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
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Philadelphia Revelations
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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.
From time to time, someone denounces big-city political machines, making the mistake of describing them as invariably Democrat. Debaters duly object, pointing to Philadelphia's Republican city machine lasting seventy-five years. It was, indeed, a very tough and corrupt organization. Whether it was Republican, is more debatable. The question might be re-phrased: How is it, with Democrats running every other big-city political machine, Philadelphia alone produced a Republican version? The explanation is buried in complex national politics just before the Civil War, when the last and final Whig convention was held in Philadelphia, following which the successors, the Republicans and also the Know-Nothing (American) parties, held their very first conventions here four years later.
James Buchanan
To stir the Philadelphia pot still further, the person who actually won the 1856 Presidential election was James Buchanan, a Democrat from Lancaster County. Just about everything political was happening right here, all at once. Lots of deals were made. The Pennsylvania Republican delegation emerged as Abraham Lincoln's king-maker, and Lincoln as President rewarded Pennsylvania for its keen insight. Appointing cabinet members from Pennsylvania, the new administration naturally steered war contracts to our local industries.
Philadelphia politics immediately became Republican in a big way, and after the war, the Republicans were then in charge of the national government for fifty years. Philadelphia had created a political machine, and it made no sense patronage-wise for many decades, for it to profess allegiance to any other party than the one it started with.
There thus exists a simple and coherent explanation for Philadelphia's exceptional behavior. A more difficult question to answer beyond dispute is: Why do big-city political machines almost invariably develop a Democrat affiliation? We're going to take a pass on that one, falling back on the observation that municipal politics usually have very little to do with national politics, no matter what Tip O'Neill may have said. Indeed, local politicians mostly wish national politicians would go back to Washington and leave them alone. National politicians certainly reciprocate that feeling, especially if they have a safe district.
But Party unity is periodically stimulated (some would say simulated) when the national figures must come back home from Washington seeking voter approval, searching out support in the clubhouses, fire stations and taprooms that are firmly in control of local warlords. Those warlords care little about foreign affairs, interest rates at the Federal Reserve, or globalization, becoming uneasy when the national politicians to whom they owe nominal fealty drag them into messy subjects like abortion and civil rights. In the clubhouses, there is a tendency to measure national leaders by patronage and pork barrel. In return, the national representative wants to be re-elected. He wants voter turnout, campaign funds, and gerrymandered districts. It's mostly the same in both parties, and in all regions.
If lowering taxes is inflationary, how can it be that several financial columnists refer to buying low priced
China Man
Chinese imports as"importing deflation"? It would seem, in both cases, that consumers end up with more money in their pockets, so both cases must be inflationary. To answer that twister, you also need to consider where the inflationary new money comes from.
chinese labor
When the government lowers its revenue by lowering taxes, it creates a deficit which is paid for by issuing bonds. That's inflationary until the bonds are paid off. If the bonds are ever paid off, the amount of money in circulation then returns to its original level. The public has effectively given itself a loan by lowering taxes, so after a temporary spell of inflation, there is no permanent effect on circulating money at all. By contrast, when Chinese workers agree to work for lower wages than Americans, that causes inflation for the American economy because Americans have more spending power left over. How they spend it is their business; the bonanza may surface as a stock market bubble or a real estate bubble, a credit card bubble or a spectacular Christmas shopping season. But gradually the extra money seeps out into the economy as extra wealth of some sort. Whether you describe it as real added wealth or just inflation, maybe a quibble -- but it clearly is not deflation.
Chinese wages
But when a successful financier, betting his own money on his analysis, says that America is "importing Chinese deflation", it's likely he says something important, however imprecise technically. In this case, it would seem to be an observation that the globalization method of creating inflation minimizes some of the usual consequences of inflation. Since the low prices of Chinese products are mainly due to low Chinese wages, they discourage wage demands in this country, even in industries which do not compete against imports. That's politically important, even though there are many more consumers than manufacturing workers, and the nation as a whole is better off for the globalization. In short, inflation is not invariably a bad thing.
Now, just think of the problems that create for the Chairman of the Federal Reserve, who is charged with maintaining level prices, and defines our whole currency system on doing whatever it takes -- to avoid inflation.
Since ups and downs of the American economy have relentlessly followed each other since the time of Alexander Hamilton, it's unfair to blame the President who happened to be in office when each bump began; but we do it anyway. Two bubbles began during the presidency of George W. Bush, the dot-com surge then the collapse of 2001, and the housing bubble which rose from the ashes of that collapse, crashing in turn in the summer of 2007. Both episodes can be viewed as responses to the world money surplus which grew out of globalization, which itself can be viewed as growing out of the computer revolution which started around 1975. Maybe that's wrong, but it's common to believe it is right. The world economy is an over-inflated tire, so bubbles appeared at weak spots. When money fled the stock market of electronics stocks, it moved to American real estate, facing us with the choice of another bubble to follow this one unless the collapse of this bigger bubble deflates so badly we have to whimper through a depression for a couple of decades.
