It’s a simple solution, but also one that is deeply problematic. The lot and the Lord are, by definition almost, diametrically opposed: the one an emblem of random progression, the other the omnipotent creator of all things. The Lord, presumably, does not have accidents, nor does he leave any room for chance. He does not—to quote a clever man—play dice with the universe. Why, then, should we? Why wouldn’t the Almighty merely declare which animal is destined to which fate, and spare us these unnerving games of chance? How might we be expected to reconcile our faith in the divine and his heavenly plan with such a blatant resort to the random and the arbitrary? And on the holiest day of the year, no less?

These are searing questions, and they resonate throughout the Bible. When they finally reach the land of Canaan, for example, the Israelites divide the land by drawing lots, and they draw lots again in Masada, selecting the few unfortunate swordsmen entrusted with setting the mass suicide in motion. We Jews aren’t alone in trusting chance: John Wesley, the father of Methodism, selected a wife by drawing lots, and the Dalai Lama used the same method to nominate his successor. Throughout time and across cultures, we again and again see the very religious turn to blind luck.

It’s a view, of course, that the very religious would very likely reject. What we perceive of as random, they may say, is but another manifestation of God’s will, unknown to us but in effect nonetheless. The woman he selected at random, Wesley was sure, was the one God intended him to marry all along. But such an attitude, and its problematic implications on the nature of free will, is one most of us reject; to us, God and chance are antithetical.

And yet, when it comes to the most meaningful questions, we frequently associate the random with the divine; when our lives depend on it, we draw lots.

In his brilliant Dicing With Death, medical statistician Stephen Senn discusses the intersections of chance, risk, and healthcare. Seeing how so many of our clinical trials, for example, are randomized, we might raise severe ethical objections to a doctor’s decision to knowingly withhold treatment from a group of patients on the basis of nothing more than a form of lottery.

“The argument,” Senn writes, “goes like this. Even if we accept that from the purely scientific point of view it might be preferable to continue to randomize patients concurrently to experimental and standard treatments, having started in equipoise, it is highly likely that a point will be reached where we have a hunch that one treatment is better than another. Once we have reached this point, if we continue to randomize, we are sacrificing the interests of current patients to those of future patients. This is to treat patients as means and not ends and is unethical.”

Ethics, however, has yet to come up with a better alternative. Nor has the law: In 1841, to cite but one renowned example, an American ship named The William Brown sank along with 31 of the men and women on board. The rest of the passengers made it onto a lifeboat, which grew more and more crowded. To ease the load and increase the overall potential of survival, the crew selected 16 passengers at random and shoved them overboard. Horrified, some of the passengers who did eventually reach shore rushed to file a complaint against the crew. One sailor, Alexander Holmes, was apprehended, and—being the only crew member present in Philadelphia, where the complaint was filed—charged with murder.

In deciding the case, the court found that “being common carriers, and so paid to protect and carry the passengers, the seamen, beyond the number necessary to navigate the boat, in no circumstances can claim exemption from the common lot of the passengers.” Holmes was convicted of manslaughter, but the court did see fit to make a statement regarding the sterling nature of random selection.

“When the ship is in no danger of sinking,” the judges wrote, “but all sustenance is exhausted, and a sacrifice of one person is necessary to appease the hunger of others, the selection is by lot. This mode is resorted to as the fairest mode, and, in some sort, as an appeal to God, for selection of the victim. … For ourselves, we can conceive of no mode so consonant both to humanity and to justice.”

The reference to God is not accidental. In random clinical trials and in harrowing decisions aboard sinking ships we see, again and again, the same logic guiding this week’s parasha. The haphazard and the holy are intertwined in our minds because, short of understanding God and his ways, and short of possessing his power to shape events, we have yet to devise a more formidable system than closing our eyes and rolling the dice and telling ourselves that the outcome, far from some cruel twist of fate, might very well be the direction some heavenly hand has been guiding us toward all along.

