... Of all professions, that of a medical doctor calls for the greatest sense of responsibility and meticulousness, and requires the utmost peace of mind to cope with the everyday challenges of the profession.
The Torah holds it in great esteem, considering the human doctor to be the direct agent of the “Healer of all flesh and Performer of wonders” to bring cure and relief both physically and spiritually, as the physical and spiritual go hand-in-hand. ...
(From a letter of the Rebbe, dated the 11th of Tammuz, erev Chag HaGeulah, 5744)
... The connection between medicine and Jewish law is found in Torah itself, as our Sages, of blessed memory, declare: “Torah brings healing to the world.”
This in no way implies that Torah [which itself brings healing] negates medicine in any way; on the contrary, the Torah establishes that in matters of health, one should consult a doctor and obey his instructions.
Understandably, at the same time [that a person uses the services of a doctor,] the person is to remember that G-d is the true Healer, and the doctor is no more than an agent of G-d, the “Healer of all flesh and Performer of wonders.”
There are two fundamental approaches to medicine: a) healing through finding a cure; b) preventive medicine.
The first approach involves active intervention when a health problem is brought to the attention of a doctor, while the second approach — and this has become increasingly prevalent in modern times — strives to achieve the maximum degree of public health by seeking to prevent ailments through inoculations, proper public and private hygiene, a nutritional diet, and by other ways and measures.
It goes without saying that while there is no escaping the need to be healed when one is already ill, preventive medicine is the ideal. Long range, it surely is the most desirable, any way you look at it, including cost, not to mention [its role in] preventing illness and suffering, may G-d protect us.
Additionally, preventive medicine does not require the kind of resources needed to perform extreme measures such as surgery, something that is sometimes unfortunately necessary when healing someone with an existing condition.
In order for preventive medicine to be most beneficial, it requires that one commence prevention at the earliest possible age, beginning with vaccinations, brushing one’s teeth to prevent cavities, a balanced diet, and so on.
With regard to Jewish children, preventive medicine also includes scrupulous observance of the laws of kosher food and drink, as it is known how this matter affects the Jewish child’s spiritual and physical development. ...
(From a letter of the Rebbe, dated the 15th of Tammuz, 5746)
... Medicine ... has two general aspects: cure and prevention. The first involves curing the sick; the second, preventing illness.
At first glance, the accomplishment of the physician in healing the sick seems more impressive — by yielding such dramatic results — than does practicing preventive medicine, where there can be the illusion that the illness may somehow have been avoided anyway.
In truth, however, [rather than having to combat an illness,] it is surely better to insure against it [from the outset]. The latter [form of healing] is the way G-d practices healing, as it is written:[215] “No illness shall befall you, for I am G-d your Healer.”
(From a letter of the Rebbe, dated the 10th of Cheshvan, 5734)
At the outset, on behalf of Mrs. Schneerson as well as on my own behalf, I wish to convey our sincere appreciation for your kind and considerate care in connection to the recent incident that occurred with Mrs. Schneerson. [Thank you] for your immediate response and home visitation at an inconvenient hour, etc., [and] all this in addition to your having provided her with your expert and skilled treatment and care.
I surely need not stress to you how important it is to the patient that the doctor expresses personal interest and attention, particularly as this constitutes a significant aspect in the patient’s healing. As you yourself correctly noted in the course of our conversation, the mind has a critical degree of influence over the entire body and one’s state of mind directly affects the healing process.
We extend our thanks in anticipation as well of your continued interest and assistance.
I hope and pray that G-d, “Healer of all flesh and Performer of wonders,” will bless you with success regarding all your patients, including this present one.
I had occasion to hear a thought from my father-in-law, may the memory of a tzaddik be for a blessing — a thought that has its place in our Torah, which is called the Torah of Life (as it serves as our guide and source of life) — that in order to assure the success of the medical treatment, the remuneration for the doctor’s services are to be in keeping with the medical stature of the treating physician.
