THE WINGS OF THE SUN
Traditional Jewish Healing in Theory and Practice
Care of the Sick
Visiting the sick (bikur cholim) is one of the greatest of all the mitzvot. It is one of the mitzvot the fruits of which a person enjoys in this world while the principal remains intact for him in the World to Come (Shabbat 127a).
Visiting the sick is included in the mitzvah to "go after HaShem your God" (Deuteronomy 13:5). It is impossible for man to literally "go after" the Divine Presence as "HaShem your God is consuming fire" (ibid. ). Going after God means following in God's ways. We find that the Holy One visits the sick, as in the case of Abraham, to whom God appeared as he recovered from his circumcision (Genesis 18:1). In the same way, we too should visit the sick (Bava Metzia 30a).
"Once one of Rabbi Akiva's students became ill. None of the other students visited him, but Rabbi Akiva personally went to see him and swept and cleaned his room. This literally revived the student, who said, `Rabbi, you've brought me back to life!' As soon as Rabbi Akiva left, he taught: `If a person does not visit the sick, it is as if he shed blood!'" (Nedarim 40a)
"Someone who visits the sick gives him life because he prays that he should live. But a person who does not visit him does not know what he needs and therefore does not pray for him" (ibid.).
"Everyone who visits the sick is saved from the judgment of hell, as it is written (Psalms 41:2-3): `God will save him on the evil day.' And what is his reward in this world? `God will protect him' - from the evil inclination - `and preserve him in life' - from suffering - `and he will be praised in the land' - all will feel privileged to be associated with him" (Nedarim ibid.).
1. Laws of Visiting the Sick
based on Yoreh Deah #335
When someone becomes ill, relatives and close friends should visit immediately. But except in the event of a sudden, serious illness, other people should not visit until after the first three days so as not to give the sick person the "name" of an invalid, which may have an adverse effect on his mazal. Each visitor takes away one sixtieth of the illness (Bava Metzia 30b). Even an important person should visit someone of lesser importance. A man may visit a woman and vice versa, as long as the two are not completely alone together. One should not visit an enemy so that he should not think one is glad about his suffering. One may visit the same person even several times in one day, and the more one visits, the more commendable it is - as long as it is not a burden on the patient. Where it is impossible to visit in person, one may fulfil the mitzvah by speaking on the telephone (Rabbi Moshe Feinstein).
The three main components of the mitzvah of visiting the sick are:
1. To check if there is anything the patient needs and to attend to it.
2. To lift the patient's spirits. Choose conversational topics that will bring him joy and vitality. Avoid anything that might give rise to depression and negativity. It is quite proper to suggest that he should put his affairs in order, and there is no reason for him to fear that this would be like preparing to die, because keeping one's affairs in order is an obligation even in times of good health. However, one should not tell the patient to confess his sins unless his condition is very serious. Be careful not to burden the patient. Be as sensitive as possible to his feelings. Sometimes it may be hard for him to talk but he feels obliged to do so out of respect for the visitor. Or he may have to attend to his needs but feel too ashamed to say so. Some conditions are highly embarrassing to the patient. In such cases, rather than going into the patient's room to see him in person, it is better for the visitor to stay outside and ask other members of the household if there is anything he can do for him.
3. To pray for the patient. Someone who visits a sick person but does not pray for him or her has not fulfilled the mitzvah. For this reason the Sages advised against visiting the sick in the first three hours of the day because most patients experience a certain improvement in their condition at that time and one may not realize the importance of praying for them. Similarly the Sages advised not to visit in the last three hours of the day because there is often a deterioration at this time and one may despair of praying. When praying for the sick, one should include him or her among all sick Jews, because their collective merit makes the prayer more acceptable. The traditional prayer for the sick is:
יהי רצון מלפניך ד' אלקי ואלקי אבותי שתשלח במהרה רפואה שלמה מן השמים רפואת הנפש ורפואת הגוף לפלונבן/בת פלוני(ת) בתוך שאר חולי ישראל.
