The Good Doctor
Examining Maimonides with Sherwin Nuland
Moses Maimonides was a Renaissance man before there was a Renaissance. A physician in Saladin’s court, a dazzling Torah scholar, a community leader, a daring philosopher whose greatest work—The Guide of the Perplexed—attempted to reconcile scientific knowledge with faith in God. He was a Jew living in a Muslim world, a rationalist living in a time of superstition. Eight hundred years after his death, his ideas about God, belief, the afterlife, and the Messiah still provoke debate and the enigmas of his character continue to fascinate. Sherwin Nuland, a winner of the National Book Award and a clinical professor of surgery at Yale, talks about his biography of Maimonides, the second in Nextbook/Schocken’s Jewish Encounters series.
You write that people know the name Maimonides because it’s on hospitals and schools, but they know so little beyond that.
Most people have the sneaking suspicion that if they looked into it, they would find this esoteric mind to which they can’t relate at all. Of course that would be wrong, and to show that is one of the purposes of my book. There is a lot in his thinking and in his writing that represents the questions, riddles, and conundrums that Jews have been wrestling with forever.
Yes, he seems so modern. He suggests that the idea of Olam Haba, the next world, is spiritual rather than a physical place, for example, that the Torah is allegorical—an idea that particularly appeals to me. But wouldn’t a strictly observant person find these assertions heretical?
He lived at a time, much like our time, in which no one really knew what the world to come was. And he felt that it was his job to give it the form, to give it substance, to say, “Look, this is what it is, and you have to stop thinking of it in earthly ways, you’ve got to think of it in ways that you don’t really understand because you have no conception of this, what this can be like.” And in that sense, you might say it’s modern. My guess is that there have always been thinkers who were inclined in this direction.
We’re looking at the 12th century, and there were no skeptics, and there were no agnostics, and there were no atheists. Everybody in some form or other believed. So, if we’re asking, “Is he a skeptic?” we are doing what I say in the beginning, quoting Rabbi Arthur Hertzberg, you know—finding the Maimonides that we need: “distinguishing between what we learn from Maimonides as he would have wanted us to learn from him, and what we make of him because that is what we want to hear, remains an insoluble problem.” We’re putting a modern twist on this.
What do you judge to be Maimonides’ crowning medical achievement?
He was essentially a compiler and a simplifier, and someone who made things accessible—like his crowning achievement in the Mishneh Torah. His books, they’re small volumes, very easy to understand, they can almost be memorized, because of course in those times people did memorize a lot of stuff. Unlike major figures like Avicenna and Rhazes who wrote long, complex, encyclopedic things, he simplified things so that every physician could easily understand it, and it was easy to find what you wanted.
You’ve basically synthesized his life—taking its long threads and making them cohere, which is what Maimonides did with his religious works and medical works. To some extent, you are engaged in a parallel pursuit. Did that process vex you? What was it like while you were in it, if you can recall?
I don’t have his brilliance obviously, he was a towering genius, but I have qualitatively, though not quantitatively, the kind of mind that everything I read, whether it’s medicine or politics or whatever, ends up synthesized. All of my books are essentially what the French call “vulgarisation.” It doesn’t mean the same thing as it does in English, it means kind of something halfway between popularizing and condensing. And that’s what he was a master of. When I read abstruse material, I automatically synthesize it in my mind. Doing the book was second nature; it’s very reassuring to come across a mind like that.
But you say in the introduction that you were skittish at the start.
Was I ever. I didn’t know that this could be done. I really believed that it took a scholar in all of these areas to accomplish it. And it was when I read that little quote from Hertzberg, I thought, how far off can I go? Then I went back to reading, and things began coming together. But I didn’t think I was capable of doing it up until that point.
How familiar were you with Maimonides before embarking on this project?
The way people are superficially familiar with Maimonides, especially if you’re a doctor and you’ve read some of his medical writings, and every once in a while dug into some of the religious writings, specifically the Guide. You read the Guide for two pages and you just want to bang your head against the wall. One thing about the Guide that I’ve never heard anybody mention, but it’s very important—in the 12th century, people wrote in a kind of a code that only the elite understood. It was dangerous to overtly write what you wanted. The goyim were looking, the Arabs were looking. And so even when you were writing in Arabic, there were certain idiomatic ways of expressing oneself. A very scholarly younger friend of mine said to me, “Why don’t people just admit it will never be possible for anybody, regardless of how deeply steeped he is in Maimonides, to understand this, because that kind of coded talk is lost to us.” So although large parts of the Guide will be understandable, a lot of the ultimate message never will.
Was there one thing you learned that most surprised you about Maimonides?
I have come to think of him as a very lonely person. He was intellectually completely alone, and he knew it. Whatever he may have had as disciples or people with whom he was friendly, it made no difference. He was aware that he was distinctive in his time, maybe in any time. Who else would have what it takes to look at the Mishneh a thousand years later and present it to the people in a different form? It’s remarkable. I think there is in such people a loneliness that fills one with awe. He must have felt a certain awe at his own loneliness, at his separation from everybody else.
This must have become more profound after the death of his brother David in 1169. His work as a trader in precious stones essentially supported Maimonides.
Yeah, this was the one person in the world for him. His father, of course, died when he was young, but the brother was the one person that was his link with the reality of the world. One person to whom he could confide, the one person I think that he ever truly loved except for his own son. And that’s gone. I think that was the ultimate, symbolic moment when the loneliness overwhelmed him and stayed that way for the rest of his life.
