A Prescription for the High Holy Days
As we approach the Yomim Noraim (Days of Awe) I’d like to offer some lifestyle prescriptions for good health and happiness:
Never overeat. Stop eating when your stomach is two-thirds full.
One should not eat immediately after exercise.
Older people need less food, and if they eat as they did in their youth they will become fat and destroy their lives.
Preserve peace of mind in all circumstances.
One should pay attention to the body’s signals.
People should sleep eight hours each night.
Spending time regretting the past or worrying about the future has no benefit.
Sick people should be surrounded by good smells and music, joyful stories and laughter.
Hands up, not my ‘prescription’ but just a few of the sayings of Moses Maimonides (Rambam), written between 1165 and 1174 CE whilst court physician to the Sultan (Saladin) in Cairo. Centuries before antibiotics, X-rays and MRI scans and even the thermometer, Rambam was a brilliant doctor who treated the patient rather than the illness and espoused moderation and disease prevention. Such was his renown as a physician that he was invited to return to England with Richard I (‘the Lionheart’) to become his Court physician but he declined out of loyalty to the Sultan.
My interest in Rambam was aroused by the discovery of a small treatise inherited from my Grandfather, part of the ‘Jewish Worthies’ series, and published in 1903. I vaguely knew that Rambam was a physician as well as a great Rabbi and Scholar but I had no concept as to how relevant his ideas could be today. He wrote ten impressive works in Arabic including volumes on asthma, poisons and their antidotes, haemorrhoids and digestion, as well as promoting health promotion and publishing a glossary of drug names in a multitude of languages. This task alone took more than 10 years and was a formidable and impressive undertaking and the first of its kind.
In order to properly assess his patients he insisted on examining them in their home environment. Modern day general practice has witnessed the demise of home visiting. Whilst undoubtedly there are efficiencies in patients attending the surgery, I can concur with Rambam that seeing patients in their own home grants a unique insight into their lives and many factors that influence their health and wellbeing.
Rambam only took up medicine at the age of 37 to support himself and his family. While he based many of his beliefs on the works of Hippocrates and Galen he was not afraid to challenge assumptions or change his views. He never claimed certainty, and constantly strode to scientifically validate his treatments. This also resonates today, with many supposedly ‘modern’ medical beliefs not standing up to scientific scrutiny, yet still routinely offered as ‘fact’. Whilst I hope there is rarely any intention these days for doctors to deliberately deceive their patients, we should nevertheless take note of Rambam’s words here: “Do not consider it proof just because it is written in books, for a liar who will deceive with his tongue will not hesitate to do the same with his pen”. It makes me reflect that ‘medical certainty’ is as rare and unlikely as ‘religious certainty’. So it seems that I am a Masorti doctor as well as a Masorti Jew. Perhaps we could say the same about Rambam?
It’s impossible to view him purely as a physician, or a scholar. Both were intrinsic and intertwined aspects of his personality and outlook. This is evident from his teachings and the manner in which he links the attainment of physical and spiritual health. In Chapter 12 of Rambam’s Guide to the Perplexed (c1190), he writes: “In so far as the soul is a force residing in the body; it has therefore been said that the properties of the soul depend of the condition of the body”.
Having begun with some of Rambam’s ‘prescriptions’ for physical and mental wellbeing, his commentary on this week’s parasha, overflowing as it is with blessings and curses, allows Rambam to impart a spiritual message that I believe has the power to carry us through the Days of Awe ahead. He reminds us in his Mishnah Torah (Helichot 3:4) of the awesome power of individuals to make a difference not only personally but to the entire world: “Throughout the entire year, a person should always look at himself as equally balanced between merit and sin and the world as equally balanced between merit and sin. If he performs one sin, he tips his balance and that of the entire world to the side of guilt and brings destruction upon himself. On the other hand, if he performs one mitzvah, he tips his balance and that of the entire world to the side of merit and brings deliverance and salvation to himself and others.”
Jonny Freedman is a GP and a member of St Albans Masorti Synagogue.