Parashat Bechukotai - Between Faith and Trust

Rabbi Shabtai Sabato

Parashat Bechukotai

גבול האמונה והביטחון

Between Faith and Trust

P a r t   T h r e e   o f   T h r e e

       Medicinal Responsibility

This third lesson in our series on Faith and Trust in G-d will seek to answer this basic question: Does the practice of routine medicine stand in contradiction to our faith and trust in G-d? May we engage in the profession of medicine and healing, or is this something that is to be left exclusively in G-d’'s hands?

The Mishna states:

King Hizkiyahu instituted six things on his own. The Sages agreed with him on three of them, and disagreed regarding the three others

... When he hid away the Book of Cures, the Sages agreed with him.

(Pesachim 4,9)

What was this Book of Cures that King Hizkiyahu sought to hide, and why did he do so? Some explain that this was a trusted book of medicine that listed the known cures for every disease. King Hizkiyahu banned it because he feared that the Jews would put their faith in this book, causing their faith and trust in Hashem to falter.

The Rambam (Maimonides) sharply attacked this approach, saying it is based on a fundamental error. Let’s say a man is hungry and tired, the Rambam argued, and he takes out a piece of bread and some water to ease his discomfort. Is it conceivable to say that his success in “curing” himself would lead to a decrease in his faith and trust in G-d?!

The opposite is surely true: It should be a reason to thank G-d. Just as we are charged with thanking Him three times a day in Birkat HaMazon (Grace After Meals) for providing us with our food, so too, when we take medicine, we are to thank Him for having created a world with methods and medicines to cure us.

Why, then, did Hizkiyahu ban the Book of Cures? Maimonides explained that it was not a book of pure medicine, but rather a collection of folk remedies. The king banned it simply because it was an unproven book with an unknown record, and likely nothing more than legends and quackery.

The following incident, recounted in the Medrash Shmuel (chapter 4), provides support for the Rambam’s position in favor of    medicine:

1. Yishmael and R. Akiva were walking on the outskirts of Jerusalem, and a third man joined up with them. The three of them met a man who was ill, who asked the two rabbis, “My teachers, can you tell me how to cure myself?” They told him, “Take such-and-such medicine until you are healed.”

The man who accompanied them objected, saying, “Who brought the sickness upon him?” They answered, “The Holy One, Blessed be He.” The man said, “How dare you intervene in business not yours? Hashem made the man sick, and you come along and cure him?!”

They answered him with a question: “What  is  your  occupation?”  He said, “I work the land; here is my scythe.” They asked him, “Who created the earth and its vineyards?” He answered, “G-d,” and they said, “And you intervene in something that G-d did? He created the land [untilled], and you eat from its fruit?!”

The man answered, “Don’t you see the scythe in my hand? If not for me going out to plow the land and fertilize it and uproot the weeds, nothing would grow!”

The rabbis then said to him, “Don’t you see that a man is similar to the earth? As the verse states, ‘Man - his days are like grass’ (Psalms 103,15). Just like a tree does not grow if it is not properly taken care of, and does not live if it is not given water, the same is true with man. What fertilizer and water do for a tree, medicines do for a man; and what the farmer does for the earth, a doctor does for people.”

When Rabbis Yishmael and Akiva said that G-d had brought the sickness upon him, they did not mean to say that He was punishing him. Their point was that this person had apparently not taken proper precautions for his health and, as a result, became sick – and G-d did not intervene in the laws of nature to prevent the disease from striking him. When a person eats unhealthful food or the like, he must utilize the means available to him, such as modern medicine, to cure himself.

Hashem created man with several tasks to fulfill, and one of them is to keep himself healthy, using the means He created for this purpose. The source for this concept is this:

וַיִּקַּח ה' אֱ-לֹהִים אֶת הָאָדָם וַיַּנִּחֵהוּ בְגַן עֵדֶן לְעָבְדָהּ וּלְשָׁמְרָה.
Hashem took the man (Adam) and placed him in the Garden of Eden to work it and preserve it. (B’reshit 2,15)

That is, even before Adam committed the first sin, he was commanded to take care of the trees in the garden, and to eat from them - in order to keep himself healthy and strong.

