As any health-professions grad student at Yale can attest, the medical district is home to some of New Haven’s least pleasant walks. Cars rush by, expelling noise and exhaust. Walkers trudge past parking lots and hustle across wide and busy intersections. Groceries, restaurants, and entertainment are several blocks away. A trip downtown from Cedar Street means crossing two high-speed frontage roads. Pedestrians can feel beleaguered or unsafe, and with good reason: since 2006, two people have been killed and one seriously injured at Frontage Road intersections.Many blame these conditions on the Route 34 Connector, the stub of expressway that runs through the medical district. Built in the late 1950s, the connector leads more than 72,000 vehicles daily at high speed between the junction of two interstate highways and the center city; interrupts Orange and Temple Streets; and spins off three exits before terminating at the Air Rights Garage. The connector’s frontage roads continue west for a mile to Ella Grasso Boulevard.When it was laid down over the bulldozed Oak Street neighborhood in 1959 as part of an epic midcentury urban-renewal program under Mayor Richard C. Lee, the connector was considered state-of-the-art city planning. City officials believed that welcoming more cars into town would bring prosperity. The road itself was expected to continue into the lower Naugatuck Valley, but those plans never came to fruition. Urban renewal also brought New Haven its Coliseum, now demolished, and the Chapel Square Mall, now an apartment complex and a community college. Like those buildings, the connector (also known as the Oak Street Connector, the Richard C. Lee Highway, and less kindly, the Road to Nowhere) looks outdated to contemporary eyes, the channel of a river of cars that takes up valuable real estate while segregating the medical district from the main campus and the city’s south from its north. Many New Haveners long for its demise.They’ll soon get their wish. Reconstruction of the roadway began this spring. On March 22, Mayor John DeStefano Jr. was joined by Governor Dannell Malloy, U.S. Rep. Rosa DeLauro, and others for the groundbreaking. The reconstruction, said DeStefano, will “knit together” a divided city. Under the plans, the connector’s final tenth of a mile will be narrowed and buried within a tunnel, turning it into a service road to the Air Rights Garage. Above it will go a $100 million office building called 100 College Street. That will happen as part of Phase 1 of Downtown Crossing/Route 34 East, a three-phase project to redesign the corridor and reclaim nearly 11 acres of inner-city land for development. The city’s Board of Aldermen approved final plans for Phase 1 in November 2012.The project’s goal is to reconnect New Haven neighborhoods and to encourage a livelier neighborhood around the medical center, with stores and restaurants at street level. Future phases will feed more of the connector underground with the remaining open-air portion edging eastward toward the interstates, and the later phases will add new buildings. Eventually, Orange and Temple Streets, now severed by the connector, will be reunited. In the meantime, 100 College Street will generate hundreds of new jobs during its construction and eventual housing of an international pharmaceutical company, as well as providing laboratories and offices for medical school faculty and possibly other biotech firms.The Board of Aldermen and the Greater New Haven Chamber of Commerce foresee an expanded tax base, as well as new construction and biotech jobs. Yale officials look forward to new office space and a more pleasant neighborhood. And the staff of Yale-New Haven Hospital (YNHH) hopes that the service road will make it easier for patients and visitors to get to the garage, not to mention ambulances: “It’s almost like a high occupancy vehicle lane for the medical center,” said Steve Merz, vice president for administration at YNHH.The hope, said New Haven transportation department director James Travers, is that the changes will begin to “weave back this fabric of a vibrant downtown.”Reinventing New HavenNew Haven has good reason to want a makeover. Attracted to cultural amenities and high-density settings that make a car optional, young professionals, artists, and middle-aged empty nesters are flocking to cities. New Haven’s population jumped 5 percent in the last decade. A new 34-story, 500-unit apartment tower at 360 State Street is 90 percent full, and half its residents do not keep cars there. The car-sharing company Zipcar is seeing heavy use in New Haven, with 57 percent of its Parking Authority garage vehicles in use at any given time. And ridership on shuttles and buses is up—a new shuttle route between the New Haven Green and Union Station now provides 20,000 rides per month.Biotech in New Haven is also bursting at the seams. According to Travers, the medical district is the source of the most prolific job growth in the city: a building at 300 George Street