"May it be Your will, HaShem my God and God of my forefathers, that You should quickly send complete healing from heaven - healing of the soul and healing of the body - to (patient's name), son/daughter of (mother's name), among the other sick members of the Jewish People.''
On Shabbat one says, "Today it is Shabbat, which is not the time to cry out. Healing will soon come! God is overflowing in kindness! Shabbat Shalom!"
When someone in the house is sick, one should go to a Sage in the town and ask him to pray for the patient and bless him. It is customary to bless the sick in the synagogue during the Torah reading, which is a time of divine favor. In a case of serious illness it is customary to give the patient a new name (i.e. add a name), since a change of name may annul a bad decree (Rosh Hashanah 16b, and see Rabbi Nachman's Wisdom #95).
The face of kindness
"Underlying the mitzvah of visiting the sick is the idea of showing them a face of radiant kindness. Rather than staying buried in our own homes and hiding our faces from the patient, we must visit him, attend to his needs and speak to his heart. By showing him a smiling face and radiating kindness, we draw down to him the light of God's countenance - `the light of the countenance of the Living King' (Proverbs 16:15), the light of the Shekhinah - and this is what gives him the new vitality he needs to be healed.
"`The Shekhinah is above the head of the sick, as it is written (Psalms 41:4) "God will sustain him on the bed of sickness"' (Shabbat 12b), i.e. specifically because he is sick, the light of the Shekhinah shines upon him. This is the light of the true Tzaddik, who takes care of all the sick, and especially those who are the sickest; he watches over them more than over anyone else in order to heal them physically and spiritually, and to bring them to higher and higher levels of knowledge of God. The true greatness of the Tzaddik lies in the fact that he makes such a great effort to heal those who are sickest of all. Because they are so sick, the Shekhinah - i.e. the light of the Tzaddik - is above their heads.
"Thus it was that when Abraham was sick, `God appeared to him in the plains of Mamre' (Genesis 18:1). Precisely because he was sick, it was necessary to visit him. The revelation Abraham attained was in the same category as the perceptions of Godliness attained by the sick through the light of the Tzaddik, which is the light of the Shekhinah" (Likutey Halakhot, Hashkamat HaBoker 4:14).
2. The Human Connection
When writing disparagingly about doctors and medicine, Reb Noson frequently uses the phrase רופאי אליל (rophey elil), "worthless doctors" (Likutey Tefilot II, 1; 3; Alim Literufah #4, #391 etc.). The phrase is taken from the book of Job (13:4), and it is illuminating to examine it in its context, because it contains a vital lesson for all those involved in caring for the sick, whether privately or in some professional capacity.
As Job sat grieving over the terrible tragedies and illnesses that had befallen him, the three friends who had come to comfort him urged him to accept that he must have done something to deserve his plight since God is just in all His ways. Yet far from giving Job any solace, his friends' lengthy speeches only exacerbated his pain. It was not that Job doubted God's perfect righteousness, but he knew he had done nothing to deserve all this suffering. Not one of his friends was willing to grapple with the deep mystery that was troubling Job: Why should a just God send suffering to those who do not deserve it? Perhaps his friends had listened to Job's words, but none of them had really heard what he was saying. They had not heard him.
This was why he cried out, "You are all plasterers of lies, worthless doctors all of you! If only you would keep completely quiet - that would be your wisdom! Please! Hear my argument and listen to what my lips are struggling to express" (Job 13:4-6). It was not his friends' words and interventions that Job needed. He was not necessarily looking for answers. What he craved more than anything was for his friends to be quiet - to listen and receive. He was pleading to be understood. This was what could have brought him some relief from his inner torment. It was because his friends were not willing even to try to comprehend him that they were "worthless doctors."
Trying to understand
No matter what the problem is in life, it is not enough to have an impressive armory of powerful remedies and solutions. The most ingenious remedy is worthless if it is not properly tailored to the problem that needs to be solved. And therefore, as every true doctor knows, before offering treatments and solutions, the first thing is to understand exactly what the problem is. One who would heal must first observe, examine and probe, scrutinizing every detail for signs, hints and clues about the true nature of the problem in all its breadth and depth.
