Rabbi's Sermons

Yom Kippur 5770
Day
September 28, 2009
 

    On this day of atonement, in which vidui, confession, is a necessary component to the process of repentance, I have a confession to make. I have a real problem, a theological problem with a prayer that is very important to most people. I am really uncomfortable with the Mi She Berakh prayer that we recite for the ill. Oh, I don’t want you to think I am uncomfortable praying on behalf of those who are sick. I just feel very uneasy about the idea of saying a prayer which by virtue of reciting it we will get God to change reality. It is just a little too close to magic. Does reciting the prayer cause God to make the person better? And if we neglect to say the prayer or say it improperly will God not heal? Do we truly believe that humans have this power over God to change destiny? The underpinnings of such a prayer seems blasphemous and yet…we say these prayers. And not only do we say them, but prayers for healing have become popular across the Jewish spectrum. Liberal congregations devote whole worship services to healing, and even in the most right wing Orthodox congregations it has become common to place greater emphasis on these healing requests. But why are we doing this? Do we really believe that we can bend God’s will if we recite the prayers in an appropriate way?
    Perhaps some do, but most of us, if we think rationally about what we want to accomplish with healing prayers, know that there are a number of valuable reasons for them. First of all it, it informs the community of those who are ill, and hopefully generates concern among the congregation. I think that it also strengthens the spirit of those for whom the blessing is said. Knowing that people care enough about you to pray for you is encouraging to many. And finally and not in the least it gives the caring community something to do. When people we care about are sick it is discouraging not to be able to do something for them. So if we ourselves are not in the healing professions, we bring chicken soup, we do the mitzvah of bikur holim, visiting the sick, and we pray for them. Often when I visit people in the hospital I let them know that we are all a team to their healing – for them to get better they need to do their part by staying positive and following the care directives from the staff, the doctors and nurses have to do their part and we at shul will do our part and say a healing blessing.
    It reminds me of the story of the Hasidishe synagogue in a small village that caught on fire, the fire dept came and was doing all they could to put out the flames. The fire chief said to the rabbi, “We don’t have that many firefighters, rabbi, we could use some help.” The rebbe said, “Of course!” And turned to his Hasidim and shouted, “Don’t just stand there, Zog Tehillim, Recite psalms!” See everyone of us has a part to play.
    Calling on God to heal our loved ones is one of many examples of prayers in which we call on God to do the good work but we understand that for such a request to be fulfilled we must become partners with God. Whereas the atheist says the Divine component is an illusion, religious individuals recognize that the natural world is a vehicle by which God transmits Divine action and blessing.
    Not all Jewish teaching saw it this way. Some understood this prayer literally, that only God provided healing and just as they believed that all illness came from God for a reason, so it seemed reasonable that only God could heal. The human role in healing was mute. But this did not become a dominant strain in Jewish thought because the majority of Jewish scholars followed a different approach. They taught that saving a life, the mitzvah of Pikuach Nefesh, was considered one of the preeminent mitzvot, a command so valuable that almost every other commandment could be violated to serve this end. In the words of Rabbi Gail Labovitz a professor of Talmud at American Jewish University, “This perspective validates medical expertise and makes the practice of healing a religious obligation.”
    Rabbi Labovitz points out that two verses from Torah in particular serve as a foundation to what has become the normative Jewish view on healing and access to health care. In Exodus 21:19 the Torah rules in a case in which one person has injured another in an altercation, that the assailant must see to it that the victim receives necessary medical attention: ”he shall certainly heal him.” The rabbis of the Talmud, derived from the doubling of the verb in Hebrew (Berakhot 60a and Bava Kama 85a) that this verse gives permission to the human healer to heal. Moses Nachmanides, a scholar and physician himself, noted in his 13th century work, Torat ha-Adam, “ people should not say ‘the Holy One has struck (the ill person) and is the One to heal….(rather) it is a commandment to heal, and is in the category of saving a life.”
    From a second verse we learn that healing is not only permissible, but can be considered a required act for those with the necessary knowledge and training. In Deuteronomy 22:2 we learn that one who finds lost property is obliged to return it to the original owner:  “you shall return it to him.” Since the Hebrew suffix meaning “it” can also mean “him,” the rabbis reread the phrase, (Bava Kama 81b and Sanhedrin 73a): “From where do we know that it is a mitzvah to return a person to health? “The Torah says, ‘return him to himself.’” Moses Maimonides, one of the great Jewish thinkers and also a physician (do we see a pattern here?), explains, (Commentary on the Mishnah Nedarim 4:4), that this includes providing medical care: “the doctor is obligated by law to heal...and this is included in the explication of the verse, that ‘return it to him’ means to include (the ‘return’ of) his body...”
