The language of planning: Cancerous development

Introduction

Planners, politicians, and citizens have long made facile use of the metaphor “Cancerous Development.” Disease-referencing metaphors are standard phrases that characterize the fight for life in the built form of developed societies. Medical metaphors express frustration with that built form and its concomitant quality of life. Professions from industrial design to landscape architecture finely polish the surface appeal of roads, car interiors, and designer kitchens in an effort to mask the clinically diseased environment, as if the surround sound system will distract us from gyrating gas prices, omnipresent drive through pharmacies, endless rows of transfer beige houses, and abandoned building carcasses.

Countering that wistful cry are many powerful voices transforming the immediate misfortune of their illness into enduring instructions on the importance of celebrating the moment, while also striving to create a better future. Two high-profile cancer battles—Steve Jobs’s (2005) Stanford graduation speech and Randy Pausch’s The Last Lecture at Carnegie Mellon (2008)—memorialize beneficent attitudes and experiences. Without glossing over the realities of their predicaments, they converted the mournful energy of a No-Win scenario into liberating, future-oriented plans. They guided and gave permission to channel individual and communal fear into individual and community prospects.

The contrast of these reactions to the agreed evil of the disease combined with personal experience inspired me to consider the meaning of the ubiquitous medical metaphor. I began this journey, not surprisingly, with a steadfast belief that the Cancerous Development metaphor was laughably inappropriate. Considerable examination recalibrated my position. Perhaps the metaphor was valuable, but wasted? Was the educational potential of the conceptual comparison, for some reason, dormant? To be educated, I had to know what was compared. Is development—generically repetitive forms or abandoned strip malls— the abnormal cancer cell? Although that universal assumption has instinctive appeal, I now suspect that the metaphor’s latency resides in asymmetrical or misconceived concepts. I now wonder if humankind, in both number and distribution, is the uncontrolled growth. This observation leads me to ask if that which most perceive as the Cancerous Development is merely the by-product of a flawed process that does not pose the question from a vantage that facilitates action? If the medical question is “How do we cure the patient?” Here, our patient is Earth. So, our question should be “What procedures do we need to enable our great-grandchildren to inhabit a healthy Earth? How do we “Envision a healthy planet!”?

My journey to understand the metaphor

My interest in this metaphor began as I was on the verge of describing an aerial image of residential sprawl. As the stock phrase Cancerous Development was rolling off the assembly line, I realized that the image bore no qualitative comparison with the cancer patient’s medical odyssey from diagnosis through acceptance of death, or re-engagement with life. Cancer spontaneously occurs within a body. Cancerous Development is foist upon the earth. As Susan Sontag (1989) says in Illness as Metaphor, medical metaphors are crude and offensive deserving retirement.

Diseases present complex stories for the patient, the inner circle, and the largest community across multiple timescales. Symptoms cause concern and apprehension. In an antiseptic environment, all details—from physical positions of who stands and who reposes, to differences in dress, monogrammed starched lab coats and anonymous flimsy gaping gowns—immediately project assumptions about authority or vulnerability. The diagnosis is heard, felt, and rarely comprehended. The patient’s first question is “Will I live?” Without answering, a doctor launches into a description of the treatment process—chemotherapy, radiation, surgery, transplant—words in rapid succession without tangible meaning, ending with a series of statistics, ratios of expected end results, and so on. I have repeatedly told doctors that I am not a statistic; if they cannot treat me as a person, they must leave the room. The disconnect between question and answer asks if we treat people or conditions and symptoms? Clearly, doctors rely upon statistics to give hope or to manage expectations preparing the patient, family, and community for death, or at best, marginal improvement.

One explanation for the metaphor’s ineffectiveness may result from a similar confusion over management of expectations. Doctors and the development community focus upon tangible, quantifiable results, whereas, patients and citizens focus on qualitative, tangible impacts upon their daily lives. People believe that the impact of physical development proposals range from death of a beloved place to a compromise in their quality of life. When told of a proposed development, people rarely conclude that it will improve their life. The development scenarios that give rise to use of the metaphor include such questions as: Will sacred places be lost? How intolerable will new buildings and parking lots be? How much new traffic will be generated? How many will accept the outcome? How does individual preference fit within diversity of opinion?

Medical treatment encompasses both physical and psychological components. Physically, medical treatment consists of irregular intervals controlled by chemical and biological reactions to treatment protocols. Psychologically, the powerful bipolar magnet of cure/no cure exerts continuous pressure. The fundamental human desire to live necessitates belief in a cure regardless of the cost. Yet, how can you disregard the No-Win death sentence? The patient is constantly challenged by the realization that you cannot LIVE in a netherworld, where all the usual reliance upon baseline data is gone. What is healthy or normal when the diagnostic goalposts keep moving? A person cannot live as a point along a proposed continuum of statistical outcomes.

