Meet the ‘original typical Penn student’

What made you think of Benjamin Rush to do this biography?

I don’t live that far from the very center of American history. I will say I had the basic pediatric understanding of what happened down the street from here. And when I started learning how to write history books, I assumed someday I would figure out some way to write about the American Revolution because it’s so close to my house, and I’m interested in it. I’ve read all the big biographies of all the better-known people, and I knew Rush a little bit because his name was on [a] tote bag that I got when the American Psychiatric Association came for its 150th annual conference in the 1990s, when I started covering mental health for Philly Mag. They had him on their symbol and he’s supposed to be the founding father of American mental health care. But I’m not sure many of them even knew what that meant. That was how I first heard he existed.

What else intrigued you?

The other thing I find intriguing about his story is that people would say, ‘Why don’t we know Benjamin Rush? Why isn’t he better known?’ The convenient answer is ‘Maybe he was too controversial,’ but what I found out is his family suppressed the most interesting parts of his story because they were controversial, and Adams and Jefferson asked them to keep the more interesting letters private, and the family chose to suppress his autobiography for over a century, because he was so open about his opinions of various people. Part of his autobiography is a burn book about every person who signed the Declaration of Independence and what Rush thought of them, and most of the major generals from the Revolutionary War.

Reading everything he was involved with, he sounds like an overachiever.

He was the original typical Penn student. You know, he wrote a lot. He could write manically, especially right after he thought he was going to die. He came close to death several times, and every time he survived and came bursting out of the blocks writing as if there was no tomorrow. He wrote an enormous amount; he was a strong first draft writer. I think sometimes he pushed send too early, even he’d admit, and then fix them later. So, there’s something about him that I think makes sense even to our modern world. The idea you write something really fast, give it to the newspaper, then you pay attention to it the next day and go ‘Oh wait, maybe I should have fixed that or shouldn’t have said that,’ and usually you get a second chance. So, he wrote a lot. 

Some of the things he wrote are dead serious and some things are very whimsical. He wrote a piece saying that if the nation was going to have a standing Department of War, even though we weren’t at war, then we should have a standing Department of Peace. And that Department of Peace should have decorations on its wall of all the kinds of people hurt by war, pictures of widows and children and people with their arms blown off and all those kinds of things. People find that essay every once in a while. It’s one of the good ones.

Why might he be especially relevant today?

Honestly, there’s two Rush stories: Rush is an eyewitness to all the stuff that happens up to and including the Revolutionary War, so you get a doctor’s eye view, a politician’s view, a brilliant writer’s view of all this. Then he leaves government. He has a run-in with Washington, he’s forced out of the medical service by his old professor from the College of Philadelphia, whom he has a contentious relationship with, and he goes home to raise his family. Then he has this period at the tail end of the war into the period before and during the Constitution, where he really starts thinking about what’s going to make someone a good American. We have no king anymore, no state religion, and what are we going to do to be worthy of the freedom we just fought for and what’s a good American going to be? And how, besides passing good laws, are we going to be good people?

He believed we should aspire to being what he called ‘republican machines,’ citizens whose lives were devoted to service to this republic we’d just created. The questions he asked about how to become this devoted citizen included how we were going to teach our children morals if there was no state religion, what would the role of the Bible be, how could we maintain the difficult balance between science and religion—because he was both Christian and a scientist, whereas most scientists were not religious and he was. How can you be a man of faith and science at the same time? How can you have freedom and good government at the same time? 

The questions he asked are still good questions. They aren’t questions that will ever go away for America; they are the questions of being the kind of government we chose to have. 

Is there anyone like Rush today?

People always ask me that. I think in terms of just being a public doctor and using one’s writing ability and caring about public health to try and influence public health, I’d say Atul Gawande is a little bit like that. I don’t think he’s as political as Rush, but there’s very few physicians in public life as both physicians and writers. And that’s what Rush was. He was also a founder of the country. Atul isn’t so much like Rush, but he’s as close as you get. I think we don’t have enough public-service-spirited physicians who can also exist in the world of politics.

But we have Dr. Ben Carson.