In point of fact, this principle applies to all professions and services, including communal services. It need not be said that my father-in-law put this into practice and I wish to do the same.
I therefore am taking the liberty to enclose my check, although I am not sure whether this is the appropriate payment. I am sure, however, that if this sum does not suffice, you will see to it that your secretary contacts my secretary so that I will be able to rectify the matter. Together with the payment comes the traditional Jewish blessing, “Use it in good health.”
One of the primary reasons for the above principle is the fact that the Torah is aware that a doctor or someone with another occupation has fiscal responsibilities to his family and community, etc., responsibilities that he can adequately take care of only if his services are adequately paid for.
Therefore, if the receiver of the services does not satisfactorily reimburse the provider of the service, a thought might arise in the doctor’s mind (fleeting as it might be) that it would be acceptable for him next time to delay treating this individual in favor of an individual who pays what is expected of him.
Consequently, the Torah strives to remove even the possibility of such a thought. Thus, whatever occupation Providence had in mind for an individual to carry out for the benefit of others, this will always be done with total dedication and devotion.
Once again, my great thanks. With respect and personal regards,
P.S. After this letter was written, your official bill was received. Enclosed please find a check. However, as I emphasized, this is a formal payment while my letter and the [other] attached payment are on a personal basis, as a much deeper and more personal gesture than that of the formal relationship between doctor and patient.
(From a letter of the Rebbe, dated erev Rosh Chodesh Shvat, 5743)
It pleases me to hear from ... about your kind concern and attitude in treating him, particularly the consideration you are showing to all his needs.
There is the known saying of our Sages,[216] of blessed memory, that while giving charity to a poor person is rewarded with “six blessings,” when done with a cheerful countenance the donor is rewarded with “eleven blessings.”
Together with the known directive of our Sages in commenting on the verse “and he shall heal,”[217] that “Permission was granted the healer to heal,”[218] there was also the concern that people may be led to believe and rely entirely on the doctor and forget that healing is ultimately in G-d’s hands. Indeed, according to many commentaries, this is why “Chizkiyahu hid the Book of Cures.”[219]
However, when the doctor himself knows that he serves as the emissary of G-d, the “Healer of all (ailments of the) flesh and Performer of wonders,” there is no room for the above concern, and consequently, his healing is more effective.
May G-d grant you success and bless you in your practice of medicine, that you be the appropriate emissary to bring healing to the afflictions of those individuals who are directed by Divine providence to you.
May G-d reward your good deeds in a similar manner, that your personal matters as well be crowned with blessing and success. ...
(Igros Kodesh, Vol. VII, p. 209)
... You no doubt conduct yourself in the same manner as do other G-d-fearing doctors, that when patients approach you and seek your advice regarding physical health matters, you utilize the opportunity to rouse them to increase their spiritual health as well — something we are all in need of, particularly in this spiritually impoverished generation, for as the verse states:
[220] “There is no man so wholly righteous on earth that he [always] does good and never sins.”
The above is particularly true as we readily observe that increased spiritual health leads to a genuine increase in physical health as well, in keeping with the verse,[221] “Be whole with G-d, your L-rd” — whole in the 248 organs and 365 veins of both body and soul, which correspond to the 248 Positive Commandments and the 365 Negative Commandments. ...
(Igros Kodesh, Vol. XV, p. 149)
I was pleased to be informed of your Conference, designed to create an organized body of Jewish religious physicians.
Unification of religious forces has always been desirable, especially in our generation, a generation confused and perplexed by the shattering events of recent years, as a result of which many thinking people have become completely disillusioned in the false ideas and ideologies which they had held in the past, and are now earnestly searching for the truth.
An organized body of religious physicians could make its influence felt in these circles through a declaration of its authoritative opinion on several issues which have been the subject of confused and misleading controversy.
Such a declaration should, first of all, do away with the misconception about any conflict between science and religion. True science, the object of which is the truth and nothing but the truth, can lead to no conclusions that are contrary to our Torah, the Law of Truth.