Especially where spiritual, mental and emotional factors are involved, it is vital to hear the suffering person out and to attend not only to what he says but also to what he leaves unsaid. What unspoken messages are contained in his choice of images and symbols, his tone of voice, his hesitations and silences, facial expressions, posture, gestures, movements...? Without sensitivity and receptivity to all this and more, the would-be healer will miss the essence of the problem, and all his remedies will be worthless.
At some point in our lives each one of us may be involved in caring for the sick and troubled. Certainly nobody should ever put himself forward as a healer without having a deep understanding of the art of healing. Yet there is a sense in which the Torah asks all of us to be healers - because we all have the obligation to carry out the mitzvah of bikur cholim when necessary. The Sages taught that visiting the sick gives them life (Nedarim 40a), and since life is what healing is all about, this means that bikur cholim is a vital part of the healing process. The principles of bikur cholim apply not only when paying a visit to a sick relative or friend. They are relevant to everyone involved in care of the sick, including both those tending cases of short- or long-term illness at home and those involved in some aspect of sickcare as a vocation, from doctors (conventional or alternative), therapists, nurses, paramedics, receptionists, secretarial and medical insurance staff to rabbis, psychologists, social workers, volunteer helpers, educational and other personnel.
The impressive achievements of modern medicine have been taken as license for the medical establishment to virtually appropriate for itself the concepts of curing and healing, as if genuine healing can occur only when the physician opens his box of tricks and intervenes with drug therapy, surgery or some other form of treatment. The main focus of aggressive, high technology modern medicine is on attacking the disease. But the person who has the disease is largely ignored! Even those vested with the task of seeing to patients' human needs tend to look on their role in the healing process as being merely secondary to that of the prestigious warrior doctors on the battlefront.
Reaching out to the person
Job's lesson is that reaching out to the person who has the illness is in fact the very essence of healing, and the "healer" whose remedies and treatments fail to touch that inner person is a rophe elil, a worthless doctor. All the science and technology and hands-on skills are lacking when something far more elemental is absent: basic human understanding. The qualities that count here are not slickness and sophistication but sensitivity, empathy and the ability to reach out and make a human connection.
It is significant that several large-scale epidemiological studies have shown a definite link between physical health and the social support in people's lives - family ties, marriage, friendships, group affiliation and the like. The number of regular social relationships people have correlates with a lower risk of dying at a given age. For example, those who have an extensive and caring social network have been found to be three times more likely to recover from a heart attack than those who are socially isolated!
In Torah terms, the sick person is in a kind of exile: a spiritual flaw on some level prevents his soul from radiating to the fullest, resulting in both his physical symptoms and a corresponding constriction in his mental and emotional state. What is necessary is to penetrate behind the manifest symptoms to the underlying spiritual flaw. In order for the sick person himself to be able to understand what the flaw is and to work to correct it, he must rise beyond his mental constriction to a higher state of da'at, spiritual awareness and insight. But "a prisoner cannot release himself from prison" (Berakhot 5b), and therefore the sick person needs the help and support of those around him in order to escape his spiritual exile.
For this reason the mitzvah of bikur cholim involves more than simply seeing that the patient's basic physical needs are taken care of. Certainly it is essential to ensure that he or she receives the best medical treatment possible and is properly cared for in other ways. But equally important are the other two components of the mitzvah: lifting the sick person's spirits and praying for his or her recovery. Praying for the patient is an integral part of bikur cholim because although healing is ultimately in God's hands, it is up to us to forge a channel for His blessings and draw them to the patient through our prayers on his or her behalf. And while we must rely on God for what is up to God, we are still obliged to do what lies within our hands, which is to show the patient the face of human kindness and support in order to help him come to the simchah that is the key to all healing.
How to pray for the sick
On Rebbe Nachman's last Rosh Hashanah in Uman, his four-year-old grandson Yisrael was with him. The Rebbe was in a very serious condition, and said to his grandson, "Yisrael, pray to God that I should get better." The little boy said, "Give me your watch and I'll pray for you." The Rebbe said, "You see, he's already a Rebbe because he tells me to give him something in order for him to pray!" The Rebbe gave him the watch, and the little boy turned aside and said, "God! God! Let my zeida be well!" The other people in the room smiled, but the Rebbe said, "This is exactly how we have to ask things of God. What other way is there to pray to God?" The essence of prayer is total simplicity: to speak to God like a child talking to his father or the way a person talks with a friend (Tzaddik #439).
The human connection is an essential part of Rebbe Nachman's healing path- way as explained in "Sound the Shofar - Dominion". It is when a person is alone and isolated that he is vulnerable to the "accusation of the angels" as expressed in the vicissitudes of material existence, including physical illness. The power to withstand these attacks comes through bonding and connection with other souls, especially with that of the Tzaddik, who has a collective soul. The Tzaddik is the exemplar of tzedakah, outreach and kindness to all who are in need, and is thus the central figure in the Jewish healing pathway. Having struggled successfully to cleanse his own heart of the worldly attachments that throw the light of spirituality into shadow, the Tzaddik has the power to radiate insight and understanding to others and help them rectify their spiritual flaws in order to be healed.
Breaking through the walls of the heart
To give the necessary direction to each soul, the Tzaddik must undoubtedly have profound knowledge of each one's roots and its place in the merkavah, the "chariot" through which God governs creation (see Biur Halikutim II, 1:2). But to form his personal connection with each individual soul, the Tzaddik needs more than this esoteric wisdom. He must also have simple, down-to-earth human sensitivity. This is what Rebbe Nachman was talking about when he said, "People bring money to a man as a pidyon, a redemption, asking him to intercede for them on high. They tell him their illness and suffering and other problems. It's a wonder to me that the man accepting the redemption doesn't suffer as much as the sick person himself!" (Rabbi Nachman's Wisdom #188). Reb Noson tells us that the Rebbe "actually felt the pain and suffering of the sick for whom he prayed. He literally felt their every ache and pain" (ibid.).
Rebbe Nachman made it very clear that this sensitivity is not simply a natural gift that some are born with and others not. It is something one has to work on. The Rebbe said, "When I first began, I asked God to let me feel the pain and suffering of others. Sometimes a person would come to me and tell me his troubles but I would feel absolutely nothing. But I prayed to God that I should feel this Jewish suffering. Now I feel the other person's suffering even more than he does!" (ibid.).
Moreover, this acute sensitivity is not something only tzaddikim are required to have. Rebbe Nachman insisted that all of us should cultivate it. "You should be able to feel another person's troubles in your own heart. This is especially true when many are suffering. It is possible to have a clear intellectual understanding of another person's anguish and still not feel it in your heart. If you don't feel it, you should strike your head against the wall! You should strike your head against the walls of your heart. This is the meaning of the verse `Know this day and put it into your heart that HaShem is God...' (Deuteronomy 4:39). You must bring the realization from your mind to your heart. Undertand this well. This is what is meant by `Hezekiah turned his face to the wall' (Isaiah 38:2). The face he turned was his awareness, bringing it inside the walls of his heart. For a person's true face is his mind, which illuminates the face from within" (Rabbi Nachman's Wisdom #39).
It is significant that Rebbe Nachman connects the idea of bringing understanding from the head into the heart with King Hezekiah's turning his face to the wall, an act that encapsulates the Torah healing pathway in its entirety. Literally, Hezekiah's turning to the wall means that he turned aside to pray. He was sick, and he was praying for his own recovery - and certainly anyone who is sick should try to break through the walls and barriers in his own heart in order to emerge from his spiritual exile and heal. Bringing deeper knowledge and awareness of God into the heart is thus one of the central themes in "Sound the Shofar - Dominion," where it is presented as the key to the redemption of prayer, which makes it possible to channel healing without the need for medicines (Likutey Moharan II, 1:5-8).
But breaking down the blockages in the heart is a task not only for the sick but also for those who are healthy, who are charged with the responsibility of caring for the sick, visiting them and praying for their recovery. As we have seen, this applies to all of us at one time or another since we are all commanded to carry out the mitzvah of bikur cholim. Empathy with the sick person is an essential part of this mitzvah. Bringing da'at into the heart so as to "know this day and put it into your heart that HaShem is God" means more than simply cultivating an awareness of God "out there," as it were. Equally important, it involves recognizing the Godly sparks within each and every one of His creatures, seeing and feeling for each one as a unique individual with his or her supreme value. This is why Rebbe Nachman gives such emphasis in "Sound the Shofar - Dominion" to the rabbinic teachings never to look down on other people and not to judge them until you truly understand their situation (ibid. #10 & #14).
I am the obstacle!
Rebbe Nachman told one of his leading followers, R. Yudel, that praying for a friend with troubles keeps a person from arrogance. R. Yudel said, "But it would seem that, on the contrary, I would just become more arrogant. If I'm praying for my friend, the implication is that I am more important than my friend!" The Rebbe answered with a story:
"There was a king who was angry with his son and sent him away. Afterwards, the prince placated his father, who agreed to have him back. The same thing happened several times, until at last the king was so angry that not only did he send his son away, but he also told one of his ministers that if the prince were to come along wanting to placate him, the minister should not allow him to enter. The minister obeyed, but he saw how much the prince was suffering because of not being able to get into his father to placate him. The minister realized that the king was also suffering, and he said to himself, `Surely I am the cause of all this since I am the barrier between them. I myself will go to the king and beg him to forgive the prince and allow him back.' The minister did so, and the king immediately agreed.
"The meaning of the story is obvious. Whenever a friend of ours is suffering, physically or spiritually, we should say, `Without doubt my sins are the cause of all this. The Holy One, blessed be He, constantly desires to bestow blessings of goodness upon His children. But my sins are a barrier holding all this back. The solution is for me to plead with the King on behalf of my friend.' When a person thinks like this, he will certainly not come to arrogance because he knows that the only cause of his friend's deficiency, spiritual or material, is the screen he himself has erected between his friend and the Holy One, blessed be He" (Tzaddik #447).
The good points
Who is this person? What has made him the way he is? Where is the good in him? How can I connect with it? The teachings on human connection in "Sound the Shofar - Dominion" are essentially an elaboration of the pathway Rebbe Nachman taught in "Azamra - I will sing!" (Likutey Moharan I, 282). Searching for the good points in all people and judging them positively is more than a mere cognitive stance, a mode of viewing other people that need not necessarily affect the way we actually behave towards them. On the contrary, the sensitivity we cultivate to the divine sparks in people must suffuse every facet of our relationships with them, governing, for example, the things we talk about, the activities we share, etc. The way we relate to people has a decisive effect on the way they relate to themselves. Rebbe Nachman said: "By finding even a modicum of good in another person, you really do elevate him and you can actually bring him back to God!" (Likutey Moharan I, 282).
From a letter of the Lubavitcher Rebbe to a doctor
"...You surely follow the practice of many other God-fearing doctors who, when patients turn to them for medical advice, take the opportunity to give them encouragement to heal the soul. Everyone needs this, particularly in this orphaned generation... especially since we see with our own eyes that an improvement in a person's spiritual health quite literally leads to an improvement in physical health..." (Refuah Shelemah pp.24-5).
While the need to search for people's good points applies in all of our relationships in life, it is of special importance in our caring relationships with the sick. In the medical paradigm the sick person is treated primarily as a patient, a passive victim of an illness who must now passively submit to treatment in order to be cured. But this can encourage the patient to evade his own responsibilities and simply wait to be cured by medicine. However, where self-neglect, bad habits, negative traits and the like have played a part in the development of illness, true healing requires a willingness to change on the part of the sick person himself. In addition to receiving any necessary medical treatment, he must also be ready to take his own life in hand and make the adjustments in outlook, attitudes, lifestyle and behavior that are needed for long-term balance and health.