is nearly filled with tenants doing medical research and health care-related work, as well as half a dozen biotech companies. Moreover, the city is seeing its lowest retail and office vacancy rates in three decades, with a particular shortage of spaces larger than 15,000 square feet. According to Kelly Murphy, the city’s economic development administrator, New Haven expects to gain millions of dollars in property tax revenues from Downtown Crossing. Phase 1 will also generate 2,000 construction jobs and 1,000 permanent jobs in the new building, plus four to six “spinoff” jobs—in restaurants, hotels, and legal firms—for every researcher who works there. Murphy noted that the developer is committed to hiring locals for construction work.The package appeared so attractive that the Board of Aldermen voted for the project unanimously. “For the vitality of the city, it’s a good step forward,” said Alderman Justin Elicker, M.B.A. ’09, who represents the Cedar Hill and East Rock neighborhoods. “From an economic development perspective, we’re going to have more people working in the city—and those people will be buying things in the city.”“This is a very important project for the entire city; in fact, for the region,” said Anthony Rescigno, president of the Greater New Haven Chamber of Commerce. “It’s going to create more people coming downtown, more critical mass in restaurants, in shops, hopefully visiting cultural venues. It’s just a very positive thing.”A three-armed pinwheelThe Route 34 Connector begins at the three-armed pinwheel where I-95 and I-91 intersect. To its south lie the medical district and Hill neighborhoods; to its north, downtown New Haven and the main Yale campus. Paid for in part by a $16 million U.S. Department of Transportation TIGER II grant, Downtown Crossing will not only bury the connector; it will also reconfigure the frontage roads into one-way boulevards that city officials say will be more congenial to pedestrians and cyclists. (North Frontage has already been renamed Reverend Dr. Martin Luther King Jr. Boulevard.) “The desire is that you enter a downtown urban boulevard environment much sooner,” said Travers, the city transportation director.The 425,000-square-foot building at 100 College Street is slated to open in 2015. It will be built by developer Carter Winstanley, owner of the adjacent 300 George Street as well as Science Park at Yale. Winstanley will also build a parking garage over the roundabout that now lies immediately east of the Air Rights Garage. The School of Medicine plans to use 100 College Street to provide space for its researchers. Winstanley will include retail space on the ground floor. Alexion Pharmaceuticals, the building’s major committed tenant, was founded in New Haven in 1992 by Leonard Bell, M.D. ’84, then an assistant professor of medicine and pathology at the School of Medicine, before the company relocated to Cheshire over a decade ago. Its return to the city comes with $51 million in state aid from Malloy’s First Five initiative, which provides incentives for businesses to create jobs. Alexion expects to create as many as 300 new jobs by 2017.“It’s an exciting development for an area of town that has enormous potential,” said Bruce D. Alexander, Yale’s vice president for New Haven and state affairs and campus development. Attracting an anchor company of Alexion’s size, he said, is a first for New Haven’s downtown. “This is an enormous step forward, because it’s hopefully a signal to the world that New Haven is an important biotech and medical center and that this is an important industry for the future for us.”“We’ve done really well with startups,” said Murphy, the economic development director, “but getting this mature firm here builds that critical mass of the industry in the city. That was exciting in terms of attracting talent and other businesses.”Dean Robert J. Alpern, M.D., Ensign Professor of Medicine, joined planning discussions with the city early on and strongly supports Downtown Crossing. “The long-term vision is to have it be an extension of downtown and to have people actually living here,” said Alpern. “My hope would be that there would be apartment buildings on this side of the connector, food stores, restaurants, and this would be a lively part of New Haven, similar to Chapel Street or Broadway.”Michael Piscitelli, the city’s deputy economic development administrator, echoed that sentiment. “This is a real first step at starting to bridge what has been a long-term divide between the two campuses of the university,” he said.Big, fast, and dangerousThough the Board of Aldermen voted for Downtown Crossing unanimously, and there is broad support for reconnecting the city, the project has dismayed some New Haveners, who say it repeats past urban renewal mistakes and doesn’t do enough to correct traffic problems. They believe that the city is missing an opportunity to improve the health of its residents, encourage alternative forms of transit, and begin to wean itself from automobiles. “We’re just plain disappointed in this result,” said Anstress Farwell, M.A. ’79, president of the New Haven Urban Design League. The subtitle of the league’s April 2012 analysis of Downtown Crossing reflects its concerns; A Highway Rebuilt, Not Removed. Said Alan J. Plattus, Professor of Architecture and Urbanism at the School of Architecture and director of the Yale Urban Design Workshop, “We may be getting rid of the connector itself or parts of it, but its imprint is going to significantly shape what takes its place.”