On the contrary, the more deeply one delves into science, the stronger must grow the recognition of the truth of the fundamental principles, as well as the ramifications, of our Jewish religion.
As physicians, in particular, you are in a position to refute decisively the path of materialism, as is demonstrated by the fact that so much of physical health depends on spiritual health.
If in the past, emphasis was placed on “mens sana in corpore sana,”[222] in our days it is an accepted principle that even a small spiritual defect causes grievous physical harm. The healthier the spirit and the greater its influence over the physical body — the greater its ability to correct or overcome physical shortcomings.
This is to the extent that even in many instances which involve physical healing, prescriptions and drugs are considerably more effective if they are accompanied by the patient’s strong will and determination to cooperate [and become well]. ...
The principle of form (quality) over matter (quantity) is further emphasized by the fact— a fact that is continually gaining recognition — that the vital functions of the organism do not depend on quantity, since the glands and their production of hormones and vitamins, etc., are quantitatively quite minute.
Parenthetically: It is written in our Holy Scriptures, “From my flesh I see G-d.”[223]
When one recognizes the dominion of the soul in the physical body (the microcosm), there remains but a small step to the recognition of G-d, the “Soul” of the universe (the macrocosm). And in the words of our Sages: “As the soul fills the body, vivifies it, and sees but is not seen — so the Holy One, blessed is He, fills the world, vivifies it, and sees but is not seen.”[224]
So much for speaking in general terms. Specifically, there are many questions directly relating to the practice of the physician, many of them of practical importance to the physician, and among them many that relate to practical Jewish law, on which your voice should be heard.
To mention a few:
To publicize the tremendous benefit derived from the observance of the laws of Taharas HaMishpachah, observing the laws of family purity, the observance of the dietary laws, and circumcision.
With regard to the genital organs: Elimination of treatment likely to cause sterility and substituting for it other forms of treatment; particularly, in connection with surgery on the prostate.
Prescription and drugs: Many of them could be made in compliance with the laws of kashrus, and only through indifference or carelessness is it not done so.
Post-mortem: For the purpose of the study of anatomy, etc., surely it is possible to use artificial forms and models. For purposes of ascertaining the cause of death — in many cases it is not essential. Where it may be of immediate necessity in order to save a life (as in the case of exonerating someone accused of poisoning by performing an autopsy, etc.) bodily incisions should be reduced to the essential minimum, and all parts of the body should be buried afterwards.
And there are many other similar issues.
Needless to say, what has been mentioned above about pointing out the health benefits that are derived from the observance of the religious precepts should not be understood as an attempt to explain the precepts by describing their benefits.
Divine precepts must be observed because they are the command and will of our Creator, and “the reward of a mitzvah is the mitzvah itself,”[225] for “this is the whole purpose of man”[226] — to bond and unite with his Maker through the fulfillment of His commands.
However, for the benefit of those who, by reason of spiritual “sickness,” cannot be induced to observe the precepts except by making them aware of their practical benefit, we must do everything possible to urge them to observe the mitzvos in daily life, even if we have to make rationalizations about the Divine commands by emphasizing their physical benefits.
(Igros Kodesh, Vol. XI, p. 202)
I received your letter of the 19th of Tammuz, and I appreciate your thoughtfulness in writing to me in detail about our esteemed mutual friend. No doubt you have already heard from your patient, who has kept in touch with me.
I am most gratified to note the personal attention and concern you have shown towards your patient. There is certainly no need to emphasize to you how important it is for the patient — therapeutically as well — to know that his doctor is taking a special interest in him.
This is all the more important in the case of a sensitive person, and especially as our mutual friend is truly an outstanding person who lives by the Torah, and particularly by the great Torah principle of “loving one’s fellow as one loves himself.” ...
(From a letter of the Rebbe, dated Rosh Chodesh Menachem Av, 5743)
... I’d like to take this opportunity to thank you for your devoted care of the
Rabbanis tichye. According to her you significantly buoyed her spirits.
May G-d will it that in the future as well, you not only heal the bodies of your ill patients but also provide them with encouragement and strengthen their faith and trust in G-d.
(Igros Kodesh, Vol. IV, p. 444)
... From the style of your writing it would seem that you are caring for ... not only in the formally prescribed manner of a physician, but also with affection and care and concern — something that is of vital importance to the course of treatment and healing.
(From a letter of the Rebbe, in the year 5730)
It pleased me to receive regards from you in a letter from ... who also related to me the kind concern and attention you show her and her entire family, and how you do all this with a cheerful countenance and so on.
There is the known saying of our Sages,[227] of blessed memory, that while giving assistance to another is extremely wonderful, it is ever so many more times so when this aid is provided in a cheerful and encouraging manner.
Surely I need not go on at length about this to an individual like you, who occupies himself in the healing arts, that the personal rapport and empathy of the doctor is influential to the success of the treatment and the confidence and trust [placed in the doctor] by the patient who turns to him, and so on. ...
(Igros Kodesh, Vol. XXV, p. 14)
This is to acknowledge receipt of your letter in which you describe the health condition of [your patient] Mr. ... . I enjoyed your letter and, most particularly, it pleased me — as I discerned from your way of writing — that you are treating him with genuine warmth and empathy.
Although such conduct, [i.e., treating one’s patients with warmth and empathy] is to be expected of all physicians, unfortunately this is not always the case. Many physicians treat their patients in a more detached and aloof manner, and even among those doctors who are more empathetic — there are many degrees of empathy, caring and concern.
Seeing how you treat your patients with such warmth and empathy encourages me to think that you will rise to even greater degrees of feeling toward your patients. This, in turn, will have an even greater beneficial effect on your patients.
... Surely I don’t need to draw your attention to the fact that the spiritual and physical are connected to each other. Medical science also recognizes that the health of the body is linked to the health of the spirit and soul — and not only to the spirit in the simple sense, but also to the Divine soul.
It is therefore my hope that when you heal your patients, you also pay attention to their spiritual state and that you endeavor to heal also their Divine soul — not only their physical body and animal soul.
Even if some of your patients do not feel the necessity [of spiritual healing] and may even be opposed to it — this itself serves as a true sign of how much they are truly in need of this form of healing.
(Igros Kodesh, Vol. XIV, p. 386)
... At this time it is my pleasant duty to express my thanks for the medical treatment you extended to ..., particularly for the thoughtfulness and empathy you and your staff demonstrated towards him. Surely I need not explain to you how important it is for a patient to be treated by his doctor in a considerate and kind manner.
Although “The reward of a mitzvah is the mitzvah itself,”[228] [i.e.,] the satisfaction of the doctor in fulfilling his task of healing the ill, and so on, it is also my obligation and a mitzvah that is incumbent upon me to express my pleasure concerning the reports that I have received [about your manner of treatment].
May it be G-d’s will that since we are living in a period when, for the time being, there are very many who are in need of healing in general, and particularly in the field of your expertise, healing the eyes, that you succeed in bringing about their healing, up to and including their complete healing.
(Igros Kodesh, Vol. XXV, p. 80)
... I completely fail to understand why the doctor who is treating your friend refuses to send a report of her medical condition to the research institute in Washington.
[229]
If, as you write, the reason is that they have not discovered the cure there: 1) What would he lose by sending the report to them? 2) How can he possibly know what has been transpiring in that institution of late? As known, it can take many months (and sometimes a year and longer) until such institutions publicize the results of their research.
I can discern only one reason [for his behavior]: that on a psychological level, he does not want to give your friend false hope. But this can be remedied by not informing her that he is sending his report to the institution.
(Likkutei Sichos, Vol. XXXVI, p. 278 [230])
In commenting on the expression of our Sages, “Permission was granted the healer to heal,”
[231] the
Tzemach Tzedek ... noted:
“He has permission to heal, but not — Heaven forbid — to bring about a crestfallen spirit” [by being the bearer of disastrous tidings that must inevitably occur], etc.