One of the primary aims of those involved in care of the sick at any level should thus be to strengthen the sick person spiritually in order to help him overcome the backlog of discouragement, demoralization and depression that may be standing in the way of his trying to make changes and take new initiatives. In addition to providing for the patient's medical and other physical needs, a central focus of care of the sick must therefore be to help him attain deeper self-understanding and spiritual insight and assist him in developing his motivation and marshaling the inner resources he needs for new growth. This is precisely what searching for and working with the "good points" - the spiritual growth-points - is all about. The very phrase bikur cholim, "visiting the sick," contains an allusion to the search for the good points, because the root meaning of the word ביקור (bikur) is "searching."
With happiness you can give life
"With happiness you can give a person life. A person might be in terrible agony and not be able to express what is in his heart. There is no one to whom he can unburden his heart, so he remains deeply pained and worried. If you come to such a person with a happy face, you can cheer him and literally give him life. This is a great thing and by no means an empty gesture" (Rabbi Nachman's Wisdom #43).
A full exploration of the applications of Rebbe Nachman's teaching on searching for the good points in human relationships in general and in care of the sick, therapy, rehabilitation and counselling, etc. in particular would require a complete study on its own. When it comes to practice, the essential challenge is to maintain our sensitivity to the feelings of others even when we are under sustained pressure. Care of the sick and bikur cholim are such great mitzvot because of the enormous difficulty of fulfilling them adequately. Caring for a sick child, a spouse, a parent, a dear friend or a neighbor can be extremely draining, especially when the illness is protracted or where the burden of extra duties is made even weightier by emotional or financial problems. For the professional doctor or healthcare worker, simply being faced with a never ending succession of suffering, anxious, lonely and demanding patients can itself be overwhelming, causing many to seek refuge behind a thick exterior of brisk matter-of-factness and superficial banter, rather than to risk opening the gates of human feelings.
In asking us to "know today" and turn our heads to the walls of our hearts, Rebbe Nachman is asking us to make the effort to remember at all times that those in our care are not just "patients" but real live people. Each one is a living soul, an entire universe with a past, a future, and an infinitely subtle, complex mesh of thoughts and tender feelings. Being empathic does not necessarily have to consume tremendous amounts of time. All that's needed is to take that second or two to try to put ourselves in the other person's place. Instead of merely throwing out a jaunty "How are you today?" without really wanting to hear the full answer, let us have the courage to make a human commitment by taking that extra moment to smile, to look kindly into this person's eyes, to make a connection, and to say, even without words: "I am here for you. I will support you. I won't try just to impose my own categories on you. I am willing to open myself to who you are and what you need."
All this can be accomplished even while delivering a tray of food, tidying around the bed or taking the patient's temperature or blood pressure.... Healing is more than just a matter of conducting tests and prescribing medicines. With all the science and technology, healing will always remain an art - the art of rebuilding the sick person by uncovering his growth points so that he can take his destiny into his own hands and live. And the only way to build anyone is through a sensitive, caring human relationship.
3. Children's Illness
How do Rebbe Nachman's teachings on healing apply to children? It is quite clear that Rebbe Nachman saw illness in adults as a call for spiritual arousal on the part of the person who is ill, which is obviously not relevant when a baby or a very small child is sick, God forbid. But the rabbis taught that little children sometimes suffer illness because of the sins of the generation (Shabbat 33b), and this indicates that children's illnesses should certainly be taken as a call for serious thought and introspection on the part of their parents and other adults around them and the community in general.
Nothing can be more agonizing than the anguish of parents when a dear child is ill. Which father or mother wouldn't rather take the illness and suffering upon themselves if only they could? It would be distasteful in the extreme to make glib moralistic judgments about the meaning of tragedies like stillbirths, crib deaths, deformities, serious children's illnesses and deaths. Why such things happen involves some of the most deeply hidden secrets of God's providence, and none of us is qualified to "utter that which we do not understand, things too wonderful for us, which we do not know" (see Job 42:3).
