Not long ago, Gloria WilderBrathwaite, or Dr. Gloria as she is called, was seeing patients in her mobile health care van at 13th Street and Saratoga Avenue NE when gunshots rang out nearby. Arriving on the scene, she found a young man lying in the street, bullet holes in his head and jaw.

While administering first aid, Dr. Gloria happened to look up and see "kids still playing basketball and a game of tag. Parents were standing around having casual conversation. No one even thought to cover the faces of the smallest kids."

For more than a decade, Dr. Gloria has operated her medical van out of Children's Hospital, serving the poor throughout the District while waging a one-woman war against what she calls a "culture of trauma."

It is a culture in which expectations are so low that many residents accept the worst. Having been conditioned to believe that they can't do anything to help themselves, let alone help others, their only hope is that, perhaps, the next day won't be quite as bad.

When it comes to health care, the trauma culture shows up as a belief that one must be on death's doorstep before going to see a doctor. And if a patient is forced to wait all night in an emergency room just to get some antibiotics, then it's because he or she isn't worthy of being treated better.

As Dr. Gloria sees it, the health of the city will not change until the "health beliefs" of its residents change.

"People need to understand that they are entitled to be safe and well, and not feel ill or threatened by gun violence and crime," she said. "Once they realize this, they will begin taking the steps necessary to get the results they desire."

Of course, during this seasonal outpouring of goodwill, there is much to suggest that the community spirit is alive and well. Thousands of meals were prepared and served on Thanksgiving to the homeless and to those with AIDS, breast cancer and other illnesses and injuries.

On the other hand, there is no season for questioning why there are so many homeless in the first place, or so many dying from all kinds of diseases and injuries -- AIDS, cancer and gunshot wounds, just to name a few -- for which there are cures and preventions, or for which there certainly ought to be.

On Wednesday night, a 14-year-old District girl who'd been out selling candy door-to-door in Fort Washington was shot to death, allegedly by a 14-year-old boy who had been selling candy with her. This is outrageous. Or at least it ought to be.

As of Friday, there had been 126 homicides in Prince George's County, compared with 119 for all of last year. In the District, as of Nov. 27, there were 272 homicides, compared with 232 last year.

Just numbers; nobody we knew.

"When I'm driving around Capitol Hill, I'll pull over and watch people having a great time walking their expensive dogs and throwing Frisbees," Dr. Gloria said. "Just two blocks over, I'll see people in poverty, dealing with serious medical problems, recovering from gunshot wounds, in the process of losing their homes. The two groups are living totally different lives. They may be neighbors, but they certainly don't see each other."

A few nights ago, as her medical van was about to pull off, Dr. Gloria saw four young girls standing outside in the cold. It's not unusual for her to see children out on the streets at all hours of the night. But these four appeared particularly vulnerable.

"It turned out that their mother had not yet come home from work and that their older sister had been held over at school," Dr. Gloria recalled. "They were waiting for someone to come home and let them in. But my question was, where are the neighbors? Why do we ignore each other this way?"

The gunshot victim Dr. Gloria had attended to was pronounced dead on arrival at Washington Hospital Center. A similar declaration could have been made about the spiritual life of those who had been so callous to his killing.

Removing her bloodstained surgical gloves as she headed back to the mobile clinic that day, Dr. Gloria wondered: "What has happened to us as a community?" And by that she meant more than just those living around Saratoga Avenue.

E-mail: milloyc@washpost.com