Doctor Who

Rabbi Wagensberg
Parshas Mishpatim - Parshas Shekalim
Doctor Who

Reuven punched Shimon so hard that he was unconscious before he hit the floor. Shimon was happy to be alive, but his recovery took a while. Eventually, Shimon was back on his feet. The court ruled that Reuven had to pay for Shimon's lost time, "Virapo Yirapei," meaning that he also had to provide for Shimon's healing. This was a pretty straight forward decision because the verse says so explicitly (Parshas Mishpatim, 21:18-19).

In the Academy of Rebbi Yishmael they said that the words "Virapo Yirapei" (and he must provide for healing) teach us that permission was granted for doctors to heal (Baba Kamma, chap. 8, "Hachovel", pg. 85a). After all, if the patient is allowed to go to a doctor and pay for his services, and then be reimbursed by the person who landed him in the hospital, then obviously the doctor is allowed to heal.

The reason why doctors need permission from God to heal is because one may have thought that it was forbidden because God made the person sick to begin with. Therefore, how could a person try to undo Hashem's decree. Such action could be viewed as chutzpa (audacious). In order that we do not think this way, the Torah gave permission for doctors to heal (Rashi ibid).

Tosafos (ibid; Divrei Hamaschil, "Shenitnah") adds that not only are doctors allowed to heal a person who suffers from an injury induced by another person (like our Shimon above), but doctors may even heal a person who suffers from an illness induced by God directly, without other people's intervention. This is derived from the seeming superfluous double lingo, "Virapo Yirapei." The first word "Yirapo" teaches us that a doctor may heal one from an illness induced by a person. The second word "Yirapei" teaches us that a doctor may even heal a person from an illness induced by God directly.

Rabbenu Bachya, the Ba'al Haturim (Parshas Beshalach, 15:26), and Reb Chaim Vital (Eitz Hada'as Tov) say that there is a huge difference between God healing a person directly as opposed to a person being healed by one of God's agents, a doctor. When God chooses to heal a patient directly, the healing process is done gently, without any pain and without any side-effects.

However, when a person's healing comes about from a doctor of flesh and blood, typically, the methods are painful, and they also have side-effects.

Therefore, every verse which talks about God healing directly, the word "rephuah (refuah)" (healing) in those verses is spelled with a letter phey which is not punctuated, meaning, without a dot on the inside. For example, "Ripha-eini Hashem V'eiraphei" (Heal me Hashem and I will be healed, Yirmiya, 17:14). "Harophey Lishvurei Leiv" (He is the healer of the broken hearted; Tehillim, 147:3). "Ki Ani Hashem Rophecha" (I am Hashem your healer; Parshas Beshalach, 15:26). Grammatically speaking, these letters phey should be articulated softly, representing that the healing comes about in a soft and gentle way.

However, when the verse talks about a doctor intervening to heal a patient, the word "rephuah" is spelled with a letter pey that is punctuated, with a dot on the inside. For example, "Virapo Yirapei" (and he must provide healing; Parshas Mishpatim, 21:19). Grammatically speaking, we must articulate that letter pey by stressing it. This represents the stress that is involved with the methods of healing that are introduced by the medical society. A dot in the letter pey forces us to pronounce that letter hard, representing the harshness and difficulty that often accompanies the healing process suggested by doctors.

The Sefer Yetzira (chap. 4) and the Sefer Hapardes (chap. 4) say that, Kabbalistically speaking, a dot inside of a letter represents "din" (strict and harsh justice), whereas a letter without a dot on the inside represents "rachamim" (compassion). This further supports the idea that when doctors heal, "Virapo"it is filled with "dinim" (harshness), but, when Hashem heals directly, "Ripha-eini," it is filled with rachamim.

The Zohar Chadash (Parshas Balak, pg. 54) says that there is another difference between God healing directly as opposed to a doctor healing. When a doctor heals, the illness can return. However, when Hashem heals a person directly, that illness never returns. This can be seen in the wording, "Riphaeini Hashem V'eiraphei" (Heal me Hashem and I will be healed). The double lingo teaches us that that when Hashem heals, we will be healed permanently.

All of this information leads us to a question. When does God choose to heal a person directly, and when does He choose to send one of his agents, i.e., a doctor?

To understand this, we will turn to a Gemara (Berachos, chap. 1, "Mei-eimasai", pg. 5a; Rava, Rav Chisda) which says that if a person sees that pain, suffering, and illness is coming upon him, he must "Yiphashpeish B'ma'asav" (examine his ways; Eicha, 3:4). If he does this introspection, and finds nothing wrong, it is probably because he is wasting some of his time (Tehillim, 94:12). Wasting time is easy to miss because we are dealing with moments and seconds. If he checked and found that he is not wasting time, then his illness is certainly "Yisurin Shel Ahavah" (pain from love). Meaning, Hashem admonishes people whom He loves (Mishlei, 3:12) in order to increase their Olam Haba or to make them grow even more by making him even more sensitive and understanding.

We see from this Gemara that sometimes illnesses can come about because of sin. Before we continue, let us clarify. Not all sickness is a result of sin. Hashem may have thousands of reasons, beyond our comprehension, for causing people to become sick. The Gemara itself just said so by introducing the concept of "Yisurin Shel Ahavah." However, it is certainly within the realm of theoretical possibility that some sicknesses are caused because of sin.

That said, it is important to mention that it is not our job to judge others who are sick. Only God is the truthful judge. We should not go around thinking that sick people must be sinners. Who knows? Maybe that person is a completely righteous person in God's eyes and is suffering only because of Yisurin Shel Ahavah. Our responsibility towards others who are not well is to be there for them. We must cry and daven for them. We must visit them and try to alleviate their pain in any way possible. We must be a listening ear, run to do their errands, and even help them financially if we can.

However, our responsibility towards ourselves is different. Yes, we should do everything in our power to heal ourselves, but, we must also examine ourselves to see if there is anything within our actions, speech, thoughts, and personalities that may have brought this pain and suffering upon us.

This means that we are supposed to do teshuva. But, when a person is suffering, it's hard to concentrate. If a person is in pain, or if he is nauseous, it's hard to invest the work necessary to make a positive change within ourselves. What, then, is this person supposed to do?

One of the Belzer Rebbes (Rebbi Yehoshuah) says that he is supposed to do a quick teshuva. A quick teshuva consists of a brief thought in which we tell Hashem that if He takes this suffering away, we will do complete teshuva and truly improve our ways.

Once a person makes this deal with God, Hashem sends one of His agents, a doctor, to heal the person. Since a doctor intervened to heal the person, the healing might only be temporary. Once the person has been alleviated from his pain, at least temporarily, God waits to see if he is going to uphold his end of the bargain and do complete teshuva. If he does, then, God comes down and heals the person completely, in such a way that the illness will never return. If the person does not repent, then the illness will probably return and he will find himself right back where he started from, in the doctor's office.

This is how Hashem chooses whether to heal the person through a doctor, or, to heal the person Himself. If the illness is there because of a sin, (which is a big "If"), then Hashem first sends a doctor as the first phase to alleviate the pain temporarily, to see if the person is going to repent, once he can concentrate again. If he does, then God steps in as phase two, in order to complete the healing process, without pain, without side-effects, and in such a way that the illness will never return.

This provides another reason why verses talking about Hashem healing directly are missing a dot inside the letter phey of the word rephuah. It is because when God heals directly, the illness never returns. This is considered to be a compassionate healing, represented by the unpunctuated phey, as we mentioned above.

However, verses talking about God healing through a doctor, have a dot inside of the letter pey. This is because when a doctor heals, the illness can return. This is considered to be a harsh healing, represented by the punctuated pey, as we mentioned before (Shvilei Pinchas).

We said earlier that a doctor is sent to heal because the patient has not yet done teshuva. The Shvilei Pinchas says that this is another reason why the letter pey is punctuated in the verse about doctors healing. The dot on the inside represents a black stain of sin that the patient has inside of himself, on his personality. This black stain of sin might very well be the cause of his sickness.

If the patient does teshuva and cleanses that stain away, then, Hashem steps in to heal the person directly and completely. When God heals, the letter phey in the verse is unpunctuated, demonstrating that the black stain of sin has been removed.

Actually, when the Talmud instructed a sick person to examine his ways, it used the word "yiphashpeish" (examine). In this word, there is a phey and a pey. The Shvilei Pinchas says that this itself carries a message. It is telling us that the person must examine whether this illness came about in the manner of a phey, without a black dot of sin, meaning, that the illness is purely "pains of love," or, did this sickness come about in the manner of a pey, with a black dot of sin that caused his condition. This will tell the patient whether or not he must do teshuva.

When Hashem sends a person health, or any blessing for that matter, like parnasah or children, it is called "shefa" (abundance; plenty). The "shefa" that Hashem sends to us travels through "tzinoros" (Kabbalistic spiritual pipes). However, when a person sins, he ruins those pipes. They either get cracks in them or they get stuffed up. Either way, the person no longer receives the over-abundant flow of blessings that Hashem is trying to send down. This can result in illness, because the pipe of health has been clogged.

When a person sins, he transforms "shefa" into "pesha" (transgression). This is a play on the word. "Pesha" and "shefa" share the same letters (shin, phey, and ayin). It's just that the first two letters can be reversed to spell either word. When a person does teshuva, he converts "pesha" back into "shefa" (Zohar, Naso, pg. 133a).

The Shvilei Pinchas says that another interesting difference between the words "shefa" and "pesha" are that in the word "pesha," there is a dot inside of the letter pey, whereas in the word "shefa," there is no dot inside of the letter phey. This teaches us that when there is "pesha," there is a black stain of sin which stuffs the pipes and prevents health. But, when there is "shefa," it shows that teshuva was done, and there is no longer any black stain of sin. The pipes are unclogged, and health can be restored.

So long as there is "pesha," a doctor is sent to heal him, as it says, "Virapo Yirapei," with both peys being punctuated, representing that the stain of sin still exists. Once teshuva was done, Hashem heals the person directly, as it says, "Ripha-eini Hashem V'eiraphei," with both pheys unpunctuated, showing that the stain of sin has already been removed.

Another interesting point to mention is that there are specifically two peys that are punctuated by a doctor healing, and specifically two pheys that are not punctuated by Hashem healing directly. Why specifically two?

The Mishna (Avos, 4:2, Ben Azzai) teaches us, "Mitzva Goreres Mitzva" (one mitzva leads to another mitzva), and Aveira Goreres Aveira (one sin leads to another sin), for, Sechar Mitzva Mitzva (the reward of a mitzvah is a mitzva), and Sechar Aveira Aveira (the reward of a sin is a sin)."

The Yismach Moshe (Parshas Eikev) and Arvei Nachal (Parshas Shoftim) explain this Mishna based on the Arizal (Eitz Chaim, Sha'ar Hakelalim", chap. 1) who says that God created this world because He is the Source of Good, and He wants to share that good with others. Therefore, He created others just in order to be able to give good to others.

Therefore, when we do mitzvos, and God rewards us, the reward itself is considered to be a mitzva because the reward that we enjoy gives God pleasure. That is exactly what Hashem created the world for, to give us pleasure. However, if we sin and God has to punish us, the punishment itself is considered to be a sin, because it brings God disappointment. This is the direct opposite of what Hashem wants.

Therefore, "mitzva goreres mitzva" means that when a person does a mitzva, it causes the person to be rewarded. The reward itself is the mitzva. The Mishna continues to explain itself by saying, "sechar mitzva mitzva," meaning that the reward for the mitzva is in and of itself a mitzva.

Similarly, "aveira goreres aveira" means that when a person does an aveira, it causes the person to be punished. The punishment itself is an aveira. The Mishna continues to explain itself by saying, "sechar aveira aveira," meaning that the reward of an aveira is punishment, and the punishment is in and of itself a sin.

Therefore, when a person sins and turns "shefa" into "pesha" which clogs the spiritual pipes, he might become ill. Then, he will need a doctor to heal him. When a doctor heals, the verse says, "Virapo Yirapei," with both letters pey punctuated. The two dots in the two peys teach us that there are two sins that this person is guilty of: 1) the actual sin, and 2) the punishment he received.

However, if he does complete teshuva, everything changes. Complete teshuva is a love-based repentance. When a person repents from love, his intentional sins are transformed into merits (Yoma, chap. 8, "Yom Hakippurim", pg. 86b, Reish Lakish). This transforms "pesha" into "shefa." Then, Hashem Himself heals the person completely. The verse which talks about Hashem healing directly says, "Ripha-eini Hashem V'eiraphei," with two unpunctuated pheys. The absence of the two dots indicates that the two sins (the sin and the punishment) have been removed (Shvilei Pinchas).