I suspect that the broadly defined development community harbors similar confusion about relative attachments to normal. What proportion of citizens will object? Who will remember “before?” How would they articulate it? Before and after the mall was built? When gas was less than a dollar per gallon?

This filmstrip of experience, reaction, and confusion fast forwards as I rapidly scan the aerial image of generic residential development and evaluate the words I am about to speak. I recognize that the dysfunction of the Cancerous Development metaphor resides in the patient’s ability to muster resources, whereas the Earth— upon whom this Cancerous Development is imposed—has no voice to challenge the impending actions. I ask myself where are the hospitals and support groups to cure Cancerous Development?

Cancer is a group of diseases characterized by uncontrolled growth of abnormal cells. The rapid cellular growth is antisocial in its voraciousness. (Varmus, 2011) The instructions to stop dividing are missing. If unattended, if left to spread, cancer will likely result in death. Cancer is caused by internal and external factors. Cancerous Development is heavily regulated. It begins with intentional processes— agents evaluate land potential. They produce jigsaw puzzles of color and abbreviations—two-dimensional classifications of land. These independently indecipherable maps are supplemented with laboriously crafted definitions. Documents separate uses from circulation and land from streets. Organs, tissues, muscles are separated from blood, oxygen, and skeleton.

From this description, we could reason that the development process alone kills the city by separating the nurturing from the nurtured. We support disease as a foundation of the plan.

The build out of the two-dimensional plan requires an iterative process with episodic inclusion of multidisciplinary teams. The public and the private sectors engage in the process with an eye to economic gain—personal and municipal prosperity. Actors who assert public benefit converse with citizens—observer/participants—whose reactions range from welcoming to skeptical to rejection.

Historically, people applied Cancerous Development at the street scale to describe urban decay: fears of abandoned buildings spreading deterioration across the public realm and contagious blocks infecting whole communities. Current usage identifies suburban sprawl at an aerial scale. Repetitive, hypertrophic, residential subdivisions funnel into monoculture commercial and employment zones that largely disregard the constraints and opportunities of the host. Water, topography, and habitat are all scrape-able in the service of accommodating development. Curiously, this physical approach, remove to facilitate growth, is the opposite of surgery to remove the cancerous tumor and cure the patient.

Perhaps the scale at which cancer is comparable to the aerial view is in the overwhelming statistics. The American Cancer Society (2012) estimates that in the United States:

As daunting as those numbers are, everyone and everything on the planet is vulnerable to the impacts of Cancerous Development—natural resources, economy, quality of life—the public impact of private decisions.

My original certainty that the metaphor was both crude and offensive lost crispness. The confusion over the appropriateness of the metaphor was compounded by its absorption into common language. Ebenezer Howard, Le Corbusier, and Frank Lloyd Wright compared the city to a tumor: London to a malignant growth poisoning the modern world, and Paris to a body in the last stages of a fatal disease—its circulation clogged, its tissues dying of their own noxious wastes (Fishman, 1991: 12–13). Lewis Mumford’s (1968) critique of Jane Jacobs’ Death and Life of American Cities is titled “Home remedies for urban cancer.” Everyone I ask viscerally understands, although rendered impotent by the comparison.

In an effort to unlock the instructive value, I examined the linguistic purpose of metaphors. In Poetics (ch. 21), Aristotle defines the importance of metaphors as transferring the meaning of a familiar concept to an unfamiliar one (Kirby, 1997). The construction of metaphors depends upon the ability to see likeness in different objects. He continues in Rhetoric (Book III) that to be productive, both sides of the metaphors must fit; without balance, the metaphor will not be clear. Aristotle explains that the instructive value, the learning that metaphors enable, derives from this balance, or appropriateness. Metaphors will pay a compliment through comparison to something better, (Robert Burns’ “My love is like a red, red rose”) or disrespect through something ugly. Clearly, Cancerous Development is meant to express fear. But why does the often repeated, derisive phrase inhibit action? If the comparison were instructive, would not the audience react?

In “Politics and the English language,” George Orwell (2009) explains that there is a continuum of metaphors. At the extremes, the working metaphors that effectively educate by evoking visual images are both the newly coined and the dead. The broad middle landscape contains phrases rendered trite by overuse. They are employed merely to save people the effort of constructing new phrases. Did that explain the usage of Cancerous Development? Or perhaps it still retains evocative power like the radical shock value of Edvard Munch’s famous painting The Scream? (1893).

