This week in Revolutionary War history, let’s check up on what was going on 250 years ago in and around the colonial Province of Massachusetts Bay. Never uneventful, last week, delegates from the Continental Congress met George Washington at his headquarters in Cambridge with discussions mostly centered on the General’s plans to make it through the winter. Washington also received information from his troops regarding their desire to continue service into the next year in order to make further conscription preparations. Cambridge also received updates from Benedict Arnold and Philip Schuyler on their offensive campaign into Quebec, which is showing its first signs of disaster.

            On October 29, 1775, Washington receives a note from his cousin and the manager of his estate/plantation, Mount Vernon, Lund Washington. Lund is about five years younger than George and has served as steward of the tract of land on the Potomac since the war’s onset. He initially writes of some unfurling behavior by the General’s wife, Martha Washington. Lund says she often departs with him being unsure of her exact whereabouts. He adds, “she has often declared she would go to the camp (Cambridge) if you would admit her.”

            He gets into the real message he wants to convey. He seeks counsel. Lund is unsure how to ensure the safety of the property in the case of a British assault, looting, or capture. The property was about 8,000 acres just off the Potomac River in northern Virginia. He recommends fortifications, and a series of walls and batteries to stop the British from disembarking. It is difficult terrain to build on, but Lund is evidently fearful of the highly vulnerable position of the property. Washington’s reply was lost to time, but such fortifications were never erected.

            On October 30, John Hancock writes with urgency and stress. “I confess I have great anxieties upon the subject,” referring to the eminent possible retiring of up to half of Washington’s officers at the end of the year. He hopes increased pay, better contract terms, and “a regard to their country” will retain some servicemen. Though the threat of a severely diminished army is a serious one.

            That same day, Governor Jonathan Trumbull of Connecticut writes from Lebanon (the city), ironically also fearing the fragile defensive position near the sea, similar to Lund’s fears the day prior. Trumbull also suggests batteries, this time floating ones in the Long Island Sound. He fears New London is a prime target of the British. He is seeking recommendations from “skilled engineers.”

            Josiah Quincy of Braintree writes Washington on October 31 (they don’t celebrate Halloween quite yet – sorry) with a potential strategic opportunity to get a leg up in Boston. When the delegates from the Continental Congress have come north last week, Quincy met with some of his friends, including Benjamin Franklin, and discussed the cruel “vengeance of a tyrannical government.” He and his friends have devised a “scheme.” In great detail, he outlines a plan to block the sea routes and starve British-held Boston of its maritime connections, thus isolating the garrison and making it an easy recapture. In speaking with Franklin, John Adams, and others, Quincy explains many possible methods for blocking the city. Including the construction of forts near the two channels into the city, the sinking of ships in said channels, or even the creation of “machines” to lay chains or barriers. “I doubt not, your Excellency will readily agree with me, that these are become objects of much greater importance, since the destruction of Falmouth (Portland, ME) demonstrates, the malicious resolution of our barbarously civilized enemies, to destroy all the rest of our maritime towns, if they can.” He then invites Washington to have a view of the harbor with him, to better formulate plans.

            Washington sends a response a few days later. The army has no supplies, and such a plan isn’t near possible at the moment.

            On November 1, Washington’s General Orders again instruct officers to manage their finances. They are not to order coats if they do not have the essential shirts and shoes first. That same day, Washington received a letter from the recently displaced Bostonian merchant Gillam Tailer: “I beg leave to represent to you that I am a young person from Boston, where I have left my all. I have been brought up in the mercantile way but by reason of the unhappy situation of affairs am now out of employ, should esteem it a great favor if your Excellency would bestow some employ on me, that I may be of some little service to my Country, for which shall ever retain a grateful sense & am your Excellency’s most obedient humble servant.” Many share a similar set of circumstances, and Tailer would become an ensign in the 2nd Continental Infantry about a month later.

            Finally in a lucky victory against the supply shortage, on November 3, merchant John Brown of Providence informs Washington “a small quantity of powder” has just arrived from Suriname. Though little, it highlights a spark of hope and assistance from unlikely allies across the Commonwealth. On November 5, Washington also gets some more good news. This time, from Canada. Major General Philip Schuyler states Fort Chambly has been captured. The fort lies only a few miles east of Montreal. A great victory that Schuyler and Major General Richard Montgomery seek to capitalize on, pushing for Montreal and then Quebec City.

This Week in Revolutionary History
By Sam Bishop

I am not a doctor, and I don’t play one on television. I don’t write a medical column either, I leave that to the good Dr. Hoffer whom you can find elsewhere in this journal. But I do know a lot of doctors. Between the missus and me, we’ve had nearly a dozen. Six of them are mine alone!

            In addition to our primary care doctor, I have a urologist, a gastroenterologist, an oncologist, an audiologist, and an ophthalmologist. I saw a cardiologist, but it turned out my heart works fine. I once visited a pulmonologist. My lungs were good, too. Then there are the anesthesiologists who made me forget the many surgeries I’ve had. I expect any day now I will have to see a rheumatologist for my arthritis.

