Distant readers can just pass on this, but there is a theme today in my e-mail inbox.
Here in Pittsburgh one of the bigger pieces of news, economic or otherwise, is that there will be a major consolidation of hospital services
in town. My synopsis is that there will (very) soon be a major downsizing of West Penn Hospital in Bloomfield
where I was born and raised for the most part. In fact it all sounds to me like an interim step toward a more complete closure, but that is speculation on my part.
It's all major piece of news for a region that has been advertising a resurgence based on "Eds and Meds", but also for a neighborhood. But the big regional economic story in this we will leave for another day. For the moment the question is what the impact will be on the neighborhood and the city. For sure, this isn't the case of Braddock where the closure of a hospital will mean drastic changes in where nearby residents can get health care. In fact I was born in St. Francis Hospital
, which was within walking distance of West Penn. Yet even with effectively two fewer hospitals than once existed in the neighborhood, there is no lack of health providers in close proximity. The St. Francis site begat the ever-larger Children's Hospital and there exist several hospitals within a few miles of the neighborhood.
So is it a big deal? Sure. Especially for the workers themselves which may see their jobs 'downsized', a word with remains as silly a euphemism as when some management consultant dreamed it up.* For the area around the hospital it gets more complicated. What is coincidential is that in the WSJ today
is a diatribe of sorts against
the philosophies of the late Jane Jacobs, sage of all things urban. See: Enough with Jane Jacobs Already
. What is fascinating about that opining is not that it opposes Jacobs' philosophies, but that it highlights just how much more following and support she has today than ever before. It has been nearly 50 years since The Death and Life of Great American Cities
was published. Trust me there are a lot of things written 50 years ago that have not been heard about for the last 49.
What's Jane got to do with it? Jane Jacobs own writings many years ago were not fond of the community impact of large hospitals much as she was not a fan of how many large institutions interacted with their neighbors. Her experience, which included being a 'hospitals and schools' editor for Architectural Forum magazine, gave her a long perspective on the impacts of hospitals. Her consistent observations were that most large hospitals were essentially isolated enclaves that more often than not did little to inhibit blight in nearby neighborhoods.
I myself wondered if that part of Jane's thinking was still valid today. Hospitals must be big and good right? We're smarter about how large institutions interact with the community I was pretty sure. Some of that may be correct, but what got me back to Jacobs' core point was observing the economic impact of the relocated Children's Hospital in Lawrenceville which is a lot less than many think; especially when it comes to nearby retail activity and invesment. The areas closest to the relocated hosptial have not had much of what anyone would call a revival as yet. It's not a critique on the way the hospital is run, or of the way West Penn operates in Bloomfield. It is hard to integrate such large insititions into neighborhoods. In fact many of the forces driving large institutions to be 'efficient' force them to be ever more self-contained and isolated than in the past. So I am not sure the impact of West Penn on the neighborhood is as large or as positive as I think many presume. My point is merely is that it's not all good or all bad when you consider the gain or loss of a large institution like this.
Nonetheless, the footprint of West Penn Hospital is a nontrivial piece of real estate for a neighborhood, if not for the city. I fear what may be the true legacy of things like the Mon Fayette Expressway. Build it or not, the impact of a perpetually hypothetical project of that scale has inhibited a generation of potential investment in the communities slated to be paved over. Likewise if this is all a sign of further downsizing at West Penn in the future then I wonder how potential investors will view the potential of the immediate environs. Clarity is the most important thing for the neighborhood to plan it's future with or without the hospital.
What it means is that a clear vision of the future is needed from the hospital. The City of Pittsburgh is right now working on a comprehensive plan for the city. What is happening to large institutions like this needs to be an integral part of that plan. Trust me that Bloomfield, the neighborhood, can deal with whatever the future holds for the hospital. What will make this all a lot more painful than it needs to be is uncertainty or vagueness going forward. I bet there are some suprising options for a Bloomfield without West Penn. The question is whether we need to start working on what those options will be.
* You downsize a house, not a person's job. Don't get me going on 'rightsizing'?