i am going to paraphrase from a letter you may have seen written by dr. katz, garacia's predecessor. it was said that a smaller one could be built. this makes sense because one would think we would want an equitable distribution of hospital beds across the city. however, that is not really feasible because highly specialized services cannot exist in all areas of the city. for one thing, it is because there are not enough specialists. secondly, to be very, very good at something, you have to do it a lot. there is not high demand for every service -- every possible to maintain competence. additionally, when people are very sick, they made services from a range of specialists, not just one, and they need to be available on site at the time needed. this is a reason why some large hospitals, such as the mayo clinic, have a broad range of services at one place. with hospital planners, that you should have community hospitals that are widely accessible and connected to a single specialty hospital, where people who are too sick at the committed to a hospital can rapid