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.
Rebecca Potts used to say there were three towns in Pennsylvania named after her family -- Pottstown, Pottsville,
Pottsville biennial
and Chambersburg. Becky never designed to explain whether Chambersburg was just a joke or whether her very extensive family really had connections in Chambersburg. It's possible either way; there were certainly Potts inValley Forge where Washington's Headquarters, which everyone visits, had been home to Isaac Potts, the third generation of Dutchmen named Potts to live there. Isaac ran a grist mill, the others mostly were ironmasters. The family seat in Pottstown was named Pottsgrove, still open for visitors. Holland Dutch they may have been, but Pottsgrove architecture is definitely of the Welsh style.
Pottsville Coal
Pottsville, much further up in the anthracite region, became notable through the novels of John O'Hara, a native son. For a whole generation, just about everybody in Pottsville was uneasy that O'Hara would confirm just who certain characters in his moderately raunchy novels represented in real life. Pottsville's main business for a century was extracting coal for the Girard Estate, which had its coal-mining headquarters in the town, based on Stephen Girard's shrewd purchase of nearly all of Schuylkill County.
The broad sweeping view from the interstate highway going north from Valley Forge makes it easy to see how Pottstown was created by the upheaval of a mountain ridge, which split open to let the Schuylkill River wind through. Pottstown is a water gap. The huge cooling towers of The Limerick nuclear power plant dominate one side of the river cliff and can be seen for miles. The cliff on the other side of the river, behind which hides the town of Pottstown, used to shelter the Wright aircraft factory, much of which was underground. That gave it a railroad (The Reading RR) and ready access to the river, plus privacy from the land side. Down to the right a mile is the Pottstown Hospital, on the edge of town, quite near the campus of the famous Hill School, fierce competitors of the Lawrenceville School in sports. Just about everything in this area is on top of some kind of hill.
Just back of the hospital, seemingly on the grounds of it, rises a peculiar steel tower, which the local workmen report is a sending station for cellular telephones. However, one of the doctors of the hospital relates a somewhat different history. He says he was once called on a medical emergency, told to ring the elevator at the little house beside the steel antenna, and travel down, down, into secret depths. He found himself in the headquarters of the Northeastern Air Defense Command, which was certainly hidden in an ideal place if the story has any truth to it. Unfortunately, that story-teller was a famous cocktail-party raconteur whose wild tales were never to be taken completely seriously. For many years, the hospital on a cliff was surrounded by corn fields, and it is certainly true you could look out the windows at a sea of corn, never suspecting you were very close to a railroad and a river, quite possibly right over an underground aircraft factory. Someday it may be possible to find out the truth of these tales of the Dutch country.
During the American Revolution, the British blockaded the coast and landed troops on the main coastal highways. The Americans responded in a quite natural way by building an inland north-south forest trail, sort of on the order of the Ho Chi Minh Trail. Pottstown was one natural stop on this trail, which tended to intersect with many roads coming up along the banks of the coastal rivers. In one very famous episode, wagon loads of Philadelphia Quakers were arrested and taken up the Schuylkill to Pottstown, then south to internment at Winchester, Virginia. They weren't exactly Tories, but they certainly were not sympathetic to revolutions. One of the most famous of these semi-prisoners was Israel Pemberton, one of the leaders of the Quaker colony. He later reported he was treated well, but onlookers in Pottstown described him as being thoroughly abused.
Pottstown had a century of prosperity during the industrial age, then declined and decayed. In recent years. The interstate highway has brought a migration of exurbanites whose taste in architecture tends toward McMansions. Let's hope they can acquire a dose of local history, starting a new historical revival of a town with great potential, considerable past glory, and a wonderful natural setting.
Philadelphia still has six cricket clubs, and used to have more. The game of cricket was invented in 1200 AD and had its rules established in 1749 at the Marylebone Club.