Even if we don’t accept this principle, even if we look at games of chance as immoral or terrifying or both, we should, at the very least, come to terms with the inarguable truth that chance consists of equal parts hope and dread. Benjamin Franklin understood that well. “I enquired concerning Moravian marriages,” he wrote in his autobiography, “whether the report was true that they were by lot. I was told that lots were used only in particular cases … if, for example, it should happen that two or three young women were found to be equally proper for the young man, the lot was then recurred to. I objected, ‘If the matches are not made by the mutual choice of the parties, some of them may chance to be very unhappy.’ ‘And so they may’ answered my informer ‘if you let the parties decide for themselves.’ Which indeed I could not deny.” Amen to that.

“The [Lower] East Side is a volcano of superstitious ignorance,” read an article in the New York Tribune in the steamy June of 1906, referring to masses of immigrant Jews prone to the kind of mass hysteria that occurs every so often in the quarters of poor and ignorant.

In this case the volcano had erupted in a riot earlier in the month when 50,000 immigrant mothers descended on their local public schools demanding to see their children, having had heard that there was a Board of Health-sanctioned child slaughter taking place. Greeted by locked doors, the screaming throngs surrounded the schools and began smashing windows and pounding on doors. On Essex Street, some white-hot mothers clambered up ladders in an attempt to break into P.S. 137 through the second-floor windows.

During this rampage, gangs of immigrants cursed out principals, fought police, and attacked anyone in the street bearing the slightest resemblance to a doctor—and, according the Tribune, this meant anyone in a pair of spectacles. Some of them raided vegetable pushcarts for ammunition while others, like one young man who pulled a revolver on a member of the Board of Health, used more serious weapons.

Word had spread among the Jews of the Lower East Side that uptown doctors were coming into downtown public schools and were, as described in the daily Varhayt, “cutting the throats of Jewish children!” After a two-hour assault, the rag-tag army achieved victory: Their kids were released early and alive, proving that no such slaughter had taken place.

Thrilled at having gotten a miraculous half-day’s vacation, the kids didn’t even know what the ruckus was about. “I dunno sir, I t’ink the school exploded,” one boy told a reporter from the Evening Post.

As with many hysteria-inducing rumors, this one contained a kernel of truth. After cases of tonsillitis kept scores of Jewish students out of school a week earlier, one school principal recommended that these kids have tonsillectomies. The mothers complained that the trip uptown for such a procedure wasn’t possible for people who worked 12-hour days, six days a week. What’s more, the 50-cent doctor’s fee was too high. So, the principal kindly arranged for doctors from Mt. Sinai hospital to come to the school and perform quickie operations.

Just days before the riot, doctors performed 83 tonsillectomies at P.S. 100 on Cannon Street. Most of the kids were back in class the following day. According to the Tribune, none of the operations were performed without parental consent, and, they added, there were no complaints. A tonsillectomy was no big deal.

But the Yiddish daily Varhayt claimed otherwise, reporting that not only did many of the young patients fail to get their parents’ permission, they had been sent home with unintelligible permission slips. “First of all,” the Varhayt editorialized, “the poor and unhappy immigrant mothers who suffer the stifling heat and confinement of the tenements can’t even read. And secondly, they aren’t able to understand the technical English on the permission slips that was being read to them.” All they knew was that when the children returned home from school after their procedures, they did so drooling mouthfuls of blood, barely able to speak. Shocked, their parents asked what happened. “Doctors cut our throats,” the children replied.

Rumors of a wholesale slaughter leapt like wildfire throughout the tenements and shops. As the gossip wended its way through the neighborhood, the story grew from “doctors cut our throats” to “two children died” to a wild “83 children died.” Street-corner orators got into the act, screaming about the massacres in the schools, comparing them to the pogroms in Russian-ruled Poland.

