The 18th century doctor, civic leader, and renaissance man Benjamin Rush was one of the youngest signers of the Declaration of Independence, edited and named Thomas Paine’s Common Sense, implemented medical practices that helped the Continental Army win the Revolutionary War, made sure Benjamin Franklin attended the Constitutional Convention, and shaped the medical and political landscape of the newly formed United States.
Yet despite his outsized influence, the varied and interesting life he led, and the close relationships he had with other founding fathers like George Washington, Thomas Jefferson, and John Adams, Rush is hardly remembered today. That’s because of just how close his relationship with those other founders was. Rush was a personal physician to them and their families, and after his death, they suppressed his legacy, not wanting the intimate and unflattering details he had recorded in his letters and journals to be publicized. In fact, his memoir was considered too dangerous to be published and wasn’t found for nearly 150 years.
My guest will re-introduce us to this forgotten figure. His name is Stephen Fried, and he’s the author of Rush: Revolution, Madness, and the Visionary Doctor Who Became a Founding Father. Today on the show, Stephen takes us through Rush’s fascinating life, from his self-made rise out of an inauspicious childhood, to how he was able to reconcile an estranged Jefferson and Adams before his death, and what Stephen has learned from studying a character who lived through very fraught and not totally unfamiliar times.
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Brett McKay: Brett McKay here and welcome to another edition of The Art of Manliness podcast. The 18th century doctor, civic leader, renaissance man, Benjamin Rush was one of the youngest signers of the Declaration of Independence, edited and named Thomas Paine’s Common Sense, implemented medical practices that helped the Continental Army win the revolutionary war, made sure Benjamin Franklin attended the constitutional convention and shaped the medical and political landscape with the newly formed United States. Yet despite his outsized influence, the varied interesting life he led and the close relationships he had with other founding fathers like George Washington, Thomas Jefferson and John Adams, Rush is hardly remembered today, that’s because of just how close his relationship with his other founders was.
Rush was a personal physician to them and their families, and after his death, they suppressed his legacy, not wanting the intimate and unflattering details recorded in his letters and journals to be publicized. In fact, his memoir was considered too dangerous to be published. It wasn’t found for nearly 150 years. My guest will re-introduce us to this forgotten figure. His name is Stephen Fried, he is the author of Rush: Revolution, Madness, and Visionary Doctor who became a founding father. Today in the show Stephen takes us through Rush’s fascinating life, from his self-made rise out of an inauspicious childhood, how he’s able to reconcile an estranged Jefferson and Adams before his death. And what Stephen has learned from studying a character who lived through very fraught and not totally unfamiliar times. After the show is over check out our show notes at aom.is/rush.
Stephen Fried, welcome to the show.
Stephen Fried: Great, thanks for having me.
Brett McKay: So you have written a biography about a founding father, but it’s not Benjamin Franklin, it’s not George Washington, not Thomas Jefferson or John Adams, it’s about a guy that I think a lot of people haven’t heard of, it’s this doctor named Benjamin Rush. And rush was an interesting character, because he was close to a lot of the founders. In fact, he was the personal physician for a lot of these guys. He also kinda acted as the go-between with the founders, and they had drama and spats between each other. And when Rush died, a lot of the other founding fathers tried to suppress his story because they didn’t want anything that was unflattering in the letters that they had written to each other to get out there in the public. So as a result of that, a lot of people just overlook Rush today, which is unfortunate, because this guy had a big role in the American Revolution and also in the field of medicine in early America. So let’s dig into the life of Benjamin Rush. We’re gonna introduce the world to Rush.
Stephen Fried: Excellent. It needs to be done.
Brett McKay: Okay. So many of the founding fathers, they were aristocrats, landowners, part of the gentry, some of them were self-made, like Benjamin Franklin. Benjamin Rush was also a self-made, so tell us about his upbringing and rise in the world.
Stephen Fried: Well, you’re right in separating the founders who were self-made and the ones who came into wealth. And Rush was definitely somebody who was self-made both in medicine and in politics. So his family owned a foam outside of Philadelphia. His father was a blacksmith, he moved the family into town when Benjamin Rush was very young, and then he died when Rush was five. And so, Rush’s mom was a working mom. She opened a store on Market Street, right down the street from Benjamin Franklin’s printing press. And she supported the family, she later married not very well, and so, Rush was brought up by her, and he was a Presbyterian, which is not one of the best religions to be in Philadelphia at this time, which was very Quaker and very Church of England, later Piscal church.
So he was sent to a religious boarding school in Maryland that was run by his mother’s cousin, so his uncle, and maybe I have that wrong, it was definitely his uncle. And so… Because he was considered quite gifted. He was really smart, he was a great talker, he had this really high forehead, even as a little kid, that people sort of notion that there was so much going on in his head that it was like bursting out. But he was just extremely smart, made amazing connections, had an incredible memory, and was just utterly fascinated by everything intellectual, everything religious, everything scientific. And so, he went to this boarding school in Maryland as did his younger brother. Many people from Philadelphia went to this boarding school. He then was admitted at age 14 to what became Princeton, then the College of New Jersey as a junior, graduated in the next year at age 16, and then decided to apprentice as a physician. And so, he apprenticed through a physician in Philadelphia, John Redman, and this is at a time when there were no American medical schools.
So, to get in a medical degree, you had to go overseas, and so Rush apprenticed for several years. He actually started taking classes in what was… What became the first medical school in America at the College of Philadelphia, which Benjamin Franklin had started. And his mentors there were recently trained doctors who were quite brilliant, but then also fought over which of them started the school, which is the thing that Rush got caught in the middle of. Basically, even among the doctors, some of them were rich guys who came from second to third generation doctors, and some of them were people who had worked their way up. And so Rush was always considering somebody who was not born into money, and never had a ton of money, but had amazing ideas. His brain was just so fascinating, and then of course, he became people’s doctors. So he had this interesting relationship with them all through this time. He’s younger than the other founders, but he was like their young doctor who gave them their first smallpox vaccination and they would ask him medical questions.