"Why are little schoolchildren stricken with illness? When there are Tzaddikim in the world, they suffer for the sins of the generation. But when there are no Tzaddikim, the little children suffer for the sins of the generation. This is hinted at in the verse, `If you do not know where to graze, O fairest of women, go in the footsteps of the sheep and pasture your tender kids by the shepherds' tents (MiShKeNot)' (Song of Songs 1:8): the little kids are taken as a pledge meMuShKaNin) instead of the shepherds" (Shabbat 33b).
Rebbe Nachman alluded to such mysteries of providence in speaking about the illnesses that struck his own small children and grandchildren. When his baby Shlomo Ephraim was sick with tuberculosis, Rebbe Nachman indicated that it was the very preciousness of the boy's soul that aroused the jealousy of the sitra achra, the forces of unholiness, which attacked the boy to prevent a great spiritual light from being revealed in the world. This was perhaps one of the main reasons why the Rebbe put so much effort into praying for the boy and begged his followers to do the same. The only way to fight such an attack by the forces of evil is by concerted efforts to strengthen the power of holiness in the world through prayer and good deeds.
Even if certain cases of children's illnesses can be viewed in a moralistic perspective, they should not be seen as requital for some flaw or shortcoming so much as a call to the parents, family, friends and other members of the community to make supreme efforts in prayer, acts of kindness and charity, Torah study and the like. When a child's life is in the balance, God forbid, it is a most sombre reminder of the preciousness of life. "Generation to generation will praise Your works" (Psalms 145:4): each and every Jewish soul comes into the world to know and recognize God in a new way. Each soul is itself a unique revelation of God. It is this revelation that the sitra achra fights so hard to prevent - and this can only be countered by maximizing the revelation of God's sovereignty through prayer, Torah and mitzvot (see Tefilin pp. 81ff.).
In the case of Rebbe Nachman's Shlomo Ephraim, even the many prayers did not bring him physical healing. But when the young son of the Rebbe's follower, Reb Shimon, was ill, although the decree seemed to have been sealed, his mother's prayers not only saved him but secured him a very long life. The Rabbis taught that "God craves the prayers of Israel" (Chullin 60b). It is as if in certain cases God may send affliction in order to squeeze the most passionate prayers from the very depths of the heart in order to bestow life. For it is prayer that gives birth to the soul and brings it to life. The prayers of Abraham and Sarah actually brought into being the souls of the converts they made in Charan (Genesis 12:5, and see Likutey Moharan I, 31:6). And so too the earnest prayers of parents, family, friends and members of the community for sick babies and children can actually win them life.
As we have seen, in cases of children's sickness in Reb Noson's family, he relied on prayer alone, refusing to call in doctors. Given the enormous advances in medicine since Reb Noson's time, it would today be the height of irresponsibility not to have a sick child treated medically when necessary. This does not mean that every minor headache, tummy-ache or temperature should be smothered with medications. Growing numbers of orthodox practitioners recognize that indiscriminate use of antibiotics and other medicines may be harmful, and many treatments that were routine less than a generation ago have been abandoned because of the long-term damage they caused. The Rambam's sage advice to minimize the use of medicines as far as possible applies to children just as it does to adults.
Nevertheless, even apparently mild problems in children must be evaluated with the utmost care, as neglect can sometimes cause irreparable damage. As we have seen, Rebbe Nachman himself gave his endorsement to preventive medicine by insisting that his followers have their children vaccinated. The Rebbe's caveat when going to doctors to be sure to seek out the very best most certainly applies to medical treatment for children. Having a child treated when necessary shows no lack of faith as long as we keep in mind at every step that it is not the doctor who gives life or health, but only God. We must put our faith in Him, not in a particular doctor, medicine or treatment.