This grand preamble is intended to answer whether a housing surplus caused the bubble, or a money surplus did. Economists at the Federal Reserve, charged with examining such questions, are firm of the view that money surplus came first, causing too many houses to be built. The money surplus, in their view, grew out of the tendency of people (in this case, Chinese) to get prosperous before they learn how to spend their new wealth, so they save it. Without further debate, we will assume excessive savings in developing countries tended to swamp the world financial markets, and if it hadn't been this bubble it would have been some other. We went 18 years without a major recession and would have to go another two decades -- forty years, in all -- for things to work themselves out calmly. It's a pity, but that's the price of being too successful.
Housing Bubble
A briefer capsule of the housing bubble would describe how surplus funds in the banking system made it cheaper to lend out mortgage money, which soon led to surplus houses, which caused the prices of houses first to go up and then to go down, soon followed by the banking system, and maybe through banks to the rest of the economy. Stock speculation is easier to manage because houses take a very long time to disappear once you build them. Judging by the experience of the 1929 crash, it takes nearly twenty years for confidence to return after a bad crash, so perhaps the loss of confidence takes longer to recover than real estate prices. In fact, Europe looks as though it may take a century to recover its nerve, and by that time Europeans could be permanently in the dustbin of history. It can all be an unpleasant set of reflections.
EVER since we finally went off the gold standard completely during the Nixon Administration, the Federal Reserve has adjusted our money supply to create a fairly steady 2% inflation. If inflation is ever less than 2%, the Fed puts more money into circulation. Since many bonds are paying less than a 2% dividend, everybody who buys and holds them at par will lose money in "real" terms. That is, everyone who buys bonds when they are issued and sells them when they mature will lose spending power. Since they fluctuate in the meantime, it is possible for a trader to buy them when they are undervalued by the market. That trader will possibly make money, but only because someone else lost money. Something like that occurred during the recent financial crash bailout, when interest rates declined from 3% to less than 2% but were repurchased by the Fed as "Quantitative Easing", effectively giving speculators a 33% profit at government expense. But that doesn't happen often, and just guess who ultimately lost the money the speculators made. There is also that daunting question: when the time comes for the Federal Reserve to disgorge them, just who is going to buy all these cheapened bonds? In Japan, bonds paid a dividend of less than the rate of inflation for more than a decade; it's hard to think of a reason why the same thing could not happen in America. So it's also hard to imagine a reason why buy-and-hold investors should not abandon bonds, perhaps suddenly all at once, at some unknown time in the future. At that point, many of them will resolve never to try that, again. The whole idea is troubling.
It's particularly troubling in view of the lack of success, so far, of TIPS. These vehicles are new; perhaps the algorithm is set to ignore minor inflation and will over-respond to more major inflation, ultimately rewarding those who buy them. But at least so far, they are a disappointment. Furthermore, TIPS are quite cleverly designed to be inflation-protected, while unfortunately inflation usually does not follow a straight line but is volatile, or saw-toothed; the jury is still out. The jury better hurry up, because all investors look for net income after expenses, which include brokerage costs, taxes, and inflation. A long-term bond might have to pay a dividend approaching 4%, just to emerge with the same net value it started with; after five years of 4%, you could be 20% behind. And yet, the bond market with or without inflation protection is far larger than the stock market and compares in size with all other kinds of market. Who buys them, especially in these huge quantities?
Somebody must maintain statistics which answer this question, but as a guess, the main buyers are insurance companies, endowments, annuities, hedge funds, banks. And foreigners, of course, to whom our follies seem trivial compared with their own. The great argument for bonds is the safety of principal, and although safety is in question anywhere there is inflation when the topic is cash flow, safety is definitely an issue. Cash shortages are what cause bankruptcies, which are mainly useful in providing time to liquidate underlying wealth to pay restless creditors. The management of a non-profit organization must meet its payroll out of cash flow, so non-profits protect themselves from dissolution by having a regular flow of nominally secure bond dividends. Income from donations and contributions can be particularly weak during times of economic stress. Since most for-profit organizations also experience variable periods of time without profits, their situation does not differ greatly from nonprofits. That's particularly true when a for-profit organization has a vocal, activist stockholder group, who will protest fiercely if the management retains abundant cash. For such a predicament, holding bonds creates safety by some definition. The price of that safety is the long-term average loss on the bond portfolio; the company's alternative losses are whatever it takes to maintain a stable work force during unstable times. The business school assessment of this tradeoff is that bond losses can usually be passed through to the customers as a business cost, while layoffs and strikes may not be.
