George R. Fisher, III, M.D.

Obituary

George R. Fisher, III, M.D.

Age: 97 of Philadelphia, formerly of Haddonfield Dr George Fisher III

Dr. George Ross Fisher of Philadelphia died on March 9, 2023, surrounded by his loving family.

Born in 1925 in Erie, Pennsylvania, to two teachers, George and Margaret Fisher, he grew up in Pittsburgh, later attending The Lawrenceville School and Yale University (graduating early because of the war). He was very proud of the fact that he was the only person who ever graduated from Yale with a Bachelor of Science in English Literature. He attended Columbia University’s College of Physicians and Surgeons where he met the love of his life, fellow medical student, and future renowned Philadelphia radiologist Mary Stuart Blakely. While dating, they entertained themselves by dressing up in evening attire and crashing fancy Manhattan weddings. They married in 1950 and were each other’s true loves, mutual admirers, and life partners until Mary Stuart passed away in 2006. A Columbia faculty member wrote of him, “This young man’s personality is way off the beaten track, and cannot be evaluated by the customary methods.”

After training at the Pennsylvania Hospital in Philadelphia where he was Chief Resident in Medicine, and spending a year at the NIH, he opened a practice in Endocrinology on Spruce Street where he practiced for sixty years. He also consulted regularly for the employees of Strawbridge and Clothier as well as the Hospital for the Mentally Retarded at Stockley, Delaware. He was beloved by his patients, his guiding philosophy being the adage, “Listen to your patient – he’s telling you his diagnosis.” His patients also told him their stories which gave him an education in all things Philadelphia, the city he passionately loved and which he went on to chronicle in this online blog. Many of these blogs were adapted into a history-oriented tour book, Philadelphia Revelations: Twenty Tours of the Delaware Valley.

He was a true Renaissance Man, interested in everything and everyone, remembering everything he read or heard in complete detail, and endowed with a penetrating intellect which cut to the heart of whatever was being discussed, whether it be medicine, history, literature, economics, investments, politics, science or even lawn care for his home in Haddonfield, NJ where he and his wife raised their four children. He was an “early adopter.” Memories of his children from the 1960s include being taken to visit his colleagues working on the UNIVAC computer at Penn; the air-mail version of the London Economist on the dining room table; and his work on developing a proprietary medical office software using Fortran. His dedication to patients and to his profession extended to his many years representing Pennsylvania to the American Medical Association.

After retiring from his practice in 2003, he started his pioneering “just-in-time” Ross & Perry publishing company, which printed more than 300 new and reprint titles, ranging from Flight Manual for the SR-71 Blackbird Spy Plane (his best seller!) to Terse Verse, a collection of a hundred mostly humorous haikus. He authored four books. In 2013 at age 88, he ran as a Republican for New Jersey Assemblyman for the 6th district (he lost).

A gregarious extrovert, he loved meeting his fellow Philadelphians well into his nineties at the Shakespeare Society, the Global Interdependence Center, the College of Physicians, the Right Angle Club, the Union League, the Haddonfield 65 Club, and the Franklin Inn. He faithfully attended Quaker Meeting in Haddonfield NJ for over 60 years. Later in life he was fortunate to be joined in his life, travels, and adventures by his dear friend Dr. Janice Gordon.

He passed away peacefully, held in the Light and surrounded by his family as they sang to him and read aloud the love letters that he and his wife penned throughout their courtship. In addition to his children – George, Miriam, Margaret, and Stuart – he leaves his three children-in-law, eight grandchildren, three great-grandchildren, and his younger brother, John.

A memorial service, followed by a reception, will be held at the Friends Meeting in Haddonfield New Jersey on April 1 at one in the afternoon. Memorial contributions may be sent to Haddonfield Friends Meeting, 47 Friends Avenue, Haddonfield, NJ 08033.

Poor Richard Plays Hardball

Several distinguished biographies of Benjamin Franklin have recently skirted his January 1774 confrontation with the British government in the "Cockpit" of Whitehall. Presumably, the exquisite details are too fancy and complicated for easy description, or possibly the cardinal significance of this intellectual duel is underestimated. It seems possible the American Revolution was declared by one man's making up his mind. A mind made up in one particular hour in one particular room, irrevocably, in front of the whole British Establishment.

The Archbishop of Canterbury was there, and so were Edmund Burke and Joseph Priestley. So were all the Privy Council, and most of British high society, giggling and hissing at his discomfort. Poor Richard stood there silent and impassive. The Enlightenment thought they were deciding his fate, but he was deciding theirs.