Part of the reason that Adams and Jefferson didn’t want their letters back and forth to Rush become public is because they would often concern both political, religious issues and then really personal medical issues, like, I have really bad diarrhea, what should I do about that?
Brett McKay: They’re talking about poop.
Stephen Fried: Yeah.
Brett McKay: Even the founding fathers did it. Something that really… You really hit home. And it really impressed me about Rush. Ever since he was a child, very curious, this self-starter, and something that he did that a lot of young upstarts did back in 17th century, 18th century, is he had a common place book and the guy just wrote down everything. How did that mental habit shape him for the rest of his life?
Stephen Fried: He did. And you know, what’s interesting, I found… I had the same question you had, and then I looked into it and I saw that even then there’s apparently a debate about how memory works. Of course, we’re still debating that, and the debate was, do you take notes and that makes you remember, or do you listen and not take notes, and that makes you remember? Most of Rush’s teachers thought you shouldn’t take notes, but Rush took notes. And so, what’s wonderful was after a certain point, we have them. I mean, a lot of things that Rush wrote are gone, I’m still hoping they will bubble up somewhere, but his commonplace books are wonderful. And part of the value of them is, of course, he did it when he was a kid, he did it when he was a student, and then when he was in the Continental Congress, he kept them about what it was like to be in the Continental Congress.
He would write little sketches about what he thought about the people in the Continental Congress, no holds bar. So he just… He wrote a lot, and so we have a lot of it, and we’re missing a lot of it, but everything we have is… What’s really nice about it also is that he wasn’t a formal writer. So he wrote in a style that we would today think of as almost like magazine writing. And it’s part of the reason that he was such an accessible intellectual and such an accessible writer is because, his writing style and of course, his penmanship were really readable, and when you read them today, they seem quite contemporary.
Brett McKay: Let’s talk about these doctors that he… They’re medical school teachers, it was Morgan, and then the other guy was Shippen.
Stephen Fried: Yeah, So Rush has a really interesting young life. So he decides to become a doctor, and in 1865, he begins an apprenticeship with John Redman, who’s a very established doctor. And then during the next couple of years, two young brilliant doctors come home from an Edinboro, which is the top medical school in the world to set up their lives in Philadelphia. One of them is John Morgan, and John Morgan is like Rush, a guy who comes from relative poverty and has worked his way up. The other is William Shippen Jr, whose father is already a big deal doctor. Shippen comes back, starts the first Anatomy class ever taught in America, which Rush was one of the first students in and was doing live dissections, which was quite controversial. And these were the first classes like this in America, and then Morgan came back and actually asked the college if he could start a medical school.
Morgan and Shippen had been friends. Shippen went nuts when Morgan said he would hire him for the medical school rather than name him as the co-founder, and they never spoke again unless they had to. And Rush, because he’d been mentored by both of them, he had been Morgan students too, was always stuck in the middle of them. And Morgan helped him a lot, Shippen went out of his way not to help him. And what’s interesting is, of course, these doctors, not only were Benjamin Rush’s main mentors in Philadelphia, they turned out to be the main doctors of George Washington’s army. And so, Rush ended up getting caught in the middle of their fight again during the war, which caused Washington no end of disbelief that doctors could be so petty and stupid when something so important as the Revolutionary War was going on, but they were fighting over just stupid stuff. And so, Rush learned early on that people can be petty and jealous and competitive, and that you had to deal with that. And so, he became very smart about that, but at the same time, he was very opinionated and sometimes he wouldn’t stop, even though he knew how it would go down.
Brett McKay: So another important figure from Philadelphia that had a big influence on Rush’s life is Benjamin Franklin. So you said he lived down the street from Benjamin Franklin, did they know each other as… Like, did he know… Like, he’d go over to Ben’s house and be like, Hey, Uncle Ben… You know, what’s…
Stephen Fried: No.
Brett McKay: I mean, what was nature of their relationship?
Stephen Fried: No, you know, what’s interesting, one, people forget that Benjamin Franklin was in Europe during many of the important periods in the American pre-revolution revolution. So, even though Franklin… Franklin’s wife and family lived down the street from the Rush’s, we have no evidence that they knew each other in their early years. What we know is that when Rush went to medical school in his late teens, he was… He and another doctor he went with, wrote letters to Franklin to introduce themselves to him and let them know that they were fellow Pennsylvanians who would come to England and come to Scotland for training. And Franklin wrote them some letters of introduction, he was in London. And so, he introduced them to some of the enlightenment figures who were in Edinboro, and that was wonderful for Rush. And then after Rush graduated from medical school, he came to London, he finally met Franklin. What’s really interesting is that Rush kept a diary of his time at Edinboro, a diary of his time in London and a diary of his time late in France, which is where Franklin helped him go.
The London diary is missing. And no one knows why. The other ones we have. It could be because Franklin, he saw something… Franklin was not considered sort of like the best husband, who knows what was in those diaries, but… So we don’t know a lot of details about what happened when the two bends met, but it was a really important thing for Benjamin Rush. Benjamin Franklin was a mentor of his his entire life, would send him letters from Europe about scientific issues, about medical issues, about political issues. And then interestingly, when Franklin came home and was quite ill, Rush, helped take care of him and also made sure that he got his due. I mean, what’s really interesting is that people forget that the Pennsylvania delegation to the Constitution was not gonna include Franklin, ’cause he was too sick. And Rush is the one who insisted, it’s like, “Hey, this guy is Benjamin Franklin, you are not gonna not include him in the Constitution of this country, even if we have to carry him on a litter over to the meetings,” which in fact is what they did.
So, they had a really interesting relationship. It would be great if we knew more about it, but a lot of things have been lost. But what’s very clear is that Rush saw himself as somebody who could continue Franklin’s work. And keep in mind that in Philadelphia, we have a different idea about Franklin’s work then the nation does in terms of his contributions to declaration or to the Constitution. Franklin was the inventor of the sort of voluntary associations that would solve social problems that they didn’t think the government would solve. So he created the first Fire Company, he created the first library, he created the first hospital as things that people should create as donations, because you didn’t know the government would ever do these things. And so, Rush picked up his work after he was dying and died and tried to continue this work. Because you know, it’s interesting, we talk a lot about public health today, you know, back then there was no public health.