    The responsibility for healing was not only on those with medical skills but also on lay members of the community. Maimonides in the Mishnah Torah, his great code of Jewish law, laid preventive care at the feet of each individual: “Health and wholeness of the body are among the ways of God, for it is impossible to understand anything of the knowledge of the Creator when one is ill. Therefore one must distance oneself from things that harm the body, and conduct oneself in ways that create health and wellness.”
    Access to health care also was a requirement for Jewish communities and Maimonides recorded this first on his list of the ten most important communal services that a city had to offer to its residents (Mishneh Torah, Hilchot De’ot IV: 23).
    Thus a prayer for healing and the firm belief that God provides healing for the sick was not an illusory hope nor an attempt to manipulate the Divine to do our will, it was a call for human beings to actively pursue a sacred mandate -  Choose life that you should live.
    And the pursuit for how best to fulfill that mandate continues to this very day. Rabbi Eliezer Waldenberg, an Orthodox rabbi and one of the leading religious authorities on Medicine today published in 1985 (Ramat Rachel, no. 24; published in vol. 5 of Rabbi Waldenberg’s collected responsa, Tzitz Eliezer) a responsum that insists that a bet din, a Jewish Court, may compel needed medical care to patients unable to pay whether or not there is reimbursement. However in a community where there are multiple doctors, no one doctor can be compelled to provide services not demanded of the others. So Rabbi Waldenberg suggests several means by which a community might provide for its members, including paying for the medical care from communal charity funds, or creating a system whereby doctors equitably share the case load on a pro bono basis. Rabbi Waldenberg’s teaching emphasizes that providing health care, in the final analysis, is the responsibility of the community as a whole.
And Rabbi Shlomo Goren, then the Ashkenazi chief rabbi of Israel, argued in a 1978 responsum that in fact this obligation upon the community meant the government of the Jewish state to ensure that all citizens have access to adequate medical care. He wrote: “The government may not excuse itself from its responsibility toward the sick, since the government — and not the doctors — is responsible for the health of the people”. (Sh’vitat haRofeh L’or HaHalachah, Assia 21)
    We are duty bound to be partners with God for healing. An ideal Jewish society is one in which we are all responsible to keep everyone healthy and secure. This command as we have seen does not fall only on the backs of the medical providers but on the people who need health care as well. While there is not one way that is THE Jewish way to provide for health care there is no doubt that there is a Jewish mandate to make health care available for the entire community. Thus it is not surprising that Jewish rabbinic and lay organizations across the denominational spectrum have agreed that we must seek the goal of an equitable system of access to healthcare in America.
    Sadly this Jewish sensibility does not hold true in America today. Too many of us American citizens either do not have health care, do not have enough health care, or live in fear of losing our health care. The stories are legion and tragic. And while I am sure that the medical professionals in this sanctuary today know all too well first hand about this crisis, as a rabbi I have heard too many disturbing stories, either in my office or from other pastors in town:
    The person who loses his job and with it his health care and now must make the decision what does he pay for – continuing to pay high medical premiums for he and his pregnant wife, keeping up his car payments or their mortgage payment. Without a car he cannot get work, without healthcare the birth of his child will put he and his wife in perhaps a lifetime of debt and without a house…well, what choice would you make?
    Or the individual who leaves their job for a significantly better one that has only one drawback :the job does not come with healthcare, you have to find your own policy, and before this person finds an individual policy, the doctors find cancer. Now try to find an insurance plan with that kind of pre existing condition.
    Or the grad student who is about to complete her studies with no guarantee of a job. She has health care through her school but what happens after graduation? What if she can’t find a job right away? Incur more debt as a student?
    What about the child with a chronic illness, currently his mother carries him with her insurance but when he reaches the age of majority how will he find his own coverage? Why should a mother have to deal with such fears in addition to her concerns for her child’s well being?
    Or yet another case in which a mother does without her own health insurance in order to assist in paying for her adult son’s continued insurance after he lost his job. She was afraid of him being injured or coming down with a pre existing condition before finding a new job and falling into debt he would never escape. Would you be willing to make that sacrifice? But why should you or any of us have to?
    This is what I hear and other pastors in town hear all the time.
    The most recent census figures that came out in early September show that there are just over 46 million uninsured people, that is 15 percent of the country. But the numbers are worse then that. First because the number of uninsured children went down due to the government run Children Health Insurance Program, meaning that the number of uninsured adults actually went up and second, because these census numbers were taken before the recent recession.