       I am the Lord Your Doctor

Given the above, however, how are we to understand the following Torah verse that seems to imply the precise opposite? G-d tells Moshe Rabbeinu:

וַיֹּאמֶר, אִם שָׁמוֹעַ תִּשְׁמַע לְקוֹל ה' אֱ-לֹהֶיךָ וְהַיָּשָׁר בְּעֵינָיו תַּעֲשֶׂה...
כָּל הַמַּחֲלָה אֲשֶׁר שַׂמְתִּי בְמִצְרַיִם לֹא אָשִׂים עָלֶיךָ כִּי אֲנִי ה' רֹפְאֶךָ.
If you hearken to the voice of Hashem your G-d and do that which is right in His eyes... then the diseases I placed upon Egypt I will not place upon you

for I am G-d your doctor. (Sh’mot 15,26)

This proclamation seems to teach that the discipline of medicine and healing belongs exclusively to G-d – and that its success depends upon whether or not we observe the Torah’s laws!

Furthermore: The renowned 13th-century Torah-commentator Nachmanides, known as the Ramban, addressed this very issue in Parashat Bechukotai. He brings two sources showing that when prophecy abounded in Israel, the proper approach for one who took ill was not to go to doctors, but rather to the prophets. Both proofs are from actions taken by Biblical kings of Judea: King Hizkiyahu and King Asa.

Proof number one is the immediate reward King Hizkiyahu received for praying to Hashem and not consulting doctors when he needed medicinal help:

בַּיָּמִים הָהֵם חָלָה חִזְקִיָּהוּ לָמוּת, וַיָּבֹא אֵלָיו יְשַׁעְיָהוּ בֶן אָמוֹץ הַנָּבִיא... וַיַּסֵּב אֶת פָּנָיו אֶל הַקִּיר וַיִּתְפַּלֵּל אֶל ה'. וּדְבַר ה' הָיָה אֵלָיו לֵאמֹר:

Hiziyahu became deathly ill, and the prophet Yeshayahu son of Amotz came to him... and turned to the wall and prayed to G-d...
and G-d’s word came to Yeshayahu, saying:

שׁוּב וְאָמַרְתָּ אֶל חִזְקִיָּהוּ נְגִיד עַמִּי, כֹּה אָמַר ה'... הִנְנִי רֹפֵא לָךְ...
וְהֹסַפְתִּי עַל יָמֶיךָ חֲמֵשׁ עֶשְׂרֵה שָׁנָה ...

Return and tell Hizkiyahu, the prince of My Nation, that G-d said:
“... I will heal you... and I will add 15 years to your life...”
(Kings II 20,1-6)

Proof number two is a negative example from King  Asa:

וַיֶּחֱלֶא אָסָא בִּשְׁנַת שְׁלוֹשִׁים וָתֵשַׁע לְמַלְכוּתוֹ בְּרַגְלָיו, עַד לְמַעְלָה חָלְיוֹ.

וְגַם בְּחָלְיוֹ לֹא דָרַשׁ אֶת ה', כִּי בָּרֹפְאִים ...
King Asa became ill in the 39th year of his reign,

in his legs; his disease became very severe. But even in his illness, he did not turn to G-d, but only to the doctors... (Chronicles II 16,12)

We see that he was censured for turning to doctors and not to G-d.

G-d promised the righteous: “G-d will bless your bread and water, and will remove disease from your midst” (Sh’mot 23,25). The Ramban emphasizes, in his commentary to this verse, that those who follow G-d’s word will have no need to summon doctors; G-d’s blessing will keep them healthy. If the Jewish people had internalized this and accustomed themselves not to turn to doctors, sicknesses would have played out very differently: A person would be sick for only as long as is necessary according to the punishment he deserves, and he would then recover as G-d sees fit. But because we do turn to medicine, G-d bows out of the picture, and leaves events such as sickness to take their natural course.

