First, a brief synopsis of the bacterial infection Cholera, largely extinguished in American cities but passed quickly in areas of high population density (and thus the dimishing returns of extreme density) and very low sanitation usually through fecal matter that has infected food or water supplies (like in Glaeser's account of NYC allowing a private firm to build the city's first resevoir and aqueduct "on the cheap" which resulted in three decades of poor water quality, countless disease, and eventual rebuild - therefore NOT on the cheap).
When you get Cholera, your body essentially tries to flush the pest out as quickly and violently as possible, out the back end. And by doing so, and so much, the victim ahem passes so much liquid out their body that they dehydrate and often die. I know, disgusting right?
In a way, it is your body acting as efficiently as possible. Anything that comes in goes right back out, flooding through your system as expediently as possible, garnering no nutrients. Compare that to a healthy digestive system, which takes time to process food through the stomach, liver, and kidneys. Expedience is not of highest import, but the range of functionality and garnering maximum value out of that food, taking all of the good and expelling the bad.
Highly efficient in its sapping of life from bodies, life from cities.
And with that brief background I offered a tweet today comparing the car-centric city to an infected patient with cholera (probably before they were diagnosed or aware something was wrong/leaky). The goal is always efficiency efficiency efficiency. And a dumbed down version of efficiency that looks at one corridor and attempts to move as many cars through that corridor as possible without regard to cross-streets, other forms of transportation, or auxiliary side-effects such as real estate form and value, pollution, quality of life, and short- or long-term costs.
Just gotta keep moving them cars (sic). Flush them right through the system. The perniciousness of efficiency is actually anything but efficient: