Human Initiative and the Divine Hand
Yeshivat Har Etzion
Shiur 11: Human Initiative and the Divine Hand
By Rav Yitzchak Blau
The rabbis taught: "King Chizkiyahu initiated six actions, three of which the Sages endorsed and three they did not endorse. He dragged his father's bones on a bier of ropes, and they endorsed him; he pulverized the Copper Snake, and they endorsed him; he hid away the Book of Cures and they endorsed him. He cut off the doors to the Sanctuary and sent them to the Assyrian king, and they did not endorse him; he sealed up the waters of the Upper Gichon, and they did not endorse him; he made a leap year during Nissan, and they did not endorse him."
What did this Book of Cures consist of and why was it praiseworthy to hide it? Rashi explains that this book enabled people to cure any ailment instantaneously. Such a book needed to be hidden because sickness also has its place in the divine scheme of things: ill health reminds people of their human frailty and turns their attention back to Hashem. Therefore, when the ability to instantly restore good health counteracted the religious benefits of sickness, Chizkiyahu removed the Book of Cures.
In his commentary on the Mishna (Pesachim 4:9), the Rambam offers two other interpretations. Perhaps the book described healing based on pagan practices, which constitutes a biblical prohibition. The Jews had such a book because a person is allowed to study this type of material in a purely theoretical fashion; once some of them began to actually use the practices in this book in response to illness, the book needed to be taken away. Alternatively, the Rambam suggests that the book was an encyclopedia of both poisons and antidotes, and the problem was that people began to make extensive use of the sections describing poisons. According to both of the Rambam's views, the problem has nothing to do with human medicinal success getting in the way of the Divine plan.
Indeed, the Rambam cites such an idea only to vociferously denounce it. He draws a powerful analogy to human attempts to deal with hunger: just as human efforts to turn wheat in to bread do not violate any religious ideal, so too curing the sick is in no way religiously problematic. Not only does the human initiative not contradict a sense of dependence on the divine, it enhances it. The Rambam points out that just as we thank God when eating food, we can thank God for creating the cure developed by human hands.
Interestingly, although the six actions of Chizkiyahu are found in our contemporary editions of the Mishna, in the Gemara (both Talmud Bavli and Yerushalmi), they are not part of the mishnaic text, and the Rambam seems to follow the Gemara. The fact that the Rambam chooses to comment on a nonmishnaic text in the context of a commentary on the Mishna reveals how strongly he felt about this idea; the Rambam begins his comment by writing that "This halakha is a tosefta, but I saw fit to explain it as well because it is beneficial." It is rare that the Rambam uses his commentary on the Mishna to discuss texts other than a given mishna. Apparently, the endorsement of human initiative in the world of medicine was so significant that he chooses to depart from his usual procedure in order to highlight this point.
The Chazon Ish (Emuna U-bitachon 5:5) refutes the Rambam's analogy between procuring food and searching for cures, arguing that seeking food is the norm of our human existence, while sickness represents a deviation from the norm. Unlike hunger, illness reflects Divine punishment; therefore, only the latter constitutes a divine message to repent, while the former does not. We respond to hunger by harvesting wheat, but ideally we would respond to illness with prayer and repentance.
While my sympathy in this debate lies fully with the the Rambam, I should mention a solid argument advanced by the Chazon Ish. He points out that the gemara (Bava Kama 85a) needs the Scriptural phrase "Ve-rapo yerapei" ("He shall certainly cure," Shemot 21:19) to allow the doctor to cure. No parallel gemara requires a source to allow the hungry person to take steps to alleviate his hunger. Apparently, the Chazon Ish argues, healing involves more religious questions than preparing food. Of course, the Rambam might counter that it was only a theoretical possibility that healing might be problematic; once we have the derivation, we discover that seeking remedies does not truly differ from seeking food.
On a theological plane, the Rambam clearly sees no distinction between hunger and sickness; illness may be less frequent than hunger, but it remains very much a part of the natural order. God set up that order for us to function within as we utilize the best of our human resources.
These two approaches reflect broad distinctions in religious understanding. I shall paint the two perspectives in broad strokes that will admittedly leave out some nuances. One approach denies or minimizes the natural order, tending to see all difficulties as divine punishments and playing down the significance of human initiative within the natural order; the other approach maximizes the natural order, viewing many difficulties as the normal functioning of nature and granting great value to human naturalistic efforts to alleviate those difficulties. (See David Shatz's fine article in The Torah u'Madda Journal, Volume 3, for a discussion of these issues.)
Rav Yosef Dov Solovetichik firmly identifies with the Rambam on this issue. In his essay entitled "Majesty and Humility," he sees human scientific efforts in general, and the realm of medicine in particular, as a fulfillment of a religious duty (Tradition 17:2, p. 34): "To live, and to defy death, is a sublime moral achievement. That is why Judaism has displayed so much sympathy for scientific medicine and commanded the sick person to seek medical help. Curing, healing the sick is a divine attribute reflecting an activity (rofe cholim) in which man ought to engage."
Rabbi Yisra'el Lifshitz also strongly endorses human science and medicine. In the context of his commentary on the mishna (Tiferet Yisra'el) on the eighth chapter of Yoma, he dedicates sections to discussing how to treat both scurvy and rabid dog bites. This same attitude is reflected in his commentary on the source about Chizkiyahu (Peaschim 4:10). Rabbi Lifshitz assumes an interpretation similar to the first explanation of the Rambam: he suggests that the Book of Cures discussed amulets with images and constellations; however, he does not think that using such a volume in and of itself constitutes idolatry. Therefore, when people were led to idolatry by this book, Chizkiyahu hid it but did not destroy it (as he destroyed the Copper Snake). This enabled people to use the Book of Cures at times of real danger. Apparently, even a work that might lead to idolatry must be retained if it can help heal serious human illness.
Thus, we see that those religious individuals who believe in the stability of the natural order and who endorse human initiative within that order must be careful not to set up a theology that removes God's providence from the world. We must achieve a certain balance between the human and the divine. Religious ideals should not inhibit human effort to alleviate human suffering; on the contrary, it should inspire such an effort. Still, at the same time, that effort must be seen as part of the scheme of Divine Providence.