Ultimately, we must place our trust in Hashem for our healing. This is because Reb Tzvi Hersch of Ziditchov (Sefer Sur Meira Va'asey Tov) and the Ropshitzer Rebbe (Zera Kodesh, Parshas Chukas) say that nature is rooted in the Name Elokim which is the Name of din. Therefore, nature is din. In fact, the Hebrew word "hateva" (the nature) shares the same numerical value as the Name Elokim, 86. This teaches us that the natural world is a cruel place (Ramak, Pardes Rimonim, Sha'ar 12, chap. 2). Water will drown and fire will burn even righteous people. Therefore, if a person attempts to get healed only using the natural laws of science and medicine, he is placing himself under the dimension of nature and din.

Obviously, we must go to a doctor when necessary and take the medicines, shots, and treatments when they are prescribed. How, then, do we get ourselves out from under the realm of din? The answer is that even when going to a doctor, we must place our trust in Hashem and in His Name Havaya which represents the supernatural. This means placing our trust in the One Who can heal us miraculously, without pain, without side-effects, and without the illness returning. When we do, we have uprooted ourselves from the dimension of din, and we have planted ourselves under the dimension of rachamim.

This affords us with another reason why the verse speaking about doctors healing has punctuated letters pey. It is because when going to a doctor, one is putting himself under the authority of science and nature which is governed by Elokim. This is the world of din. As such, the peys are punctuated to remind us of this.

However, when the verses speak about God healing directly, the pheys are not punctuated. This is because when one places his trust in Hashem, he is putting himself under the energy of transcendence which is governed by Havaya. This is the world of rachamim. As such, the pheys are not punctuated to remind us of this (Shvilei Pinchas).

The Sefer Eser Kedushos adds that this explains our custom of wishing others to get well by saying the traditional, "Rephuah Shileima" (have a complete healing). When the letters of the word "rephuah" are rearranged and split into two, it spells, "raphey - vov hey" (heal, with the letters vov hey left over). When the letters of the word "shileima" are rearranged and split into two, it spells, "shalem - yud hey" (complete, with the letters yud hey left over).

This teaches us that our wish to sick people is that the complete (shalem) healing (raphey) should come about by Yud, Hey, Vov, Hey (Havaya) directly so that the healing will be transcendent, without pain and in such a way that the illness will never return.

This week, there are four practical applications of this teaching:

Number One:

We should never need to go to a doctor, but, if we do have to, let us make it a practice to say the following statement and prayer. "Although I am going to a doctor of flesh and blood, ultimately, I place my trust in Hashem and in His Name Havaya to bring about my healing in a transcendent way. Therefore, Hashem, please heal me without pain, without side-effects, in just such a way that the illness never returns."

Number Two:

When we daven Shmoneh Esrei and get to the beracha of "Ripha-einu" (heal us), keep in mind that the words "Ripha-einu Hashem V'neiraphei" (heal us Hashem and we will be healed) have two letters phey that are unpunctuated. Meaning, we should be thinking that our prayer to God is that He should heal us in a compassionate way.

May I also point out that this bracha just so happens to be the eighth blessing of the Amida (Silent Prayer). This is not arbitrary, because, in Judaism, the numbers seven and eight are huge. The number seven represents teva because God infused all the laws of nature into this world during seven days of creation. Therefore, sheva (seven) and teva (nature) are synonymous with each other. However, the number eight, which is one notch above seven, represents that which transcends nature. Even the way we write the shape of the digit eight today serves as the sign of infinity which is transcendent (Kli Yakar, Parshas Beshalach, 15:1). By thinking about this during the recitation of this bracha, we are placing our trust in Hashem and His miracles which are beyond nature.

Number Three:

When we wish each other, "Rephuah Shileimah," let us keep in mind that we are wishing the person that Havaya (coded into those words) should bring about the healing (raphey) in a complete (shalem) way, without pain, and in such a way that the illness should never return.

Number Four - for doctors:

Make it a regular practice to pray for your patients (many doctors already do this), and say, "Dear God, please grant me the humility and clarity to realize that it is not I, but You, Who grants healing. May I deserve to be Your agent in treating this patient, like it says, "Shelucho Shel Adam K'moso" (an agent takes on the essence of the one that appointed him). May the methods that I suggest bring complete health to this person without pain, in such a way that the sickness never returns to him."

So, may we all be blessed with the strength to do teshuva on all of our "peshas," and may we all be blessed with the clarity to place our trust only in Havaya, in order that all of our illnesses be healed speedily, without pain, without suffering, without side-effects, in such a way that the sickness never return, so that all of Am Yisrael experience a shefa of rephuah shileima once and for all! Amen!