The closest thing they had to public health were the things that doctors volunteered to do. Pennsylvania Hospital was free for poor people, it was not a hospital like we think of today. Doctors volunteered their time to take care of the indigent there, that’s what it was. That’s what a hospital was. People with money were treated at home, even when they had surgery, they had it at home. So, what Rush was trying to do was continue the intellectual life that Franklin had created, and I think just to largely, he really did. His role at the University of Pennsylvania during the period… Especially during the period when the capital was in Philadelphia, is really not understood as well as it could be, but when Franklin died, there was a real need to make sure that the ideas that he had about what it meant to be a citizen, what it meant to be an American, what our responsibilities were to our fellow man, especially to poor people and imprison people, Rush thought about these things a lot.
And so their relationship, the artifacts we have of it are amazing and fascinating, and I continue to believe that there are more that we will find. Because some things are still in private hands, a lot of things about the revolutionary period were bought by collectors a long time ago, we still haven’t seen them, so I continue to hold out hope.
Brett McKay: Okay, so early on in Rush’s medical career, like you said, he loved to write and he started writing pamphlets. This was the equivalent of a blog, right? If you wanted to get the word out back in revolutionary time, instead of starting a blog, you start publishing pamphlets and started selling them.
Stephen Fried: I don’t know if it’s the same as a blog, because it was a way of making money, it was almost a way of publishing a personal magazine.
Brett McKay: Yeah. Right. How about a Substack, it’s more like a Substack, a…
Stephen Fried: Yeah, I mean, it’s more like a Zine. You remember Zine?
Brett McKay: Yeah, yeah, yeah.
Stephen Fried: Which you would make and you print them up yourself and you sell them like an alternative bookstore.
Brett McKay: Right.
Stephen Fried: That’s more like what pamphlets where.
Brett McKay: Yeah. So he started putting these out, but he’s writing about health, and he…
Stephen Fried: Yes.
Brett McKay: Advocated for things like… He was kinda ahead of his time, he was advocating for temperance like, Hey, you guys take it easy on hard liquor, also said, people should start exercising, which was kinda weird for the 18th century. But then his health writings, they started to get a little political, but he still wasn’t in the public sphere as a politician, but he did start getting political, so how did his health writing lead to revolutionary rhetoric?
Stephen Fried: Well, so the first big thing that he published was, you’re correct, it was a guide basically for wealthy people to take better care of themselves, ’cause when he came out of medical school, his practice was very mixed. What’s cool about him is his practice was mixed by race, by socioeconomic class, and many people couldn’t afford to pay, so he was hoping to get some paying customers. So he put out a pamphlet, which is really like the first self-help book, and you’re right, it talks about temperance, although we always have to remember that back in Rush’s day temperance didn’t include wine and beer. Because wine was medicine and beer was not considered to be something dangerous alcoholically. So temperance was hard liquors. It’s one of the first places that talks about the people exercising, although you can always see Rush always has a political edge, so he talks about the need for people to exercise, but then he can’t resist making an abolitionist statement, because he’s totally against slavery.
And he basically says, “Well, of course, the reason you have to exercise is because all the things you’re supposed to be doing outdoors, you enslave people to do. So, if you didn’t do that, you wouldn’t have to learn how to exercise.” So, part of the thing is that Rush always had those kinds of comments which he would give a whole speech and then at the end, he would make a comment having to do with abolition and how bad slavery is. He’d make a comment about independence and just create a hot button issue when he wasn’t originally talking about something else, that was just Rush. So, the leading abolitionist of the day, Anthony Benezet, read Rush’s thing and realized that Rush could write on abolition issues. So he encouraged Rush to write a pamphlet on abolition. And this is… It came out in 1773, so early, and it’s certainly the earliest of any of the writings of the founders on these issues.
And so he wrote this pamphlet of the self-help for rich people, he wrote a pamphlet on abolition, and that actually led to him being asked to be one of the ghost writers for the proclamation that led to the Boston Tea Party. So every city was gonna have a Tea Party. Boston just happened to do theirs first. So the proclamation about why he shouldn’t be able to come into the country, the Philadelphia group that wrote their proclamation, everybody liked that one best. So that one was in the Boston newspapers, which led to the Boston Tea Party. In Philadelphia, they stopped the boat with the tea before it came to Philadelphia. And so, these are the kinds of things, he was known as somebody who could be a really good writer, he was also a really fast writer. And so, people saw initially that he was smart, that he was… Had a lot of interesting ideas and that he could write things that the public would understand. And I think a lot of what he did was trying to explain ideas to people as best he could.
And he was responsible of that in a lot of different ways. I mean, many people don’t know, for example, that he is the one who encouraged Thomas Paine to write what became Common Sense, because he believed that somebody needed to explain the idea of independence, especially to people in Philadelphia who were not so into it. Because Philadelphia was the most powerful city in the country at that point, they had the most lose by changing the world they lived in. So, Rush didn’t write it himself, he had started a pamphlet, but he had gotten in so much trouble ’cause of his abolition pamphlet, he lost of his customers, because they found out he wrote the Abolition pamphlet, that he instead encouraged Paine to write this pamphlet on independence. The goal of which was to explain why independence was a good important thing and not something to be scared of. And the process in 1775 of Rush and Paine that fall… You know, Rush edited these pages as Paine wrote them, and then he was the one who found the publisher for it and he actually named it.