            She has a gynecologist, has seen a dermatologist recently and a nephrologist. (That’s a kidney doctor. Everything was okay.) No doubt one day we’ll both have to see a gerontologist. I call them all our “gist club.” Those don’t include our dentists, hygienists, our optometrists, the many phlebotomists who draw gallons of blood over the course of a year, assorted physician assistants and nurse practitioners. Some people have suggested I ought to see a psychiatrist, but I ignore them.

            I probably should see a podiatrist… my feet hurt, and maybe an allergist because I am allergic to shellfish. Naw, I have enough doctors. If you are like me, the stress of just thinking about going to a doctor raises your blood pressure sky high.

            I’m thinking about taking some time off from doctors’ appointments. Maybe go on a long vacation. If you’d like to join me, I may have discovered the ideal place. Mars!

            A group in Mongolia (yes, that Mongolia) called MARS-V, is planning to offer a Mars Retreat for tourists in the Gobi Desert. They say that “nowhere else in the world mimics climate and geography” of Mars than the Gobi. The landscape is red and pretty desolate. The temperatures range from minus-40 degrees Fahrenheit to 113 degrees. Sounds pretty hospitable, doesn’t it.

            The whole package, including three months of training, physical dexterity and mental tests, costs a mere $6,000. (A lot less than the $28,000,000 it would cost to go to the real Mars). All this to stay three months in a “habitat” of tiny “pods” in a space suit. For your dining pleasure freeze dried, dehydrated Mongolian delicacies like dumplings and mutton stew will be served.

            It might be better to consider some place closer. There is a mansion available in Newport. It’s for sale for $28,000,000. Mmmm. (Odd that it is listed for the same price as a trip to Mars.) Maybe I could just rent it. It has 60 rooms, 29 bedrooms, 18 bathrooms, 11 stone fireplaces. The place is big enough that my doctors will never find me. And, it has a grand, gilded-age ballroom.

            I hear a grand, gilded ballroom is the “in thing” these days.

            Mattapoisett resident Dick Morgado is an artist and happily retired writer. His newspaper columns appeared for many years in daily newspapers around Boston.

By Dick Morgado

            Since we are in the Medicare “open enrollment” period, Oct 15-Dec 7, now is a good time for a quick review.

            Medicare was enacted in 1965. It established parts A and B. Part A is free to all Americans 65 and older and to younger people with chronic kidney disease or who are chronically disabled. It pays 80% of hospital bills after a deductible. Part B, for which you pay, covers doctor fees and most outpatient services. Part B also has a deductible and covers 80% of the charges.

            While Medicare B is voluntary, it would be playing Russian roulette to not take it, as you would have no coverage for doctor bills. Most people pay $185/month for Medicare Part B, though this goes up for those with higher incomes. It also goes up if you delay enrolling.

            Medicare Part D became available in 2006. It is optional and helps pay for prescriptions. You must sign up and choose a plan annually. Typical premiums run about $50/month.

            Because A and B only cover 80% of your medical bills, and these bills can mount up dramatically if you have a serious illness, most people pay for a supplemental policy to cover the 20%. These so-called “medigap” plans are offered by private insurers, not the government.

            Part C, establishing what is now called Medicare Advantage, began in 1997. It gives private insurance companies a fixed amount per person per year to cover their medical expenses. The theory was that private health insurers would provide equal or better care and save the government money, a theory that has been proven wrong.

            Medicare Advantage plans advertise heavily, and promise lower costs and extra benefits. At this time of year, you will be inundated with direct mail, phone calls and media blitzes trying to entice you to join an Advantage plan.

            If you join such a plan, you must still pay your Part B premium, but typically will not have to pay for a medigap plan or Part D. Your monthly insurance premiums will usually thus be lower. There is, however, no free lunch. Under traditional Medicare A and B, you can be treated by almost every doctor and hospital in the country. This is not true for Advantage plans.

            In return for the lower insurance cost, you will be restricted in the doctors and hospitals you can use and you will find that your doctors’ recommendations are subject to the whims of the insurance companies. Most hospital care and any expensive test or medication will only be covered if the insurance company approves it. I do not have space here to cover all the issues, and strongly recommend you Google “John Oliver Medicare Advantage” (the 31 minute one) for a biting and humorous look at the problem.

            People who sign up for Medicare Advantage when they are healthy can be fine if they stay healthy. If they develop a serious illness they may regret their choice, as they find that the doctors and hospitals they would like to use for their care are not available.

            Switching back to traditional Medicare would seem like an option, but there is a catch. When you first go on Medicare, you have free choice of medigap plans. They cannot refuse you because you are in poor health. If you try to sign up for one of these plans later, they can refuse to cover you at all or refuse to pay for pre-existing conditions. Just when you would need that 20% covered, it will not be, so you are locked into your Advantage plan.

            My strong advice is that if you can afford the extra cost, start and stay with traditional Medicare and a good medigap plan. Otherwise, if you choose an Advantage plan, stay healthy!

            Edward Hoffer MD is Associate Professor of Medicine, part-time, at Harvard.

What Does The Doctor Say?

By Dr. Edward Hoffer