Parshas Mishpatim Medical Interventions and Hashem’s Artwork

By Rabbi Yosef Tropper

Posted on 01/28/19

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1) Doctor’s Permission to Heal

Verapoh yerapeh (Shemos 21:19).” If someone causes damage to his friend, he is obligated to pay for the medical bills.  But, it is a double expression, “Verapoh, yerapeh.” Which translates as, “He will surely heal him.” The gemara in Bava Kamma (85a) says, “Tana d’beih Rab Yishmael.”  Rav Yishmael taught, the pasuk says, “Verapoh yerapeh. Mikan She’nitan reshus larofeh l’rapos, we learn from here that a doctor is granted permission to perform healing interventions.

Why This Way?

Asks the Gra:  What going on over here? It should say there’s permission given to the choleh, the sick person, to go to the doctor to be cured?  Why does it express the permission in terms of the doctors has permission to cure? 

Let’s zoom out for a second, what’s the alleged problem with going to a doctor? We know the famous Ramban (Bechukosai) which in not halacha l’maaseh, that says that if someone believes fully in Hashem, you won’t need a doctor.  And, all the poskim say that this is not the way we follow.  Even Ramban himself was a doctor. Many of the rishonim were doctors.  All the gedolim of today’s generation, as my rebbe Rav Asher Zelig Rubenstein zt”l always pointed out: Rav Elyashiv, Rav Shlomo Zalman Aeurbach, every single gadol: chassish and litvish all went to doctors, and it’s a mitzvah to go to the doctor if a person is sick, and certainly a mitzvah to go to an expert if a person has a complication. However, the patient needs permission to go and the doctor needs permission to heal.

Hashem is Real Doctor

Says the Chovos Halevavos in Shaar Habitachon and says the Gra over here: When engaging in medical care, we have to know that the Rebono Shel Olam is the One that is healing us. It’s a halacha in SHulchan Aruch that when a person takes a medication he says the yihi ratzon: Please let this refuah be a shaliach to help cure me, but really I know it’s all You Hashem.” I recognize that the Rebono Shel Olam is giving permission to the rofeih.  Hashem says: Really I should come down and heal you myself, but I’m giving permission that the rofeih to carry this out. The doctor has a right to be a shaliach for me. Therefore, Hashem is transferring that shlichus.  That’s what it means, “V’rapoh yerapeh.”  Hashem says: I am the Rofeih chol basar u’mafli la’asos.  I’m the one that’s rofeih choleih amo Yisrael.  But, I give permission for the doctor to be my shaliach. That is why it is stated in the context of the doctor’s permisson.

I would like to suggest that when we think about Chazal’s critical words about doctors, we can better understand them. The Gemara in Kiddushin says, “Tov she’biroffim l’gihenom, the best of the doctors go to purgatory.” What did the doctor do wrong?  So, many of the doctors think that they are G-d, and they forget that the Rebono Shel Olam is the one who’s merapeh because medicine offers so many apparent options. It is so important in life that whatever we see and do, we recognize, even though it looks like it’s us, it looks like the doctor has a right to claim credit for himself: I’m just a good doctor.  I have a lot of experience.  I know what I’m doing, and I heal people.  It’s very easy to forget about the Rebono Shel Olam.

2) Greatest Artist

I saw a beautiful p’shat from the Ponovezher Rav, who was the rebbe of my great rebbe, Rav Asher Zelig Rubenstein zt”l. The Ponovezher Rav was a talmid of the Chofetz Chaim, and one of the world’s greatest fundraisers as he built up the Ponovezh Yeshiva after the Holocaust, building it l’kavod, u’l’tifarres.

The gemara (Berachos 32a) says that when Channah sang her beautiful song, praising Hashem forgiving her a son, finally after nineteen years of being barren, so she says there’s no one as great as Hashem, and “ein tzur k’Elokeinu.”  There’s no rock like G-d.  And, the gemara darshens “ein tzayar k’Elokeinu”. There’s no artist like G-d. The mefarshim talk about what’s so great about an artist. What does that mean “there’s no artist like G-d”.  

Says the Ponovezher Rav: What is the greatest thing that the artist strives for?  What’s the greatest compliment that we give to the artist?  No, it’s not about how much money he sells his artwork for.  When we look at the Mona Lisa, what do people say?  They says it is so lifelike.  It looks so real.  The greatest compliment that we give an artist is that what he drew looks so real even though it’s not.  It’s totally fake.  It’s a picture.

Hashem is the Greatest Artist! Olam Hazeh Mirage

Says the Ponovezher Rav: Rebono Shel Olam created the world with such artistry and such brilliance that the Rebono Shel Olam makes it look like we’re real, that we exist independent of him.  The Rebono Shel Olam’s world is a world that allows for bechira, allows for free will.  And, the Rebono Shel Olam is such a great artist that he created a world where literally the world itself could block him out, and it looks like we’re real.  We think that we do things.  We think that we have control.  We think that our choices that we make and the things that we do are what bring out an action, and our challenge is to turn to the Rebono Shel Olam and say: You’re the artist.  Rebono Shel Olam You’re the one, like we sing on Rosh Hashanah and Yom Kippur that Hashem we are just clay in Your hands.  You’re the potter.  You’re the one that’s putting this together.  You are everything and we are nothing. 