Let us see how the Ramban deals with the following Talmudic passage, which appears to strongly negate his point:

It was taught in R. Yishmael’s academy: The Torah states v'rapo y'rapeh, "[an injured person] shall be healed” (Sh’mot 21,19). We learn from this that a physician is permitted to heal. (B’rachot 60a)

It appears that hiring a doctor does not negate one's faith or belief in
G-d!  The Ramban clarifies as follows: Yes, a physician is permitted to heal - when he is faced with someone who is ill and who has turned to him instead of to Hashem. But the sick person himself must know that he must not consult the doctor for help instead of turning to G-d.

We can sum up as follows: According to the Ramban, the doctor has the Torah’s permission to heal – but the sick person does not have permission to be healed by him. But the Rambam says that when one is ill, he is to pursue a cure from those who have the relevant medicinal know-how. (Let us note that both the Rambam and the Ramban were physicians).

       Bearing the Responsibility

Let us see if there is a way to reconcile the seemingly conflicting opinions of these two great Torah giants on this matter.

The Rambam, in his famous work Guide for the Perplexed, notes that most sicknesses are caused by people’s negligence. They often eat and drink unhealthful foods, and in inappropriate amounts. In addition, ugly traits such as envy, hatred, anger, and the like also have negative effects upon their physical health. As such, it makes no ethical or logical sense for those who harm themselves to then turn to Hashem and beg Him to cure them! Before they plead with G-d, let them first take care of themselves by taking preventing measures in the first place, both ethically and physiologically, or, if it is too late for that, by taking the medicines that G-d provided.

This is akin to one who wishes to repent: He must regret his sins, and take upon himself not to commit them again, before he asks G-d for forgiveness for them.

The point can be proven by the above-quoted verse:

וְכִי יְרִיבֻן אֲנָשִׁים וְהִכָּה אִישׁ אֶת רֵעֵהוּ בְּאֶבֶן אוֹ בְאֶגְרֹף וְלֹא יָמוּת וְנָפַל לְמִשְׁכָּב... רַק שִׁבְתּוֹ יִתֵּן וְרַפֹּא יְרַפֵּא.

 If two men should fight, and one strikes the other with a rock or a fist, and the other does not die but is rather hurt and bedridden... The assailant must pay for the loss of [the victim's] time, and cause him to be healed. (Sh’mot 21,18-19)

We see that one who injures another must pay his medical expenses, i.e., he must pay the doctor to heal him. The Torah thus recognizes such treatment as legitimate. We can therefore conclude that just like one who causes physical harm to another must pay a doctor to rectify it, similarly, one who harms himself directly or indirectly – such as by not taking proper care of himself – must treat himself by going for medical help.

But this is not the case when the source of the sickness is not one’s own carelessness. When disease comes directly from Hashem, it is a Divine signal that the person must mend his spiritual path and correct his ways. He must realize that he has sinned to G-d, and must turn to a prophet, or to a rabbi, or to the Torah directly, in order to understand how he has sinned, what he must rectify, and how to do so. In such a case, turning to a doctor is not the proper approach.

In short: When Hashem wishes to inform a person that he is spiritually ill, He sends him a physical sickness with no apparent cause. The person will then realize that it is not a medical issue, but rather a spiritual/ethical one, and that he must examine his deeds and attempt to “heal” his spiritual degeneration.

Let us here note a critical point. Some diseases attack entire population sectors, including righteous people and babies who have not sinned. This is certainly not an indication that they all suffer from a specific spiritual fault. Epidemics of this nature rather stem from “public” sins, i.e., iniquities perpetrated by a large sector of people or their chosen leaders. In such   cases, even those who are not specifically guilty of those sins are liable to be affected.