Well, Dr. Ben Carson is exactly the opposite of this. Dr. Ben Carson is the kind of person who reminds you of what it would be like if somebody who was a great doctor and great political communicator, who cared not only about medicine but about America, how much power that person could have. And I think that you don’t see it that much. Now we have a whole generation of people in government who have little history of public service. 

And public service is the key. It’s what Rush was known for all his life. There’s a reason the AMA and American Psychiatric Association give Benjamin Rush awards for physicians who do public works. Because Rush, on top of everything else, treated many poor people for nothing. He was involved in all the free clinics that were among the first in the country here in Philadelphia. And really believed very strongly the role of a doctor was to be a public citizen and to save whatever lives you have to save. His wife often complained he did not get paid for most of the things he did. As the daughter of a prominent lawyer [her father, Richard Stockton, was also a signer, from New Jersey], she sometimes fretted about how much care he did for free, and how he balanced time with her and their children and his political and educational pursuits. [Besides being the public face of Penn’s medical school, he founded Dickinson College and what became Franklin & Marshall, and was an active alum of his undergrad alma mater, the College of New Jersey—now Princeton.] But she admired his commitment to public health, especially for people with mental illness, and public education—and also to free care for individuals who needed it. That is his legacy as much as being a signer. During his life, and even today, Rush is an inspirational character in a lot of different ways.

Why didn’t he run for president?

His experience in politics, in elected office, was pretty brief, and he found he was more effective as a political doctor than a doctor who was a politician. He was only in the Continental Congress for less than a year; he helped encourage Thomas Paine to write ‘Common Sense’—he started himself and then realized if he published and it was a disaster, it would ruin his reputation. Thomas Paine was a freelance writer and had less to lose if the whole thing went to hell. So, he convinced Paine to write it. He’d met him in a bookstore and had talked about independence, and he edited ‘Common Sense’ with Paine and got it published. He chose the title—Paine had called it ‘Plain Truth’—and obviously this pamphlet made a huge impact on America at a certain point. It was really an explanatory pamphlet about why people should care about independence.

Within six months of its publication, Rush was voted into the Continental Congress and signed the Declaration of Independence. But he and Paine became political enemies, because Paine believed independence meant complete democracy. No meritocracy, no professional politicians, just the will of the people. And Rush didn’t believe that. He believed in a republic. Paine wanted a state constitution with one representative legislature, one house of representatives, and no senate. And a weak executive and judicial branch. Rush was against that, so he found himself voted out of the Congress by February of that year, in part because he and Paine, and people like Paine, disagreed on these basic political issues. Eventually the position Rush took won, but people don’t know the history of all this. I know I had no idea. People in America were very afraid of Paine and the Pennsylvania constitution—which also, at the time, did not separate church and state. And Rush, regardless of his own personal religious beliefs, was an absolute supporter of separating church and state.

So, Rush was voted out of office for that reason, and then he became surgeon general in Washington’s army and did that as a political appointment. But by the time that was over, he was disgusted by politics and I think he felt his role was to help create voluntary and civic and public organizations that would address the issues politicians could not. And I think as soon as the war was over, he started looking at doing some of the things Franklin had done earlier in the more modern world. Franklin had created some very important institutions in the colonial world. And Rush was trying to create similarly important institutions in the United States. I think part of him wished someone had begged him to run for office, but I think at the same time he understood he was too much Benjamin Rush to run for office, and certainly not for president.

I think he thought politics was good for lawyers, who could argue really aggressively and then walk away. Because that was their job. I think Rush, as a doctor, he didn’t know how to walk away. He was incredibly compassionate about these things and I think he knew himself well enough to know if he’d been in the public eye—even the amount he was in the public eye was hard for him. And his wife had to dial him back and reel him in. I think he knew himself well enough to know that was not something he could do. But I think, during the time the government was here he talked about it with Adams, and we have evidence of them talking about it, but when Adams would say ‘You should do it,’ he’d say, ‘I know that’s not for me.’ And he built his own empire at Penn, and his position there grew with the University from the early 1790s until Rush’s death in 1813. His books became more popular, he helped train and inspire the first 3,000 American doctors—who took his teachings all over the country, which is why Rush Medical College in Chicago, along with Rush Street was named for him. And, he became better and better known as a scientist and philosophical writer. He got his power from that.