Medicine’s ultimate healer

The age-old Jewish love affair with medicine began this week, as it were: with Exodus 21:18/19, which discusses mayhem, the willful assault by one person upon another. According to the Torah, the guilty party must provide healing for the victim — from which the Talmud deduces (Bava Kamma 85a) the aggressor’s obligation to pay for medical care (with extra remuneration for pain, humiliation, and damages for loss of income). 

If the injuring party is also a doctor, who offers his/her own medical services instead of paying someone else, the injured party can refuse, because, to the victim, the assailant is like “a lion lying in wait,” and victims have the right to doctors whom they trust. Nor can the assailant supply a doctor-friend who will heal for free, since the victim can argue that “a doctor who heals for nothing is worth nothing” (Bava Kamma 85a). 

In addition, the assailant cannot claim (for example) that the victim need only pray and God will answer the prayer, because, says Rashi, it is forbidden to rely on God alone to provide healing. The Tosafot go further, specifying consultation with doctors also for what we would call “acts of God”; even there, we cannot count on God alone to “undo the damage.” 

The Talmud prohibits Jews from even dwelling in a town where there is no doctor (Sanhedrin 17b). So early on, Judaism decided that we cannot rely simply on God, that doctors are therefore necessary, that they may charge for what they do, and that those who need healing have a right to it. Pretty advanced thinking for late antiquity and the Middle Ages!

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Yet inexplicably, the same Talmud also says (Mishna Kiddushin 4:14=Kiddushin 82a), “The best of doctors belong in Hell” (gehinom, in Talmudic parlance). It’s only a side comment, one of many unauthoritative aphorisms, so we cannot put much stock in it. But we learn a lot from later rabbinic attempts to understand it. The comment pointedly specifies doctors who are “the best,” not “the most righteous,” we are told, having in mind doctors who think they are beyond the obligation to heal the poor (Rashi); or those whose arrogance prevents them from consulting with medical colleagues in cases where their own faulty judgement might do harm (Maharsha, Samuel Edels, Poland, 1555-1631).

When it comes to valuing life and those who help sustain it, rabbinic tradition has much to be proud of. But the rabbis do not just anticipate modern-day perspectives. They offer a spiritual insight that is nowadays easily forgotten. Healing derives ultimately from God, they insist, so physicians do their work as deputies from God. To be called to the profession of healing is to be God’s presence in the face of pain. But it is more, even, than that. Since God’s ultimate presence is seen in the original act of creation, healing must be viewed as the continuation of that act.

As a prisoner in Auschwitz, Primo Levi remembers having to watch a man die slowly on the gallows. As the victim twists in agony, Levi thinks, “To destroy a man is almost as difficult as to create one.” Like the gallows, disease too slowly destroys what God has created — destruction and sickness on one hand; creation and healing on the other. 

Each morning, we say a blessing that praises God for “healing and doing miracle work” (rofei kol basar umafli la’asot). “Healing,” then, is “miracle work.” We may know how medicine works its wonders, but it remains a wonder nonetheless — a miracle that anything works at all. The best of doctors are not those who deserve gehinom, but those who stand in awe at the gift of being God’s personal agents on earth, charged with nothing short of creating lives as God once did.

Rabbi Lawrence A. Hoffman is cofounder of Synagogue 3000 and a professor of liturgy, worship, and ritual at Hebrew Union College-Jewish Institute of Religion.