Activists in the impoverished communities around University of Chicago Medicine on the South Side pleaded for years for the affluent system to open an adult trauma center. The catalyst behind their rage and grief: their friend and fellow activist died after having to trek to a center 10 miles north, though he was shot just blocks from U of C’s sprawling medical campus. The system had closed its center decades earlier. The activists’ momentum grew as the Black Lives Matter movement swept the nation. Add to that the city had shuttered mental health clinics and schools, impacting poor and minority communities the most. It took a five-year contentious battle, but U of C finally gave in. What prompted this change of heart from one of the biggest and most powerful health systems and universities in Chicago? Two compelling reasons: the university’s bid to snag the prestigious Obama presidential library, and a lucrative cancer institute for the health system.