Maimonides also comes off to me as somewhat arrogant.
I don’t know if arrogant is the right word. There’s a fine line between arrogant and self-confident. When I wrote a small book on Leonardo, I came to the conclusion that there is an occasional person whose mind is nothing like your mind or mine. And no matter how smart we may be, no matter how many Phi Beta Kappa keys are dangling from our noses, there are certain intellects that are far beyond that. They occur once in a while. I am sure Leonardo was one. And the more I think about Maimonides, the more I think he was one, too. It’s hard for me to believe that he didn’t know that. Here he was, having these debates, disagreements with the most important rabbis of the time, and he must have intuited as he talked to them that they couldn’t hold a candle to his thinking patterns.
Let’s talk about the Maimonidean Oath, or Prayer of Maimonides, a kind of medical credo put forth by in the 19th century and attributed to Maimonides but never proven to have come from him. How does it differ from the Hippocratic Oath?
The Hippocratic Oath starts off asking for help from Apollo, but that was just a standard form of oaths. It’s an expression of the separation of medicine from religion. That was the great contribution of the Hippocratic physicians—they were the first people to say sickness has nothing to do with God, or the gods, or whatever.
Now, Maimonides believed that one got sick independent of God, but that God was there, and a doctor could ask God for help. He couldn’t ask God to cure the patient, but he could ask God to give him the understanding that he could cure the patient. If you read that first chapter carefully, I try to put that through all of it, that Jews don’t believe, or didn’t believe in those days, that sickness came from on high and cure came from on high. But what we did believe was that if one got sick, the doctor could ask for the mental wherewithal, the physical wherewithal to cure these people.
Maimonides trod a line: the leader of a Jewish community, but within the Muslim court; a doctor and theologian, but also a diplomat. In your memoir, Lost in America, you write about changing your name, getting into Yale, trying to shrug off the identity that you grew up with. Did you feel any kinship with Maimonides in straddling different worlds?
I’ve actually never thought of it until you said it, but of course you’re right. I was at Yale at a time when there were no Jews, not a single Jewish full professor on the faculty of the medical school. There were people who had been born Jews but who were living as Christians, and there was a very specific quota. It was very hard to be a Jew at that time in this particular atmosphere. And one had to stand on one’s ear to negotiate the passages.
But Maimonides represented the Jewish people to the court of Saladin, and I did not represent the Jewish people, although my classmates all knew I was Jewish. Maybe in a sense I did, because I ate Kosher, there were three of us in the whole bloody medical school. We used to meet at the home of a Kosher caterer three nights a week, Mrs. Wicksman, of blessed memory. On the other nights I would eat at the same greasy spoon where the other students ate, and I’d eat tuna fish and halibut and stuff like that, and everybody knew why.
Did writing this book change the way you think about yourself as a doctor?
I don’t think so. A lot of his attitudes are similar to attitudes I’ve had for a long time. One of them is uncertainty, and the other is the necessity to act with certainty even though the basis for your action is uncertainty. When you’re a doctor, you’re always making decisions based on incomplete information. But you must make them with great authority. That’s what Rambam did. He was a man who realized that a lot is unknown, that a lot is dreadfully uncertain, but in order to achieve his goal, keeping the Jewish people together, he had to function as though everything was certain and he understood it. That’s a situation I’ve been for all of my career, on a much smaller scale obviously, but I admire that kind of thing.
Did this book in any way change your relationship to Judaism?
Well, I’m a funny kind of a Jew. I call myself an observant agnostic, because I go to shul every Saturday. The rabbi knows I’m an agnostic. You know, my colleagues in the shul know I’m an agnostic, but I get carried away by the emotion of the thing. Having been brought up in an Orthodox home, I become the biggest shuckler in the place. And without meaning to, in becoming someone knowledgeable in the biography of Maimonides, I look at myself as a little more a part of the Jewish community of this town than I did before.
As I read your book. I wondered, does Maimonides believe in God or is he a total skeptic? My father’s a professor who writes a lot about Maimonides, and I asked him this question. He said, it’s the great debate: Leo Strauss says Maimonides didn’t believe, he was just playing a political game, and Shlomo Pines says that he was an agnostic, and then Marvin Fox says he was religious. And then there are people who think Maimonides was a deist. What do you think?
It’s a conflict that has been going on forever. Whole books have been written to justify some of the things that he’s said, trying to prove that he is, indeed, a believer. I didn’t think it was appropriate in a book written by a non-scholar to take any sort of stand on that. My first serious contact with studying Maimonides, other than what one does on one’s own, was about 15 years ago when I was asked to address a Yale Hillel function on the topic, Maimonides: Greek or Jew? And at that time, I came down on the side of Greek—that he was a rationalist. And I’m still not convinced that belief was paramount in his mind. What was paramount was keeping the Jewish people together. The more I think about it, the more I’m convinced that was the ultimate purpose of his life and his writings. It made no difference whether he believed or didn’t. He believed in the Jewish people.
You went to Sri Lanka to help out after the tsunami. Do you see this as being in the spirit of Maimonides?
Oh yeah. The tsunami was Sunday, I left the following Friday. On Thursday night, I called all four of my kids, and I said to my older son, “I’m going specifically because I’m a Jewish doctor.” There is something about the traditional Jewish approach to medicine that says, I am the only one who can do this, this is my responsibility. This is a specifically Jewish thing, the notion that if you find yourself called upon by a patient to deal with their illness, or to treat them, you must treat it as though you are the only person who can do it. It’s a sense of great personal responsibility.