Baseball, on the other hand, was established in 1849 by Abner Doubleday of Cooperstown New York, with the convention of confining the runners to a diamond infield. Modern rules and established leagues of players only came along twenty years later. Actually, no one disputes that cricket is older. The question is one of manliness. Having listened for centuries to American jibes about tea and watercress sandwiches, the crickets have had enough. Their champion, Alan Lawley, recently threw down the challenge to baseball-crazy Americans at the Philadelphia Right Angle Club, where Lawley is Recording Secretary. Pardon me, blokes, but why do you tough guys consider it necessary to catch the ball with those big leather gloves? Don't you notice that cricket players catch the ball with their bare hands? Most of the excitement comes at that moment when the player is circling to catch the batted ball. He'll get it all right, but will he drop it? The essential inferiority of baseball to cricket has been documented for pages and pages by legions of British subjects, but the main point is about those gloves.
So the challenge is out. Let's see you gashouse beer drinkers take off those big protective mitts, and then try to catch the ball. And while you're at it, let's hear you pronounce Marylebone.
In 1789 while arguing for the establishment of a National Bank, Alexander Hamilton made one of the most famous counter-intuitive assertions of his controversial career. "A national debt, if it is not excessive, will be to us a national blessing".
The very suggestion of such an idea enraged Thomas Jefferson and his Calvinist adviser, Albert Gallatin. James Madison, ever the political schemer, immediately recognized a new bargaining chip in his move to relocate the national capital to Virginia. Political parties were promptly invented to mobilize votes on both sides, and the national bank remained a divisive issue for half a century afterward. Neither a borrower nor a lender is; how could anyone, then or now, say the debt was a blessing?
Indeed, that's evidently how the leaders of Singapore, Malaysia, Australia, China, and several other prosperous states still feel about it. While not eliminating taxes, these countries accumulated surpluses and created sovereign-wealth funds. Having paid off the national debt, and still finding a national surplus, what else are you going to do with it?
Gallatin
These countries hired investment advisers to buy stock for the funds, evidently feeling American stocks were the safest bet; it's hard to criticize that conclusion. In the present credit crunch, they are investing five and ten billion per transaction in the equity of America's premier investment banks. So far, they only acquire 5 or 10 percent ownership, but then the credit crisis may not be over yet. For them eventually to acquire 51% controlling ownership somewhere is not at all inconceivable. An ominous sign of where that might lead is found in our own captive pension funds. The state employee pension funds have quickly become captive to unions with their own agenda, with the result that the prosperity of the companies in the portfolio could be sacrificed to the benefit of interest groups. And yet, it wouldn't be so hard for America to do the same thing. If Congress had adopted the Bush proposal of three years ago to create an investment fund for Social Security, we ourselves would soon have what amounts to the largest sovereign wealth fund in the world. Could this be a solution to the weakness of the Federal Reserve in controlling the currency with bank debt? Could we somehow create a common world currency based on a common fund of sovereign wealth funds and with that, create a new definition of wealth based on equity rather than debt? The technical answer to the potential corruption issue would probably lie in stripping the voting power from such shares and then submerging them in a world index fund. The United Nations sound of it nevertheless still boggles the mind. Are people who oppose an equity-based world currency going to be forced like Gallatin to eat their own dusty words when the reality of debt-based currency sinks in? How many of the ambassadors of ideas about such suggestions, both pro, and con, would eventually surface as sneaky connivers like Madison, with a hidden side-agenda? After all, in a democracy, everyone is expected to marshal every argument, weak or strong, for his own self-interest.
Federal Reserve
The loss of banks as a tool for the Federal Reserve would undermine the way the Fed does its job. A deeper reality is that many governments really don't want the job to be done perfectly and independently. The European common currency, the Euro, is already irking the French and other national governments who sometimes hanker to inflate away their debts or deflate their way out of the subsequent inflation. A perfectly automatic currency regulation threatens an important ingredient of the sovereignty of nations, thus the whole concept of nationhood. Somehow, the desire of markets to enhance wealth must come to terms with the desire of governments to re-elect themselves.
It will take more than the present crisis to provide credibility for ideas as wild as substituting equity-based currency for the present debt-based one. Unless someone devises a better-sounding scheme, it seems more likely that financial Jacobins will propose sacrificing the unwelcome intruder. Derivatives, whatever that means, started this mess. Maybe we should make them illegal.
