The musings of a physician who served the community for over six decades
367 Topics
Downtown A discussion about downtown area in Philadelphia and connections from today with its historical past.
West of Broad A collection of articles about the area west of Broad Street, Philadelphia, Pennsylvania.
Delaware (State of) Originally the "lower counties" of Pennsylvania, and thus one of three Quaker colonies founded by William Penn, Delaware has developed its own set of traditions and history.
Religious Philadelphia William Penn wanted a colony with religious freedom. A considerable number, if not the majority, of American religious denominations were founded in this city. The main misconception about religious Philadelphia is that it is Quaker-dominated. But the broader misconception is that it is not Quaker-dominated.
Particular Sights to See:Center City Taxi drivers tell tourists that Center City is a "shining city on a hill". During the Industrial Era, the city almost urbanized out to the county line, and then retreated. Right now, the urban center is surrounded by a semi-deserted ring of former factories.
Philadelphia's Middle Urban Ring Philadelphia grew rapidly for seventy years after the Civil War, then gradually lost population. Skyscrapers drain population upwards, suburbs beckon outwards. The result: a ring around center city, mixed prosperous and dilapidated. Future in doubt.
Historical Motor Excursion North of Philadelphia The narrow waist of New Jersey was the upper border of William Penn's vast land holdings, and the outer edge of Quaker influence. In 1776-77, Lord Howe made this strip the main highway of his attempt to subjugate the Colonies.
Land Tour Around Delaware Bay Start in Philadelphia, take two days to tour around Delaware Bay. Down the New Jersey side to Cape May, ferry over to Lewes, tour up to Dover and New Castle, visit Winterthur, Longwood Gardens, Brandywine Battlefield and art museum, then back to Philadelphia. Try it!
Tourist Trips Around Philadelphia and the Quaker Colonies The states of Pennsylvania, Delaware, and southern New Jersey all belonged to William Penn the Quaker. He was the largest private landholder in American history. Using explicit directions, comprehensive touring of the Quaker Colonies takes seven full days. Local residents would need a couple dozen one-day trips to get up to speed.
Touring Philadelphia's Western Regions Philadelpia County had two hundred farms in 1950, but is now thickly settled in all directions. Western regions along the Schuylkill are still spread out somewhat; with many historic estates.
Up the King's High Way New Jersey has a narrow waistline, with New York harbor at one end, and Delaware Bay on the other. Traffic and history travelled the Kings Highway along this path between New York and Philadelphia.
Arch Street: from Sixth to Second When the large meeting house at Fourth and Arch was built, many Quakers moved their houses to the area. At that time, "North of Market" implied the Quaker region of town.
Up Market Street to Sixth and Walnut Millions of eye patients have been asked to read the passage from Franklin's autobiography, "I walked up Market Street, etc." which is commonly printed on eye-test cards. Here's your chance to do it.
Sixth and Walnut over to Broad and Sansom In 1751, the Pennsylvania Hospital at 8th and Spruce was 'way out in the country. Now it is in the center of a city, but the area still remains dominated by medical institutions.
Montgomery and Bucks Counties The Philadelphia metropolitan region has five Pennsylvania counties, four New Jersey counties, one northern county in the state of Delaware. Here are the four Pennsylvania suburban ones.
Northern Overland Escape Path of the Philadelphia Tories 1 of 1 (16) Grievances provoking the American Revolutionary War left many Philadelphians unprovoked. Loyalists often fled to Canada, especially Kingston, Ontario. Decades later the flow of dissidents reversed, Canadian anti-royalists taking refuge south of the border.
City Hall to Chestnut Hill There are lots of ways to go from City Hall to Chestnut Hill, including the train from Suburban Station, or from 11th and Market. This tour imagines your driving your car out the Ben Franklin Parkway to Kelly Drive, and then up the Wissahickon.
Philadelphia Reflections is a history of the area around Philadelphia, PA
... William Penn's Quaker Colonies
plus medicine, economics and politics ... nearly 4,000 articles in all
Philadelphia Reflections now has a companion tour book! Buy it on Amazon
Philadelphia Revelations
Try the search box to the left if you don't see what you're looking for on this page.
George R. Fisher, III, M.D.
Obituary
George R. Fisher, III, M.D.
