The Doctor Is Still In

By Philip Kennicott
Washington Post Staff Writer
Saturday, November 26, 2005

No one in his right mind today would willingly submit to the medical ministrations of Moses Maimonides, the great 12th-century Jewish doctor and philosopher. Maimonides, very much a man of the medieval world, possessed a medical wisdom that was little more than a mix of herbs and hokum, borrowed from the ancient Greeks. At best, it might meet the basic ethical dictum to do no harm.

Yet Maimonides remains almost a saint among doctors, a medieval Albert Schweitzer, a Jewish Hippocrates. Hospitals around the world bear his name and Jewish doctors still gather together in Maimonides Societies in almost every American city. And as Yale surgeon and best-selling author Sherwin Nuland points out in a new book, many Jews still feel a deep affinity for the man they know by an acronym of his Hebrew name, "the Rambam."

Nuland, author of the 1994 "How We Die," begins his new "Maimonides" with a discussion of an intriguing question: "Why is it, in fact, that so many Jews have become doctors?" And why do so many of them, and so many Jews who haven't read a word of Maimonides' abstruse texts, revere the old doctor and religious leader as a living presence in Jewish cultural life? Nuland, whose book is part of a new series devoted to Jewish literacy published by Schocken and Nextbook, locates the answer in some basic trends in Jewish history, trends that Maimonides epitomized.

For Jews, medicine was a portable profession during long centuries of persecution and migration. It was also a natural extension of a tradition of learning. Maimonides, born in Spain in 1135 to a bookish father, was buffeted by intolerance and fled across the Mediterranean world before settling in Fustat, Egypt (near Cairo) in 1168. There, he emerged as the spiritual leader of Egyptian Jews but scrupulously refused to take payment for his religious services. So even as his name was spreading to the ends of the medieval world, he turned to medicine to make ends meet. Such was his intellectual gift, and personal appeal, that he was soon made physician to the court of the Muslim sultan of Egypt.

Although the Jews, writes Nuland, never created a specifically "Jewish" medicine, as the Chinese created a Chinese medicine, they associated healing with basic religious duty.

"One who is ill has not only the right but also the duty to seek medical aid," wrote Maimonides, because, he argued, we maintain the body to support our spiritual quest to know God. Christians, on the other hand, attributed disease to supernatural causes, and through the example of Jesus and the martyrs, they placed redemptive value on suffering, Nuland argues. The Jews found that nonsense and focused on healing as a religious calling -- which gave medicine a special status and urgency within Jewish culture. Medicine, for them, was a calling, and perhaps for that reason they were renowned (even among Christians) for being very good at it.

"That kind of thinking has so suffused medical thinking in a large extent because of Maimonides," Nuland said in a recent interview, while visiting Washington from his home in Connecticut. The notion that medicine is more than just a job or a career, that it brings with it a deeper moral obligation, is no longer a specifically Jewish attribute of medicine, he said, but it is one of the Jews' great contributions to the field.

Nuland comes to an interest in Maimonides not only as a Jew -- he grew up in a Yiddish-speaking, Orthodox house in New York -- and a doctor but also as a historian of medicine. His new book is the second in Schocken's Jewish Encounters series (the first, by poet Robert Pinsky, is devoted to King David; the next up is a biography of the boxer Barney Ross). Jonathan Rosen, editor of the series, said it was a natural to call on Nuland for this volume.

Rosen said he decided on Nuland even before he knew the celebrated Yale professor -- a trim, articulate man in his seventies -- was born Shepsel Nudelman. Rosen was looking for an author who could connect with Maimonides not just philosophically. He wanted someone who "could swim across this gulf of 800 years and find if Maimonides has something to say to him. Do they speak the same language?"

Other writers have taken up the many intellectual challenges thrown down by Maimonides' life-long effort to make Jewish law and learning as intellectually orderly and convincing as ancient Greek philosophy. But Nuland connects with a more emotional Maimonides, a human figure with familiar frailties and feelings. Although it's easier to construct a picture of Maimonides' intellectual life, there are fewer clues with which to limn his personal character. We know, for instance, that when Maimonides' beloved brother David died in a shipwreck, Moses was disconsolate. He went into a dark depression for nearly a year. Later, he would write, "Eight years have since passed, and I still mourn, for there is no consolation. What can console me? He grew up on my knees; he was my brother, my pupil."

"His description of clinical depression could be in a modern psychiatry textbook," Nuland told an audience earlier this month at the Jewish Community Center.

Nuland also marshals evidence from a letter written in 1199, when the philosopher, then in his sixties, was at the pinnacle of his power and responsibility. Writing in response to a translator who sought to visit and work with him, Maimonides strongly discouraged the visit, saying he had no time to spare. And then he laid out the shape of his day: He traveled to Cairo and back again, a mile and a half each day, to attend to his court duties; he ate only one meal in 24 hours; and even at home he found himself swamped with suppliants, patients and the practical duties of leadership. "Patients go in and out until nightfall, and sometimes even I solemnly assure you, until two hours and more into the night," he wrote. "I converse and prescribe for them while lying down from sheer fatigue, and when night falls, I am so exhausted that I can scarcely think."

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