Where's the Playground?

In the morning fog and rain, I followed the directions to the Columbia Family Practice Clinic, where I and a few other interviewees would be meeting with the program director of Columbia University's Family Medicine Residency Program (one of 10-15 places I'm looking at to train in the fine art of family medicine for three years after graduating from medical school this May). The clinic is up in the Inwood/Washington Heights area of Manhattan, an area that is mostly populated by people of Dominican Republic heritage -- those who have lived here for generations and those who have recently immigrated to the United States.

I lived in the Washington Heights area of Manhattan for over a year, about twenty blocks down from this clinic, when I was attending Columbia's school of public health. While taking walks in the summer evenings and nights, I'd see whole families of kids, parents, grandparents, dogs, babies, and friends lounging and having fun outside their apartments. For me, the word "community" remains defined with this image and its positive associations.

Yesterday morning though, in the fog and rain, I experienced a different feeling as I tried to find the "playground" landmark on the directions to finding the parking garage near the clinic. I couldn't find it. Finally, upon observing the entrance to the underground parking garage, I looked opposite the street for the playground that the directions mentioned. I saw an asphalt basketball court, surrounded by fence. Children were even playing basketball at this early hour, but for some reason I hadn't made the connection that this was the "playground". I was thrown off balance.

Something about the congestion of these streets and the lack of ability to have grass on a playground or something more than two basketball poles took me by surprise. Just a few years ago, when I was going to school there, I would have recognized the basketball court as a playground. I've been outside of Manhattan for the past few years -- I've been going to medical school and living in or near Newark, New Jersey -- but Newark is by no means a suburban big-playground type of town, so I found my reaction a bit shocking.

Next to the basketball court was an apartment building (or was it a school?) that also had a playground, with some playground toys and equipment, but it was on the roof of the apartment building, about five or six floors up from the ground and again grassless. All around were stores and apartment buildings, and a few steps down I found myself at the entrance of the Columbia family practice clinic. I'm considering this residency program for my next three years of training, and as a place where I can serve a wonderful, vibrant and hardworking community. At the same time, I'm processing my feelings of a palpable sense of congestion and squeeze on the people, the resources, and the breathing space (the playgrounds and fun spaces) of the northern areas of Manhattan. And I'm grappling with what I want in a residency program -- do I want to be in an underserved area of northern Manhattan? Or do I want to be in an underserved area in central Albuquerque? Two very different terrains, of course. Questions, questions. I found myself more at ease upon discovering the existence of some nice parks in the Washington Heights area.