So their relationship… I wish we knew more about it. We know about it mostly ’cause Rush talked about it later. ‘Cause at the time, it was a big mystery who wrote Common Sense, ’cause of course, the British would come and kill them, but it’s really fascinating, his ideas about explaining complicated ideas to the public, and then later after the revolution, he’s trying to wrestle with the idea of what is an American citizen? What are the responsibilities of a person in this country we just created… I mean, we’re still debating this every day. What’s interesting is that Rush lays out a lot of the basic challenges because they’re hard-wired in the country, they’re not about the internet, they’re not about any recent president, they’re about America. And Rush identified that immediately. And that’s why his writing on this is really… It’s timeless.
Brett McKay: Yeah, I thought that was interesting, this pattern of his life where it’s going up the revolution, it’s like the early 1770s, he’s a great writer. He has opinions that he wants to share, but at the same time, he struggles with, Okay, I got a growing medical career here, I have to kind of figure out how to balance my ideals with the day-to-day, I gotta pay the bills.
Stephen Fried: Exactly, he is not rich, and every time he does something political, he knows there will be consequences.
Brett McKay: Yeah. And so he kinda, as you say, he kind of played behind the scenes, he ghost wrote some things, he would encourage Thomas Paine to write Common Sense, so he sticks to the margins when it comes to political life, but then somehow he ends up being one of the signers of the Declaration of Independence. So how did he go from behind the scenes guy to, I’m putting my life on the line.
Stephen Fried: Well, he started being more on the scenes in 1775 and 1776. He got married in early 1776 to Julia Stockton, whose father, Richard Stockton was sort of the most powerful lawyer in New Jersey, and whose family had given the land for Princeton, who also became a signer, and so he started getting more involved in 1776, and he was asked to write the… Not only was Thomas Jefferson writing a National… Supposedly National Declaration of Independence that everybody would sign on to, but each state, each colony had to write their own Declaration of Independence. So Rush was actually the leader of the writing group for the Pennsylvania Declaration of Independence. So he was involved at that point, and then Rush had been involved… The only politics he’d been involved in were the state constitution, and keep in mind, there was no federal constitution. So the state constitutions really mattered. So he starts getting more involved, and then what happens is he’s close with this group of people who are the delegation from Pennsylvania, and one of the most outspoken members of the delegation is John Dickinson, who’s a very well-known lawyer, older than Rush, Rush has known him for a long time.
Rush’s brother worked in his law firm, and Dickinson felt very strongly that the Declaration of Independence was coming too soon, so he wouldn’t sign it because he thought it was too soon to declare independence, and in a very well-documented and dramatic series of events, he leaves the Continental Congress in late June, early July of 1776, and Rush is immediately elected to take his place and sign. So out of nowhere, Benjamin Rush who is certainly well known to all these people. Jefferson comes over to his house, Adams comes over to his house, Washington comes over to his house to eat, they hang out at the city Tavern, he’s like their doctor and their Philadelphia friend during these Continental Congresses, but all of a sudden he’s one of them, and he signed the Declaration, and we have in his Commonplace Book exactly what it was like. He wrote about what the debates were like, which is some of the best descriptions we have of the debates in the Continental Congress during 1776. And he quickly makes a name for himself there, but he also quickly feels that he wants to be helping on the battlefield because as you know the war is starting to come closer to Pennsylvania, so they got their butts kicked in New York, the British were coming down through New Jersey, and Rush wants to be there.
So in the fall, late fall of 1776, he leaves the Congress so that he can go treat patients on the battlefield and help as a doctor. And the great value of this for us narratively is that he’s with Washington at the banks of the Delaware the night before Washington crosses the Delaware, and our descriptions of what Washington was thinking that night, these really famous images of Washington writing victory or death on little pieces of paper, these all come from Rush’s Commonplace Books and from letters that he wrote, because he was with Washington, Washington sent orders with him back to the different groups… There were four groups along the Delaware, they were different state militias, so Rush went from Washington’s group, back to the Pennsylvania militia with orders that Washington gave him, and through Rush’s writing and through looking at all the details that you can actually recreate what it was like, not only for Washington’s crossing, but for the other groups crossing, and that’s what I really try to do, I try to make even the crossing of the Delaware something more of like… What was it like for everybody? Because crossing the Delaware, Delaware is not that wide, but it was frozen, so there was a lot of big ice flows, and of course, they were taking things, they were floating horses across the Delaware, and they were floating canons across the Delaware on barges and rafts.
None of this is easy, but we have great descriptions of it and Rush crosses, he’s with the troops, he goes to Trenton, he takes care of troops that were treated at the battle of Trenton, then he goes to Princeton, where he went to college. And the battle of Princeton is on and just ending, and he is caring for patients on the main grounds of Princeton where he went to school, and the British had been in the chapel where he had taken lots of his classes. So it’s incredibly powerful. And also at the same time, his father-in-law, Richard Stockton, was kidnapped by the British, so he also was waiting to see if his father-in-law was dead. So it’s very dramatic and Rush just gives you… It’s like everything you already knew about this stuff, plus… The way I think of it is like Rush had another camera running in many of the events of the revolutionary war, and no one realized that the film didn’t get developed for hundreds of years. So Rush is always giving you just sort of a different perspective on this, but he’s getting more and more involved in the war, and he’s also ultimately less and less involved in Pennsylvania politics, so he gets voted out of office after all these experiences in war, and then he’s immediately made Surgeon General of the middle department, which is the biggest department in the war in the spring of 1777.
The problem being, he’s perfect for this job, but his boss is William Shippen Junior, his old mentor tormentor from Philadelphia who hate his guts, and so in fact, they are fighting about everything all the time. One of the things that Rush does at this time to make sure that his ideas get out there is he writes a very powerful medical treatise about taking care of soldiers during war, which became the first important piece of writing about medical… About war medicine, and what was really interesting about it is it’s not so much about what you do on the battlefield, it’s about preventive medicine, because Rush believed very much that they didn’t have anywhere near the kind of treatments that they needed, and many of the injuries that they had where people’s arms are being blown off me and all they could do is amputate. But what he believed was that hospitals were dangerous places full of infection, and that what was really important was for to do preventive medicine with soldiers… Really simple things, it seems so stupid now, but soldiers weren’t told to go to the bathroom far away from their tents, so people got dysentery and other infections because of stuff like that. Rush had to tell them to do that.
