Our next paper is the Physician Signers of the Declaration of Independence, Implications for Service for Today's Neurosurgical Leaders, and Dr. Rousseau will be educating us on that now. Dr. Rousseau? Well, it's a pleasure to be here, and thank you for holding out to the end. It's been a great meeting, and I want to congratulate Alex Volatka and his team on a really superb meeting, but also on their choice of theme. And when I saw that Alex had chosen the privilege of service, I thought, what can I do to add to that theme, which he chose to be able to demonstrate not only how great it is to be able to serve others through what we do as neurosurgeons, but as you know now, he's expanded that theme to the multiple ways in which neurosurgeons and doctors in general can serve. So this project was designed to build on the historical founding of physicians and what they did, and even before the United States was a country, in signing their names to the Declaration of Independence, and then at the end, I'll bring it up to the modern day and show you what's happening with the federal government and the physicians who are involved in it today. So it does begin and relate to Cushing and his famous, now biography of Cushing. Fulton described a 1935 meeting at the Harvard Nathan Smith Club, which Harvey Cushing attended, and he was eager to attend because the talk that evening was going to be about this very subject, the five physician signers of the 56 signers of the Declaration of Independence. So first, a few words about the colonial era physician in general. They were usually apprentice trained, and in fact, only about 10% of them even had a medical degree, and those of you who are involved in global surgery know that even today, medicine and yes, even neurosurgery is practiced in some parts of the world without a medical degree. At that time, physician social status was inferior to that of lawyers and the clergy, and as we'll see, very often, physicians quickly migrated to other fields in order to achieve that enhanced status and economic independence. Unfortunately, other than one about whom we'll talk very briefly, their contributions to the medical literature were largely fairly undistinguished, although their contributions to the canon of those documents that created the Foundings of America was important indeed. But as a whole, they believed in the age of enlightenment that fostered the ideas of Voltaire and others that brought on this spirit of liberty and equality, and that that same spirit of enlightenment would also advance medicine mightily by the advancement of reason and science. So first of all, there were some famous revolutionaries who were called doctor, mistakenly, but in fact were not medical doctors, and the most famous of these, of course, is Benjamin Franklin, often referred to as Dr. Franklin, who was, in fact, elected to membership in medical societies in London, Paris, and Edinburgh. He was, as you know, a polymath, a true Renaissance man who was interested in literally everything and contributed to all areas of science and human inquiry. But part of this mistakenness about calling him Dr. Franklin, even in his own lifetime, is because he spent much of his adult life, during which time he was extraordinarily famous, in Paris, where he was referred to as a physicien, and that's a physicist, but it was confounded with physician, and so he became known as Dr. Franklin. He did, in fact, receive honorary degrees as well, but he was so famous in two particular engravings that identified him in France as physicien, that it was on plates and tea towels and so forth, kind of like the royal wedding of the present time. Now colonial era, oh, pardon me, then famous revolutionary physicians who are not signers included Joseph Warren and Samuel Prescott. Warren, tragically, most people believe would have been one of the true founders of our nation, but tragically, he died at the beginning of the Revolutionary War at the Battle of Bunker Hill, and then Samuel Prescott was one of the third generation of physicians of Concord. He actually, on the famous Midnight Ride of Paul Revere, took the same ride, but outperformed Paul Revere, and as you may recall in this ride out from Boston that was ordered by Dr. Joseph Warren, Dr. Samuel Prescott was the only one of the three to actually get as far as his target, which was Concord, and warn the Minutemen. So physicians and medical students during the Revolution, as I've said, they were five of the 56 signers, and we'll talk about them individually in just a moment, but there were 34 military commanders, including 15 brigadier generals who were all physicians. Three physicians died, they're listed there, there were 21 physicians who were members of the Continental Congress, and in general, American medical leaders did serve in the armed forces or in the Continental Congress, and the British medical leaders at the same time were not involved in the conflict. Now Benjamin Roche is the first and most famous of the physician signers, went to Princeton, apprenticed to John Redmond, and I thought this quotation from his book is interesting, in his five year apprenticeship, he was not away three nights in five years, and that would be certainly a residency work hour restriction violation. He was highly cultured, his reputation, however, as a physician was enhanced by the fact that he was also a professor of chemistry, much more important than being a doctor at that time. He wrote important essays on slavery, on temperance, and if he were speaking to this group today, he would perhaps, which his sermons or his lectures to fellow physicians were called Sermons to the Rich and Studious, so that is, I thought it was an interesting and self-promoting concept. He also gave the