Cornwallis and the British regulars came thundering down the narrow waist of New Jersey from New Brunswick to Trenton, just before Christmas, 1776. Washington's troops retreated before them, fleeing to the Pennsylvania side of the Delaware River. The British then fortified the Hessians in Trenton and went back into their own winter quarters nearer New York. Plenty of time seemed available to finish off Washington in the Spring, and then leisurely conquer the enemy's capital in Philadelphia. The Continental Congress thought so, too, and moved its capital to Baltimore. Only three members of the Congress, Robert Morris, George Clymer, and George Walton (of Georgia), remained in Philadelphia to run the government; Morris was essentially in charge, in the role of financier whatever that meant. With Congress seeking refuge, Morris was for practical purposes, acting President of the United States. Washington swept up all of the boats on Delaware, set up camp on the Pennsylvania side, and begged Morris to get him some money to reward re-enlistments by January 1. Others saw the end of the year as Christmas time; Washington saw it as the end of the year when enlistments expired. He quite plainly stated that it was all over for the Continental Army unless he could get some hard currency, silver preferred, to show the troops that the rebellion could survive another year. About ten dollars per soldier would probably do it, but then there was also a need for hard money to buy food and supplies for the starving troops.
General Charles Cornwallis
Just how Morris managed to find the money is unclear, or how much of it was his own. But he did manage, with the lucky arrival of a gunpowder smuggling ship from France, and eighteen cannon somehow supplied by General Knox. The Colonials rallied to re-cross Delaware, surprise the Hessians, outmaneuver Cornwallis as he once more thundered back down the New Jersey waist, now intent to wreak vengeance. The military essence of it all reached a climactic moment when Washington used fake bonfires to trick the British while he sneaked around them. Captain Sam Morris and Philadelphia's First City Troop managed the bonfire deception. When cannon fire in Princeton announced the trick, the British raced back to their ships at Staten Island to protect their supplies before Washington who now had a head start, could get to the ships, leaving the British to starve in the woods. Both sides were exhausted by the chase, and although he had won this race, Washington had to retreat to winter quarters in Morristown, New Jersey (named after a former New Jersey Governor.) Meanwhile, with Congress taking refuge in Baltimore, Philadelphia was nearly deserted except for some Quakers who felt they had no quarrel with the British. And Robert Morris, who continued to run his smuggling operation with Beaumarchais the famous playwright on the French end of it. Tradition has it that some Quaker gardens were dug up to find enough silver to reward reenlistments, and if so it is unclear how much was freely contributed and how much was just plain stolen; indeed, how much of it might have been Morris' own money. By the next fall, Washington was able to fight the largest battle of the war at the Brandywine Creek, so Morris must have been very active smuggling guns and gunpowder to resupply the Colonials during that intervening winter and spring.
During periods of the lull in infantry warfare, other warfare including privateering at sea, blockades, and the diplomatic intrigue in Paris, were unmerciful. If Washington's army had been wiped out, the Revolution would have ended. But other misadventures might have ended it as well. The colonists were demoralized, and their dismay was summarized by a letter from Morris to Silas Deane, a line of which was the bitter observation that "Sorry I am to say it, many of those who were foremost in noise, shrink coward-like from the danger.".
A few days before that fateful Christmas, Ben Franklin had arrived in Paris to take over our diplomatic mission with the French. When the news of Washington's victory reached him, the new American arrival was being acclaimed as the world-famous scientist and witty author and was thus in a position to make the most of it with the French court. He may be forgiven for exaggerating Washington's exploits a little. The Trenton victory was rough and ragged, but it would serve. Washington, Franklin, and Morris. The three Americans who mainly won the Revolutionary War for us now took the stage, front and center.
Four Prescriptions: Proposals or Reform of Health care Financing
Rx. I: PRE-FUNDED HEALTH INSURANCE
INTRO page 1.
Introduction
Benjamin Franklin organized the first American fire insurance company in 1736. Success in the insurance business rests almost unnoticed among the many scientific and political accomplishments of that remarkable man. Even in Philadelphia, few people realize Franklin’s company and several others like it still operate comfortably. Franklin called his company a “Contribution shipâ€, but a more familiar modern term is “mutual†insurance company. Even though mutual life insurance companies have come to predominate, for important reasons fire insurance has been more salable when provided by profit-making companies. The ancient mutual fire insurance companies remain small but reflect some important thinking which this book argues should be applied to health insurance, where ideas are currently badly needed.
