Alleys as Arterioles

M

elissa was finishing her second year of medical school at Georgetown University and one late spring afternoon she found herself meandering through one of the few reclaimed alleys in the area. She had just finished a grueling cardiovascular system pathophysiology exam, was exhausted from nights of cramming and blissfully let her mind wander aimlessly. She felt safe. The golden beams of a dying afternoon sun danced over the alley bricks and bounced randomly off the walls of stables and other century-old alley buildings.

Still flushed with images of the circulatory system swimming in her brain, she couldn’t help but think about alleys as arterioles or little arteries and streets as larger arteries and highways as the aorta. The gutters became lymphatic channels. People and cars and bicycles became red blood cells and white blood cells and platelets. She remembered one of the questions that she knew that she had gotten correct on the exam. (It’s asked every year) Q. What are the three things that result in clots in a blood vessel? A. (a) Slow blood flow (b) Damage to the walls of the blood vessel and (c) An increased tendency to have blood elements stick together (clot). Now her alley-arteriole-analogy took on a more dynamic rheological perspective. What did alleys (like blood vessels) require to stay healthy? They needed a steady flow of people and dogs and cats walking through them, attracted because they were places that were different and interesting and beckoning. They needed to be kept free of damage such as graffiti, collapsing roadbeds and buildings that were being demolished by neglect. They needed to be free of trash and overflowing dumpsters that attracted more trash and the obstruction of abandoned mattresses, abandoned cars and worn out water heaters that made alleys impassible.

It suddenly all seemed blindingly simple and clear to Melissa. As an undergraduate she had toyed with the idea of studying urban planning and had taken a couple of courses before changing her mind.  She understood what professors and pundits meant when they discussed the growth and development of cities as an ecology that followed the rules of nature.  She wondered why everyone couldn’t see this.

With a light heart she picked up her step and continued on her way home, wrapping her mind around large buildings as bones, bridges as appendages and traffic lights and streetlights as parts of a giant flickering nervous system. She was now discovering a human physiologic equivalent in everything she saw all around her. For this afternoon at least, through the haze of her fatigue, Washington D.C. and its alleys had become alive!