Chukat | On Healing

Summarized by Aviad Brestel. Translated by David Strauss

Our parasha includes the account of the bronze serpent:

And the people spoke against God, and against Moshe: Why have you brought us up out of Egypt to die in the wilderness? For there is no bread, and there is no water; and our soul loathes this light bread. And the Lord sent fiery serpents among the people, and they bit the people; and many people of Israel died. And the people came to Moshe, and said: We have sinned, because we have spoken against the Lord, and against you; pray to the Lord, that He take away the serpents from us. And Moshe prayed for the people. And the Lord said to Moshe: Make you a fiery serpent and set it upon a pole; and it shall come to pass, that anyone who is bitten, when he sees it, shall live. And Moshe made a serpent of bronze and set it upon the pole; and it came to pass, that if a serpent had bitten any man, when he looked to the serpent of bronze, he lived. (Bamidbar 21:5-9)

How were the people of Israel healed by the serpent? The Mishna explains as follows:

Now, did the serpent kill or did the serpent keep alive? [No!] Rather, when Israel looked upward and submitted their heart to their Father in heaven, they were healed, but if not, they deteriorated. (Rosh Ha-shana 3:8)

That is to say, it is clear that the bronze serpent itself did not heal. What heals is turning one’s thoughts to God and praying to Him.

The Ramban: “God Sends Death and Makes Alive”

In a similar vein, the Ramban emphasizes the miraculous nature of the healing by way of the bronze serpent. He explains that this was essentially a miracle within a miracle, because the healing was achieved specifically by way of the same thing (a serpent) that caused the harm in the first place. He then relates this idea to disease in general:

It appears to me that the secret of this matter is that this is one of the ways of the Torah, every deed of which is a miracle within a miracle. Thus [the Torah] removes injury by means of the cause of the injury, and heals illness by means of the cause of the sickness… Now, it is a well-known medical principle that all people bitten by poisonous creatures become dangerously ill when they see them, or [even] when they [only] see their likeness… The general intention [of this section, then] is that God commanded that they should be healed by the harmful agent whose nature is to kill; therefore, they made its likeness in form and name, and when a person concentrated his gaze upon the bronze serpent which resembled totally the offending agent, he lived. This was to make them realize that it is God [alone] who sends death and makes alive. (Ramban, Bamidbar 21:9)

According to the Ramban, the message that emerges from this narrative is that it is ultimately God, and not any human agent or wisdom, who grants life or death. This idea is further explained in his decisive remarks on Parashat Bechukotai:

In general then, when Israel is in perfect [accord with God] and constitute a large number, their affairs are not conducted at all by the natural order of things, neither in connection with themselves, nor with reference to their land, neither collectively nor individually, for God blesses their bread and their water, and removes sickness from their midst, so that they do not need a physician and do not have to observe any of the rules of medicine, just as He said: "For I am the Lord that heals you" (Shemot 15:26).

And thus did the righteous ones act at the time when prophecy [existed]; even if a mishap of iniquity overtook them, causing them sickness, they did not turn to the physicians, but only to the prophets, as was the case with Chizkiyahu when he was sick… One who seeks the Lord through a prophet, will not consult the physicians. What part do the physicians have in the house of those who do the will of God?…

This is also the intent of the Rabbis’ statement: "'And he shall cause him to be thoroughly healed' (Shemot 21:19) – from here [you deduce the principle] that permission has been given to the physician to heal" (Bava Kama 85a). They did not say that "permission was given to the sick to be healed" [by the physician], but instead they stated [by implication] that since the person who became sick comes [to the physician] to be healed, because he has accustomed himself to seeking medical help and he was not of the congregation of the Lord whose portion is life, the physician should not refrain from healing him – not because of fear that he might die under his hand, since he is qualified in this profession, nor because he says that it is God alone Who is the Healer of all flesh, since [after all] people have already accustomed themselves [to seeking such help]. Therefore, when men quarrel and one smites the other with a stone or his fist (Shemot 21:18), the one who smote must pay for the healing (Shemot 21:19) – for the Torah does not base its laws upon miracles, just as it stated: "For the poor shall never cease out of the land" (Devarim 15:11), knowing [beforehand] that such will be the case. But when a man’s ways please the Lord, he need have no concern with physicians. (Ramban, Vayikra 26:11)
 

That is to say, while in our current situation there is no choice but to seek the help of doctors, the ideal would be for healing to come directly from God, without the mediation of doctors.

The Book of Remedies

The question of the proper way to achieve healing arises in another context in the Gemara:

Our Rabbis taught: King Chizkiyahu did six things; regarding three they [the Sages] agreed with him, whereas regarding three they did not agree with him. He dragged his father's bones [corpse] on a rope bier, and they agreed with him; he crushed the bronze serpent, and they agreed with him; [and] he hid the Book of Remedies, and they agreed with him. (Pesachim 56a)

Why did they "agree with him" when he "hid the Book of Remedies"? Rashi explains:

“And he hid the Book of Remedies” – … because their hearts did not submit as a result of their illnesses, but rather they healed immediately. (Rashi, Pesachim 56a, s.v. veganaz)

Similar to the Ramban’s approach with respect to the bronze serpent, Rashi explains that healing by way of "the Book of Remedies" was problematic because it led to a situation in which "their hearts did not submit as a result of their illnesses." This is the downside of having a Book of Remedies. The positive purpose of hiding the book away, to cause the sick to pray, is explicit in Rashi’s words elsewhere:

"That he hid the Book of Remedies” – so that people would pray for mercy. (Rashi, Berakhot 10b)

The Rambam: “We should also thank Him for creating a cure”

The Rambam totally disagreed with this approach, and explained the Mishna in an entirely different manner:

The Book of Remedies was a book containing a series of remedies that the Torah does not permit employing as a cure, such as the things that talisman experts think … are effective [in curing] certain illnesses, and the like, using forbidden objects. And its author only composed it to [use as] a method of study of the nature of the world, not so a person would do anything in practice that is included in it, and this is permitted… And when people became corrupted and healed themselves according to the book, it was hidden away.