That’s the ultimate emunah and bitachon, and that’s the madreigah that we’re supposed to have.  When we go to the doctor, we recognize: Rebono Shel Olam, I’m doing my hishtadlus because You commanded me, but I know it’s all You because You’re the artist, and I’m just the fake.  

If you think about it, the Ponovezher Rav’s vort is such a beautiful vort.  How many of us think that we are lifelike and we are real and forget about the Rebono Shel Olam who’s the one who’s running the show.

Look Deeper for Artist

If you think about what the Ponovezher Rav is saying, it’s so important because in that artwork that is so lifelike, and the Rebono Shel Olam created such a beautiful world that looks like it’s independent of Him, but if you look deeper, you see the Rebono Shel Olam’s signature everywhere.  You see the Rebono Shel Olam’s style everywhere.  And, so, that lifelike item actually brings us back to G-d Himself, and that lifelike item, “Mibesari echezeh Eloka.” Moreso, you can recognize the artist’s unique style in each stroke as well.

We see the Rebono Shel Olam through the art that it actually comes back, and, so too, we could use this world as place, not to deny Hashem, and to think: Oh look, I’m a great piece of art. I’m in control. But, to see Hashem in every single action and to see Hashem in the medicine that look at what the Rebono Shel did.  Look that the Rebono Shel Olam brought this refuah. Look what the Rebono Shel Olam created in the world that’s the greatest inspiration.  Such beautiful and powerful thoughts. We could use it everyday.  Everyone should be well and no one should need a refuah, but when we turn to the Rebono Shel Olam we recognize that: You’re the artist and You’re the one that runs the show, that’s the beauty of life.  We should be zocheh tol ive that way.

3) Doctor’s Knowledge is Limited

Another p’shat of the Gra in “V’rapoh yerapeh” is very interesting that the Gra writes that when it says that a rofeih is allowed to be merapeh that’s only referring to a rofeih chitzonis.  It’s only for external things that the doctors have some expertise.  However, for internal things, they don’t know anything.  And, this is just an interesting thing to take a step back.  Doesn’t mean that we don’t do our hishtadlus and it doesn’t mean that we don’t try to understand the doctor.  But, I think that what the Gra is trying to teach us is that people think: Oh, the doctor knows, and whatever the doctor says is true. Well, we have to be careful because a doctor’s knowledge is also very limited and doctors are constantly bafelled by things.  Look at the vestigial items that they claim that are worthless. Who needs an appendix? And, who needs tonsils?  Well, there’s always things that are found that they actually have medical needs.  It’s true, one can live without certain limbs.  One can live with only one lung, etc. and other things, you know.  A liver can regenerate and be cut off. We could replace hearts nowadays with medicine, but it’s all the Rebono Shel Olam’s chochmah as well, and the doctors really don’t know so much.  There’s so much they don’t know.

To Heal and Give Hope Only, Nothing Else

This is the climax of what I believe is p’shat that what I believe is p’shat.  

There was a man that came to the Gra and said that the doctors gave up hope on me.  I went to them and they said that they have no way to help me and I’m going to die.  He was so broken and so bitter.  And, the Gra said: the doctors have permission, based on Chazal and the pasuk “v’rapoh yerapeih”.  He has permission to heal.  The doctors were never granted permission to give up hope.  That’s not the right that the doctor has.  So, now turn to the Rebono Shel Olam and daven.  

I don’t know what the end of the story is.  Whether the person had a refuah or not.  But, the point is that the perspective is that it’s nitein reshus l’rapos.  Yes they have a reshus to heal, but no one said that theyhave permission to be not merapeh and to make the patient give up hope and to tell them that you’re going to die.  How many times they’ve been wrong!

4) Eyes, Teeth, Hands, and Feet are Riches

Finally, the last thought is: we have the pesukim “Ayin tachas ayin, shein tachas shein.” Gra says that the Roshei Teivos of the word ashir, which means rich person, happy person is “Ayin” which means eyes, “Shein”, which means tooth, “yad” which means hand, and “reish” which means foot.  And, so what’s the p’shat?  Says the Gra that if a person has these things in life, he should be happy just for that.  That’s enough to make him happy.  By the way, this is also brought down from the Maharal’s brother in Igerres Hatiyul.  He also brings this same vort.  He lived before the Vilna Gaon in the sixteen hundreds, Rav Chaim Lowy.  And so, if a person is an ashir, you’re rich.  If a person has eyes and teeth and hands and feet, he’s rich.

Awe-Inspiring People

Now, someone might ask and someone one time asked me this: Well, hey, I’m missing one of those.  Now what?  Well, my answer to you is: Ask anyone that is missing one of those and they’ll tell you the amount of compensation and greatness that people accomplish in their life despite physical challenges is awe inspiring. The Rebono Shel Olam created us and we should look around and look at the things that we have and thank Hashem accordingly.

We should be zocheh to live according to the Gra’s understanding and inspiration to know that the Rebono Shel Olam is the greatest artist and that our lives are all dependent on Him and He’s the one that sends the refuah and He’s the one that does everything in this world and we should just have a life of thanking Hashem and praising Him for all that he has blessed us with.


Rabbi Yosef Tropper is a rabbi and psychotherapist. Subscribe at ParshaThemes.com