Coming on the heels of a particularly brutal pogrom in Bialystok that had just been reported on—accompanied by gruesome photos—in the Yiddish press, the Lower East Side surgeries morphed, in the eyes of gullible parents, into evidence of an American pogrom. Accustomed to such violence in Europe, many of the recent arrivals believed such things could happen even in America.

But if the Tribune implied that the Jews were superstitious dupes prone to wild overreaction, the Yiddish Varhayt shot back that the fault lay with the Board of Health and the school’s principal for stupidly sending home permission slips not in Yiddish. The Varhayt also launched into a tirade about how Irish principals have no respect for Jewish immigrant parents and essentially do what they want with the children.

All the Yiddish papers decried the overwrought reaction of the mothers. But in an attempt to fully blame the Lower East Side’s Jews for the riot, both the Tribune and the New York Times alleged that there was a gaggle of local Jewish doctors who had spread the rumor because they were furious that uptown doctors were performing tonsillectomies on local kids for free, when they could be getting 50 cents a pop. The Yiddish press opted not to remark on that theory.

The Tribune also took the opportunity to bemoan the episode as one of a series of events that plagued the overcrowded and frequently obnoxious Jewish quarter. Four years earlier, they noted, Jewish women rioted against local butchers, and three years earlier, they rioted against doctors who were treating their children for trachoma. These same immigrant women joined together most consistently for “Landlord Riots,” which exploded every time rents were raised, and for bank riots, which occurred every time a Jewish bank went belly-up, leaving its poor immigrant depositors with bupkes.

The great tonsil riot fizzled quickly, as it occurred at the end of the school year and was forgotten almost immediately as students graduated and parents kvelled. The police, however, worried a little longer and, according to the New York Times, posted squads of cops outside heavily Jewish schools, on Essex and Grand Streets, where, on the last day of classes, graduates performed scenes from The Merchant of Venice to their Yiddish-speaking parents, none of whom rioted or even panicked. Well, maybe they panicked just a little.

New Yorkers sometimes complain that the city stinks. They have no idea. When New York was a horse-powered town, the stench of manure and urine was gag-inducing, especially in the dog days of summer. It was on one of those steaming days near the end of August 1871 that a rickety trunk was delivered to the baggage room at the Hudson River train depot. It sat undisturbed until a baggage agent noticed an odor so pungent emanating from it that even the city’s general putrid stink failed to mask it.

The contents of the trunk horrified the workers who jimmied it open. Crammed into the 2-foot-8-inch box was a comely, naked young blond. Even while decomposing, the girl was a stunner, if we’re to believe the words of a news pamphlet which described the body. “A tangled mass of the most beautiful golden hair fell in waves over her shoulders, which must have been white as Parian marble, and eyes of blue, that even death’s horrors cannot pale,” it said. “The limbs were white and shapely and the feet tiny and delicate. The arms and hands were faultless in their symmetry, and every feature showed refinement and grace.”

The morgue report was less forgiving. The coroner estimated the girl had been dead for three days. Thought to be around 20 years old, the body showed no signs of having sustained blows. But her “lower parts” were “swollen.” More to the point, the doctor discovered a placenta stuck in her uterus, a sign that she was the victim of metro-peritonitis, hemorrhaging from an abortion gone wrong. He was puzzled over how the 5-foot-2-inch young woman had been pretzeled into the trunk. Rigor mortis would have forced perpetrators to break her limbs to make the corpse fit, leading to the conclusion that the woman was forced in while still alive.

While the hows of her death were solved, the police went about trying to identify the corpse. They tracked down the wagon driver who delivered the trunk to the station. And the driver, in turn, led the police to a 2nd Avenue basement belonging to Dr. Jacob Rosenzweig, who was promptly arrested. A known abortion provider who sometimes operated under the name “Dr. Ascher,” Rosenzweig denied knowledge of the whole affair.

