NEW YORK - She was not supposed to be working on Friday at Bronx-Lebanon Hospital Centre, making afternoon rounds on the 17th floor. Dr Tracy Sin-Yee Tam usually worked in a ground-level family medicine clinic, where she would treat patients from the hospital's South Bronx neighbourhood.
But those who knew Dr Tam were not surprised to learn what she was doing inside the hospital when the authorities said a gunman, a disgruntled former doctor there, opened fire, killing Dr Tam and wounding six others before killing himself.
Another doctor had needed his shift covered. Dr Tam volunteered.
"She would never say 'no'," Dr Tam's friend Jude Beckles-Ross, 46, said through tears on Sunday outside the doctor's home in Queens.
She was early in her career, but Dr Tam, 32, had established a reputation for being caring and conscientious in a way that those around her found remarkable, even in a field built on caring for others that requires intense commitment.
Dr Tam, whose father drives a taxi in Queens, had struggled to make it into medical school, but mentors and colleagues said she had plenty of options when she graduated. Again and again, she chose to work in demanding environments in neighbourhoods of New York City where people had limited access to medical care, places that few young doctors enthusiastically pursue.
At Bronx-Lebanon, about 70 per cent of the patients are on Medicaid, and physicians regularly assume a role that goes beyond physical care, helping patients address family disputes or emotional issues, said Dr Sridhar Chilimuri, Bronx-Lebanon's physician in chief. The atmosphere can chip away at a young doctor's idealism, he said, yet he was impressed by how strongly Dr Tam, who had been an attending doctor at the hospital for a year, held fast to hers.
"Training young physicians to be doctors is an extraordinarily difficult thing," Dr Chilimuri said. "Making them idealistic, and also do exactly what we're doing, is just impossible." He added, "To lose somebody like that now is really a monumental loss for us."
Dr Tam was in one of the earliest classes to enrol at Touro College of Osteopathic Medicine, a medical school that had its first graduating class in 2011. The school occupies an old department store building in Harlem. Much of the student body comes from New York City, said Mr Martin Diamond, the college's founding dean, and its mission is to recruit minorities into medicine and to train and encourage students to work in locations that were historically underserved.
Dr Tam started at Touro in a master's degree programme, which provided a one-year window to make it into medical school, but required students to maintain a high grade point average. "This was a good avenue for us," said Dr Jennifer Dorcé-Medard, a friend who practises family medicine in Fort Lauderdale, Florida. "A better chance and a second chance for us to achieve our dreams."
Dr Tam lived in Jamaica, Queens, Dr Dorcé-Medard in Corona, so they would pair up for study sessions that went late into the night. The two made it into the medical school, a four-year programme from which they both graduated in 2013. Dr Dorcé-Medard recalled seeing Dr Tam last year, as they were finishing their residencies. "Can you believe we did it?" she remembered telling her. "It was like we conquered something together."
After Touro, Dr Tam started her residency in family medicine at Palisades Medical Centre in North Bergen, New Jersey, and from there, she moved to a clinic in Harlem, which placed her back in the kind of community she had sought to work in.
Dr Tam's professors remembered her sweet smile and her politeness. Colleagues and friends said she was shy. Her commute, to New Jersey as a resident, and later to the Bronx, was a punishing one, a long way to travel from Queens.
One mentor, Dr Naghma Burney, said that last year, Dr Tam spent what should have been a month off working with her in the hospital, hoping to learn more.
"The way she died was the way she lived," said Dr Shailee Udani, a physician in Manhattan who worked at Palisades Medical Centre.
Outside of medicine, her family was her focus. She lived with her parents, who immigrated from China, and her younger sister. On Sunday, friends and other doctors visited Dr Tam's home, a two-storey brick house in the Hillcrest Estates neighbourhood. Some left flowers on the front steps, while her family mostly stayed inside, avoiding visitors. A relative who answered the door on Sunday declined to talk to a reporter.
Ms Liza Raza, her friend, said Dr Tam was "just perfect, in terms of her humanity".