He also popularized the crew cut, the army crew cut in America by explaining how keeping your hair short would be healthier, and so this was the thing that he wrote, he actually published it in the newspaper, and then George Washington later had it printed and given to all the solder.
Brett McKay: We’re gonna take a quick break for words from our sponsors. And now back to the show. Yeah, Rush, early on, he recognized that most people in war, most soldiers in war died because of disease, not because of the…
Stephen Fried: Exactly.
Brett McKay: So he played a big role… Whenever you think about war, you’re always thinking about the guns and the canons, but the medicine, if you have six soldiers, you’re not gonna win, and so… He played a big role in helping the Americans win the war.
Stephen Fried: He did, and he also got thrown out, one, because he and Shippen fought about everything, but two, he was obsessively concerned that the government wasn’t spending enough money taking care of soldiers and with preventive medicine, and then actual hospital medicine. And what’s ironic is… One of the biggest turning points in Rush’s life, so he… 1777, he becomes Surgeon General in the middle department, he lives through a terrible Battle of Brandywine, America loses every war the summer and fall of that year, 1777, he’s there at all of them, just watching, just horror, and then he wants Washington to pay more attention to this and to give more money for medical care, and so he writes to Washington and Washington doesn’t write back fast enough, they’re separated because the capital moved and Rush is separated from his wife, ’cause she’s somewhere safe, Adams is gone, and Rush could be pretty manic if he wasn’t calmed down, he’s a pretty kind of bipolar guy, and he always needed people to reality check him and there was no reality check on him, and so he was so upset that Washington wouldn’t write back to him, and he was hearing from the generals that Washington had made some questionable choices, and of course they were losing every fight.
He wrote a very famous letter to Patrick Henry anonymously, basically questioning whether Washington’s choices were good and whether he was the right guy to go forward with, and this was pretty blasphemous for the time. He wrote a similar letter to John Adams, which didn’t make any big deal, ’cause it just went to John Adams, we actually discovered a third letter that he wrote to his wife… There’s a library in Philadelphia, but he clearly was kinda losing it because he felt that he didn’t have… He wasn’t impacting Washington’s decision making, and in fact, it just turned out that Washington was busy and didn’t get back to him, because in the time that Rush wrote these letters saying, we need more money for medicine, and then he freaked out and wrote this letter to Patrick Henry questioning whether Washington was the right guy, Washington wrote back to him and said He agreed with him, and that they would do these kinds of things, but it was too late, and later Patrick Henry shared that letter with George Washington, and George Washington never forgave Rush for writing that letter.
Because Washington had heard all these complaints, it was a very complainy time, this is leading up to Valley Forge, just a tough time in the war, but for Washington to see in handwriting of somebody who was his friend, and Rush was his friend at that point and was a former congressman, somebody who mattered, that he had questioned whether Washington was making the right choices, Washington never forgave him for that. And their relationship went from friendly to frenemy and everybody knew it. And over the years, some people tried to repair the relationship, but it was not to be repaired, and When Washington died, he made sure that that letter got into the hands of his biographer, so people would know that Rush wrote this letter questioning him at the darkest moment, and this impacted Rush’s life all through the rest of his life because people knew that he and Washington were no longer friends.
Brett McKay: So after the war, Rush decides to take a break from political life, it was… Like you said, he’s kind of manic, he’s probably not suited, his personality is not suited for public life, so what did he do instead? What did he do with his career?
Stephen Fried: Well, he went back to being a doctor. As soon as the British left Philadelphia, he went home and he tried to build up his practice again, he tried to build up also some hospital work, and a lot of that had to wait until the war was actually over, but then when the war was over, he became very active, he wanted to become not only a powerful doctor, but a writer who would help shape the post-war period because his belief was that winning the war was an unbelievable accomplishment, but figuring out what to do with this new country was much harder. And he wanted to be part of that discussion. So he basically wrote things saying, The war is over, but it really isn’t over because the revolution is just starting, and one of the things he wanted to focus on was education, so he felt that if the populist wasn’t educated, there would be no way they would understand their responsibilities as citizens. So he starts the first world college in America, Dickinson College in Carlisle. He starts that himself. He writes out a plan for the first public school systems to be put in place in Pennsylvania, but is influential all over the country.
He starts a second college called Franklin College, which is now Franklin and Marshall, and then he starts writing all these different things that really deal with important issues that he hopes will influence the process of writing the constitution and figuring out how to govern because the country is really mushy in terms of what to do after the war, so we tend to forget the period from 1781 until the Constitution is signed, to us that’s just like, whatever, but that’s a really dangerous time. Anything could have happened. And so it’s very interesting to see what Rush did to try to make people think about these big ideas, and by the end of that period, he was not on the Constitution Convention, he was there, and he was the leader of the Pennsylvania delegation to prove it. But he very much had a hand in a lot of these debates, and by the time that was all done, he had become the most important doctor in America, so John Morgan, who had become… Was the most important doctor died in 1789. Rush took over for him, and then the colleges that were in Pennsylvania consolidated into the University of Pennsylvania. And then you have this whole period when Philadelphia becomes the capital, those 10 years are unbelievably formative for America, and obviously unbelievably formative for Philadelphia.
And Rush is like the God, the medical God of Philadelphia, political advisor to everybody, he’s close friends with Adams and Jefferson, which may not mean anything to us today, but that was being close friends to the top Republican and the top Democrat, and both of them confided in him and he was sort of caught in the middle of them a lot, and so his time during that is fascinating and he matters in a huge way to all the players, and both in terms of medicine, in terms of politics, and also just in terms of, it’s his city, it’s like he’s also the editor of Philadelphia magazine, so he knows where all the good restaurants are, and all that kind of stuff. So Abigail Adams says, It’s so great to have Benjamin Rush as your friend when you have to live in Philadelphia, he kinda knows everything and everybody, so his life becomes real different and real fascinating, and it’s so well documented during this time, the letters between him and Adams… It’s well documented until Adams comes to town. I’ll tell you one of the things that kills you as a historian, when the characters you love are all in the same town, the letters disappear.