To restate the characteristics of willing bond purchasers, they are governments and corporations who have no common stock issuance alternatives, but regularly face a need to have money available for payroll. They also include borrowers and lenders at nominal interest rates like banks and insurance companies, who can afford to ignore inflation because their own liabilities are in nominal dollars, or come due at a date certain. And then, there are a host of beneficiaries of special-interest bond provisions, like "Flower bonds", state and municipal governments, foreign aid, student aid, etc. As an overall statement, natural bond buyers are those who either do not possess steady equity (common stock) alternative to offer investors or else are shielded in some way from the inflation and tax costs of buying bonds. Speculators and traders are excluded from the discussion because fixed-income trading is a zero-sum game, something you should teach your children to avoid. Other than these special niche opportunities, bonds should be regarded by the ordinary investor as trading opportunities when interest rates get too high, which is roughly every fifteen years or so.
Things in the bond market were not always so bad; Robert Morris, Jr. was a genius for devising this market in 1784. But the equity market was then not so well developed, life expectancies were shorter, and a minimum 2% inflation was not guaranteed by the Federal Reserve. The income tax had not been invented. It was possible to enjoy the promised benefits of lending in those days, for decades or even lifetimes. It was much harder to find investments of superior performance, without getting involved in business management. Meanwhile, the bond market just got huger and huger. Modifying or dismantling it in logical ways would have enormous disruptive effects. So enormous, the Congress has just adopted the stance called "kicking the can down the road", which is a debt you never seriously intend to repay.
Are we waiting for the bond market, the bond vigilantes, or speculators to find some vital vulnerable flaw, and topple it all into the ashcan of history? Or is there some better plan that no one has mentioned?
The task I set for myself was to design a cheaper better system of funding healthcare, utilizing individual accounts rather than government ones, and collecting compound interest rather than borrowing. Here it is, warts and all. And in retrospect, it isn't politics which worry me, so much as unforeseen consequences.
Always the first is the consequence of getting what you wish for. If compound interest pays for most of essential healthcare, will non-essential healthcare just take its place? Is the appearance of being free always invincible? Second, if we generate the funds for 16-18% of the gross domestic product, will the economy shrink by 16-18%, or grow by 16-18%? That is, would these proposals be inflationary, deflationary, or neither? I have no experience in such matters, although I have lots of experience reading nonsense on the editorial pages of distinguished media. In fact, I briefly served on the editorial board of the largest newspaper in America, and consequently, have some reluctance to accept opinions from that direction. In fact, I indirectly experienced the theories of John Maynard Keynes at work in two severe depressions and one devaluation of the currency, and am not a fan of his for the long run.
Maybe no one knows the answers, and careful study of pilot projects is the best you can expect for guidance. In the other direction, I was personally instructed in the economy by William Niskanen, couldn't understand why he said what he said, and later found he was probably right. So I can't trust my judgment about whose judgment to accept, and perhaps no one knows for sure. But it seems reasonable to ask what experts seem to think about the effect of these ideas on the currency, and on the economy.
For example, if our economy is based on bank debt, and bank debt supports several times its value in "credit" issuance, and if the Federal Reserve is unable to force inflation to 2% by some weird definition of inflation, what will happen if we remove 16-18% of GDP?
And finally, I have an idea which may be hare-brained and don't trust my judgment to advance it too openly. If we are moving toward index funds as the best available way to participate in an advancing economy, I am certainly advising folks to add several trillion dollars to the number of index funds in their Health Savings Accounts. The last I heard it was $30 billion and comparatively little of that is in index funds. But with a 90-year horizon, these accounts justify a very large equity proportion. Is it a good thing to leave so little residual stock in the hands of people who vote the underlying shares? Where does that lead us? If we are looking for a monetary standard, wouldn't index funds of our whole economy serve the dual purpose of universal desirability and flexibility?
So all that leads in entirely unexpected directions. We now have 8000 tons of gold which are supposedly unattached to the currency, and leads some commentators to say we are on a gold standard without admitting it. I have no idea whether that is a correct interpretation, but I remember the gold standard was criticized as being too inflexible, too much at the whim of some bearded prospector discovering a boatload of it somewhere, and too little connected to the real economy. If that is so, what is wrong with using index funds as a currency standard, to supplement or supplant the inflexibility of gold? What seems to be wrong with it is it effectively puts the money supply in the hands of the Legislative Branch. But if the gold in Fort Knox were used to sterilize that tendency, perhaps the money supply could regain its independence. If index funds grow much bigger it will be hard to corner the market or manipulate the price. The market price of index funds (the second dilution of control) certainly is related to the ups and downs of the stock market, if flexibility is what we crave in a currency standard. And if people follow the advice of this book, there will eventually be three hundred million owners of index funds, who can certainly impose their will on politicians through it. Would that be good or bad? As they say, it's beyond my pay grade.
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.
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.
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!
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.
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.
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.