In Metaphors We Live By, Lakoff and Johnson (2003) explain that our conceptual explanatory system is largely metaphorical. Concepts are partially structured by metaphor; meaning can be extended in some ways but not others. The system that allows us to comprehend one concept in terms of another necessarily hides some aspects; this keeps the focus on the relevant features, creating channels between concepts to eliminate inconsistent aspects.

So, the next task was to determine what Cancerous Development illuminates, and what it masks. I turned to Kevin Lynch’s (1960) The Image of a City for a rubric. Lynch defines five criteria of imageability: paths, edges, districts, nodes, and landmarks. I asked how well these criteria fit.

Paths are channels along which an observer moves. For a cancer patient, one path is from diagnosis to cure. Or veins for infusion therapies are a path for conducting treatment into the body. In Cancerous Development, one path is from land use designation to habitable development. Paths also provide circulation through and between developments—roads, sidewalks, and greenways.

Edges are linear elements, boundaries between two phases. For the cancer patient, there is prediagnosis, postdiagnosis, and remission. Each one of these discrete stages identifies a different physical phase that engenders a different psychological environment. In Cancerous Development, arterial and collector roads separate one residential sector from a commercial project, or walls around gated communities.

Districts are medium-to-large sections of a city recognizable by a common, identifying character. In cancer, organs are districts. With Cancerous Development, one purpose of subdivisions is to create homogenous districts.

Nodes are strategic spots that an observer can enter, that is, concentrations of use. Nodes are related to paths and districts where events on a journey converge. Nodes are the intensive foci of a district. The tumor within an organ is the node. I find nodes in Cancerous Development problematic because monocultures inhibit nodal convergence. Cancerous Developments are really superblocks that disallow concentration. Some will say that a mall is a node, but they are highly stratified. Do we refer to the mall with the Dollar General? Target? Bloomingdales? This intentional stratification and single purpose minimizes meaningful convergence.

Landmark is an external point of reference, at both local and regional scales. Cancer has landmark events: diagnosis, therapy, surgery, remission, and efforts to reclaim some semblance of original activity. In Cancerous Development, this is a problem. Is it the gatehouse? Or Outback Steakhouse’s 60-ft neon sign where half the letters are dark?

Clearly, there are sufficient similarities in terms of imageability that warrant a continued exploration of the value of the metaphor. We know that metaphors assist our thoughts, help to structure our thinking and action. We also know that if left unattended, cancer spreads, eventually causing death. We don’t want places where people live–work–play to die. Therefore, this has a powerful metaphorical potential. Yet, it has commonly been used for over 100 years, and the situation is only more dire today. What has the metaphor taught us? If Howard, Wright, Corbusier, or Mumford experienced a contemporary city or region, I suspect they would employ the same descriptive language: the patient has not regained health; the diseases they recognized have not been cured.

So I thought a good metaphor is a terrible thing to waste

To help examine the potential effectiveness, I turned to another metaphor that inspired action: The War on Cancer. A decade of aggressive social, philanthropic, and professional pressure on researchers, practitioners, and politicians culminated in full-page ads in the Washington Post and New York Times comparing the importance of curing cancer to the moon landing. This activism resulted in President Nixon’s signing the National Cancer Act known as “The War on Cancer” in 1971. Although some challenge the impact, after 40 years, there is no definitive cure, but who will seriously debate the value of knowledge gained, and lives saved? To those who believe that planning’s political battles present insurmountable challenges, I offer Siddhartha Mukherjee’s (2010) Pulitzer prize winning book titled “The Emperor of All Maladies: A Biography of Cancer.” A brilliant chronicle of the fight required when pharmaceutical companies routinely refused to produce new drugs and alternative therapies because of underwhelming trial results. Today, this narrative of the fight that doctors waged because they believed that saving individual lives mattered is a cult book among the very broadly defined circle of cancer survivors.

As I read that book, I repeatedly asked two questions: why is all of the effort focused on how to cure, rather than prevent, this epidemic? And, what lessons can planners learn to cure Cancerous Development? These questions led me to “Epidemiology in Public Health.” This methodology examines the natural history of a disease, charting the course from inception to resolution. (Aschengrau and Seague, 2008)

Beginning with pathological onset, how do we recognize an asymptomatic location as precancerous? For a person, there are medical tests. For a place? Susceptible green fields? Massive development or vacancy of commercial or residential structures? How many units? In what physical proximity? Over what period of time? Or, sporadically clogged roads? How would you recognize precancerous symptoms in the physical environment?