Age: 97 of Philadelphia, formerly of Haddonfield
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.
Recently, Chip Kelly prodded us into trying something new; it was a straight-faced rise-from-your chair discussion of the meaning of a just society. Perhaps that should be capitalized: A Just Society.
It could be that the club has for so long adopted a habit of fixed presentations, that members begin to look around for a mechanism, any mechanism, to create a general conversation among a group of fellows who have grown to know each other very well. But the tone of the ensuing remarks suggests something more is afoot, very likely growing out of the current economic Recession, with the new President calling for disruptive Change of a redistributionist sort. The old saw has it that politics and religion are best avoided in conversations among friends, but once every eighty years cannot do much damage.
Bill of Rights
Allusions to the Marxist doctrine of "from each according to his ability, to each according to his need" were actually offered, and praise was openly made of the Chinese Communist system. To which were rejoined remarks about the 40 million Chinese who died in the Cultural Revolution, and the apparent effort to add a new right to the Bill of Rights, this one called the right to a job. This suggested right implies that people have a right to insist that someone else start a business; that's not how businesses have been started in the past. That such a broad new entitlement could be suggested at a time when the nation is plainly unable to afford the existing health and retirement entitlements -- makes it clear this discussion is not entirely about economics. People in the general public are tentatively feeling each other out on these sensitive subjects, and not always pleased with what they discover. Although the demeanor is invariably civil and tentative, one has to worry that hot words are not far away.
Plato
Even more remarkably, a lawyer stood to warn against excessive lawyering; the physician who followed him pointed out that all Utopias since Plato's have suggested that physicians should run any utopia -- a questionable notion in view of the examples of Che Guevara, or Assad the current dictator of Syria, or the behavior of German doctors under the Nazi regime. In fact, the behavior of medical students has traditionally been rowdy. It isn't the training that makes the characteristic personality of a physician, it is the experience of practice. Put all doctors on salary, and you may not get the same result.
Any idea of a smoothly orchestrated introduction of the new law was jarringly interrupted by the U. S. Supreme Court, which granted a hearing to a complaint by 26 State Attorney Generals, that the ACA Act was unconstitutional. It was big news that the whole Affordable Care Act might be set aside without selling a single policy of insurance. The timing (before the Act had actually been implemented) served to guarantee that the constitutional issue, and only that issue, would be discussed at this Supreme Court hearing. By implication, there might be more than one episode to these hearings.
While many could have declaimed for an hour without notes, about difficult issues perceived in the Obama health plan, questioning its constitutionality had scarcely entered most minds. Then of a sudden, near the end of March 2012, a case testing the constitutionality of mandatory health insurance was granted certiorari and very promptly argued for three full days before the U.S. Supreme Court. Twenty-six state attorneys general brought that case, so it was not trivial. In jest, one Justice quipped he would rather throw out the whole case than being forced to spend a year just reading 2500 pages of it. But Justices are practiced in the art of quickly getting to the heart of a matter; it soon boiled down to one issue: was it constitutional for Congress to force the whole nation to purchase health insurance? Is there no limit in the Constitution about what the federal government can force all citizens to do, even though the federal government itself is severely limited in scope? Even though the Tenth Amendment states that anything not specifically granted to the federal becomes the province of the states? Would a people who fought an armed revolution for eight years over a 2-cent tax on tea, now consent to a much larger requirement which it was not constitutionally authorized to impose? Most people finally wrapped their heads around some formulation of this non-medical concept to a point where they vaguely understood what the Judges were arguing about. This was beginning to look like a topic where We The People made a covenant with our elected leaders, and reserve the sole right to change it.
The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.
Tenth Amendment
The Constitution describes a Federal system in which, a few enumerated powers are granted to the national government but every other power is reserved to the state legislatures. The Constitution had to be ratified by the states to go into effect, and the states had such strong reservations about the surrender of more than a handful of powers that they would not ratify the document unless the concept of enumeration was restated by the Tenth Amendment. If states could not be persuaded of the need for a particular power to be national, they might refuse to ratify a document which enabled permanent quarrels about the issue. That wariness explains why The Bill of Rights goes to the extra trouble of declaring certain powers are forbidden to any level of government.
