Why We Get Sick

Recently on one of my rabbinic listservs, a colleague asked about this week’s Torah portion of Metzorah. The portion speaks of tzara’at, the biblical affliction commonly translated as leprosy (but not really connected to what we consider leprosy). This portion and last week’s, named Tazria, both deal with this issue. In fact the two portions are usually read together, but because of some calendar issues, they are read separately this year. Here is a longish excerpt from Tazria (bear with me):

God spoke to Moses and Aaron, saying: When a person has on the skin of his body a swelling, a rash, or a discoloration, and it develops into a scaly affection on the skin of his body, it shall be reported to Aaron the priest or to one of his sons, the priests. The priest shall examine the affection on the skin of his body: if hair in the affected patch has turned white and the affection appears to be deeper than the skin of his body, it is a leprous affection; when the priest sees it, he shall pronounce him unclean. But if it is a white discoloration on the skin of his body which does not appear to be deeper than the skin and the hair in it has not turned white, the priest shall isolate the affected person for seven days. On the seventh day the priest shall examine him, and if the affection has remained unchanged in color and the disease has not spread on the skin, the priest shall isolate him for another seven days. On the seventh day the priest shall examine him again: if the affection has faded and has not spread on the skin, the priest shall pronounce him clean. It is a rash; he shall wash his clothes, and he shall be clean. But if the rash should spread on the skin after he has presented himself to the priest and been pronounced clean, he shall present himself again to the priest. And if the priest sees that the rash has spread on the skin, the priest shall pronounce him unclean; it is leprosy. (Leviticus 13:1-8)

And another one from the portion Metzora (hang in there):

God spoke to Moses, saying: This shall be the ritual for a leper at the time that he is to be cleansed. When it has been reported to the priest, the priest shall go outside the camp. If the priest sees that the leper has been healed of his scaly affection, the priest shall order two live clean birds, cedar wood, crimson stuff, and hyssop to be brought for him who is to be cleansed. The priest shall order one of the birds slaughtered over fresh water in an earthen vessel;  and he shall take the live bird, along with the cedar wood, the crimson stuff, and the hyssop, and dip them together with the live bird in the blood of the bird that was slaughtered over the fresh water. He shall then sprinkle it seven times on him who is to be cleansed of the eruption and cleanse him; and he shall set the live bird free in the open country.  The one to be cleansed shall wash his clothes, shave off all his hair, and bathe in water; then he shall be clean. After that he may enter the camp, but he must remain outside his tent seven days. On the seventh day he shall shave off all his hair — of head, beard, and eyebrows. When he has shaved off all his hair, he shall wash his clothes and bathe his body in water; then he shall be clean. On the eighth day he shall take two male lambs without blemish, one ewe lamb in its first year without blemish, three-tenths of a measure of choice flour with oil mixed in for a meal offering, and one log of oil. These shall be presented before God, with the man to be cleansed, at the entrance of the Tent of Meeting, by the priest who performs the cleansing. (Leviticus 14:1-11)

Quite strange. In short, if one develops this disease—this “scaly affection”—they go to the priest who examines it and makes a determination. Such a disease can render a person ritually impure, so the priest does an examination, makes a diagnosis and prescribes a remedy of isolation and ritual cleansing. Not the way we approach illness and healing in our day and age.

The text is not only strange to us. It bothered the ancient rabbis as well, but for different reasons perhaps. While we may find this notion of ritual purity a foreign concept, the rabbis are worried about the origins of the disease.  The Torah does not give a reason as to why one person or another would get leprosy, but the rabbis in the Talmud make a suggestion:

Resh Lakish said: What is the meaning of: “This shall be the ritual for the leper?” [Leviticus 14:2] It means, “This shall be the ritual for him who brings up an evil name.” (Babylonian Talmud, Arakhin 15b)

Using word play, they say the one who brings up an evil name (Heb., motzi shem ra)—i.e., one who speaks ill of another—will become a leper. (Heb., the metzora.) The similar sounds in the Hebrew create the connection. In other words, one who uses hurtful speech will be afflicted with this skin disease as punishment.

