Thursday, November 6, 2014

The Ramban on the spiritual basis of Illness and the ideal role of doctors

 One of the truly great Jewish spiritual leaders, Rabbi Moses Ben Nachman, also known as the Ramban, or Nachmanides, lived most of his life in Spain about century after Maimonides.  Like Maimonides, beside being a phenomenal Torah scholar, eminent philosopher and universally recognized leader, he was also a prominent physician, insisting on earning his livelihood as such, rather than taking a salary for a rabbinical position. In his commentary on the Torah, The Ramban, (Leviticus 26:11) speaks in great detail of the spiritual basis of illness, and what the role of doctors should ideally be:

"The following may be taken as a general principle: When (humanity) is in a refined state where it acts as it should , the laws of nature do not at all control what happens. Nothing is left to happenstance, neither as it affects each person, nor as it affects the land. This applies collectively as well as individually. For God `will bless their bread and their water, and remove illness from their midst' (Exodus 23:25), such that  they will never become sick and therefore never require a doctor, or any kind of medical intervention,  even as precautionary measures, `For I, G-d, am your Doctor' (Exodus 15:26). When prophecy was still part of daily life, righteous people acted accordingly. Even if they happened to sin and became sick, they consulted not doctors but prophets, as did King Chizkiyahu when he was sick (Kings II, 20, 2-3). It is said of King Asa that `even in his sickness he did not seek out G-d, but he turned to the doctors' (Chronicles II, 16:13). If it was common for them to go to doctors, why should the verse mention doctors at all? Asa's only guilt lay in the fact that he did not seek out  G-d...."

"What is the role of doctors, therefore, for those who carry out the will of G-d, after He promised that `He will bless their bread and their water, and remove illness from their midst'? The function of the medical profession in times when people live according to  G-d will,  will  be to give nutritional advice - what to eat and drink and what to avoid.   The Gemara reports (Brachot 64a) that for the entire twenty-two years during which the great Rabbah's was Rosh Yeshiva (dean of the Talmudic seminary), Rav Yosef never felt the need to  call any medical practitioner  to his house. They went by the principle that `a door that does not open to charity will open to the doctor' (Bemidbar Rabbah 9:3). This is consistent with what the Gemara also brings down,(Brochot 60a) 'People ought not to depend on medical intervention at all, but it is their habit of going to doctors.`  This means that  had they not become habituated to visit doctors and resort to medicine, sickness would struck only as  a consequence of sin, and healing would occur  only through the will of God. However, since they resorted to medicines, God abandoned them to the vicissitudes of nature."

"As to the rabbinic comment on the verse, `...And he should surely heal him' (Exodus 21:19) - `that from here we learn that the physician has been given sanction to heal' (Berakhot 60a) - this does not mean that license has been given to the sick to resort to medicine! What they meant is that if a doctor is approached by a patient who tends to resort to medicine and is not part of the community of God whose share is life, the doctor should not refrain from treating him, neither from fear that the patient might die under his hand (assuming, of course, that  the doctor is expert in his craft),  nor on the grounds that G-d alone is the healer of all flesh, since this patient has already established the habit of resorting to medicine." 

And even though the Torah states that if two people quarrel and in the course of their conflict one injures the other,  that the attacker must pay the medical expenses of the injured party (Exodus 21:18), this is because Torah law does not rely on miracles, for G-d knew that `the needy will not cease from the midst of the earth' (Deuteronomy 15:11). But when a person's ways find favor in God's eyes, he has no business with doctors."

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