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Our foundation as a nation and the care for the sick, poor, and injured are inextricably linked

Cesar Padilla, MD
Policy
April 22, 2020
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As Americans, we rarely question the authenticity or relevance of our constitution. Although segments are hotly debated, and parts are amended over time, the document stands as a light of legal and ethical truism. The foundation of our country and its revolutionary ideals served a purpose – to escape the grip and tyranny of the British empire. Before our independence was won, however, America had some soul searching to do. We needed an identity. Benjamin Franklin – stand out star and founder of our nation –  alongside a little-known doctor at the time, led that search.

In the 1730s, Franklin’s close friend Dr. Thomas Bond, a medical student at the time, was completing his studies in England and France. While in Paris, Dr. Bond spent time at the famous Hotel Dieu – a charitable hospital for the sick and poor ran by the Catholic Church. The hospital it turns out, represented something deeper, more purposeful and meaningful. France, and the rest of Europe at the time, is in the middle of The Enlightenment. A transformation of ideas, personal freedom, and social awakening is flickering in the minds of Europeans and Americans alike. Hotel Dieu, an institution of social welfare and platform for justice, is more than a hospital, it’s a thorn in the side of the French monarchy. The hospital, quite literally sitting in the shadow of King Louis XV’s reign, was winning the philosophical war – it would foretell the eventual fall of the French monarchy some 50 years later.

Now imagine a few American patriots rubbing shoulders with French doctors during this time. The socially awakened, tattered but tough French Catholics are teaching the restless, scrappy American Quakers lessons beyond medicine.

The Enlightenment burns in the minds of revolutionaries.

Dr. Thomas Bond returns to America inspired. He wants to establish a hospital for the sick and poor – much like Hotel Dieu – in the Colony’s intellectual hub, Philadelphia. Recently named Port Inspector for Contagious Diseases of Philadelphia (our country’s first infectious disease specialist), Dr. Thomas Bond was alarmed at the rate of disease transmission in Pennsylvania’s trading ports. At the time, public hospitals did not exist. Doctors would make home calls, and access to health care was on a service for fee condition. The idea of a charitable hospital for the sick and poor was unpopular amongst the rich and politically elite of the time.

Running out of options, Dr. Bond seeks help from his friend and rising political star Benjamin Franklin. Already an established politician, Franklin muscles the political support and successfully presents a bill to the assembly and secures funding for the hospital. Pennsylvania Hospital, our nations’ first, is founded in 1751.

The hospital, as time proves, becomes the medical nucleus of the United States. Regarded as the first teaching hospital in America, it becomes the hospital of our nation’s first medical school – the University of Pennsylvania. Like Hotel Dieu, its more than a hospital – It’s an intellectual hotbed for ideas.

Fast forward 25 years. It’s 1775. There is blistering tension between England and the American Colonies, eager to win their independence. The Revolutionary War begins. Well into his 60’s, and even more stubborn in his societal and revolutionary ideals, Dr. Bond answers the call for war. Dr. Bond’s weapons however, are not muskets and cannons. He sets out, along with his adult son, to help create our nation’s first field hospitals for the Continental Army. Battlefield medicine, a core component of our nation’s defense department, is born.

As we contemplate our growth and lessons to be learned from our current pandemic, it is imperative that we hold a candle to a mirror and examine our identity as a country. When our politicians debate about Medicare for all and its constitutional considerations, it’s imperative to remember that our foundation as a nation and the care for the sick, poor, and injured are inextricably linked. Our health care’s construct – its DNA – can be traced back to Dr. Bond’s endeavors. We hold Benjamin Franklin’s contributions – the Declaration of Independence and the U.S. Constitution, among others – as unshakable pillars of our identity.

It is our societal and ethical obligation to continue to hold Dr. Thomas Bond’s contributions in the same light – free care for the sick, poor, and injured –  as unshakable pillars of our democracy.

Our history demands it.

Cesar Padilla is an obstetric anesthesiologist and can be reached on Twitter @themillennialmd and on Instagram @doctor_cesar_.

Image credit: Shutterstock.com

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Our foundation as a nation and the care for the sick, poor, and injured are inextricably linked
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