So there’s all these amazing letters between Adams and Rush, and while Adams is overseas, and then when Adams is in New York during their brief time in the capitals in New York, and then as soon as he gets to Philadelphia, there’s a quiet time. And then after he leaves, and after the capital leaves and moves to Washington, there’s tons of letters.
Brett McKay: Okay, so Rush, after war, he picks up Franklin’s mantle of creating voluntary… Took valiant voluntary associations to help this new country develop… He called them Republican machines. So these individuals…
Stephen Fried: Oh no… He said the individual people needed to be Republican machines. He saw that as the personal responsibility of each person to be a machine, to fulfill its responsibilities to the new republic.
Brett McKay: Right, so he’s doing that, but at the same time, he’s also building up his medical career, but he takes a really keen interest in mental illness, and this was revolutionary for the time, a lot of people didn’t know what to think of mentally ill people, but he thought that we could cure mentally ill people with medicine. What was going on there?
Stephen Fried: Well, so basically, this is a time when medicine is starting to become a little bit more scientific, and when it comes to mental illness and addiction, mental illness and addiction were for many centuries seen as either human weaknesses or failures of faith, and Rush, as a doctor knew that neither of those were true, and that alcoholism, that mental illness, depression, mania, these were medical conditions, he assumed that the only way they could be treated, if they could be treated was by medicine, and it was very important for him to make people understand that we needed to treat the people whose brains were different than ours in a gracious way, in a caring way, in a medical way, and because people with mental illness and alcoholism at that time were locked in the basement of Pennsylvania Hospital, they weren’t treated, they were just jailed to keep them from hurting other people and people were allowed to come and pay to look at them. You see these images in movies all the time, it’s horrible. They also weren’t heated these cells because the belief at the time was that people with mental illness couldn’t feel cold. So in the 1780s, Rush took this on, he knew it would be hard, but at the same time, he also provided a place to take care of people.
So as I said to you, Pennsylvania Hospital was for poor people, except for the part of it that was for people with mental illness, because those people couldn’t be taken care of at home. So Rush was treating both people who lived on the street who were brought into the hospital, he treated some of the children of the founding fathers. He eventually, in the 1790s, forced him to build a second building only for people who had mental illness and addiction, and so the Pennsylvania Hospital, which is still there, you can still tour it, but the original A Street building had cells in the basement, he forced them to build a mirror building on nine street only for people with mental illness and addiction, and he began writing down what happened there, the beginnings of talk therapy, the beginnings of occupational therapy, all happened there and the irony, the utter irony of this is he does this for decades, and then his elder son, who’s a physician, who’s interested in these things too, his master’s thesis was about suicidality, becomes mentally ill, has a huge psychotic break, tries to kill himself many times, and ends up being Rush’s patient. So this is the doctor who Rush expected to take over his practice, instead, he had a psychotic break in his last… Late 20s after killing his best friend in a duel, and he ended up being Rush’s patient and he lived the rest of his life at Pennsylvania Hospital, in the new mental illness wards that Rush had created.
Behind the scene stories, just as they are today, people don’t talk enough about how alcohol, how other addictions, how mental illness affects life, but it certainly does. The biggest thing that happened in John Adam’s life was that his son died of alcoholism, it’s not something that people talk about a lot, but I guarantee you that that was a huge thing that hung over John Adams, so people were never afraid to talk to Rush about these things because they knew he understood and that he believed there was a medical approach, even though… Look, as then, as today, it’s really hard to treat people with mental illness. There’s no silver bullet, there’s no easy way to make it all go away.
Brett McKay: So in 1793, there was a yellow fever epidemic in Philadelphia, and yellow fever is awful. You get it and you kind of have a headache and then maybe some nausea, but when it gets bad, your skin starts turning yellow, you get jaundiced, you start vomiting blood. It was awful. They didn’t know what spread it. It’s mosquitoes, right? That’s what spreads yellow fever.
Stephen Fried: Yeah, but it was 100 years after that before they learned that.
Brett McKay: So Rush… And mostly everyone in Philadelphia, they left, they got out of town, it was like, We’re gonna get out of this… Out of Philadelphia. Rush, he stays there and he’s just treating patients, and despite the fact that he could be… Come down with yellow fever any moment, what was his role in the yellow fever epidemic?
Stephen Fried: So the yellow fever… Look, there had been yellow fever before, but there’d never been an epidemic like the one in Philadelphia in 1793, and again, remember Philadelphia was the US capital at that time, so the people who were fleeing were like George Washington and people like that. So ironically, the yellow fever epidemic came right on the heels of… Rush had been working with the black clergy in Philadelphia to build the first free black church, and they just had this dinner to celebrate the roof raising of the first free black church, which was fascinating because all the white people who helped with it, they were served by the black members of the community, and by the clergy, and then they got up and served the black members of the community, it’s such an amazing scene that Rush actually writes about to his wife, and it would have been so great for people to be able to hold on to that wonderful feeling, but the yellow fever came immediately afterwards, and yellow fever was both a medical challenge and a racial challenge, sadly, because what happened was the black clergy who Rush was close with volunteered to help when all the doctors left.
They did it, I think primarily because it was the right thing to do, the medical literature actually said that they were less likely to get the illness, but honestly, I don’t think they cared about that, they cared about helping. And it turned out within weeks, they knew that the medical literature was wrong and everybody got it the same, but 10% of the population of Philadelphia died in three months, and Philadelphia was the biggest city in the country at that point, every treatment that people gave didn’t work. And what we know from going through COVID, is that when smart doctors and dumb doctors don’t know what to do and nothing works, they just take off after each other, and then that leaves us all the sick people just even more freaked out. And that’s exactly what happened here. And it got political. Alexander Hamilton announced that he had been cured of the yellow fever by his doctor who didn’t like Rush, so he published his thing, his treatment, which Rush knew didn’t work and then Rush went after him. It’s all politicized. It’s all a mess. It’s actually extremely well documented, we have all of Rush’s letters that he wrote almost every day.
