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.

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.

Shifts in Meaning

One of our quests as individuals is to make meaning within our lives. That is one of the purposes of religion, to frame moments of time and infuse them with the understanding that we are part of something greater than ourselves, that what happens to us is a part of who we are as individuals, that we have the ability to grow and change. 

Making meaning is not rationalizing, about saying “everything happens for a reason.” It doesn’t. It is about fully integrating the event into our life’s narrative and perhaps emerging from the challenging episode with some new insight or learning so that when we enter the next stage of our journey we are better prepared, or more aware, or have a different outlook. 

Easier said than done. It is mightily hard to do, especially when it comes to the stumbling blocks we face. 

Having recently come out of a serious illness, I have struggling with this. The events and circumstances of my recent illness were a whirlwind as they were going on. Now, as people approach and say how scary it was, and as I read about the rarity of meningitis and its not insignificant mortality rate (plus the rate of impairments for those who do survive), I reflect on the seriousness which was my situation. And while I have come out of the other end of it and escaped danger, I still worry about my condition (am I more forgetful since the illness or am I imagining that?) and I still struggled spiritually with what it all means. 

On the spiritual side, when someone is stricken with a serious illness, and then recovers, there are two poles one can lean towards: the illness or the recovery. Focusing on this illness-asking why did I get sick in the first place-leaves one in a place of vulnerability, of the fleeting nature of the world, of the complete lack of control we have when one day we are healthy and the next day we are not. Focusing on the recovery-on I was very ill but I recovered-brings one to a place of gratitude, of appreciating the preciousness of life and all it contains. And I admit, for the past few weeks I was stuck in the former, and was focused on how vulnerable and weak I felt, and was depressed about the turn of events. 

Until last week. I was attending a conference back east, the alumni retreat of the Rabbis Without Borders fellowship in which I participated last year. I had planned to go for a while, long before I got sick, and was able to make it to the conference. It was a tremendous experience of learning from great teachers and colleagues on a wide range of topics. 

I found myself in a workshop lead by a wonderful colleague, Rabbi Laura Duhan Kaplan, who is a neighbor to the north in that she serves a congregation in Vancouver, BC. In the workshop she pushed us on the idea of meaning making through our ability to examine events, particularly a chain of events, and discern any links or connections, a concept called synchronicity. 

We were introduced to this text by the Jungian psychologist Janet Dallett: 

Discontinuous events are usually though of as chance occurrences. In many instances this is sufficient explanation. Sometimes, however, we come up against happenings whose coincidence in time does not appear to be random, even though there is no causal relationship between them…In synchronistic occurrences the connecting factor is meaning rather than causality.

In the workshop we had the opportunity to discuss in hevruta(study pairs) experiences where we might have seen synchronicity operating in our lives.

At first this was hard. I couldn’t see beyond the past four weeks of hospital, medicine, bed rest, headaches, etc. But then I realized where I was, sitting in a retreat center thousands of miles from home. I had made the plans to go east months ago, but just a week and a half before the trip I didn’t think I would make it. While I did not have any medical restrictions on flying, I was still quite low energy, and I thought the trip may be too depleting. I had even contacted the organizer and told her I may not make it.

But in the days leading up to when I would fly I was feeling stronger and stronger, and while I was still a bit nervous, I felt much better than I did even that week and a half ago, and so I boarded the plane. The trip was fine, the conference was restorative, and I was glad I went.

Each morning we gathered for minyan, for a shacharit(morning) service. The first morning was Monday, a traditional day for reading of Torah, and I thought that I was ready tobentch gomelGomel is a blessing recited, usually in the context of a Torah service, by one who has escaped danger, recovered from an illness, returned from a long trip, given birth or some other experience which in some way carries risk. I had an aliyah to the Torah and then said the words: “Blessed are You, Adonai our God, Ruler of the Universe, Who bestows good things on those in debt to You, and Who has granted me all good.” And the community responded, “Amen. And may the One Who has bestowed upon you good, continue to bestow upon you good.” Reciting this beracha, in a room filled with friends and colleagues, people who share my rabbinic path, in a room which radiated compassion and care and connection, was truly powerful.

So then later in the conference, sitting in the classroom with my hevruta, I drew together these two experiences into a whole. The timing of my illness allowed me to still come to the conference. If I had gotten sick a week later, perhaps, I would not have made it to the retreat. But the arc of the illness allowed me to make the trip, and be in that room, and offer that blessing, and transition from one who is ailing to one who is fully in recovery.

And here is where I shifted from one pole to the other. Rather than focus on my vulnerability and weakness, my recitation ofgomel at that time brought me to that place of gratitude. And I realize this is a better place to be.

Perhaps I was weakened physically by the meningitis. Indeed, the working theory by my doctor in the hospital is that my neurosurgery from a few years back may have made me more susceptible to contract meningitis, and thus he suggests I be more vigilant in keeping my sinuses and nasal passages clear. Plus that and general wellness is again a concern. But I hope to emerge from it stronger spiritually.

Not everyone makes meaning the same way. And again, it is not easy. But the ability to reflect and self-reflect with the goal of emerging from our life’s events with some new insight, with some shift in how we see ourselves and the world around us, is important and a blessing. It is another good thing that is bestowed upon us.