Who Needs Doctors?

In this week’s Parsha, Bechukotai, Ramban (Vaykra 26:11) discusses the blessings that the Torah promises to those who follow its ways. He then touches upon the issue of using doctors to heal us.

רמב"ן ויקרא פרק כו

והכלל כי בהיות ישראל שלמים והם רבים, לא יתנהג ענינם בטבע כלל, לא בגופם, ולא בארצם, לא בכללם, ולא ביחיד מהם, כי יברך השם לחמם ומימם, ויסיר מחלה מקרבם, עד שלא יצטרכו לרופא ולהשתמר בדרך מדרכי הרפואות כלל, כמו שאמר (שמות טו כו) כי אני ה' רופאך. וכן היו הצדיקים עושים בזמן הנבואה, גם כי יקרם עון שיחלו לא ידרשו ברופאים רק בנביאים, כענין חזקיהו בחלותו (מ"ב כ ב ג:

Generally, when the majority of the Jews are perfect, they are not under the sway of natural laws, neither as to their body nor as to their land, neither as individuals nor as a group. For God will bless their bread and water, thereby removing illnesses from among them to the point they will never need doctors or their medicines as it says “for I God am your healer”. That is how the righteous behaved at the time of prophecy, they sought out prophets rather than doctors as Chizkyahu did when they became sick because of a particular transgression.

Ramban had explained earlier that sicknesses result when the land is cursed producing fruits that cause sickness while when God blesses it, the food itself is medicinal. Thus if a majority of the people are righteous the produce of the land is blessed and sickness is eliminated. Ramban is consistent with his understanding that science is an illusion. Observable phenomena are a result of, either the indirect control of God via spirits or other such supernatural powers, or, as in the case of the Jews in their land, God’s direct intervention. He then makes a famous statement:

ומה חלק לרופאים בבית עושי רצון השם

What place do doctors have in the house of those who fulfill God’s will?

אבל ברצות השם דרכי איש אין לו עסק ברופאים

When God approves of a man’s ways, doctors have no place with him.

In general, Ramban sees the use of medicine as a concession and a human weakness. Righteous people would never avail themselves of doctors nor would they need to.

In Massechet Pessachim, the Mishna says that Chizkyahu destroyed the Book of Healings. Rambam proposes two possibilities as the reason. Either the book contained magical potions which are nonsensical harming people who used them instead of good medicine. Another possibility is that it contained poisons that people used to harm others. It is because of one of these reasons that Chizkyahu decided to destroy it. Rambam is not satisfied and continues:

פירוש המשנה לרמב"ם מסכת פסחים פרק ד

ולא הארכתי לדבר בענין זה אלא מפני ששמעתי וגם פירשו לי ששלמה חבר ספר רפואות שאם חלה אדם באיזו מחלה שהיא פנה אליו ועשה כמו שהוא אומר ומתרפא, וראה חזקיה שלא היו בני אדם בוטחים בה' במחלותיהם אלא על ספר הרפואות, עמד וגנזו. ומלבד אפסות דבר זה ומה שיש בו מן ההזיות, הנה ייחסו לחזקיה ולסיעתו שהודו לו סכלות שאין ליחס דוגמתה אלא לגרועים שבהמון. ולפי דמיונם המשובש והמטופש אם רעב אדם ופנה אל הלחם ואכלו שמתרפא מאותו הצער הגדול בלי ספק, האם נאמר שהסיר בטחונו מה', והוי שוטים יאמר להם, כי כמו שאני מודה לה' בעת האוכל שהמציא לי דבר להסיר רעבוני ולהחיותני ולקיימני, כך נודה לו על שהמציא רפואה המרפאה את מחלתי כשאשתמש בה. ולא הייתי צריך לסתור פירוש זה הגרוע לולי פרסומו.

I talk about this at length because I heard and was also told that Shlomo composed this book of healing to be used by sick people. It was a very effective medical treatise and worked as predicted. Any sick person that turned to it and followed its instructions was healed. As Chizkyahu realized that instead of turning to God when sick, they used the medicines recommended in the book to heal themselves, he decided to destroy it. Besides this making no sense and being a fantasy too, they also accuse Chizkyahu and his group of perpetrating a stupidity that one would not expect from the lowest among the masses. According to their idiotic and erroneous imagination, a hungry person that eats bread, relieving his great pain, demonstrates that he does not rely on God? O fools that they are! The same way I thank God when I eat for having provided me things that alleviate my hunger and thus sustain me, so too do I thank Him for having provided me with the cure to my illness that is available for my use. It should not have been necessary for me to negate this explanation if not for the fact that it is so widespread!

The contrast between Ramban and Rambam’s understanding is jarring. As we saw to Rambam, understanding the sciences is the way to finding God. It shows His greatness and omniscience. Ramban on the other hand sees science as deflecting from God. The repetitiveness of what we consider to be natural law is an illusion. If we look carefully, we will see that there are powers that influence things at whim. While all the other nations are under the auspices of the stars and the spirits, we, the Jewish people, when in our land, are under the direct control of God. If we follow His laws, nothing bad can happen to us. That obviously miraculous providence is the greatest proof for the existence of God, the Creator.

The implications of these two world views are immense and affect how we are to understand providence, reward and punishment, prayer and generally, what the meaning of Mitzvot is.