TO CONSIDER THE future of our cities here in the building of the New York Academy of Medicine, [1] at 103rd Street and Fifth Avenue, presents an opportunity for some telling contrasts between the city in which this grand building went up and the city of today. These contrasts suggest themselves in particular to me because I was born only a few blocks from here, on 103rd Street between Second and Third Avenues, just about the time the New York Academy of Medicine was being built. The area to the east was poor then, and it is poor now. Then it was a dense area of five-story tenements, now it is an area in which public housing is mixed in with, and indeed dominates, privately built tenement housing. Mount Sinai Hospital was there then, serving the neighborhood, and it is there still. In those days children were born at home, at any rate in the tenement areas. My mother would recall that when the appropriate time for delivery came, one would call for an intern from Mount Sinai (not by telephone—home telephones were not common in tenement areas then—but by sending an older child running), and the intern would come to assist at the birth. Perhaps she had the details wrong, but if she is right, it is interesting to note that in those relatively benighted days one could get a doctor to come to a walk-up tenement to assist at a birth, and that this was considered a norm.  One wonders whether this balanced out the fact that medical services in general were far less sophisticated and advanced.