In the meantime, the body was put on ice while a parade of curious gawkers attempted to identify her. A seamstress from Paterson, New Jersey, whose daughter had gone missing a week before, was too upset to see if the festering corpse was her beloved Alice. Instead she dispatched the family’s doctor and dentist, who identified the girl by an unusual vaccination scar and a missing eye tooth.

Everyone in Paterson considered Alice Augusta Bowlsby virtuous, and wondered what kind of malevolent lothario could have possibly put her in this situation. The answer became apparent when Walter Conklin, the son of a well-off alderman and silk mill owner, was denounced by his own mother as Alice’s seducer. In response, Conklin shot himself in the head; in his pocket was a note with the address of one of Rosenzweig’s offices, this one on East 24th Street.

Bolwsby’s seducer, Walter Conklin

Rosenzweig was publicly excoriated. In papers ranging from The New York Times to The Milwaukee Sentinel, journalists referred to him as a “miscreant,” “devil,” “fiend,” “monster,” “murderer,” “slaughterer,” and, perhaps most devastatingly, a “pirate of human happiness.” Many of these writers had followed the abortion issue for some time—then, as now, it was a hot topic. Less than a week before the trunk’s discovery The New York Times published “The Evil of the Age,” an exposé about the abortion industry in New York City. The crusading reporter, Augustus St. Clair, visited a number of providers, including Rosenzweig, whom he described as “a fat, coarse, and sensual-looking fellow, without any traces of refinement in person or manners and [who] does not bear the faintest appearance of the educated physician. None but the wretched creatures, who, driven to desperation by their condition and the fear of discovery by friends, would place any confidence in his skill.” It probably didn’t help Rosenzweig that when St. Clair interviewed him, the doctor, increasingly agitated by his questions, attacked the journalist, who pulled out a revolver to ensure that he could escape unharmed.

Short and fat, Rosenzweig had curly light brown hair and searing blue eyes; a treacherous, diabolical Jonah Hill. He claimed to have attended medical school in Warsaw (an unlikely possibility for a Jew at that time) and to have received a diploma from an unnamed medical college in Philadelphia, though it was subsequently reported in the Times that Philadelphia was the center of the country’s bogus diploma industry.

Covering Rosenzweig’s arrest, Augustus St. Clair reported that Rosenzweig “claims to be a Russian, but his voice has the twang of a German Jew,” and proceeded to quote him in dialect: “These other fellows are all humpugsh; they bromish to do somting vot they don’t do. I poshitively do all operashunsh widout any danger, and as sheap as anybody.”

In reality, Rosenzweig hailed from Plotsk, a shtetl 60 miles from Warsaw in Russian-ruled Poland. He was married with four children and lived in a house on Second Avenue and 22nd Street. He arrived in the United States in 1865, though it’s unknown what work he did when he got here or how he became an abortion provider. Five years later, the 1870 census lists him as a doctor. As for his nom de travail, Dr. Ascher, Rosenzweig had bought his main office on Amity Place (now 3rd Street) from a man of that name, whose sign Rosenzweig kept intact, leading him, at that office anyway, to answer to the name Ascher. In building a case against Rosenzweig, the Manhattan District Attorney suggested the intermittent ersatz alias was proof this man was the Jekyll and Hyde of abortions.

Advertisements in The New York Times, September 1868

It’s not clear why Rosenzweig got into the abortion racket. Medicine in the 1870s was fairly sketchy and anyone who put up a shingle reading “Dr.” and paid a $10 “physician revenue tax” was legally recognized as such by the state. This allowed all manner of quacks to present themselves as medical experts and advertise all manner of elixirs, curing everything from cancer to scrofula. One of Rosenzweig’s ads in The New York Herald promised, “Ladies in trouble guaranteed immediate relief, sure and safe; no fees required until perfectly satisfied; elegant rooms and nursing provided.”