(Igros Kodesh, Vol. XV, p. 187)
... You should also try to influence your brothers
sheyichyu that they, too, put on
tefillin daily (aside from
Shabbos and
Yom Tov).
Explain to your brother, [the doctor,] that as a doctor, he surely knows how much spiritual health impacts physical health, as the health of the soul affects one’s sense of well-being, enabling the person to be resilient and in good spirits.
Being a doctor, he is surely also aware of numerous medications and methods of treatment that are very effective, although doctors do not know how and why they heal. Nevertheless, [i.e., notwithstanding the lack of understanding as to how and why the medications and treatments are effective,] they are utilized, for we recognize that they are of benefit and assistance.
The same is true regarding Torah and mitzvos: It is not understanding [the how’s and why’s of their effectiveness] that is most important, but the actual acts [of studying Torah and performing mitzvos].
... A person should not make conditions with G-d, the greatest Healer of all, that first he must understand how His “medications” [of Torah and mitzvos] work, and only then will he swallow the medicine.
Rather, just as trust is placed in the doctor and professor, so too must a Jew’s approach to Torah and mitzvos be in a similar manner. Doing so will make for a healthy Jew, both in soul and in body.
(Igros Kodesh, Vol. V, p. 183)
In reply to your letter in which you write that you are pleased with the neighborhood into which you have recently moved, as it possesses many attributes of Torah,
Yiras Shamayim and
Chassidus as well.
Surely you and your wife tichye are doing your part to enhance these matters, for a neighborhood is anchored by the individuals who are found there and are active in its affairs. Each and every man and woman [residing in the neighborhood thus] has a specific and important role to play to insure its status as a viable neighborhood.
This is particularly so since you are a doctor, and in present times all agree [and doctors know this better than others] that physical health depends on the health and tranquility of the spirit.
There is also the well-known saying of our Sages[232] regarding the peace that is accomplished in this world through Torah, i.e., living a life in harmony with the dictates of the Torah, which — as the Alter Rebbe, author of the Tanya and Shulchan Aruch explains — refers to the peace between man’s Divine and animal soul.
Surely you can find the appropriate words, in harmony with your patients’ natures, to also explain to them matters relating to healing of the soul — explanations that are found in many places, among them Shemoneh Perakim of the Rambam, as well as sefarim of Chassidus and Mussar. ...
(Igros Kodesh, Vol. XIII, p. 488)
... In keeping with your position as the director of the Medical Association, I extend to you a special blessing that you succeed in utilizing your talents to bring cures and healing to all who turn to you in this regard.
Additionally, and this is of primary importance, that you and your colleagues succeed in eliminating and preventing disease to the extent that healing becomes unnecessary — the ultimate achievement of realizing good health.
Surely — in light of what you write and what I have heard about you — it is superfluous to emphasize that the physical health of all people is connected to their spiritual health, and particularly so with regard to each and every individual Jew.
It is therefore my hope that you are influencing the members of your association to do all they can regarding all those who turn to them, that their patients succeed in possessing healthy souls within healthy bodies.
This is in accordance with the directive of our Torah, the Torah of Life, and its commandments, concerning which the verse states:[233] “You shall live by them,” [and as it is also stated:[234]] “For they are our life and the length of our days.” ...
(From a letter of the Rebbe, dated the 6th of Iyar, 5732)
... You ask my opinion about going to an excellent non-Jewish medical practitioner — one who has a good name among Jews as well:
[Surely you should go see him, and] I don’t understand your reservations, for with regard to healing, no distinction is made [between a Jewish and non-Jewish doctor. This is particularly so in light of the fact that] “An artisan will [perform his work honestly, and] not blemish his work.”
Even our Nesiim conducted themselves in this manner [of going to non-Jewish doctors]. Especially so since [in your case] — as you write — the doctor is a religious person.
May G-d send His “healing words” through [the channel] of “this specific doctor and this particular form of treatment.”
