraska, and Minnesota that were granted to the Lakota Nation by the U.S. government in a series of treaties, most of which were signed in the late 1800s. Pine Ridge, about a hundred miles south-east of Rapid City, is in the heart of America’s Great Plains—prairies, canyons, buttes, and dry riverbeds stretch impossibly far in any given direction, framed by the Black Hills on one side and the Badlands on the other. I speak to Guy regularly to get updates on his life and news of the reservation—a result of my visits over the last few years to film a documentary that I am producing.

When Traversie woke up after his surgery and begged for painkillers, a male nurse told him to shut his fucking mouth, or it would be shut for him.

The film I am working on is in many ways about history, and how Guy uses his own family’s legacy to raise his children. So perhaps this historical perspective influences how I look at things there; it is difficult for me to divorce much of what exists on the reservation—especially the dynamic between the reservation and the white communities surrounding it—from historical narrative. Pine Ridge has been the site of some of the most pivotal clashes between Native Americans and the U.S. government, including two incidents at Wounded Knee: a massacre of unarmed men, women, and children in 1890 and an armed occupation by activists on the same site in 1973.

Media coverage of the reservations often focus on widespread poverty, and indeed, the statistics seem to speak for themselves. But beyond the statistics—which include staggering rates of unemployment, diabetes, alcoholism, and teen suicide—there is a clear historical thread that ties the so-called pacification of the American West to present-day circumstances. Vern Traversie is one more entry in a very long list of injustices that have helped define the region.

When Traversie woke up after his surgery and begged for painkillers, a male nurse told him to shut his fucking mouth, or it would be shut for him. Because Traversie is blind, it was difficult for him to identify those who mistreated him and those who cared for him. A day before his discharge, he says, a female nurse approached him and urged him to have someone photograph his torso as soon as he got home, saying that she thought it was horrible what had been done to him. She also told him that she would not testify or identify herself, as she feared for her family’s safety. What strikes me about this story is that the nurse asked Traversie to identify himself by confirming his name and birth date before she told him all this. That is to say, she hadn’t accidentally discovered his wounds on him—she had heard about them. It is easy to imagine, then, that Traversie’s mutilation was an open secret amongst hospital staff and that many know the names of those responsible.

In order to access basic goods and services, people who live on the Rez generally have to go off it. And that is where trouble lies.

Acts of racism, from profiling to hate crimes, are endemic for Lakotas on Pine Ridge and in Traversie’s nearby Cheyenne River Reservation. But Traversie’s is a particularly brutal and blatant case, one that that may cast him as a figurehead in a movement targeting the rapidly deteriorating conditions in which Native Americans live. Economic opportunities are scarce on the reservations of South Dakota; like inner-cities, the nation’s economic crisis has hit them especially hard. But the harder someone is squeezed, the harder the blowback will be, and Traversie’s mutilation may be a breaking point. Like Rodney King, the brutality Traversie faced was more than just ferocity and ruthlessness—it represented an abuse of power and of public trust. And like King, Traversie may be the unwitting victim that causes an already tense situation to explode.

After Traversie’s story went public, Rapid City Regional released a statement saying it was “deeply committed to providing excellent care to everyone, regardless of race.” I personally know several Lakota families who would scoff at this and am confident that thousands more would join them.

I have spent a fair amount of time at Rapid City Regional Hospital. At various times during our production shoots, several people we know (whose identities I will keep private for obvious reasons) ended up there—one after a stroke, one for gall bladder surgery, and one for injuries resulting from a car crash. The adults I know who received care there reported receiving a barrage of withering and hateful treatment from nurses and doctors (children were treated more compassionately). The father of the auto-accident victim told me that no attempt had been made to clean the wounds, and he spent the better part of the night removing gravel and dirt from his son’s neck, which were concealed underneath bandages hospital workers had hastily placed there. Despite this pattern, many Lakotas depend on Rapid City Regional because it is the closest major hospital.

Last November, thousands of KKK pamphlets were found inserted into merchandise in Walmart, Best Buy, and Scheels in Rapid City. No one was apprehended.

