My book project, Poison Pill: Debt, Medicine, and the Most Toxic City in America (tentative title), uses Baltimore as a case study to analyze “embedded and embodied” forms of inequality wrought by deindustrialization and racial exploitation. As I show, the rise of academic medical centers after WWII anchored a care economy every bit as damaging to communities as the manufacturing base it replaced. Living adjacent to Johns Hopkins’s expanding medical campus, African American communities mounted social, economic, and environmental justice movements as the city’s labor force traded its hard hats for sterile scrubs. At the same time, however, these same families began to suffer an environmental crisis among the worst in the nation: a childhood lead poisoning crisis festering in rental buildings held by absentee landlords. Living in homes layered in toxic lead and financed with predatory mortgages, Black Baltimoreans struggled to navigate the city’s failing health and welfare systems, policy gaps that materialized into dramatic mortality and life expectancy disparities. Hopkins Hospital, meanwhile, grew into the city’s largest employer, landlord, and political power broker. Today, residents living in the shadows of Hopkins describe the sprawling institution—and its extractive relationship to its surrounding community—as “the plantation.”