Abortion in the 1870s was perfectly legal. Accidentally killing a patient, stuffing her body in a trunk, and shipping it out of state was not. Rosenzweig was tried for medical malpractice and manslaughter. It took a jury less than two hours to convict him and a judge sentenced him to seven years hard labor. Rosenzweig appealed; the court had been swayed by public opinion, he argued, and had disallowed evidence in his favor. After serving a year and a half in Sing-Sing, Rosenzweig won a new trial. Unfortunately for him, in the interim his case had spurred the state legislature to pass a law criminalizing abortion, which meant that now Rosenzweig would be tried for murder.

His attorney William Howe, a man described in the press as “indefatigable,” cried foul, and rightly so, as Rosenzweig’s malfeasance occurred before the new law was passed. In the end, though a second trial never took place; double jeopardy applied and Rosenzweig went free, apparently leaving the country without a trace while journalists like St. Clair were left to hound other well-known practioners like the Grindles and the van Buskirks, two married teams of abortion providers, and the legendary Madame Restell, nicknamed “the wickedest woman in New York.”

Health officials say that ultra-Orthodox parents in Brooklyn are as susceptible as their crunchier counterparts to the belief that there may be a causal link between the measles-mumps-rubella vaccine and autism. (Public health officials say there is no evidence to support the claim.) The kids of most skeptics serve as free riders, staying clear of the infection because most other children they come in contact with are vaccinated and safe. But the tendency of Hasidic parents to wait far beyond the recommended 12-month vaccination deadline produces a large pool of potential victims for viruses trafficked by unvaccinated—and frequently visiting—kids from Israel and Europe. “Herd immunity can’t protect you if you’ve got a case in there and a large pocket of unvaccinated people,” said Jane Seward, deputy director of the division of viral diseases of the Centers for Disease Control in Atlanta. “It just ignites.”

Health officials haven’t been able to identify the source of this year’s infections, which have cropped up in Borough Park and Williamsburg, two of Brooklyn’s most observant neighborhoods. Investigators believe it could have been introduced by travelers from Antwerp or London, both cities with large ultra-Orthodox communities and endemic measles. A dozen people, including nine children between eight months and four years old, have fallen ill so far.

Last year’s outbreak, New York’s largest in 15 years, produced more than two dozen victims. A handful of visitors from Israel, which was in the midst of a months-long outbreak that sickened more than 1,000 people, brought the disease with them and passed it on, mainly to unvaccinated toddlers. The rash of infections was concentrated in Borough Park, but the scare spread to a Long Island mall and to a wedding hall in Rockland County, north of New York City.

Outbreaks have cropped up elsewhere. Last year, a dozen children in San Diego were infected (and dozens more quarantined) after an unvaccinated child returning from a family vacation in Switzerland passed the disease on to classmates whose parents had refused to inoculate in their all-organic earnestness.

But New York, unlike California, doesn’t allow parents to exempt their children from vaccination on the basis of personal belief, and 92 percent of children, including those in the ultra-Orthodox community, are vaccinated by the time they reach school age. New York health officials say they are instead seeing a watered-down version of the anti-vaccination trend, in which parents don’t inoculate until they can be sure their children don’t have autism, at around age two or three. “Out of an abundance of caution they just wait,” said Jane Zucker, New York City’s assistant commissioner for immunization. “They’re happy to get the child vaccinated for school but not before.” That risk is then exacerbated by a widespread reliance on homeopathic medicine and, in some cases, lax oversight by private yeshiva schools, said Moshe Tendler, Yeshiva University’s professor of Jewish medical ethics.

Zucker said she was satisfied with compliance from Jewish schools, and said her office has distributed flyers in ultra-Orthodox neighborhoods and cultivated help from community members to encourage parents to vaccinate on time, when their children are about a year old. Within the local ultra-Orthodox community, some lay the blame on their Israeli counterparts, whose long history of resistance to government-mandated programs includes vaccination drives, and was a factor in the outbreak that began in 2007 in Jerusalem and Bnei Brak, before spreading to New York last year. “It all started when the Yerishalmys [Jerusalemites] refused to take shots to prevent it from spreading further,” wrote one commenter last year on the Yeshiva World News website, triggering a heated debate.