Dennis Banks, one of the founders of the American Indian Movement (AIM) in the 1970s, estimates that “$40 million of Indian money goes to [Rapid City Regional] every year.” He is perhaps the first, but certainly not the last, to demand a boycott of the hospital in the wake of Vern Traversie’s mutilation. The occupation of Wounded Knee in 1973 was probably the height of AIM’s national visibility. Since then, their influence and general organization has largely waned. The ranks of their leadership have been thinned by violent deaths and incarceration, which tended to leave their followers without the direction or stomach to continue the struggle. But that may be changing, as more and more young people attend meetings and protests and the original “AIMster Gangsters” become active again. “I thought I had retired from all that AIM stuff,” Guy told me on the phone the other day. “But I just had to get in there and encourage the boys to get in there…somebody has to.” The family had recently returned from one protest and were making plans to attend another. Guy’s fear, however, is that things really will come to a head, and that’s just what the South Dakota government is waiting for. The Siege at Wounded Knee was resolved just short of the 82nd Airborne being called in, which would have had certain and devastating results for the occupiers.

I have always thought that for the Dull Knifes, or any Lakota, living on a reservation that is surrounded by state parks, monuments, and highways named after US military officials who essentially committed genocide would be humiliation enough. But from my perspective (the Jewish, progressive, New York one) the conditions that were set up decades ago to keep Native Americans dependent on government handouts and contained on a reservation seem very much intact. In part because of the reservation’s sovereign status, it is often difficult for residents to access credit or obtain loans, as there is nothing that can be legally repossessed without going through tribal court—a risk that most banks are not willing to take. The result is that there are strikingly few businesses on the reservation, and those that do exist are rarely owned by Native Americans. Thus, in order to access basic goods and services, people who live on the Rez generally have to go off it. And that is where trouble lies.

I’ve made the trip from Pine Ridge to Rapid countless times, but for those that don’t share my white privilege, the journey can be fraught. Once off the reservation, a stop by state troopers is practically guaranteed, and any minor infraction results in citations: a broken headlight, one or two miles over the speed limit, a small crack in the windshield. Many people that I’ve spoken to have reported getting two tickets on the way in to Rapid and two tickets on the way back—essentially several hundred dollars in fines just for leaving the reservation. The guiding philosophy of local law enforcement seems similar to that of Stop and Frisk—stop someone all the time, and eventually you’ll catch them doing something wrong. And like many inner cities, a community that is over-policed and under-serviced can become desperate.

Indeed, there is a feeling that things could blow up at any moment. Last November, thousands of KKK pamphlets were found inserted into merchandise in Wal-Mart, Best Buy, and Scheels in Rapid City. No one was apprehended. KKK graffiti has appeared on the road signs and pavement between the reservation and Rapid City, telling Native Americans to stay on the Rez. It is difficult to discern whether the marks—on Rapid City’s roads and on Vern Traversie’s torso—are the result of organized directives of a local Klan chapter, or simply the actions of a few angry young men clinging to white supremacist imagery. What is clear is that since Obama’s election, Klan membership has nearly quadrupled nationwide; the number of hate groups that the Southern Poverty Law Center refers to as “Patriot Groups,” has also sharply increased. Easily exploitable issues like immigration, gay marriage, and now even healthcare, have made recruiting disaffected white men easier than ever.

Too often, the stories that do make it out of Pine Ridge are slanted in one direction, depicting the situation as intractable, leaving outsiders feeling sympathetic but powerless.

Vern Traversie, after documenting and reporting his wounds to tribal officials, retained a lawyer, who told him not to talk about the case. He complied, and his story was not made public. After six months of watching his case languish, Traversie dismissed his lawyer and started a social media campaign. In April, friends of Traversie’s released a ten-minute YouTube video in which Traversie speaks gently and directly about his story, but eventually breaks down, continuing while choking back tears. It’s hard to say that Traversie’s campaign has gone viral—as of today, the video has around 71,000 views and his change.org petition still has less than ten thousand signatures—but for a community whose routine oppression is largely ignored by the rest of the country, it shows promise.

