Not to mention it's a small town with a lot of bigger city amenities, close proximity to Detroit, and with it being a college town the average IQ is pretty high.
Pittsburgh couldn't turn around like it did without Carnegie Mellon.
Monroe has like a sixth the population in the city limits and still less than half the size comparing the two metro regions. Ann Arbor is in a different class than Monroe. Monroe is a small town. Ann Arbor is a medium-small city (over 100,000 in city, over 300,000 in metro area).
Ann Arbor is centered around the University of Michigan, consistently ranked the #2 public school in the country, just behind UC Berkley. It has around 45,000 students. And yet Ann Arbor is big enough that students are still a minority of the population.
The UofM hospital is generally ranked one of the top 10 in the country, so it's not surprising for someone to go their for some special visit.
But sure, it's small and quaint compared to any real big city.