Separation of powers further explains why Mr. Romney's mandatory health insurance plan might be legal for the Massachusetts legislature but prohibited to Congress. After Chief Justice Roberts got through with it, whether that truly remains the case will now depend on whether it is described as a tax, a penalty, a cost, or whatever, and only if the U.S. Supreme Court later agrees that was a proper definition. Because -- to be considered a tax it must be too small to be considered coercion. The law itself apparently does not underline this distinction in a way the Justices felt they could approve. Indeed, while Mr. Obama in his speeches firmly declared it was not a tax, later White House "officials" declared it might be. There was agreement the Federal government could tax, but no acknowledgment that taxes might have any purpose other than revenue.
Under circumstances widely visible on television, however, it was clear that the House of Representatives had been offered no opportunity to comment on this and many other points in this legislation. To a layman, that fact itself seems as clear a violation of constitutional intent as almost any other issue, since the Constitution indicates no idea was ever contemplated that any President might construct laws, nor like the courts, interpret their meaning. The first three Presidents repeatedly raised the question of whether they had the authority to do certain things we now take for granted. And Thomas Jefferson was similarly boxed in by a clever Chief Justice, who said, in effect, Agree to This Decision, or be Prepared to Get a Worse One. The Constitution says it is the function of the Executive branch to enforce the law, "faithfully". Presumably, all of the thousands of regulations issued by the Executive Branch under this law must meet the same test.
Given that the Justices now hold it constitutional for the federal Congress to mandate universal health insurance, based on some authority within taxation, the immediate next issue is paying for it. Millions of citizens, usually young and healthy but sometimes for religious reasons, do not want to buy health insurance and would be forced to do so by this law because the only available alternative is to pay a revenue tax. The purpose of including them is to overcharge people who will predictably under-use community-rated insurance, and thus enable the surplus to reduce costs for those who do want to buy health insurance. (Here, the Court had the pleasure of reducing an unusually opaque law to an unusually succinct summary.) To avoid the charge of a "taking", the Administration must either surrender on the universal mandatory point or else surrender the level premiums of community rating. The lawyers for the complaining attorneys general laid great stress on this particular issue in their arguments, and it occasioned much of the discussion from the bench. However, until the law is in action there is as yet no cause for damages.
Here it will depend on whether you call it a permissible activity for Massachusetts or for the Federal government. The Constitutional point seems to be that it is a legitimate Federal power to tax for the "general welfare", so it now becomes essential to know if the taxes for noncompliance in Obamacare are really a penalty. The Justices seemed to be questioning whether the whole scheme would collapse with the forced subsidy eliminated, and because of that be deemed to have been a "general welfare purpose" adequate to meet the constitutional requirement of a permissible enumerated purpose. Lawyers can generally find such a defined purpose in the words of the Constitution, even if they have to dip into the penumbras and emanations of the words. So the question might just devolve into whether a majority of the Justices wish to declare the penumbra to be within the enumerated powers of Congress. To all of this, the lawyers for the attorneys' general reply that such an enumerated power is impossible because there is no limit to what could be done by this method. Congress would then be allowed to mandate that everyone eat broccoli for dinner, or buy a General Motors car in order to pay for the deficits of rescuing that company from bankruptcy. Almost anything could be mandated by establishing a penalty called a tax; including a mandate that everyone buys a product in order to pay for the deficits of mandating it, illustrates there exists at least one circularity of enumerating something like a power of Congress. According to this reasoning, mandated health insurance cannot, therefore, be an enumerated power of Congress, either now or at any time in the future. The sort of speculative law outlined in this paragraph is exactly the sort of thing the Supreme Court dislikes and shows the utility of denying access to the courts to anyone who cannot claim "standing", defined as a claim of actual injury from a law.
The Justices undoubtedly had to weigh the fact that the American public has a strong distaste for this sort of convoluted reasoning, which sounds like a convention of Jesuit priests having fun. On many other occasions, however, the public has accepted the judgment of people it hired to understand this sort of thing; that's called respect for the law. Eighty years ago in the Roosevelt court-packing case, there was the same sort of collision between the Court and the President, and the Court knuckled under even though the public supported the Court. In both cases, the Court seemed to be yielding to the President, with the unspoken compromise that the President would not pursue his earlier course with quite so much vigor. Since the really central 1937 question of overturning the Interstate Commerce clause ("Commerce among the several states") was left unaddressed, the velvet glove might yet contain an iron fist.