Lord Alexander Wedderburn

Franklin had published some letters he had promised not to publish, but they showed the British government in a very bad light. Alexander Wedderburn the Solicitor-General had deliberately orchestrated the meeting to shift the emphasis to Franklin's broken promise and away from British provocation of it. The room had been packed with highbrows promised a delicious treat, and Wedderburn's speech was meticulously planned as an entertainment for the intelligentsia. The man who discovered electricity was mocked as "conducting" the letters. And a famous man of letters was reminded that the ancient Athenians would brand three letters on the back of the hand of a thief: FUR, the name for a thief, an elaborate 18th Century pun making reference to fur hats and collars, which were the traditional symbol of printers. Wedderburn roused himself to the climactic announcement that the famous Roman, Plautus, had invented the famous derivative epithet, "Homo, triumph literarum," portentously meaning a three-letter man. The galleries of Whitehall tittered and applauded this thrilling attack. Franklin continued to stand, his face perfectly inscrutable to the end.

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Deplessis Portrait of Benjamin Franklin

In his report back to the Massachusetts Legislature, Franklin used dismissive understatement to show he had not been asleep while he was impassive. He had been, he said, "the butt of his invective ribaldry for nearly an hour." After that, Poor Richard seemed to disappear from British society for nine months, seeing only close friends in his house, and then he sailed home to America, becoming a member of the Continental Congress the day he stepped off the boat. Meanwhile, he had arranged to have his portrait painted by Duplessis, the most distinguished painter in France, eventually to have it hang next to a painting by the same artist, of the King of France. To the original sketch for the portrait had been added a fur collar, the traditional emblem of the painter's guild. At the bottom, where a motto ordinarily would be found, was the single, three-letter Latin word, "VIR," or man, which would today be equivalent to he-man. And just so everyone would get the point, Franklin sent an otherwise anonymous letter to the newspapers, signed "Homo Triumph Literarum" in which he taunted that the friends of Mr. Franklin would have to agree he was a thief, as in the famous line of poetry that "He stole the lightning from the skies." But old Ben wasn't just bragging. Anticipating the baseball player Dizzy Dean by two hundred years, he was in effect saying "It ain't braggin' if you really have done it."

On Feb. 6, 1778 he and Silas Deane went over to the French palace to sign the Treaty of Alliance with the King of France. Instead of his usual brown suit, Franklin was wearing a faded blue one, and Deane questioned why he wore old clothes to such an important ceremony. "To give it a little revenge," was the answer. "I wore this suit on the day Wedderburn abused me at Whitehall." The true depth of Franklin's feelings would never have been known if Deane had not asked.

As a reminder, the Treaty they were signing said, "The essential and direct end of the present defensive alliance is to maintain effectually the liberty, sovereignty, and independence of the said United States. . . ." All in all, not a bad academic performance for a man who never went past the second grade in school.

REFERENCES

The Invention of Air: A Story of Science, Faith, Revolution,and The Birth of America, Steven Johnson ISBN: 978-1-59448-852-8

Amazon

West Fairmount Park

Fairmount Park is considerably larger on the west bank of the Schuylkill than on the east, and the points of interest are somewhat more diluted by woods and pasture. Partly, that is a consequence of being the site of the 1876 Centennial Exhibition , and partly that urban growth had not encroached so much into the farmland at the time the park was created. On the west bank at the time of the Revolution, there were still 300-400 acre farms, whereas the east bank farms had been cut up into gentleman's

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Centennial Exhibition

estates. The Schuylkill takes two 90-degree turns within the Park limits, leaving a point of high land on either side of the river. On the east side, the East Park reservoir is at the apex, and on the west side, the dominant point is Belmont Mansion. For a while, there was a restaurant at Belmont, but at the moment it's a pity but little advantage is taken of a very scenic view. Two judges once lived in the mansion, William Peters, and his nephew Richard Peters. William was a Tory and had to flee to England. Richard made a better guess and as a rebel, therefore could live on in scenic splendor.

