After the Separation, the Return

This week’s Torah portion has always been one that has seemed somewhat esoteric and hard to understand. Then the coronavirus happened.

The double portion of Tazria/Metzora describes various skin diseases and how they are treated. If one has an outbreak, or a rash, or lesions, they go to the priest to decides whether or not the person is “clean” or “unclean.” If unclean, there is a time of separation from the camp and ritual sacrifices upon reentry.

The terms “clean” and “unclean” regarding physical illness are always challenging to accept, but the intent of the text is to describe more of a spiritual impurity: the physical illness is seen as an outward manifestation of some sort of inner shortcoming. But this raises its own challenges, as we have a hard time ascribing illness to moral failings as the biblical authors and early commentators did.

So let’s just take a step back and say that regardless of the details, the text is simply describing a mysterious ailment that requires individuals to be put in quarantine, apart from the rest of the community.

Now this portion sounds hauntingly familiar.

Of course in our case it is not just those who are ailing who are in quarantine. In order to slow the spread we are all in a form a quarantine, separated from our community and keeping our distance from other people.

In the Torah, after the one with the skin affliction (usually translated as the “leper” or “one with leprosy”) has spent time outside the camp, the priest would go to visit them to see if they have been healed. If so, then there is an elaborate ritual that is performed. If you will indulge me, I offer a lengthly excerpt from the text (feel free to just skim!):

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. The priest shall take one of the male lambs and offer it with the log of oil as a guilt offering, and he shall elevate them as an elevation offering before God. The lamb shall be slaughtered at the spot in the sacred area where the sin offering and the burnt offering are slaughtered. For the guilt offering, like the sin offering, goes to the priest; it is most holy. The priest shall take some of the blood of the guilt offering, and the priest shall put it on the ridge of the right ear of him who is being cleansed, and on the thumb of his right hand, and on the big toe of his right foot. The priest shall then take some of the log of oil and pour it into the palm of his own left hand. And the priest shall dip his right finger in the oil that is in the palm of his left hand and sprinkle some of the oil with his finger seven times before God. Some of the oil left in his palm shall be put by the priest on the ridge of the right ear of the one being cleansed, on the thumb of his right hand, and on the big toe of his right foot—over the blood of the guilt offering. The rest of the oil in his palm the priest shall put on the head of the one being cleansed. Thus the priest shall make expiation for him before God. The priest shall then offer the sin offering and make expiation for the one being cleansed of his uncleanness. Last, the burnt offering shall be slaughtered, and the priest shall offer the burnt offering and the meal offering on the altar, and the priest shall make expiation for him. Then he shall be clean.

Leviticus 14:1-20

Thanks for sticking through this, and this description adds to an already weird and seemingly irrelevant text. Yet the point here, and why I quoted the whole passage, is to note that the Torah spends a tremendous amount of ink on how to reintegrate one back into the camp after a period of quarantine. Indeed, it seems that the reintegration is almost more difficult and deliberate and important than the original separation. It is easy to separate someone, it is harder to reconnect.

We will need to be deliberate in our return as well. In the coming weeks and months we will start to see how individuals, groups, organizations, and businesses will be able to “open up.” It will not be easy, and it won’t be all at once. I anticipate that large gatherings will take a while to return. (I’m already beginning to think about what a virtual High Holidays will look like as I’m assuming we will not be able to completely return this year.) It will be, as Governor Inslee says, like turning a dial, not flipping a switch.

And we should accept this deliberation. Like the intricate ritual of the leper and the priest, we need to pay attention to each of the steps it will take to come back together, and how to do it in a way that allows for meaningful connection and the safety of all.

Healing is a forward process, not a return to what was. When we heal we still maintain the scars of that which wounded us. When we emerge from our “staying at home” and social distancing, and reintegrate with one another, we may be different as individuals and as a congregation. So we can begin to ask ourselves what that return will look like. What vestiges of the past we will maintain, and what new behaviors or tools will we introduce? How can we emerge “clean”–whole in body and spirit, impacted by our experience and yet ready to face a new future?

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.

I Am The 0.0009%

Oftentimes in describing the details of life we talk about the percentages. I realized recently that I am one of the 0.0009 percent.