“The new roads look a lot like the old roads. They are big. They are fast. They are dangerous by design, much like the existing roads.” So reads an August 6 statement by Elm City Cycling (ECC), a nonprofit coalition supporting alternatives to motorized transportation. ECC withdrew its support for Downtown Crossing the day after the Board of Aldermen approved it.Although he voted in favor of the plan, Elicker shares some of the critics’ misgivings, and had called for changes that would mitigate the heavy traffic. The plans do include designated places for bikes to wait at traffic signals; a one-block bike lane separated from traffic; and an on-road bike lane along Reverend Dr. Martin Luther King Jr. Boulevard. Pedestrians will also see improvements. The roads are designed to include such traffic-calming measures as intersections that rise a few inches higher than the surrounding roads—an unusual feature on a road this busy—as well as textured crosswalks and buttons that allow pedestrians to pause all traffic. But the roads will be too wide and busy to attract new cyclists, said ECC board member Mark Abraham. And pedestrians will have to cross between three and five 11-foot lanes, which can add up to a long traverse for slower walkers or people in wheelchairs.Early versions of the plan also included uncomfortably narrow sidewalks along the south face of 100 College Street between the School of Public Health and the hospital. As part of a complex land-disposition agreement among the city, the state, and Winstanley, the developer was granted property rights to the edge of the traffic lanes and was asked to build sidewalks as a public easement. But when activists petitioned for 12-foot sidewalks, Winstanley expanded the sidewalks to 15 feet.Elicker noted that any decisions about the project required agreements among multiple partners—the state controls some roads while the city controls others, federal money is involved, and the developers also have a say in what happens. And the new roads will have to keep many vehicles—including emergency vehicles—moving smoothly between the interstates and local streets, while remaining inviting to people on two wheels or none. Trying to serve all those users is leading to some unusual measures, as Joe Balskus explained. Balskus is a traffic engineer with Tighe & Bond, a firm that has worked with the hospital for years on issues of traffic flow and parking, and which is studying the possible effects of Downtown Crossing. Collector roadways like these boulevards, Balskus said, typically don’t include traffic-calming measures like raised intersections, in part because it’s imperative to prevent traffic from backing up onto the interstates. Ambulances too must have unimpeded access to the hospital area, a point on which Balskus is focusing closely in his analysis. Though the city does anticipate higher traffic volumes, how much higher isn’t clear: according to Balskus, the city is reexamining its traffic-flow projections.Travers, the city’s transportation director, maintains that programmable traffic signals will help control flow. In addition, he said, the city is working to make Union Station, the destination for Amtrak and MetroNorth trains as well as intercity buses, a more attractive transport hub. Proposals include providing covered bike racks there and redirecting some expressway traffic to enter the city via the underutilized Church Street Bridge. And again, traffic itself can reduce traffic. “We hope that by adding some level of congestion—congestion that moves, not just gridlock—people will start to look at taking different routes,” Travers said. “That in itself will start to minimize those numbers.”The major players are committed, and Downtown Crossing will go ahead. While Phase 1 has already begun, the timing and details of the next two phases are still up in the air. “There may be some fine-tuning of the ultimate plans,” Rescigno said, “but basically this is a done deal, and we’re all excited about it.”“We’re not 100 percent there,” said Merz, the hospital administrator, of questions surrounding traffic flow. “Am I confident that we’re going to eventually get there? Yes. It’s in everybody’s interests. The city needs the hospital to be strong, it needs the medical school to be vibrant, and it needs the community to grow. ... It just hasn’t quite come out of the oven yet.”—Jenny Blair, M.D. ’04, a freelance writer based in Austin, Tex., is a frequent contributor to Yale Medicine.