For orientation, the West Park mansions extend in an arc from The Solitude in the south to Chamonix in the north. For the moment limiting our list to houses present when the Park was created, there is Sweetbrier, The Pig-Eye Cottage, Belmont, Ridgeland, Greenland, and the Lilacs. The last three houses belonged to three well-known Philadelphia families, Garrett, J.B. Lippincott, and Walnut, who established themselves in 19th Century commerce rather than 18th Century politics. Sweetbrier was one of those centers of French Philadelphia, when Samuel Breck continued his father's close relationship developed as the fiscal representative of French Forces in America, entertaining LaFayette and other such friends of the new Republic. The Pig-eye cottage is used by the Park administration, and closely resembles the Caleb Pusey house, but otherwise has no remarkable history. Solitude, on the other hand, really was the retreat for John, then Richard, then Granville. John Penn entertained George Washington here while he was presiding over the Constitutional Convention.

fair

Fairmount Park is notable for some buildings which are unfortunately no longer there, and some other buildings that were transplanted there. The East Park is a historical monument, while the West Park is more a house museum. Governor Mifflin's house is gone from the Falls area, Powelton is gone, and Lansdowne the estate where the Proprietor John Penn was seized by rebel soldiers. His family was later paid less than a penny an acre for the 21 million acres of Pennsylvania land they clearly owned. Sedgley is also gone, and all of these places have a place in history. On the other hand, it is well to remember that all of the industrial slums along the river were cleared away to be replaced by the charm of Boat House Row.

Exhibition

It keeps being repeated that Fairmount Park is the largest urban park in America, but the fact is it is bigger than the city can afford to maintain, just as a monument to the colonial style of life. It was a grand place to have a World's Fair in 1876, and Memorial Hall remains, along with the Japanese pavilion, a truly priceless reproduction of Japan under the Shogun. Fairmount Park has the first Zoo in America, still a place of note in zoological circles, and many ballparks, summer music halls, and other modern recreational attractions. It contains Cedar Grove, a splendid Quaker homestead in Welsh style, transported from its original location in Frankford. The Letitia Street House was too fine an example of 17th Century urban architecture to lose, so it was moved to the Park from Letitia Street, approximately 2nd and Market Streets. William Penn lived for a while on Letitia Street, named after his daughter, but it is not entirely clear who lived in this particular little house. There doesn't seem to be anything you can do about people calling it the William Penn House.

Fairmount Park is the largest urban park. It doesn't have roley coasters, but we don't miss them, and it doesn't have Mickey Mouse, at least so far. There is absolutely nothing like it anywhere. Anyway even if there were, Philadelphians wouldn't notice.

Andrew Hamilton (1676-1741)

Philadelphia City Hall

An admirer of Philadelphia Reflections recently asked who is the most under-appreciated Philadelphian, and the quick answer would be William Penn. He's inadequately praised right at the present time, perhaps, but after all the whole State of Pennsylvania is named after him, along with countless universities and institutions, and his thirty-seven foot statue is on top of City Hall. The Pennsylvanian who seems most under-appreciated on a more or less permanent basis is Andrew Hamilton.

Andrew Hamilton

That is definitely not Alexander Hamilton, nearly a century younger and no relation. Andrew was born in Virginia but moved to Philadelphia in 1716, aged 30. He is frequently referred to as the finest lawyer of his era in America, holding numerous public offices. He was Speaker of the Pennsylvania House of Representatives in 1735, and 59 years old, when he took on the task of defending John Peter Zenger the New York publisher. For this successful case, he is mainly known today, but it is not true at all that he was then a young unknown lawyer trying to establish a reputation as, the lawyers say, a rainmaker. Rather, he took up the task of defending Zenger in another colony, without fee, because he felt there existed a threat to the entire judicial system and someone had to assert leadership about it. Zenger was in conflict with the Governor of New York, evidently a ruthless sort of person, and the Governor had disbarred Zenger's two defense lawyers for opposing him. Hamilton felt it was the duty of an eminent lawyer from another colony to come forward and see that justice was defended. It was surely not immodest of him to feel that even a wild and wooly governor would not dare disbar the famous chief legislative officer of Pennsylvania. There was probably still some personal risk, and even some risk to professional reputation, because Zenger seemed clearly guilty of breaking the libel laws as they were then understood.

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Trial

Zenger had published articles describing the outrageous conduct of the Governor, and could not deny he had published them. In the common view, he had labeled the Governor. The judge refused to hear evidence that the published stories were true because the law stated that truth was not a defense. The only defense seemingly possible was that the stories somehow did not meet the definition of libel, and the judge suggested to Hamilton that he get on with arguing that particular escape-hatch. Hamilton, however, would have none of it.

William Penn

His first statement in defense was that he and his client readily admitted the published articles met the definition of libel, so he would save the prosecutor's time presenting witnesses on the point. He turned to the jury and urged them to nullify any law which prevented injured people from making a truthful complaint, as William Penn had established they had a right to do, nearly a century earlier. In a sense, both Penn and Hamilton were going back to the Magna Charta, where a jury was seen able to set a limit on what any king could do to an Englishman. The judge intervened that a jury may do what they were instructed to do. Yes, said Hamilton, and they may do otherwise. Although the jury had surely never heard of such legal fine points, they didn't like the idea of punishing a man for telling the truth, and firmly declared that Peter Zenger was therefore not guilty of anything, including libel, for doing so.