And perhaps it was a book that contained lists of harmful herbs… And when the doctor saw those illnesses, he would know that he had ingested such and such an herb, and he would give him other foods that combat it to save him. But when people became corrupt and would kill with these substances, it was hidden away. (Rambam, Commentary to the Mishna, Pesachim 4:10)

This passage offers two understandings of the nature of the Book of Remedies, and thus also of the reason it had to be hidden away:

1. According to the first understanding, the book included magical and mystical remedies that are forbidden by Torah law, and this is why Chizkiyahu hid it away.

2. According to the second understanding, the book included lists of harmful herbs; experts could recognize their effects and offer suitable antidotes. When corrupt people began to misuse this knowledge, Chizkiyahu hid the book away in order to prevent further harm to the community.

After these two suggestions, the Rambam continues at length to reject a third possible understanding, one which parallels Rashi’s approach:

And I have only elaborated to speak about this matter because I have heard and they have told me that Shlomo composed the Book of Remedies, so that if a person became ill with a certain illness and turned to him, and did as he said, then he recovered. But Chizkiyahu saw that people were not trusting God with regard to their maladies, and instead they relied on the Book of Remedies, so he went and hid it.

And besides the nonsense of this matter, which has elements of fabrication to it, they have [also] ascribed foolishness to Chizkiyahu and those who agreed with him, the like of which one should only ascribe to the lowliest of the masses.

According to their erroneous and weak logic, if a person is starving, and then eats bread, which will undoubtedly cure him of that great pain – would we say that he removed his trust in God? One should tell them they are deranged. Just as when I eat, I thank God that He created something to remove my hunger and to keep me alive and well, thus we should also thank Him for creating a cure that cures my illness when I need it. And I would not have had to contradict this terrible explanation if not [for the fact that] it was publicized. (Ibid.)

We see then that the Rambam cites the approach which we saw earlier in the words of the Ramban (but not his actual words, for the Rambam preceded the Ramban), and totally rejects it in the severest terms.

There is no need to add any further explanation of his position, as his words speak for themselves. I will just note that attention should be paid to the fact that the Rambam speaks out against two different trends:

First, he objects to the prevailing view in his day, according to which we must please and pacify God so that He will satisfy our needs. The Rambam viewed the relationship between man and his Creator completely differently.

Second, contrary to certain conceptions, the Rambam argued that it is possible, and even desirable, to intervene in nature and control it.

Before we continue, it is important to emphasize that the Jewish people have totally accepted the Rambam's approach in this matter, and even the most religious and God-fearing people make use of hospitals.

The Virtue of the Doctor

From medicine, let us move on to doctors themselves. First, consider the virtue of the physician: A doctor gives of himself to perform acts of kindness at the highest possible level, because he enables life. This is an unparalleled act of kindness, and the nature of this virtue should be taken into account when choosing a profession. Many doctors are exceedingly righteous people, and I say: "The best of the doctors, to the Garden of Eden!"[1]

All of this is certainly true, but there is a flip side – because a physician wields great power. A physician saves lives and can determine the fate of his patients. The problem arises in the case of physicians who practice medicine not out of idealism and a desire to perform acts of kindness, but for the sake of that sense of power, which can (extremely) adversely affect the interactive human skills of a physician who practices with that mindset.

The reason for this phenomenon is quite clear: medicine leaped forward in the twentieth century, and remains the century’s greatest moral achievement. These developments occurred as the medical profession transitioned from relating to the patient as a subject to relating to him as an object; the flip side of this progress is that medicine began to objectify the patient. Thus, medicine is liable to suffer from a lack of humanity.

The best example is surgery: the patient is anesthetized and silenced, and the doctor has nothing to do but cut into his flesh – just as a butcher does in his butcher shop. Thanks to his action, the patient is saved and continues to live.

However, we can see the phenomenon not only in areas that have inherent challenges to the human side, like surgeries and anesthesia, but also in seemingly minor issues. For example – in the fact that the patient wears pajamas all the time, regardless of his condition (which is, of course, reminiscent of a prison). Another example is the fact that during doctors' rounds, the patient is left alone without his relatives to protect him, and his privacy is completely trampled on.

I knew a respected professor who wore a suit all his life, but from the moment he arrived at the hospital in his old age, he was deprived of everything and treated as just another patient. How sad! In another case, when my wife Michal underwent a Caesarean section, I was not willing to remain in the room and see her as an object; I stayed outside to say Tehillim, to continue to see her as a subject.

So far the problem. What is the solution? The basic answer is of course simple: what is needed is a more humane approach toward patients. I saw a good example of this when my father z"l was in the hospital after surgery: when his roommate asked him if he was the rabbi from Rav Sabato's book, and he answered in the affirmative, and he asked him for a blessing, everything changed. No longer just the patient "Aharon," he became "Rabbi Lichtenstein." In this way, he stopped being an object and once again became a subject.[2]

However, despite all the problems that exist, it is important to reiterate that many of the righteous people of the world are found among the doctors serving on a hospital's medical staff. The best of the doctors, to the Garden of Eden!

[This sicha was delivered at seuda shelishit on Shabbat Parashat Chukat 5778 (2018).]