We have Rush’s letters from his wife back to him, she’s in Princeton with their kids scared to death that she’s never gonna see her husband again. Their friends are dropping like flies everyday, every treatment they do doesn’t work, so Rush keeps increasing, he does more bloodletting… He doubles the bloodletting, he doubles the Calomel, he doubles the bark, which are all the things that you treat people during this and nothing works. Rush got yellow fever himself, as did Richard Allen, one of the two pastors who was involved in the care, luckily, they both lived. Many of Rush’s staff died, Rush’s sister who stayed in town to take care of him, she died of it, and it’s just… It’s unbelievably horrible, and it’s unbelievably knowable because we have all the writings of it, so you can know what happened during those days at a very close level. So there’s a lot to read about the yellow fever epidemic, and I do fear that people have strong opinions about it without knowing that much about it. The more you go into its history, the more you learn not only about medicine, but just about American politics, because this is also, the birthplace of American partisanship.
A lot of American partisanship was created by Alexander Hamilton in 1791 2,3,4, this is when the party split, this is when there came to be a Republican and Democratic version of everything, and it was probably a natural process, but this is when it happened, and yellow fever contributed to that too, so I would only urge people when they read about this, and I hope you do read about it, to see it as a medical phenomenon and see it as a political and an American phenomenon, because we are replaying a lot of these things today.
Brett McKay: Yeah, I thought it was funny, Hamilton, he wrote that thing about his cure, they called it The Federalist cure.
Stephen Fried: The Federalist cure. Yeah.
Brett McKay: Yeah, but some people thought it was a little too weeny. It wasn’t enough, it wasn’t like… It was kind of woosie, and so you need to do…
Stephen Fried: It was nothing. It was nothing. The treatment was, let them sit there and give them water.
Brett McKay: And then there’s the Democratic Republican cure, where it’s a little… You had to be a little more aggressive with this thing… Yeah, it’s… As I read this, it was like, this is just… This is deja-vu. The more things change, the more they stay the same.
Stephen Fried: Yep. America… The thing that’s fascinating, and I never realized it until I did this book, America was America the minute it began, and everything we think that came because of, Oh, this technology or this World War, this kind of stuff, it’s just all incrementalism from the beginning. I find that actually comforting.
Brett McKay: Yeah, I do too.
Stephen Fried: Because I think in every era, there are people who think, Oh, we broke this thing. It was really good until we broke it by doing this or doing that, but in fact, the fissures were there from the very beginning, and they are part of the country, and they’re okay. But you have to… As long as you look at the founders and you don’t see the founders as people who didn’t think that, if you look at the founders and think that they didn’t think that, you are not reading the founders closely enough.
Brett McKay: Alright, so after the yellow fever epidemic, Rush survived, he spent the rest of his life still doing some doctor work, but then he’s devoted a lot of time to reconnecting John Adams and Thomas Jefferson… ’cause they became estranged. Why did Rush think that was important to do?
Stephen Fried: Well, first of all, Rush in a way, never recovered from the yellow fever epidemic, it became a thing that hung over him for years, it really hurt his business, it hurt his popularity. John Adams had to give him a job at the US Mint so he could have money because his practice was so hurt by the politics of yellow fever, so it was really rough, and then of course, the US capital left Philadelphia, which Rush was crushed by and went to Washington. So when Adams lost to Jefferson in the election of 1800, which was unbelievably contentious, unbelievably contentious, the two of them didn’t speak for years, and Adams left Washington in a huff, went back home, was unbelievably depressed. Rush and Jefferson stayed in some contact, but Rush and Adams were out of contact for five years, and these are guys who used to talk every day, and when they were apart, they would write to each other all the time. And then after five years, Adams sends Rush a letter and he just says like, Before one of us dies, we should talk again. And this letter triggers this unbelievable flurry of events, which are a lot of the reason we really understand the American Revolution, and here’s why.
So when this letter was sent in 1805, Adams and Jefferson had not spoken in five years, and you can argue that Adams and Jefferson created this country. The intellectual… The basis of this country, Adams and Jefferson created it, Rush, certainly felt that. He felt that the dissolution of their friendship was an unbelievably dangerous thing for America, that if Adams and Jefferson could be torn apart by partisanship, what did that mean for the rest of the country? If the guys who invented the intellectual underpinnings of the country couldn’t talk to each other, even after all this stuff, so he was fascinated to be back in touch with Adams. His letters back and forth to Adams are very much sort of treatment for Adam’s depression, but they’re also just an amazing back and forth between two founders talking later in their lives about, was it all worth it? And what did we do and what should happen next? And a lot of what we understand about the American Revolution doesn’t come from the real-time writing when it was happening, it comes from these later letters which are unbelievably detailed and fascinating.
So these go on for a number of years, and part of what Rush starts seeing is that he understands the part of what this letter writing can be is that he maybe can get Adams and Jefferson back together. So you see in these letters to Adams, the beginnings of this sort of… Again it’s founding father family therapy. It’s like, What do I have to do to get Adams to think about that he and Jefferson should be friends again? And he starts doing it with Jefferson too, and we have all these letters, so he also, during this time, Jefferson makes him the medical person for Lewis and Clark. So Lewis comes to Philadelphia, Rush tells him what to do before Lewis and Clark goes out. So Rush and Jefferson are back and forth, but he gets it in his head that these letters can be the reason that Adams and Jefferson get back together, and for years then he starts saying to them like, You guys could still be friends. Don’t you miss each other? Some of it is real high school stuff. He’s like, I heard from a friend in Boston that Adams says, he still loves you. I’m serious, this is what some of the stuff is. The letters are so unbelievably personal, they’re great. You can understand why Adams and Jefferson didn’t want anybody to see them.