    Now look, some of you may be rolling your eyes and saying I did not come to shul to hear politics. But this is not about politics, this is about Torah and Jewish values. The issue is not whose health care reform program is preferable. This is not about whether the Torah promotes Obamacare or not. This is about how Torah demands that we create communities that fulfill the mandate of “Choose Life”, this is about the mandate that doctors are obligated to heal and the society is obligated to support their sacred work.
    And if one were to say to me, as some in the Jewish world might, ‘Well the Torah and Jewish scholars were talking about Jews healing and caring for fellow Jews.’ I say that I think the people in this room are too decent to go there. We are all proudly American and proud of what our nation represents and as American citizens we are part of the fabric of this society and take upon ourselves all the obligations of other fellow citizens. But as Jews we must be informed by our tradition.
    And our tradition demands that we strive to be Godlike. Rabbi Hama bar Haninah asked, “How can a human being follow and hold fast to a God of whom it is said that God is a consuming fire (Deut 4:24). He answered his question, One holds fast to God and acts like God by imitating Divine Qualities. Just as God clothes the naked, as he clothed Adam and Eve in garments of skin, so you should clothe the naked. Just as God visits the sick, as when he visited Abraham after his circumcision, so you should visit the sick. Just as God buries the dead, as he buried Moses, so you must bury the dead.” And just as God heals the sick, as God healed Miriam from leprosy, so we are commanded to heal the sick.
    Rabbi Irwin Kula tells of a Jewish doctor whom he met on vacation in Nantucket who told him when he learned what Rabbi Kula did that Judaism was silly and how he hated hebrew school. At some point Rabbi Kula asked him what he did and he said he was a fertility doctor. “What is it like to be a fertility doctor?” All of a sudden the doctor became reflective and said Rabbi Kula wouldn't understand. Rabbi Kula said, “try me”. And he said, "well you see people come to you who think they have death inside and if you are very very fortunate you create life."
    And he was quiet. And Rabbi Kula said to him, "Do you think in some way, at the deepest level of your consciousness, in fact somewhere in your subconscious there is some connection between your being a fertility doctor and describing the creation of life the way you do and the fact that the very first command in our tradition is to create life...that what God wants is more life? And the guy burst out in tears.
    Ours is a tradition that seeks to sustain and create life. And our current healthcare system is not living up to our ideals.
    We are not the only religious faith tradition that recognizes that healing and universal access to healthcare is acting in Godlike fashion. The United Religious Community published a letter to all the faith communities of Michiana in which it reads in part:
    “In the tumult over policy, many have lost sight of the moral and spiritual principles undergirding the very issue of healthcare and healthcare reform….We boldly proclaim that all persons have a right to quality healthcare…To continue down the path we are going with rising costs and reduced access guarantees that some will unnecessarily suffer and, in fact, die because of indifference and neglect… As representatives of the member congregations of the United Religious Community of St. Joseph County - Christian, Jewish, Muslim, and Baha’i faiths – we call on our legislators and community representatives to do all they can to achieve the changes needed in our present system that will allow all access to quality healthcare and enable all of God’s children to be confident that such care will continue and be there when they most need it.”
    In a few moments we will intone the Unataneh Tokef prayer, with its disquieting verse – Who shall live and who shall die, whose life shall be shortened, and whose will not be; who shall have tranquility and who shall be disturbed; who shall be at ease and who shall be afflicted; who shall be impoverished and who enriched…
    The refrain tells us that these fates are inscribed and sealed during these 10 Days of Awe. But for many Americans, every day is a Yom Nora, not an Awe – filled day, but an Awful day. Every day is a day of not knowing your fate. Our liturgical response to the anxiety produced by these words is that repentance, prayer and tzedakah can mitigate the bitterness of whatever our destiny is to be. Our response as Jews and as Americans has to be to support ways that our nation can mitigate the fears and suffering of millions of our fellow citizens who either lack health insurance, are underinsured, or fear losing their health insurance. And let us not forget that many of those individuals are sitting in this sanctuary at this time.
    Our tradition suggests a different vision for a healthy and enlightened society. The prophet Micah envisioned a day when “(God) will judge among the many peoples, And arbitrate for the multitude of nations, however distant; And they shall beat their swords into plowshares And their spears into pruning hooks. Nation shall not take up sword against nation; They shall never again know war; Rather every man shall sit under his grapevine or fig tree With no one to disturb him.” It is a vision of security and comfort and it is our responsibility to act in ways that make that vision a reality.
    May we in this coming year know when we intone our prayers for healing that our words alone will not be a substitute for the actions required to create access to affordable and quality healthcare for all Americans.

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