But Tendler said it was ultimately the responsibility of parents to follow best medical practice for their children. “If they don’t vaccinate, they are in violation of Torah law by not following the best medical advice,” he said. “The responsibility of the parent is to listen to the doctor and then pray to God, because to pray to God and not listen to the doctor is not going to help.”

Circumcision, laws governing intercourse, eugenics, big noses, fleshy lips—all of these figure somewhere into notions of Jews and their physical selves. In the new book The Jewish Body, out now from Schocken and Nextbook’s Jewish Encounters Series, anthropologist and physician Melvin Konner explores some of these ideas.

He spoke with Nextbook about physical stereotypes of Jews, the importance of purity rituals, and the rise of muscle Jewry.”

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.

The waters compassed me about, even to the soul: the depth closed me around about, the weeds were wrapped about my head. — Jonah 2:5

So cried out Jonah to the Lord, recalling how he had been “cast into the deep, in the midst of the seas,” before being taken up into the capacious warm body of the great fish. He had done what he could to avoid the impossible task for which he was chosen by a power whose determination was not to be escaped.

And so, too, I cried out to Jonathan Rosen, the general editor of this new series of books on Jewish themes, when I had for several months been immersed in the deep, inky waters of the vast Maimonidean literature, and not yet sighted a whale. I was being suffocated by weeds so densely wrapped about my head that, emulating Jonah, “I cried out by reason of my affliction” and begged to be relieved of a burden for which I had become certain that I was incompetent.

But Jonathan would hear none of it; I was not to be allowed the flight to Tarshish and the release for which I so desperately yearned. Though I bombarded him with the names of scholars who had spent distinguished careers swimming comfortably in the Judaic and Aristotelean seas in which I was being drowned, Jonathan rejected them all. There had been several reasons that I—rather than an acknowledged authority—had been chosen for this mission, he replied to my importunings. He did not want a scholar steeped in the complexities of his subject’s philosophy; he wanted a writer, who might seek out the essence of the man and tell the story of his lifelong journey toward understanding. Mainly what he was seeking, he explained, was an encounter between a contemporary observer and that towering figure from the Jewish past. Is there some common ground on which Rabbi Moses ben Maimon—commonly called by the acronym “the Rambam” but since the Renaissance more often known by the Hellenized appellation—can walk together with a man or woman of today? Are the issues that absorbed him so different from those with which we grapple in our secular era, that his memory can only be iconic rather than meaningful? In the more restricted sense, how does a Jewish doctor of the twenty-first century relate his sense of calling to the legendary Jewish doctor of the twelfth? Is it, in fact, even possible that anyone other than the small cadre of dedicated and deeply learned Maimonidean scholars can discover any sort of intellectual or emotional relationship with that great man of so long ago? Can we in our time recognize in him attributes we see in ourselves, or is he so removed from the experience of a present-day mind that we can only study him, but never fully comprehend who he was? “If Maimonides is lost to you,” wrote Jonathan, “then he is lost to all of us.”

And with those words, I decided to become Everyman. Not yet a bit less fearful of submitting a simplistic, superficial, or error-filled manuscript, I returned—resigned, though still reluctant—to the confrontation with my ignorance. I began reading again, immersing myself once more in the very waters from which I had sought rescue. And like many another drowning man, I one day unexpectedly found a buoyant object to which I might cling, at first desperately and then gradually with an increasing sense that I might yet be saved, and my literary undertaking with me. It came in the form of a single sentence written by one of the scholars whom I had recommended to Jonathan Rosen. In his introduction to Jacob S. Minkin’s 1087 volume The Teachings of Maimonides, the eminent historian Rabbi Arthur Hertzberg had written, “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.”