(Igros Kodesh, Vol. XI, p. 127)
... Hospitals and even convalescent centers provide specific regimens of diet, rest and medication in order to heal or strengthen the health of an individual who currently is or recently was unwell.
It is self-understood that such a regime is entirely unsuitable for healthy individuals. On the contrary, such a regimen can make healthy individuals unwell, even dangerously ill, although this very regimen is good and beneficial to those who are ill. For, as we know, there are many medications that are actually extremely toxic but can be extremely valuable when given in minute doses to an individual with a specific ailment.
Someone who is completely healthy does not need to have explained to him or be warned against following the regimen of a hospital or a convalescent center.
This does, however, have to be explained to someone who is not entirely well, or to one who had been ill and became used to such a course of therapy, as it is possible that such an individual will conduct himself in the aforementioned manner even after he becomes well. Such an individual must have explained to him the dangers inherent in such conduct.
Doctors as well, seeing as they do the benefits that patients receive in hospitals and the efficacy of medications in helping to save so many lives, have to be reminded that this manner of conduct is only for those who are ill and not for those who are healthy. For those who are well, the opposite is the case [as mentioned above].
Just as doctors are obliged to provide medication to those who are ill, they are equally obliged to explain to their patients that when they become healed from their maladies they are to completely distance themselves from their previous manner of conduct, [i.e., the taking of medications, etc.].
Only when physicians act accordingly can they be considered proper doctors and healers who fulfill their obligations regarding the sick not only [by assisting them] in the present, but also [by helping prevent medical misfortune] in the future.
Doctors have to be vigilant with regard to the above in respect to themselves as well:
Since they are occupied with healing the ill by providing medications, diet regimens, and so on, and even during their free time they are aware that soon they will have to engage in this once again, this habitual conduct may lead them to mistakenly believe that such behavior, [e.g., taking certain medications,] would be beneficial for them as well; that they too should conduct themselves in this manner.
Doctors should therefore be alert to the possibility [that they may erroneously follow such regimens], [and instead] be constantly aware that such conduct only pertains to those whose health situation calls for such conduct [of taking medications, etc.,] and while doctors are permitted and empowered to assist those who are ill, the doctor himself — if he is healthy — is to conduct himself as healthy people do.
(Likkutei Sichos, Vol. XIII, p. [235] 235)
... As soon as a person enters a well-stocked pharmacy, he will observe a vast number of remedies and medications that assist in healing many sick people, even those who are very seriously ill. Understandably, this arouses a feeling of awe in the person who beholds this.
Nevertheless, the pharmacist must explain to that person, and even more importantly, to explain to himself, that all these medications are merely a preparation for healing. In order for the person to be healed, though, two crucial factors are necessary:
An expert in the field needs to indicate which particular medicine, how much, and when that medication is to be taken by the patient. But even this is of no avail if the patient will not actually take the medication; [efforts must be made to assure that the patient does so and is healed].
(Igros Kodesh, Vol. III, p. 145)
Notes:
- (Back to text) Shemos 15:26.
- (Back to text) Bava Basra 9b.
- (Back to text) Shemos 21:19.
- (Back to text) Berachos 60a.
- (Back to text) Ibid. 10b; Pesachim 56a.
- (Back to text) Koheles 7:20.
- (Back to text) Devarim 18:13.
- (Back to text) “A healthy spirit in a healthy body.”
- (Back to text) Iyov 19:26.
- (Back to text) Midrash Tehillim 103:5.
- (Back to text) Avos 4:2.
- (Back to text) Koheles 12:13.
- (Back to text) Bava Basra 9b.
- (Back to text) Avos 4:2.
- (Back to text) In all probability, the National Institute of Health.
- (Back to text) From a letter of the Rebbe, dated 5 Adar Sheni, 5725.
- (Back to text) Berachos 60a.
- (Back to text) Sanhedrin 99b.
- (Back to text) Vayikra 18:5.
- (Back to text) Text of the evening prayer.
- (Back to text) From a sichah of the Rebbe, dated Yud-Beis Tammuz, 5717.
Chapter 13