What the world already knows about these quaint little companies is almost a hindrance. Occasional articles in the Philadelphia Sunday supplements do sometimes mention them, mostly fascinated with how socially prestigious it is to be a member of their boards of directors, what excellent dinners are served at directors meetings, what priceless antiques are to be found in their headquarters. Franklin to be sure would probably relish the elegance. Unlike the Quakers of Colonial Philadelphia, Poor Richard was not frugal in order to be inoffensive; he was frugal to get rich. Dying the second richest man in the city, he lived the kind of life many Yippies might admire.
Mutual fire insurance companies sell something called "perpetual insurance" which turns out to be perfectly ordinary homeowner's insurance, with one big twist to it. The customer makes one large lump sum deposit in advance, then never pays premiums. During all the time the insurance is in force, perpetually if need be, no further premiums are paid. The deposit earns enough interest to pay the full premium cost of the insurance protection. In that way, the customer has the perfectly astounding experience of having every penny he paid to the company returned when he eventually gives up the insurance. Centuries of experience show that a single deposit of roughly ten years conventional premium will generate enough investment income to cover all anticipated costs from "losses" and administration. The deposits themselves "share the risk", eliminating the cost of paying investors to provide a "contingency reserve". This simple scheme is Perpetual mutual insurance.
As everyone knows, that isn't the way most fire insurance works; the only things perpetual about a more typical policy are the yearly premium notices, which in the aggregate eventually cost much more than making a deposit and giving up the income from it. It is left to the typical stockholder company to worry about getting contingency reserves coming from investors are more popular with homeowners than reserves they have to provide themselves, consequently why perpetual premiums are so much more scalable than perpetual insurance. The young homeowners is typically a debtor, stretching to buy the best house he can afford when he can stump up a down-payment; fire insurance is something his mortgage banker insists he buys. In order to have the American dream a little earlier, the homeowner agrees to pay a little more, later.
Two hundred years after Franklin's death it is possible to gain other insights from "perpetual" insurance because the unfamiliar approach makes us ask basic questions. The next several chapters of this book now set out to argue that health insurance has some serious problems which could be improved by asking those questions. The problems of health insurance are not trivial; many experts question whether we can afford to continue the present system. Whether a breakdown of health insurance would lead to worse care, no access to care or rationed care, the whole subject of health insurance is important to more people than insurance executives. We will return to Franklin's idea after a flyover of current major problems of health insurance, with reflections on how things got to be such a mess. Then, after compounding several insurance remedies based on Franklin's formula, an effort is made to identify potential harmful effects but few are found. The main problem with the prescription is that it has a rather bitter taste.
WHAT'S WRONG WITH HEALTH INSURANCE
There are many things good about the American system of health insurance. Compared with the nationalized health insurance schemes of other countries, our health insurance is a utopia. Indeed, the main reason to criticize the American system of health insurance is to save it from itself, since the foreign alternatives are so much worse. No doctor ever saved a patient by ignoring the symptoms. To be concise, our health insurance system is unfunded, inappropriately linked to employment, adequate for moderate illness but not for catastrophic ones, and incredibly expensive to run. For each of these four disorders, this book offers a prescription. In the first section, keeping Poor Richard in mind, the disorder under examination is that health insurance is unfounded. For the ailment of being unfunded, the prescription offered is the IRA for Health.
Unfunded, Being unfunded does not mean cheap. It costs a typical family about $3500 a year for health insurance premiums. It has become commonplace to read newspaper articles announcing or predicting 15-30% increases. Annual national costs of healthcare are about $500 billion. Those who would like to solve the problem with a national health scheme should remember that $500 billion would be half of the current Federal budget; the $200 billion already federalized are nearly destroying the government. Health care is expensive all right, and unfunded.
Further, because an employee can escape income taxation on a health insurance premium if his employer pays it for him, that's the way health insurance.
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.