These principles were destined to become embedded in the United States Constitution fifty years later and were greeted with great praise and published applause by Benjamin Franklin, then the young publisher of the largest newspaper in Pennsylvania. Evidently, Franklin and Hamilton sought each other out, and in time Franklin became the protege and main political associate of Hamilton in the Pennsylvania Legislature.

The Zenger case established the fame of Philadelphia lawyers for all time, and Hamilton is honored by the Philadelphia bar association as their patron saint. No doubt he welcomed the praise of his colleagues, but he certainly did not need it. He had already risen to the top before this case, and it was for that reason he took it on, not as a duty to Zenger, but as a duty to the Law. Like so many people who achieve a little eminence, he had everything to lose and nothing to gain by taking risks. But unlike a common lot of prominent people, he felt a duty to do what he had to do.

Details of the rest of Andrew Hamilton's life are surprisingly sketchy, but property records establish that he was remarkable in a lot of other ways, too. He purchased the land on which Independence Hall is situated, and gave it to the public. He purchased five hundred acres in the wilderness and founded the City of Lancaster on it. And he purchased two hundred fifty acres, later expanded to six hundred, on the high bank of the Schuylkill where European settlement had been first begun by the Dutch, at Gray's Ferry. His son built Woodlands as a country estate, established Woodland Cemetery along Woodland Avenue, and built Hamilton Village as the place in West Philadelphia where the Drexels, Weightmans, Pauls and other wealthy families put their mansions. If you like, you can stroll down the center of the University of Pennsylvania campus, on Hamilton Walk.

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Penn Railroad

Someday, the glory of all this will surely return. Meanwhile, the Pennsylvania Railroad and successors have made the Gray's Ferry area nearly uninhabitable. Woodland sits behind a thicket of untended bramble, hidden from the trains except for the briefest glimpse if you know to look. The Veteran's Administration Hospital sits on the edge of Woodland, blocking the view unless you know to use Google Earth to see it sitting there begging to be visited. The University has turned its back on Woodland, using it mostly as a backdoor driveway toward its numerous parking garages, fearful the world might notice how close it is to deplorable slums.

ut some day, we can confidently expect that vision will re-emerge, the Schuylkill waterfront should resemble the Seine through Paris, linking Woodland to Bartram's Gardens, and perhaps on to Fort Mifflin. When that day dawns, maybe more people will also remember who Andrew Hamilton was.

Bloomsburg / Danville

J. Edgar Thomson

The North Branch of the Susquehanna winds its way through the mountains of central Pennsylvania, particularly from Wilkes Barre to Danville. The zig-zag course of the river is confusing, with long stretches of westward flow reversing the long eastward flow between Binghamton and Sayre, between which are long stretches due south. At Danville, the river makes its final sharp turn and then begins a straight southern chute toward Harrisburg. The discovery of iron ore between Bloomsburg and Danville was just in time for the advancing railroads of J. Edgar Thomson, and the Iron King of the area was George Geisinger, whose widow Abigail founded the hospital of that name where the Geisinger Clinic now flourishes. As iron and steel moved west to the Pittsburgh region, the Geisinger Clinic now pretty much dominates the area, like a self-contained ocean liner at sea.

Around 1850, the county seat was moved to Bloomsburg, causing the irritated citizens of Danville to break tiny Montour County off from Columbia County, and making Danville at least the county seat of some county. Whatever else it does, this split-off stimulated a vigorous football rivalry between the two otherwise fairly friendly towns.

At the moment, the shale-gas bonanza is somewhat distant from this region. But it is fairly clear that legislative actions about extractive industries are just as closely watched as geological ones, for signs of a coming gold rush, or possibly tax rush.

At nearby Elysburg, the Knoebels Grove Amusement park provides an interesting footnote to a dramatic Pennsylvania development of 19th Century amusement parks. There are probably more surviving examples of this entertainment center in Pennsylvania than in the other 49 states, and Knoebels Grove founded in 1926 claims to be among the largest. Whether that so depends on the system of measurement employed, but Knoebels Grove is clearly unique in not charging an overall entrance fee. As well as being the home of the annual Fisher Family reunion, where in August State Policemen can be found directing traffic among the various family branches. For unexplained reasons, the members of this far-flung family bear a comparatively little physical resemblance to each other but claim to be descended from one Sebastian Fisher, who arrived around 1697 by way of New York. Sebastian had fourteen children, and most of them had similar numbers, so mathematics soon puts an end to most ancestral arguments around the picnic tables.