And finally in 1812, so again, Adams and Jefferson haven’t talked to 12 years, and Rush has been on Adams for seven years to interact with Jefferson, and they finally write to each other, and they finally rekindle their friendship only because of Rush. And this is fascinating because Rush is much younger than them, and Rush is doing this because he’s afraid one of them will die before their relationship is rekindled, and Rush only lives another year, and they live another 13 years. So they end up dying in 1826 and we then have letters between them from 1812 through 1826 that are remarkably in-depth that go over many aspects of the American Revolution that we otherwise wouldn’t know, because Rush started this letter writing thing, and after Rush died, Rush’s son, Richard, who was in the government, was in the letter writing too, as was of course, John Quincy Adams, Adam’s son, because Rush’s son and Adam’s son are the only founding fathers sons who mattered in the US Government. So John Quincy Adams obviously became president. Richard Rush was Attorney General, he was Secretary of State, he was John Quincy Adams’ vice presidential candidate the last time John Quincy Adams ran and lost.
But they were lifelong friends. So the interactions between Rush, Adams and Jefferson while they’re all alive, and then after Rush dies, between Adams and Jefferson, John Quincy and Richard Rush are the basis of a lot of our understanding of how the founders looked back on the American Revolution and the retelling of some of the stories that some of them we didn’t know before, some of them just… There’s a different version of them in these letters, they’re so interesting and they’re so human, and they’re ultimately just two friends, and again… These guys never saw each other. Adams and Rush never saw each other after the capital left in 1800, and Jefferson and Adams never saw each other either, this was a friendship completely through letters over decades, and it is the basis of so much of our understanding of the American Revolution. It’s amazing.
Brett McKay: So after researching and studying and writing about Rush’s life and spending so much time with him, are there any lessons you’ve taken from them?
Stephen Fried: A lot. A lot. First of all, I never understood how fascinating and personal the American Revolution was and how close it was to not happening. I just don’t think that anybody ever tried to explain to me the real human drama of the period leading up to the war and the war itself and the period after the war and the writing of the Constitution, and just the creation of a government, and the movement of the government up through the war of 1812, and with Rush, you get basically everything… He died in 1813. So you get up through the war of 1812. His son is in Washington during the War of 1812, and he and Adams are talking about this ’cause Richard’s there, why is he doing this and putting himself in danger? So you really get to see the early years of America and especially… What’s interesting is this is the time when American History wasn’t taken seriously by Americans. Independence Hall wasn’t called Independence Hall until the 1820s, when Lafayette came back and they started talking about American history, ’cause America had been around long enough that they could think about it’s history. Independence Hall was gonna be knocked down and the Liberty Bell was gonna be melted, ’cause no one thought that any of it was that interesting, so as America became a real country that was gonna last, which they all weren’t sure it would, then people started understanding that its history was gonna matter.
And so I feel like I have met a really human version of the American history of this country, and I’m really grateful to have it, one. And two, it I did a lot of this stuff during the last years of the Obama Administration and during the Trump administration that’s the time I was writing. And it’s really important when your country is tearing itself apart, to understand the history of that and to be able to put it in context and to know that it’s horrible, but it’s not that new and it’s American, and it is in America to survive it. And you learn that from Rush and Alexander Hamilton screaming at each other on the streets of Philadelphia in 1791. You learn that from the fact that this country was built on people screaming at each other, and so that I have to say, I found very comforting. And I’ve also just found Rush really interesting, for everything that I learned about him, I’ve learned many more things since the book came out, Rush’s story wasn’t that well documented, we did, I hope a pretty good job in the book, but we’ve continued to do research, we’ve put up… With pen, we built a Benjamin Rush portal so that people could get easy access to everything that Rush wrote that’s digitized.
And we’ve actually been working with the National Archives and with the University of Virginia return to press to try to get Rush’s letters to be all available for free, so people can read them and read his autobiography because they’re key parts of the American story, and a lot of people don’t know where to go read them, they’ve seen the quotes from them, but I’ve read a lot of history books by well-known historians where they’re quoting secondary sources on things that are in Rush’s writing, I assume ’cause they can’t get a copy of the original piece, so we’re trying to get people so they can access Rush’s actual letters, Rush’s actual Commonplace Books, Rush’s actual memoir and see what he wrote, to be able to put those things in the proper perspective, but I must say it’s not just because yellow fever… COVID made Yellow Fever seem really interesting, and politics made a lot of Rush things seem really interesting. Rush is just a different way of seeing American history and I think a comforting way…
The way I think of it is this, Rush wasn’t a politician, he was a doctor. So politicians see problems differently than doctors do. I think politicians see problems as things that if they pass a law, the problem will go away, and doctors know that isn’t true, that in every generation, disease comes and that their jobs, to do the best job they can and to innovate within that, and to see the history of the country through the eyes of a physician who is a politician second, rather than somebody who’s a politician or a business man first, is a real different way to see the country, and I find it to be a more comforting way to see the country.
Brett McKay: Well, Stephen, this has been a great conversation, where can people go to learn more about your work?
Stephen Fried: Well, you know the book is called Rush, it’s anywhere you wanna find it, I have a website at www.stephenfried.com, S-T-E-P-H-E-N F-R-I-E-D.com, and links to all the other stuff that I do come from that website, and I would just encourage you, read about Rush, get interested in whatever entry point, is interesting for you because it’s over a long period of time, has lots of different subjects that he gets you to, but each of them brings you a better understanding of the country you live in now, and how it got to where it is.
Brett McKay: Alright, Stephen Fried, thanks for your time. It’s been a pleasure.
Stephen Fried: Thank you.
Brett McKay: My guest today was Stephen Fried, he’s the author of the book, Rush: Revolution, Madness and the Visionary Doctor Who Became a Founding Father. It’s available on amazon.com and book stores everywhere, you can find more formation about his work at his website, stephenfried.com. Also, check out our show notes at aom.is/rush, you find links to resources and we can delve deeper into this topic.
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