Everyone at the court of Sultan Saladin of Egypt was happy when the great Maimonides, Rabbi Moshe ben Maimon, was appointed personal physician to the sultan. Everyone, that is, except Hakim, the Muslim physician who had held the position before and was now given second place. Maimonides would now treat the sultan and his immediate family, while the Muslim physician was left to treat other members of the royal household and court.
Ever since Maimonides had come to Fostat, the old city of Cairo, his reputation as a physician had spread quickly. The Jews regarded him as the greatest scholar and Talmudist of the age, but to the non-Jews he was the greatest physician of the age. Rich and poor flocked to him for medical treatment, and he treated the poor, Jew and non-Jew alike, entirely without charge. The more Maimonides became known, the more was the Muslim physician forgotten. A deep jealousy and hatred for his Jewish rival filled the heart of Hakim, and he began to scheme and plot in order to discredit Maimonides in the eyes of the sultan and bring him to his doom.
One day Hakim came before Sultan Saladin and told him that he had discovered a plot to poison the sult anand that none other than Maimonides was at the bottom of it.
The sultan paled with fright, but could not believe such a thing of his trusted physician and friend. “If you can prove that what you say is true, I will have Maimonides beheaded; but if you cannot prove it, I shall have you beheaded instead,” the sultan said.
“I can certainly prove it,” the Muslim physician said, “and this is how: It is known in our medical profession that a deadly poison can be made harmless by a stronger poison. Now, let the king order us both to prepare the strongest possible poison, so that if the king will be given poison in his food, all he will have to do is to take the strongest poison and his life will be saved.”
“That is an excellent idea,” the sultan said, “but how am I going to know which of yours is the strongest poison, and how will you prove that Maimonides plots to kill me?”
“This is simple, Your Majesty. When we both bring our prepared poisons, I will gladly take the poison prepared by my rival, and then drink my own poison, and be none the worse for it. Let Maimonides then take my poison and afterwards his own, and he will die. You will then know that he was not truthful with you and plotted against you.”
“This means that I am going to lose one of you, but it will be worth it, for I will then know who is my real friend,” the sultan said.
The next day, the sultan ordered both physicians to appear before him.
“My dear physicians,” the sultan began. “Last night my Prophet came to me in a dream and told me that one of youhe did not say which oneis plotting to poison me. Now, do not interrupt me, I know you will both deny it, of course, and perhaps both of you would be right. However, I cannot treat the matter lightly. Can you prepare a medicine for me that would make any poison in the world harmless?”
Both physicians answered “Yes!”
“Fine, but how am I going to know which is the strongest? Well, we will have to have a little test: tomorrow both of you will bring to me your prepared medicines. Then we will carefully divide up each medicine in two parts, and each one of you will drink the others poison and then his own. . . .”
“But Your Majesty,” Maimonides said, “that would kill my good friend standing here by my side.”
“My rival is only trying to get out of it, Your Majesty. I dont mind a bit, taking the test. I will be glad to take his poison and prove to you that mine can make it harmless.”
“I am glad that both of you are sure of yourselves; that makes it a fair test,” the sultan said. “Gentlemen, the thing is settled. I will see you tomorrow at noon.”
Thoughtfully Maimonides walked out together with his rival. He did not at all like the satisfied smile on his rivals face. What was the fellow up to?
He thought about it as he rode home on his donkey, but could not understand it. Surely, Hakim must have known that he, Maimonides, could prepare a stronger poison; why should he take such a chance? Or perhaps he had thought up some trickery? Hakims happy expression betrayed some secret plan, but what might it be?
When Maimonides came home, he found the waiting-room filled with people, as usual. Some of them were patients, others were community leaders, still others, scholars who came to ask his insight into difficult passages in the Talmud. Maimonides greeted them all with a smile, and begged them to forgive him while he took some food, as he had not eaten anything that day, for he would not have anything to eat at the palace. After a hurried meal, Maimonides attended to the patients, then talked to the community leaders and scholars. By the time he had finished with all his visitors it was nearly sunset. He recited his prayers, sat down to his studies and writings, and finally retired to bed in the early hours of the morning, thoroughly exhausted.
During his busy day and evening, he had had no time to think about the important event that was to take place at the sultans palace the following day. Now, lying in bed, he could not fall asleep immediately. He had a premonition that his life was in danger and that his mortal enemy, Hakim, was at the bottom of the “life and death” contest. Suddenly light dawned on Maimonides! He knew now what the wily Hakim had thought up, and he also knew how to outwit him! Maimonides felt calm and relaxed, and soon fell asleep.
The following morning Maimonides rose early, and after reciting his prayers and taking time off for some study, he ate a light breakfast. Then he went into his laboratory and prepared a harmless solution of sweet water with red wine. He then rode off to the palace. Hakim the physician was already there, and seemed quite impatient to get on with the contest. The sultan was ready, too.
At the sultans signal, Maimonides and Hakim poured about half of their medicines into empty bottles which they had brought for this purpose, and exchanged bottles.
“Your turn first, Hakim,” the sultan said.
Hakim lost no time. He swallowed the mixture which had been prepared by Maimonides, then swallowed his own. He remained quite steady on his feet, with a broad smile on his face.
“Your turn next, Maimonides,” the Sultan said.
Slowly Maimonides swallowed the mixture which had been prepared by his adversary, and then drank his own. He, too, seemed none the worse.
For a few moments all three stood there, silently and tensely. Suddenly, Hakim cried out in an agony of pain. He dropped to the ground in painful convulsions, and soon lay dead.
“I am glad, my dear Maimonides, that you are all right,” the sultan said. “I did not doubt for a moment that you were the greater physician. As for that miserable wretch, I never liked him, and I am glad you killed him.”
“But your majesty, I did not kill him. He did it by his own hand,” Maimonides said.
“I dont understand,” the sultan said.
“Permit me to explain,” Maimonides began. “Hakim knew that I could prepare a stronger poison than he could, so he thought of a vicious plan: he would take a slow poison at home before coming here, then bring with him a harmless solution. By drinking what he thought would be a stronger poison which I would bring with me for the contest, he would be cured of the slow poison he had taken at home. He would then drink his own harmless mixture and remain well. On the other hand, I would drink his harmless solution, then drink my own strong poison, and thus, he thought, I would die by my own poison. . . .”
“The treacherous dog!” the sultan hissed. “But what really happened?”
“Well, your majesty, suspecting this trickery, I also prepared a harmless mixture. . . .”
The sultan thought for a moment, then burst out laughing, not letting Maimonides finish. It was all as clear as daylight.
“Not only are you the greatest physician, Maimonides, but you are also the wisest of men,” the sultan said. “From now on you shall be my adviser as well as my physician.”
Opioid epidemic in one chart – correlation conflated with causation
There is no cause-and-effect relationship between prescribing and overdose mortality. But millions of patients are being denied safe and effective pain care.
Seniors over age 62 are prescribed opioids for pain three times more often than youth under age 19. But youth have overdose rates three times higher than seniors. No medical model can explain these demographics.
Source: Richard A Lawhern, PhD, Patient Advocate