Will Obamacare Reduce the National Debt?

It looks as though the first priority for the Obama administration is the reduction of the national debt. That may not have been the President's initial priority or even his present one, and indeed it probably has been furthest from his mind. However, almost any other priority except national security is likely to be crowded out if the debt is not reduced, and the essence of reducing the national debt is either reducing the Defense Budget or reducing the Healthcare deficit, and there are signs that he would rather reduce security than the health agenda. It does not matter as much as it seems. The cumulative long-term debts of everything the government is involved in will ultimately be reflected in the national debt, and government healthcare deficits are the largest item. If the longterm growth of debt from that source is not constrained, almost everything else is in danger of being crowded out. With restraint in government healthcare costs, attention can be shifted to educational costs, or housing costs, or foreign affairs. Without it, the bond market will dominate what he must do.

The health of the economy is the main determinant of the whole matter, not the health of the public. {bottom quote}

To state the obvious, the healthcare deficit results from expenditures running $250 billion a year greater than revenue for the program, or about half of its costs. To a degree seldom seen in the private sector, the fluctuations of revenue have almost nothing to do with healthcare, the core business of this issue. Revenue is mainly derived from a payroll tax of nearly 3%, half from employees and half from the employers. Payroll taxes go up and down with the national economy, but any connection to improved or worsened healthcare is entirely accidental. The second main revenue source would be from Medicare Part B and D premiums, whose fluctuations are likewise related to the economy rather than the core business of healthcare. From this, it can be concluded that the health of the economy is the main determinant of the whole matter, not the health of the public. Premiums are similarly related to the economy, although possibly to a smaller degree. Payroll taxes are collected on those with jobs, premiums by those who have retired. Payroll taxes are therefore more sensitive to the economy than premiums.

Unproductive to look closely at direct costs; concentrate attention on the indirect kind. {bottom quote}

Expenditures are of two sorts: direct and indirect. Although the fiction is maintained that every expenditure is related to something which generates a charge, the direct costs are more accurately audited because their relation to the core business of healthcare is readily understood. The accounting of indirect costs is much more fanciful, with the total costs aggregated and distributed among the various departments of a hospital according to such debatable theories as the proportion of floor space occupied, and sometimes leading to bizarre instructions to hospital architects about tiny accident rooms and enormous surgical nurses lounges. For the time being, it seems fairly unproductive to look closely at direct costs and concentrate attention on the indirect kind. The item sizes are generally much greater, and the justification weaker. It is here that an auditor is likely to find padding in the remuneration of officers who make decisions about the remuneration of officers. The direct costs are much more likely to rise and fall in tandem with medical activity so that computer algorithms related to the variations of direct costs would rather easily distinguish indirect costs which might require more external guidance from auditors.

So what generates the $250 billion deficit? To a large extent, it represents fluctuation in the economy or GDP, about which nothing can be done by insurance auditors, from either the public or private sectors. It does result from an unknown amount of padding in the indirect expenses, and probably a fair amount of imaginative accounting from state Medicaid programs. Hospital administrators complain that there are many unwarranted debts from unpaid deductibles and insurance copayments. And the originators of the Affordable Care Act attribute huge losses to the unpaid bills of uninsured patients.

We are now engaged in a very contentious stress test to see what the truth is. {bottom quote}

In the early days of congressional debate about healthcare reform, it used to be argued that mandatory health insurance would eliminate the bad debts from the uninsured, which would not only eliminate those losses, but reduce the cost of insurance carriers including Medicare by eliminating the need for the cost-shifting employed (through the indirect cost manipulations) to shift these costs of the uninsured into pseudo-costs of insurance. For obvious reasons, everyone was hesitant to be too specific. And so, it could be alleged, we are now engaged in a very contentious stress test to see what the truth is. The proponents of this theory have grown very quiet since they acquired better access to the facts, and it would be a very bold position to contend that the $250 billion dollar deficit is about to disappear. It is probably not even possible to stretch the true savings which will undoubtedly appear into something -- say, $100 billion a year -- which would make an appreciable dent in the National Debt, or international balance of payments, where there would then be a reason to call the experiment a real success. For that far more important goal, transforming the Medicare debt into an agricultural or Defense Department debt by creative accounting accomplishes very little. Reducing the deficit in the international balance of payments by reducing one of its main components, on the other hand, would be an astounding achievement in the face of almost universal skepticism. Just so it isn't done with smoke and mirrors.