Amendment III
No Soldier shall, in time of peace be quartered in any house, without the consent of the Owner, nor in time of war, but in a manner to be prescribed by law.
The Third Amendment
The Third Amendment to the Constitution received a few moments of attention during the War of 1812, and the Civil War, but has only been litigated once during a strike of prison guards in New York state. It is, however, the somewhat fanciful basis for the right of privacy, devised for Roe v. Wade, and related this to the controversy over abortion rights.
It would appear that requisitioning the homes of private citizens was largely an expense-saving feature of the peacetime standing armies of European nobility, and thus agitated the opponents of aristocracy and feudalism. Its expense-sparing feature was a source of discontent during the French and Indian War, with its long wilderness border making housing difficult to find. The memories of people living near the frontier were long, however, and Charles Pinckney introduced to the Constitutional Convention one of a great many ill-considered motions which were defeated by that body, opposing the quartering of troops in peacetime. This action was taken up in demagogic style by the Anti-federalist faction, and during the ratification process, quite an issue was made of woeful inadequacy of a Constitution which failed to protect a nation's defenseless households, etc., etc. Matters reached a point where Madison was afraid not to include the matter in the Bill of Rights.
The matter may come up again, however, not merely in abortion controversies, but related to the increasing tendency to wage undeclared wars. Apparently, it was Madison's intent to throw the issue into the Executive Branch in the case of "time of war". No declaration of war was made in the Civil War, or in several other conflicts so that the issue which remains unresolved is what to do about undeclared wars, wars against terrorism, and other conditions which are not exactly either peace or war.
Alexander Hamilton, John Jay, and James Madison collaborated in 85 essays, published in the newspapers to win over New York State to ratify the proposed 1787 Constitution as written (which meant approving it without further amending it). The collected essays are now known as the Federalist Papers , authored under the collective pen name of Publius. They were written in great haste during the period before the New York ratifying convention, so there are signs of lack of coordination between the authors. Most of the articles were written by Madison, so his contributions scarcely paused for thought before going on to another topic.
Madison's paper, now called Federalist No. 10, is thought to be the most famous of the group, possibly the most influential. However, its theme is that wide diversity of opinion in a large republic will neutralize itself and therefore eliminate partisanship. Nothing could be farther from what turned out to be the case, however, since Madison himself was one of the principal actors in the drama which soon and apparently permanently established the dominance of the two-party system. As a further irony, his main opponent was his co-author Hamilton. This change of heart, never satisfactorily explained, was particularly bitter on a personal level. Washington essentially never spoke to Madison again, in spite of the close personal collaboration of the two in engineering the Constitutional Convention, the Bill of Rights, and the cultural characteristics of the republic. Unless someone discovers hidden documents from the time, it is likely we can never be certain whether Madison's change of heart was a result of Jefferson's persuasion or persuasion by events. Some conspiracy theorists have suggested that Madison never believed what he said in No. 10, while other cynics point out that Washington could merely offer him fame, but Jefferson was in a position to make him President. Unfortunately, Madison's subsequent presidency was an undistinguished one, and some have pointed to his switch as early evidence of unreliability. In any event, he did reverse positions from regarding partisanship as the main destroyer of republics to coming very close to proving it in the War of 1812. Perhaps he was merely reading the handwriting on the wall. Partisanship has been a constant feature of the nation ever since the election of 1800, and traces of it can be found much earlier than that.
It remains a possibility that Madison's switch was the result of this bookworm's faulty analysis of the roots of partisanship in a republic. His opinion was necessarily based on criteria other than personal observation. There had been no good models to examine since the fall of the Roman Republic in 44 B.C., and even these historical events had been highly mythologized. The essential activity which nourishes partisanship is vote-swapping. When many different issues are laid before a representative of a district, it is inevitable to value some more than others, even to the point of trading his meaningless votes (meaningless to him, or to his district, or both) for more valuable considerations. Sometimes these considerations can be dismissed as corruption, but most commonly the consideration is personal advancement. The congressman needs the votes of other congressmen to advance in the power structure, and it is usually in the interest of his district for him to advance. Whatever he does in the arena of party politics seldom betrays his district, but often involves betraying some fellow representative. It is in this sense that party politics are "dirty". However, the durability of two-party systems allows personal distinctions to be buried within a party label, thus constraining the main concerns of the district to an absolute minimum of choices. There is no need to debate proportional representation; an unconstrained election process itself forces compromises which drive the party toward the center in order to win. In those nations with splinter parties, it is necessary to bargain and compromise after the election in order to achieve a governing majority, so the bothersome public is shut out from participating in the "deals". The essential decisions in coalition governments are often made by a handful of leaders, many of whom achieved party leadership by highly questionable methods. Without saying one word about political parties, our Constitution drives us to a two-party system.