I had already begun to perceive through the mists of my vague comprehension that many of the twentieth-century commentators on the Rambam had made interpretations that reflected their own religious or historical worldviews; that hyperbole and hagiography were common; and that an element of the muddling factor that historians call presentism—seeing the events of the past through the prism of today’s values and knowledge—existed in far too many of the books and essays of even the most authoritative biographers. In each generation, scholars have found in Maimonides what they have wished, or needed, to find.

And of course, this last observation describes a state of affairs that is not all to the bad. Much the same might be said of the Bible, of Jewish scripture in general, of historical events and trends, and it is certainly true of the Constitution of the United States or of any other democracy. Particularly in biography, constant reinterpretation can be a source of strength in a body of writing or knowledge, if one can but avoid the presentism and the exaggerating distortions that too often accompany it. As for the subjectivism, that is not in itself necessarily an obstacle, because a degree of subjectivity can only benefit the freshness of commentary. And freshness of commentary is, after all, the hallmark of the Rambam’s contribution to religious thought. All of this was very reassuring to me as I thought over my communications with Jonathan.

Armed with these new realizations, I returned to the work; the present volume is its issue. This book is, quite simply, the outcome of the ancient Jewish dictum that one is not permitted to turn away from a responsibility, though it may prove impossible to bring it to a state of finality. And that, too—the impossibility of ultimate completion—is a good thing for this enterprise, because there will never be a finality in the interpretation of the Rambam’s body of work or of understanding the events of his life, nor should such a thing be sought. Setting aside a bit of remaining trepidation, I continued to read and to study and to ruminate and to discuss with any colleague I thought knowledgeable (and some, chosen quite deliberately for this reason, who were not). In time, the turbulent seas somehow began to calm themselves, although at first ever so slowly. After some months, I really came to believe that I could see just a bit into the mind of the man I had been taught since childhood to revere though so much of him had been unknown or at least obscure to me. With further study came further understanding. Of course, the mind I was seeing into was as much my own as his.

What is presented in these pages is, as Maimonides himself might have put it, a guide for the perplexed—those many like me who have known of Maimonides all of our lives and familiarized ourselves with just enough of him to believe, whether justified or not, that we have some modicum of understanding, but that it is never quite enough. To the majority of us, he has been little more than an honored name. And yet, some of us have frequently recited his Thirteen Principles of the Faith in our synagogues; some of us have had our photographs taken alongside his bronze statue in the Plaza of Tiberiades in Cordoba; some of us have made the pilgrimage to the site believed to be his grave in Tiberias; some of us have attended lectures about him by learned authorities; some of us have tried to learn more by occasionally spending an evening reading directly from The Guide for the Perplexed, and found much of its text well-nigh impossible to comprehend; some of us have pored over the large volume of twentieth-century literature about his teachings; some of us have even ventured into the pages of his Mishneh Torah to clarify a point of Jewish law, without so much as wondering about the man behind the words; some of us have donated funds to support a Maimonides school or hospital; and some of the doctors among us have belonged to a professional group in our communities called the Maimonides Medical Society.

I have done almost all of these things, and yet remained perplexed, needing a guide. The attempt to learn that was involved in producing this volume has been that guide. I have written it in much the same way as Maimonides wrote his Mishneh Torah,a book brought forth to elucidate Jewish law, or halakha, to the Everyman who would read it. It is not a book for scholars. Its aims, like the Rambam’s, are clarity and conciseness; its purpose is to make Maimonides accessible to myself and therefore to others. To understand this little volume of mine, no previous knowledge of Moses ben Maimon or of his era is required, nor of philosophy, medicine, Judaica or academic methods. It is accordingly without references that might distract the general reader; it is completely the product of the understanding to which I have come after a long voyage of study; in emphasis and interpretation, it is without any attempt to avoid a certain level of personal viewpoint and subjectivity; on reaching its last page, each reader must decide individually whether he or she is any closer to answering the questions posed in the third paragraph of these introductory thoughts. I offer my book as this Jewish doctor’s study of the most extraordinary of Jewish doctors.

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