On the one hand this is a nice midrash. If we understand the leprosy as metaphoric, then the rabbis are saying that hurtful speech has consequences. This is something we can understand. Unlike the children’s rhyme about “sticks and stones,” we know that the emotional damage brought about by hateful speech can be just as painful as broken bones.

But sometimes it is hard to read past the literal. Here then was my colleague’s question. This past year she was diagnosed with cancer. In light of this very real illness, how can she teach the traditional midrash of the portion which posits that illness is the result of the patient’s bad behavior? How can she teach a text that appears to “blame the victim?”

I appreciated her question as it is one I continue to wrestle with. Up until 10 years ago I was healthy, never broken a bone, never had a major illness, never been in the hospital. Then I began to lose my peripheral vision and a series of diagnostic steps led to my diagnosis of a cerebral cyst, followed by surgery. The cyst recurred two years later, followed by another surgery. (And so far, no recurrence. I recently went in for my routine 3-year MRI which was, in medical parlance, “unremarkable.” My next one has been pushed back for 5 years.) And then three years ago I contracted bacterial meningitis, which I amazingly not only survived but survived without any major complications, which put me in a small statistical set. Its been quite a decade for me, health-wise.

Computed_tomography_of_human_brain_-_large
Brain. Not mine.

One of the first questions people ask me when I tell them my story of meningitis is, “How did you get it?” The answer: I don’t know. In fact, the medical community does not know how anyone gets meningitis—I remember the infectious diseases doctor telling me this explicitly. And the cyst I had has no specific cause, it was congenital, and was slowly growing in my head since birth, not an issue until it was.

Through all these medical experiences I have learned that despite how much we have advanced in medicine and treatment and health care technology, there is still so much we do not know when it comes to how and why illness occurs. This is both humbling and scares the shit out of me.

I therefore don’t see the rabbis connecting tzara’at to negative speech as blaming the victim, but rather exercising a fundamental human impulse—to make order of chaos, the understandable out of the random, to create a clear cause and effect. It is an impulse we still have today when we talk about illness, we try to find causality in eating habits, or behavior, or family history. But the real answer oftentimes to how or why illness happens is, “I don’t know.”

That is what the Torah is saying. In the pshat (plain meaning) of the Torah text, there is no reason given as to why a person will get this “scaly affection.” And while I don’t like the midrash of the rabbis connecting it to harmful speech, I am sympathetic to their motivation. Because even though we may find it troubling to say that a specific act brought about a physical affliction, the pshat is even scarier: that tzara’at—or illness in general—is random. This is a truth that the rabbis were trying to come to terms with, and it is a truth that we must try to come to terms with as well.

It’s difficult and unsatisfying, but it is our reality. And yet we also understand the truth and reality of healing as well. For while the pshat of the Torah is scary, it is also hopeful. On the one hand it teaches that random illness exists. So too it teaches of the possibility of recovery.

3 responses to Why We Get Sick

  1. lisastrange says:

    As I am studying psychology, including psychopathology as well as brain diseases such as Alzheimer’s, I have noticed my tendency to want to find the causes of these problems. Many experts admit that the causes are unknown. Some pathologies are thought to be caused by genetic mutations. But what causes these mutations? Some sources point to trauma of various kinds. One family in Columbia with a rare form of inheritable early-onset Alzheimer’s traced their family tree back to a Spanish conquistador, suggesting to me that the family’s origins contain traumatic experiences. Many physical and psychological disorders appear to have their roots in early childhood trauma in particular. It is also known that trauma can cause genetic abnormalities that get passed on from one generation to the next, and even to the third generation and beyond. I find myself then looking for the possibility of trauma history in every instance of disease or dysfunction. On the one hand, my research supports the imperative that we must work to prevent trauma, especially child abuse, sexual and domestic violence, and war. This research also suggests that trauma-informed therapy should be a part of every treatment plan. On the other hand, am I just trying to explain the unexplainable? To understand that which is beyond understanding? To secure certainty in the face of randomness? I am aware of the human tendency to seek meaning. But meaning may also be found in the living experience of a thing, without knowing its origins, and without a solution. I am not likely to give up searching, but it seems equally important to just be with what is.

    Like

    • Rabbi360 says:

      Great questions Lisa, thanks for reading and commenting!

      Like

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