Madison argues in No. 10 that a multiplicity of competing interests would make it progressively more difficult for political parties to remain stable. It is a reasonable argument, which has been reformulated to mean that durable parties must engineer loyalty to a few broad enduring themes, in order to survive from era to era. Rich versus poor would seem a suitable theme, rendered somewhat unsuitable by America's ideal of the poor immigrant, rising in the scale of things to become a rich immigrant or rich immigrant grandson. In recent years, the argument emerged that we should selectively seek immigrants with talents or wealth, thereby enriching our whole nation. As such refinements of a larger theme appear, parties can change. The D's and the R's have completely switched positions on the tariff, for example, and on federal taxation. A constant state of percolation has not had the effect Madison imagined; partisanship has proved stronger than issues. Paradoxically, as parties shift their ingredients of appeal, they become more alike, and the country comes closer to a dead tie in national elections. National balloting is probably not perfected to the point where it can withstand repeated examples of nearly tied elections, so this tends to stabilize may eventually destabilize itself. Tinkering with the election process is viewed with suspicion by the public. So, in the long view of things, perhaps the Constitution has it right. The best policy about political parties is to have no policy.
REFERENCES
The Federalist Papers: James Madison ISBN-13: 978-1936594405
We have had judges and case law (also called common law) continuously since Roman times, longer than any government has survived. By contrast, "statutory "law usually responds more suddenly to the changing natures of rulers, often seeing military law or anything resembling it, as a temporary expedient for the survival of the state. The two forms of law are frequently suspicious of each other, so if both forms of law coexist, they often link through a Constitution defining their boundaries. Common law usually evolves slowly and coherently, whereas statutory law has less patience with traditions, and becomes based on some variant of force imposed by unrelated kings, emperors, tribunes or legislatures, often resisted by local citizens through compromise or rebellion. Much depends on whether or not there are long periods of stability between episodes of war. English common law traces back to the Norman Conquest of 1066, gaining its present form after notable negotiations with King Arthur, Charlemagne, and Francis Bacon, among many others. It seeks "fundamental" truths, eventually founded on the customs of the people defined in that same Constitution. The first written Constitution of any nation was the American one, And it was the only one to last two hundred years, even though several hundred Constitutions have been tried by numerous other attempted democracies. Generally speaking, constitutions define the boundaries of statutory law but also contain a Bill of Rights. The latter is politely worded to define limits to how a simple majority may learn the will of the public, or beyond which statutory authorities may not go without special forms of extra permission. The heart of American common law lies in the first ten amendments to the Constitution, written by James Madison, and called the Bill of Rights. It might well be stated that it protects minorities from majorities, avoiding armed rebellion, but even hinting at that recourse in the Second Amendment. Madison was chairman of the designated committee of the first Congress, extracting ten of the hundred proposals the committee received from fellow members. This degree of mistrust was certainly a clear sign of coming dissatisfaction with any form of government whatever, by a people who mostly hoped to be left alone.
109 Volumes
Philadephia: America's Capital, 1774-1800 The Continental Congress met in Philadelphia from 1774 to 1788. Next, the new republic had its capital here from 1790 to 1800. Thoroughly Quaker Philadelphia was in the center of the founding twenty-five years when, and where, the enduring political institutions of America emerged.
Philadelphia: Decline and Fall (1900-2060) The world's richest industrial city in 1900, was defeated and dejected by 1950. Why? Digby Baltzell blamed it on the Quakers. Others blame the Erie Canal, and Andrew Jackson, or maybe Martin van Buren. Some say the city-county consolidation of 1858. Others blame the unions. We rather favor the decline of family business and the rise of the modern corporation in its place.