Next, what are the clinical symptoms? The diagnosis? The treatment plan? What specialists must be brought to the table to cure the patient? The conventional approach to cure cancer is to cut, burn, and poison. There are also alternative spiritual and physical approaches, namely, nutrition, prayer group, and faith healing. With Cancerous Development, the planning equivalent is prayer group and faith healing. We hold public meetings hoping that they will dissipate individual concern.

Then comes remission. Cancer employs medical tests to determine if they got it all. Is revitalization or infill remission for Cancerous Development? If urban decay is cancerous, is gentrification remission? Given the fragmented approach of multiple agents, stakeholders, and the perennially overlooked, how do we determine holistic benefit? If planning agents applied a proactive approach in search of urban remission what would it look like?

The final epidemiological stage is relapse and death. We know what that means for a human. I suggest that there is significant relapse of Cancerous Development. First, in the rust belt, dead downtowns spread their decay to suburban malls, now affectionately known as grayfields. The 2010 U.S. Census documents this spread from rust belt to sunbelt. Surely, the current condition of the great recession, the housing bubble, massive foreclosures, and the global demonstrations of “Occupy Wall Street” indicate a very serious disease.

What do planners learn from the medical comparison?

The mandate to cure Cancerous Development and to instead create healthy communities raises logistical questions. First, there is a significant structural difference in the locus of decision making between medical and planning practices. In the search for control over their own body, which has turned against them, the cancer patient assembles a team with tunnel vision who harmoniously ask how to cure the patient—a holistic package with a systems approach. In Cancerous Development, commissioners review planning staff’s recommendations regarding third-party applications. Elected and appointed officials accept or reject professional staff recommendations. A cancer team would never present a treatment plan to the hospital’s board of directors for approval. The economic impacts of large-scale development will keep politics in planning, but commissioners need better instructions. We cannot cure Cancerous Development through a negotiated process when the decision-making unit is removed from those with skill, judgment, and vision. This process only allows attempts to manage expectations of problem-huggers, that is, those who question whether life can get better.

Next, one must identify which two concepts the metaphor seeks to compare and what is the appropriate scale of contrast to engender learning. In developed societies, the negotiated development outcomes provide for the needs of humankind. The intentionally and rigorously produced forms must be the by-product, not the spontaneous and random disease itself. Therefore, the built forms—the roads, malls, and houses—are equivalent to the medical supplies—the syringes, infusion bags, and medicines—that facilitate treatment of the disease. I posit that the uncontrolled growth of an abnormal cell is humankind itself. It took humankind from approximately 8000 BC to 1800 AD to reach a global population of 1 billion. The second billion took approximately 120 years, and was reached in 1920. In 1959, we reached 3 billion; in 1974, 4 billion; by 1987, 5 billion; and in 1998, we reached 6 billion. In late 2011, we reached 7 billion people worldwide. Whether we will reach 10 billion by the end of the century is open to speculation. Nonetheless, this population increase has no historical, global precedent. It is clearly a pattern that has lost contact with an instruction book. Feeding, let alone clothing, housing, and employing, this group will present significant challenges.

Perhaps discerning the pedagogic value of the Cancerous Development metaphor would benefit from a brief comparison with other metaphorical forms. The visual arts have long served to instruct the populace or to convey social commentary and critique to viewers conditioned to the didactic power of images. For centuries, the naves of catholic churches were lined with frescoes and mosaics narrating Biblical stories; their progression frequently culminated with images of the Last Judgement. Positioned behind the altar, the metaphorical instruction for achieving salvation was direct and overt. Art as political propaganda, especially, calling for regime change or presenting images of corruption and government complicity in the mistreatment or death of its citizens also has a rich tradition. The prints of Honoré Daumier and William Hogarth exemplify this tradition. Théodore Géricault’s The Raft of the Medusa (for the Salon of 1819) depicts a contemporary shipwreck as a social and political commentary on the Ancien Régime. Accounts from the few survivors questioned even the King’s involvement in the human error responsible for the suffering and deaths (Grigsby, 2002). The iconic painting illustrates the moment of potential hope: as the sailors writhe in pain on the verge of death, they spot a ship on the distant horizon. They frantically wave seeking rescue. Tormented figures twist in the immediate foreground drawing viewers into the emotionally fraught scene. The stark realism and somber colors of the monumental painting reinforce the human impact of political decisions. In a modern genre, the science fiction movie The Matrix—intended for popular consumption similar to the works of Daumier, Hogarth, and Gericault—presents a critique of a hypothetical future. In a final effort to control the planet, the Machine Agent Smith labels humans as a virus or cancer who destroyed the planet through their voracious, sprawling development. He claims the Machines are the miracle cure who will avert complete destruction. Although these artistic statements are partially entertainment, they also operate as heuristic devices whose warnings hold a mirror to society. They challenge viewers to assess their current behavior in light of future consequences.