Regarding this, our Sages taught this important principle:

Why were the Israelites commanded not to leave their houses on the night of the Plague of the Firstborns? Because once the destroyer is given permission to destroy, he does not distinguish between the righteous and the evil. (Bava Kama 60a)

The destroyer is given license to wreak havoc where public sins are rampant. The rectification must be carried out on the national level, by the spiritual and ethical leadership.

Clearly, those who are ill cannot rectify the communal sins, and in such a case, the Ramban would certainly agree that they must utilize the accepted medical services. If they do not do this, they would be guilty of not preserving their health.

       Law and Judgement

We can now understand more fully the verse quoted above, “I am G-d your doctor.” Let us look at it in its full context, immediately after the miraculous crossing of the Red Sea. The Torah tells us that Israel had come to a place called Marah, and could not drink the water there because it was bitter. When they complained to Moshe, “He cried out to Hashem, and Hashem showed him a tree. Moshe threw it into the water, and the water became  sweet; there He gave them law and judgement, and there He tested them.” That was when G-d said, “If you hearken to the voice of your G-d... then the diseases I placed upon Egypt I will not place upon you, for I am G-d your doctor.”  (Sh’mot 15,23-26)

Was it simply by chance that the People of Israel arrived in Marah? Certainly not, for the Divine Cloud was traveling in front of them to guide their path. In fact, their next stop on the journey was Elim, with its 12 sweet-water wells (verse 27). Clearly, G-d could have brought them first to Elim, but instead He chose quite purposefully to bring them to a place of bitter waters. Why?

It was because G-d wished to teach them an important lesson in faith: Whoever does not implement “laws and judgements” cannot live; he must implement and follow a Divine system of law. The special tree that G-d showed Moshe and with which he “cured” and sweetened the water became a symbol for Israel of a necessary legal system. Just as the tree was the cure for the poison of the bitter water, so too, the Torah’s commandments are the “cure” for other sicknesses.

What  is  meant by  “there He gave them law and judgement and  there

nisahu, He  tested  them”? It  means that Hashem accustomed Israel to

walk in His ways of justice, as in the verse, "The tender woman who was not nistah, accustomed to set her foot on the ground...” (D’varim 28,56)

When we look at the above verses, we see this in greater detail. The Ten Plagues that G-d brought upon Egypt are referred to as “the diseases I placed upon Egypt” (as quoted above). They had no rational or natural cause, but were rather a Divine signal that the Egyptians had sinned grievously by subjugating the Children of Israel so cruelly and unjustly.

Hashem thus tells Israel: “Since ‘I am your doctor,’ and so that I won’t have to do to you what I did to Egypt, I hereby direct you to implement the system

of ‘law and judgement’ that I chose. And in order that you understand that you are currently spiritually ill, I am bringing you to a place of bitter water - the disease - and I will also show you the tree, in which is found the cure. In the same way, I am providing you with a system of law, as a cure for disease brought on by spiritual sins.”

“And ‘if you hearken to G-d’s voice,’” G-d continues, “I will not have to bring you again to a place of bitter waters, reminiscent of the blood with which I filled the Nile River as punishment for drowning the baby boys of Israel. ‘The diseases I placed upon Egypt I will not place upon you.’”

In short: When one has a physical problem caused by negligence or other known reason, he must take care of himself and find an expert doctor who will help him – even as he remembers that it is Hashem Who provides the knowledge and ability to cure. But when an illness appears that cannot be explained rationally, the solution must be found spiritually, by turning to a prophet or a Torah scholar – one with a proven record in finding the causes of a spiritual disease – and not a doctor.

This concludes our series of three articles on faith and trust in G-d, shedding light on the thin line between the personal efforts we must invest in accordance with natural law, and our trust and faith in Hashem. The foundation is the axis of law and judgement, as we read in Psalms:

צֶדֶק וּמִשְׁפָּט מְכוֹן כִּסְאֶךָ חֶסֶד וֶאֱמֶת יְקַדְּמוּ פָנֶיךָ.

Righteousness and judgment are the foundation of Your throne; kindness and truth come before Your   countenance.

(Psalms 89,15)