No, this isn’t a reference to income inequality (wouldn’t that be nice). This is a reference to two years ago, when I was struck down by bacterial meningitis-an inflammation of the layers surrounding the brain-and wound up in the hospital for a five days (half in the ICU) and on antibiotics for a few weeks after that.

So what’s with the percentage? One day I was playing around with numbers. At first I didn’t realize how rare meningitis is-you read about outbreaks in the newspaper every so often. But then it settles in that the reason is it newsworthy is because it is rare. So I looked up some statistics: Bacterial meningitis strikes about 4100 people a year in the United States. Of those, 500 die. And of those who survive, 1 in 5–or 720–have permanent disabilities. So I am one of the 2880 people in the United States each year who contract bacterial meningitis and survive without permanent injury.

And with a U. S. population of 318.9 million, 2880 is 0.0009%.

This Friday I recently learned has been designated World Meningitis Day by the Confederation of World Meningitis Organizations. Worldwide, meningitis kills or disables about 1.2 million people a year, and bacterial meningitis kills about 120,000 people a year. World Meningitis Day is a day set aside to raise awareness for the disease and its potentially devastating effects. A day to become educated on the warning signs and symptoms and the possibilities for treatment. worldmenigitisA day to offer support for those who have been stricken by meningitis or lost a loved one to the disease. And a day to remember that there is a vaccine that can help prevent meningitis outbreaks. (I wrote about vaccines last week.)

This weekend, in addition to being World Meningitis Day, is parashat Tazria/Metzora in our weekly Torah reading. On Shabbat we turn our attention to this double portion, one of the more esoteric and foreign in our text. We are in the midst of Leviticus, and up until this point we have been reading about sacrifices and the priesthood and the dedication of the Tabernacle. And while we may struggle with the details, we can understand the underlying values of spiritual community, ritual, worship and communal organization.

But then we get to Tazria/Metzora. And the Torah turns its attention to purity and impurity (or cleanliness and uncleanliness), and especially how it relates to bodily functions. We are also introduced to metzora, commonly translated as leprosy, in texts such as this from Leviticus 13:

When an inflammation appears on the skin of one’s body and it heals, and a white swelling or a white discoloration streaked with red develops where the inflammation was, he shall present himself to the priest. If the priest finds that it appears lower than the rest of the skin and that the hair in it has turned white, the priest shall pronounce him unclean; it is a leprous affection that has broken out in the inflammation. But if the priest finds that there is no white hair in it and it is not lower than the rest of the skin, and it is faded, the priest shall isolate him for seven days. If it should spread in the skin, the priest shall pronounce him unclean; it is an affection. But if the discoloration remains stationary, not having spread, it is the scar of the inflammation; the priest shall pronounce him clean.

So what’s up with this? On the one hand, we see in the text the demonstration of the practice of medicine: a skin blemish needs to be checked out, brought to the local “doctor” who makes a diagnosis and a treatment plan. Very simple.

The later rabbis, however, have some difficulty with it. What is the reason for the leprosy? If a priest is involved, there must be a spiritual component to it. So they determine in the midrash (commentary), through a bit of word play, that if one suffers from leprosy it is because he engaged in the sin of hurtful speech. They read the word metzora (leprosy) as a short version ofmotzi shem ra (“one who brings out a bad name”)-or one who speaks ill of another.

This is a nice commentary, and I think we can all agree that hurtful speech has negative consequences, which is what the midrash is trying to teach. But how that message is conveyed is probably even more problematic than the original text. For here the rabbis offer a theological reason for illness, a leap which I don’t think any of us want to take. I certainly don’t. To accept this is to accept the fact that anyone who suffers from physical illness has some spiritual deficiency.

And at the same time, we can sympathize with the rabbis’ motivations. Illness is scary, especially when there is no apparent cause. A direct causation makes sense. It provides comfort.

When I was playing with the numbers, and I came up with that percentage of 0.0009, I was humbled. Why did I get ill? I don’t know. Why did I survive? I don’t know. Why did I survive without major complications? I don’t know.

But what I do know is that I am grateful.

World Meningitis Day for me is a day of awareness and sympathy and connection and gratitude. I’m glad I learned about it. And parashat Tazria/Metzora teaches that while we may get ill with various afflictions, we can also heal from them.

We know that is not always the case, and even with survival comes challenge. And yet we persist, sometimes despite and sometimes because of, the percentages. Because that’s life.