first concept, the first description of golf in the U.S. literature, something American doctors are also quite interested in. He supplied the publisher and even the title for Common Sense. He was not, strictly speaking, a member of the Continental Congress in July of 1776, but he did join shortly thereafter, and he signed the embossed copy in August. And his most lasting medical contribution to that effort was the Directions on Preserving the Health of Soldiers, which guided all of medical care in the military until the Civil War. Then there was Oliver Wolcott, I'll summarize. He was one of the youngest son of one of the oldest families in Connecticut, a Yale graduate in the same class with Lyman Hall, who was another signer of the Declaration of Independence. He apprenticed himself to his older brother, who had a slave named Primus, who also became a very skillful physician in this apprentice era. But he became the third Wolcott to be governor of Connecticut, was an active farmer and trainer. He was elected in 1775 when they threw the bums out from Connecticut and had an underperforming Connecticut representative was recalled. He was a militia general. He was with Washington at his disaster at Brooklyn Heights, but he found glory again when he was at the Second Battle of Saratoga at Bemis Heights and caused Burgoyne's surrender. But interestingly, 37% of the delegates in the Continental Congress did serve in the military. There is his signature. He also had significant patriotism in his family. He was a wealthy man. He personally acquired the leaden equestrian statue of George III that was torn down on Broadway in New York. He acquired it, and the women you see at the bottom are his wife, Laura, and his daughter, Marianne. They melted down George III into 15,000 bullets that were used by the Revolutionary Army against the British. But in conclusion about him, Benjamin Rush wrote that he was a worthy man of great modesty, sincerely attached to the interests of his country. Then there was Matthew Thornton, who was an Irishman who signed the Declaration of Independence, largely by chance. He practiced medicine in or near Derry, New Hampshire for 40 years, having been apprenticed to someone who was both a doctor and the Baptist minister in town. So he had Dr. Thomas Green was the single most important man in Leicester, Massachusetts, much larger town at that time. Matthew Thornton was 60 years old at the start of the Revolution, so he was not an active fighter in the battles. But he was very important in the writing that he learned to do at that time and in his public service role. He was the president of multiple New Hampshire Congresses, and probably most importantly, besides his role in signing the Declaration of Independence, is his role in presiding over the writing and adoption of the first independent constitution in North America, which was written and signed actually before the Declaration of Independence. Another RRC violation, he said he was so busy traveling on behalf of the colony that at one point in time, he did not change his clothes or remove them for 10 nights. So pretty sure the RRC wouldn't like that if that happened to one of our residents these days. Now Congress announced their famous vote that we celebrate on the 4th of July every year, but they didn't reveal who the signers were. We revere them now, but in order to protect their privacy and their lives, honor, and sacred fortune, the names of those individuals who signed was not released until January 1st of 1977. He was a funny guy, he was Irish in the way that Irish can be. Adams wrote, quote, he had a large budget of droll stories with which he entertains company perpetually. John Rush wrote, he was a practitioner of physic, which is what physicians were called at that time, of Irish extraction, abounded in anecdotes. He was ignorant of the world, but believed to be a sincere patriot and an honest man. So moving on to, pardon me the other way, moving on to Josiah Bartlett, a 40-year career, he was inoculated against smallpox by Rush, treated wounded at the Battle of Bennington, but his most important medical contribution, in addition to his signing, is that he started the New Hampshire Medical Society and established the notion that there should be bodies of physicians who monitor other physicians, that it was a self-monitoring profession. And then finally, to conclude with Lyman Hall, who had trouble getting started in the ministry, continued to have some trouble in medicine, served on scientific congresses, but he ultimately became governor of Georgia and helped found the University of Georgia. So that, with that introduction of five physicians who signed, we now come to the physician members of Congress, of which there are 15. The top three in bold are the senators, the rest are the members of the House of Representatives. And for this project, we contacted all of them to ask them about the relationship they saw between medical services physicians and their public service. And just a couple examples, Mark Dunn and what he saw, a freshman congressman from Florida, Michael Burgess, who's an obstetrician, a long-time member of Congress as physician. When we see something or something that could be made better, we try to fix it. That's what elective office is all about. And finally, this photograph taken here on Sunday night, Bill Cassidy, who said, as a physician, you see what needs to be done, and you get people organized to do it. To conclude, my final slide, seize the opportunity, said Benjamin Rush, to diffuse useful knowledge doctors, no less than others, should speak out on public opinions. Thank you. Thank you very much.

physicians

Declaration of Independence

neurosurgical leaders

colonial era physician

age of enlightenment