Diagnosing Cities

This morning I had some spare time, so I started popping up whatever academic journals I could find. At first, I started searching for urban policy journals. They all had weird titles, and a lot was closely related to economics. Not exactly my cup of tea (yet). However, I soon found myself reading the New England Journal of Medicine.

On the website there is a very interesting link (http://www.nejm.org/image-challenge), a sort of trivia/puzzle game. The editors post a picture of a patient, and you, the reader, can choose one of five possible diagnoses. I thought the idea was awesome! So I started googling the possible diagnoses. First I tried using google images to cross-reference typical symptoms with the given visual data. Soon, I realized that 1. it was hard to see the differences between two possible diagnoses visually, and 2. many images on google were not at all similar to the problem at hand. For example, a picture of someone's hands with tumor-like clumps was not in fact cancerous, but bulimia nervosa--the patient used his/her hands to induce vomitting frequently.

What I realized is that the art of diagnosis in medicine is highly complex, full of surprises, and often misleading. And while readers of the NEJM were most likely doctors or medical students, the statistics of each game showed that there was no clear majority that selected the correct diagnosis. Of course, it's just a game. But I think there is enough complexity in differentiating symptoms that no one person can readily know the finer points of hydropneumothorax versus phrenic nerve palsy- without consultation to an expert or encyclopedic body of knowledge.

That sort of made me wonder something about my job working in a redevelopment agency. In many ways, cities mirror human bodies. They share very basic anatomical structures: the body has arteries and veins, while cities have roads. The similarities are such that transportation engineers have a term for typical 4-lane suburban lanes: Arterial roads. Police forces are simply the immunological T- and B-cell of our cities, which congregate upon intruding bodies: drug dealers, vagrants, etc. SWAT forces can be the macrophages. It's all analogical*.

So, how can we classify blight, or urban decay? A cancer of the city? Will these cancerous regions metastasize across other regions of the city, via blood/capillary action? Perhaps we are stretching the idea too far.

But really, if it is possible to make such detailed diagnoses on individual patients, can it be possible to make equally detailed diagnoses for cities or neighborhoods? Can we treat blight not as simply blight, but a highly complex and precise problem? Can we differentiate between different types of blight? And do we not have smart ways for treating them, not as a whole but as individual and unique problems?