On May 21st AIM members organized a protest march in support of Traversie. Roughly five hundred people marched through the streets of Rapid City, ending at the hospital where state troopers awaited them. Guy attended the march with several of his family members. Two of his sons were AIM security, charged with keeping the protest peaceful. It started out as a rally for Vern, Guy told me, but people had so many complaints, it quickly got out of hand. People in passing cars shouted “Go back to the Rez!”

“Vern Traversie was the reason we all gathered there,” Guy told me after the rally, “but once we were all together, all our grievances started coming out. We’ve been taking years of abuse without saying anything, and people are fed up.” Despite the frustration and taunts, the protest remained non-violent. Organizers Dennis Banks and Tom Poor Bear were let through the State Police cordon to meet with hospital officials. This temporarily diffused the situation but has not led to action. Almost two months later, neither an internal nor public investigation has been initiated. In all likelihood, the person or persons responsible for mutilating Traversie—and anyone else who may have known about it—are still employed at the hospital.

The FBI has promised to take a statement from Traversie, and that an investigation will follow. But most of the protestors have little faith that the FBI will bring them any justice. Many of the crimes committed against members of the Black Panther Party in the ’70s through COINTELPRO have been exposed in the last two decades, and many similar crimes were committed against AIM members—perhaps with even less accountability. The FBI is thus largely perceived to be the political police of the U.S. government, and their own illegal activities with regards to AIM members, especially on Pine Ridge, have been only spottily documented. The war between the Black Panthers and COINTELPRO was a tragic part of our nation’s recent history, but transparency and accountability for law enforcement organizations have increased since the mid-’70s. COINTELPRO gave way to Reaganomics, crack-era policing, and Rockefeller laws, and oppression of black communities became more insidious. Less so, perhaps, on the reservations. The issues—illegal expropriation of Native land and resources, institutional racism—that led to initial clashes between the FBI and Native American activists seem barely to have evolved. And losses suffered by both sides seem still fresh.

Robin LeBeau, a tribal council member on Traversie’s Cheyenne River Reservation and one of the organizers of the march in Rapid City, is helping Traversie obtain a new legal team. She recently summarized her interview with the FBI in a post on the “Justice for Vern Traversie” Facebook page, reporting that they seemed more interested in finding out about future protest activity than in gathering information about the case, even reminding her that gatherings such as the protest march make people “uneasy.” It seems like a throwback: the U.S. government is still on edge about the prospect of too many Native Americans massing in one place. This nervousness seems to indicate that the government understands the grievances are legitimate.

Guy has told me that if things get truly heated, there will be no happy ending for Native Americans in South Dakota. As he puts it, “we’re just outgunned.” I trust his assessment—Guy is a combat veteran of both Vietnam and the Siege at Wounded Knee. I also share his lack of faith in public officials and the FBI. But that does not mean the struggle is futile: hope can be found in Trayvon Martin’s case, where local officials were similarly content to remain silent until the wider public—through petitions, social media outrage, and protests—demanded action. If Vern Traversie is to receive justice, and if the conditions that enable institutional racism to become entrenched are to be eradicated, change must be demanded from without as well as from within.

I myself am testament to the fact that much of the country lives in relative ignorance of the everyday racism that Native Americans often live with; I was unfamiliar with many of these issues until a film project brought me to the region. Too often, the stories that do make it out of Pine Ridge are slanted in one direction, depicting the situation as intractable, leaving outsiders feeling sympathetic but powerless.

It would be gratifying to see Vern Traversie have his very own Gareth Peirce fly in and kick the asses of some backwards state justice official who never saw it coming. That would give us a Hollywood ending. But Traversie’s scars are permanent—“I’m going to have those marks on my stomach for the rest of my life, and I also have those on my spirit,” he says through tears in his YouTube video. When I sit at home thousands of miles away from the Cheyenne River Reservation watching this, I cannot help but think that while the brutal attack is something only he lived through, it should burden us all. If the letters were burned into his spirit, they are burned into ours too.