Deeper faith and increased efforts in prayer and mitzvot are without doubt the proper response to children's illness for the parents and other adults. But what about for the child? Obviously this depends very much on the age and maturity of the child. As in the case of adults, there is no wisdom in waiting for illness to strike before giving attention to the spiritual dimensions of healthcare. As part of children's Torah education parents and teachers should make every effort to inculcate in them the preciousness of God's gift of good health by pointing out the wonders of human bodily functioning and teaching them to take proper care of themselves. The emphasis should be on protecting health so as to be able to keep the Torah and serve God.
All this can be conveyed in simple ways even to children three or four years old. Example is the best of all teachers, and parents who live sensibly and moderately, avoiding smoking and other forms of abuse, are doing their children a lifelong service. Accustoming children to a wholesome diet from an early age will help them be content with a minimum of cookies, candies, etc., which should be given as special treats rather than being allowed to become a regular component of their diets. Children should be provided with every possible opportunity to enjoy fresh air and exercise.
As a child matures it is right and proper to talk to him seriously about the takhlit - the purpose of life. We have seen how Rebbe Nachman spoke to a nine-year-old boy about life and death. This goes contrary to the widespread present-day tendency to "protect" children from knowledge of death and dying and other realities of our existence, even though most children are exposed to a constant diet of violence and murder through the media. This may be part of the reason for the widespread irresponsibility and often callous disregard for human life and dignity among many segments of contemporary youth. "Train a child in the way he should go" (Proverbs 22:6). With due sensitivity it is possible to imbue children and adolescents with a sense of responsibility and a strong feeling for the purpose of life, which can only help them appreciate life's preciousness, and encourage them to take full advantage of the opportunities they are given to fulfil themselves through Torah and mitzvot.
The Torah educational establishment fully understands the importance of teaching youth the basics of prayer, blessings, Shabbat observance, festivals and other regular mitzvot. It is therefore surprising that the mitzvah to "take care of yourself" (Deuteronomy 4:9) is widely ignored in religious educational institutions - this despite the fact that "bodily health and well-being are part of the path to God... and one must therefore avoid anything that may harm the body, and cultivate healthy habits" (Mishneh Torah, Hilkhot De'ot 4:1). Parents and teachers who make a serious effort to teach children and adolescents the basic principles of healthcare, hygiene, diet and exercise are obviously providing them with a sound basis for a lifetime of health, especially if they also make sure to teach them the principles of spiritual healthcare - faith, simchah and the vital embrace of Torah and mitzvot.
The best way for parents to convey to their children that illness and healing are from God is through the way they conduct themselves in practice. Even in the case of minor problems, one should make a point to say to a child, "Let's pray to HaShem for refuah shelemah." This can be done even while putting on a bandaid or before giving the child a spoonful of cough syrup. It leaves a lifelong impression on a child when he sees that in cases of fever or other problems the parent does not merely run to the medicine cabinet or rush off to the doctor but also takes a moment to give charity, say some words of prayer, recite a few psalms and ask "What mitzvah should we be paying more attention to?" When taking a child to a doctor, a parent should emphasize that the doctor is only God's agent, and that even when using medicine as a means of healing we must have faith in God and put our main efforts into teshuvah, Torah and mitzvot.
When caring for a sick child, raising the child's spirits in whatever way appropriate is just as important as it is in the case of adults. The key to healing is simchah, especially the joy of Torah and mitzvot. Sick children of sufficient maturity should be encouraged to pray and carry out other mitzvot as far as possible, because "they are our life and length of days," and children's prayers and mitzvot are very precious. In conversation with the child one should tell stories about the tzaddikim and discuss other Torah topics in accordance with the age of the child. Children who are faced with a life-threatening illness, God forbid, often have a deeper awareness of their situation than some of the adults around them imagine. Where the child wishes to speak about life and death matters in his or her own way, it is proper to respond and do everything possible to enhance the child's awareness of God's protective presence and kindness.
May God send health and healing, spiritual and physical, to all the sick children of
BACK TO WINGS OF THE SUN HOMEPAGE
By Rabbi Avraham Yehoshua Greenbaum
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