As I visualize the challenge of providing shelter for the world’s burgeoning population, I confront a confounding Escheresque characteristic of Cancerous Development. In contemporary usage, the metaphor is most frequently applied to the aerial view of suburban sprawl. Yet, at the street level, the suburban house with its white picket fence, dog in the yard, mother in the kitchen, and two (or three)-car garage is “The American Dream.” How can a house be both dream and cancer? Perhaps the answer to that question and to the misconstruction of the metaphor resides in the elasticity of willingness to accept responsibility.

The cancer diagnosis requires the patient to make a choice, aggressively fight or passively become angry at the unfairness of an uninvited, random, and indiscriminate action. The patients must mentally steel themselves to conquer an invisible enemy OR to abdicate responsibility, to use illness as an excuse for inaction. The patient longs for a new day, while attempting to retain memory of pre-illness normal. The average citizen does not recognize the global invader as such because increase in the local expression can only be gaged by the developed by-product, buildings and roads, which are necessary to accommodate local newcomers. Citizens feel responsibility for their own homes, and so that is a dream. However, they sense that the cumulative accommodation of the newcomers is out of control; that in their daily lives is the cancer. Because individual dreams can never add up to collective cancer, like Agent Smith, I now conclude that development is not the cancer, rather, humankind must be the cancer. Both cellular division and human reproduction are natural and necessary activities to ensure survival. However, when each fails to respond to warning signals, the necessary activity transcends into an antisocial activity. This aggressive consumption of territory identifies each as a pernicious disease in need of treatment.

This leads to one final question. Cancer has afflicted humankind for centuries during which time doctors have continually sought cures of cut, burn, and poison. Today, with stem cell research and proteomics (the study of all proteins), doctor’s are identifying a comprehensively different understanding of the nature of cancer. (Brockman, 2010) Proteomics will allow doctors to understand the dynamic conversations between the molecules that build and maintain, or breakdown and destroy the body. Individual bodies experience different conversations. Therefore, the trajectory of this research seeks specific, individualized treatments rather than protocols based on statistical outcomes of an organ-based diagnosis. Brockman expects proteomics to produce tectonic shifts in the treatment and management of cancer. Mukherjee hypothesizes that though a complete cure is unlikely, doctors will probably soon be able to manage most forms as chronic diseases: debilitating but not life threatening. He posits that the war on cancer will be “won” only if we redefine victory.

What does this mean for our metaphor? Can we imagine a similar tectonic shift that would allow planners to act differently and for the planning community to produce a different outcome? In the 19th century, scientific understanding of the spread of cholera gave rise to professions advocating for public health through planning. Will the science of climate change ever be settled enough that it can provide the necessary nutrition for our burgeoning population? Or will it take complete depletion of natural resources to force behavioral change? How sick must the patient become? Recognizing that “good” is a highly debatable planning outcome, Gunder and Hillier (2007) propose a performative practice that might, like proteomics, enable individualized practices. Because places are both internally multidimensional, and individually distinct, they argue that the hegemony of utopia stifles the deep understanding necessary to cope with complexity. They posit that a utopic process would valorize different therapies that would enable health in complicated places. Like proteomics, utopic planning would elevate process—conversations between proteins—over products—statistical reliance upon organ-based protocols—in the search for enabling healthy and happy communities.

Conclusion

As I gather the lessons from this journey, I am reminded of one of Randy Pausch’s instructions: always recognize the elephant in the room. Our elephants are

Some believe that resource maximization has enabled a century of successful growth. But our voracious approach depletes resources and fouls our nest. Man is the only creature that fouls its own nest. What cultural advances have we produced? Not only would Howard and Wright recognize our world, but also Thomas Edison and Henry Ford. Humans build to accommodate uncontrolled populations claiming economic gain without regard to repercussions on place. Yet, Earth is a patient that must be healthy to provide water and air for critters, habitats, and humankind. Fullstop.

Steve Jobs spoke of the importance of abandoning other people’s dogma, to have the courage of convictions. Perhaps if we wish to envision a healthy planet, we need a new beginning: First, do no harm!