What Can we Learn About Preventive Medicine from Parashat Ki Tetze?

Parashat Ki Tetze

Why is Preventative Medicine so Important in the Torah?

Praying for the sick is vital, but even more important is praying for the healthy. I try to pray daily, for myself and my loved ones to stay healthy. I’ve learned – and even if I hadn’t learned it, it makes total sense – that prayer, as preventative medicine, is much more effective than a prayer for the sick. Once a person falls sick, many more prayers and merits are needed to bring about his healing. Although healing the sick is a Torah obligation, Judaism puts a priority on preventative medicine because the Torah is a blueprint for living holy, healthy lives on all levels: spiritually, emotionally, and physically. We have a mitzvah to protect our health, based on the Torah verse “only watch yourself – watch your soul” (Devarim 4:9). This verse entails the mitzvah of safeguarding our health (Rambam, Hilchot Rotzeach 11:4). The most famous Torah verse about preventive healing appears soon after the splitting of the sea. Hashem assures the Israelites that living Torah lives and keeping all the mitzvot scrupulously is the best preventative medicine, as it states: “…if you listen to the voice of Hashem, your G-d, and you do what is proper in His eyes, and you listen closely to His mitzvot and observe all His statutes, I will put none of these diseases upon you which I put on the Egyptians, for I am Hashem, your healer” (Shemot 15:26). This implies that Hashem, our healer, teaches us Torah and mitzvot so that we may be saved from these diseases – like a physician who says to a person: “Do not eat things that will cause you to relapse into danger from illness” (Rashi ad loco.). This verse sets the tone for the many Torah verses, and commentaries by Torah sages, that emphasize the importance of preventative health. 

Preventative Medicine is a Mitzvah

Just as G-d’s healing role is to prevent illness, so too, a physician must emulate the Divine role, by emphasizing prevention of illness. For we are obligated to “follow the ways of G-d” (Devarim 11:22; Sotah 14a). For a long time, I have been teaching and striving to live according to the world’s greatest physician, the Rambam, and his directives in Hilchot Deot, Chapter four. This chapter – written to guide healthy people in maintaining their health – opens with the rationale for why preventative medicine is a mitzvah: “Since maintaining a healthy and sound body is among the ways of G-d – for one cannot understand or have any knowledge of the Creator if he is ill – therefore he must avoid that which harms the body and accustom himself to that which is helpful for the body to become stronger” (Rambam, Mishneh Torah, Hilchot Deot 4:1). The following anecdote about Rambam highlights his emphasis on preventative medicine. During the period when Rambam served as the Sultan of Egypt’s royal physician, the Sultan never became ill. One day, he asked Rambam: “How do I know that you are an expert physician, since during the period that you have been here, I have never been ill, and you have not had the opportunity to test your skills?” Rambam concluded that “we learn that the ability of a physician to prevent illness is a greater proof of his skill than his ability to cure someone who is already ill.”  In this spirit, I’m going to share three examples of prevention from Parashat Ki Tetze. 

 

?Why Does the Torah Seem so Cruel to the Rebellious Son

ספר דברים פרק כא פסוק יח כִּי יִהְיֶה לְאִישׁ בֵּן סוֹרֵר וּמוֹרֶה אֵינֶנּוּ שֹׁמֵעַ בְּקוֹל אָבִיו וּבְקוֹל אִמּוֹ וְיִסְּרוּ אֹתוֹ וְלֹא יִשְׁמַע אֲלֵיהֶם: (יט) וְתָפְשׂוּ בוֹ אָבִיו וְאִמּוֹ וְהוֹצִיאוּ אֹתוֹ אֶל זִקְנֵי עִירוֹ וְאֶל שַׁעַר מְקֹמוֹ: (כ) וְאָמְרוּ אֶל זִקְנֵי עִירוֹ בְּנֵנוּ זֶה סוֹרֵר וּמֹרֶה אֵינֶנּוּ שֹׁמֵעַ בְּקֹלֵנוּ זוֹלֵל וְסֹבֵא: (כא) וּרְגָמֻהוּ כָּל אַנְשֵׁי עִירוֹ בָאֲבָנִים וָמֵת וּבִעַרְתָּ הָרָע מִקִּרְבֶּךָ וְכָל יִשְׂרָאֵל יִשְׁמְעוּ וְיִרָאוּ:

“If a man has a wayward and rebellious son, who does not obey his father or his mother, and they chasten him, and [he still] does not listen to them, his father and his mother shall take hold of him and bring him out to the elders of his city, and to the gate of his place. Then they shall say to the elders of his city, ‘This son of ours is wayward and rebellious; he does not obey us; [he is] a glutton and a guzzler.’ And all the men of his city shall pelt him to death with stones, and he shall die. So shall you clear out the evil from among you, and all Israel will listen and fear” (Devarim 21:18-21). 

The laws of the rebellious son have always been difficult for me to understand. It seems unfair that someone should be judged on account of actions that he hasn’t yet committed. Rashi explains: The wayward and rebellious son is executed on account of [what he will become in] the end. The Torah penetrates to his ultimate intentions. Eventually, he will squander his father’s money, seek what he has become accustomed to, not find it, and stand at the crossroads and rob people [killing them, thereby incurring the death penalty. Says the Torah, “Let him die innocent [of such crimes], rather than have him die guilty [of such crimes].” [San. 72b]; (Rashi, Devarim 21:18). We are not just talking about a minor judgment. How can it be fair to evoke the death penalty on someone for sins he hasn’t committed? How can anyone be so sure that he will commit these sins? What about free choice and teshuva? Why do they not pertain to this wayward son? Moreover, how can his parents, whom we assume would love their child, be so heartless to take their own son to be mercilessly killed?

“There Was Never a Wayward and Rebellious Son” 
The Talmud assuages my distress. Even in Talmudic times, it was clear that the harsh punishment for the “wayward and rebellious son” is only theoretical, as it states, “There has never been a wayward and rebellious son and there will never be one in the future.” This is because no boy will ever meet all of the halachic qualifications of the ‘wayward and rebellious son.’ Why then was this law written? That you may study it and receive a reward [for the Torah learning, despite its lack of practical application]” (based on Babylonian Talmud Sanhedrin 71a). We may, therefore, wonder why this law is written? The answer is that studying the laws of the hypothetical “rebellious son,” will help prevent the need to implement them. By educating people about the ruthless punishment for the rebellious son, the Torah helps prevent this tragic breakdown in family and society from occurring in the first place. This is what the Talmud means by “Study it and receive a reward.” The very study of the subject is its own reward. As each generation is educated about the dangers of the “rebellious son” and absorbs the message of the gravity of the offense, this horrendous situation is avoided. (Based on Gold from the Land of Israel, pp. 324-326. Adapted from Otzarot HaRe’iyah vol. II, p. 187).

Torah Law as Preventive Measures to Avoid Injury

An altogether different preventive law in Parashat Ki Tetze is the mitzvah to build a fence around our roof. We need to safeguard and avoid the possibility that someone might fall: 

ספר דברים פרק כב פסוק ח כִּי תִבְנֶה בַּיִת חָדָשׁ וְעָשִׂיתָ מַעֲקֶה לְגַגֶּךָ וְלֹא תָשִׂים דָּמִים בְּבֵיתֶךָ כִּי יִפֹּל הַנֹּפֵל מִמֶּנּוּ:

“When you build a new house, you shall make a guard rail for your roof so that you shall not cause blood [to be spilled] in your house, that the one who falls should fall from it [the roof] (Devarim 22:8).

In Bat Ayin, there are many flat rooves or porches, where family and friends might hang out. Without a proper fence, this could be an inherently dangerous place. Therefore, we must anticipate the danger and build a railing, so that no one will fall. With this mitzvah, the Torah clarifies that it’s not enough to refrain from pushing someone off a roof. We must anticipate and proactively protect against that danger. This applies not only to roofs but to any situation where we foresee danger. We are bound to anticipate any potential danger and preemptively protect people against it. For example, at the very end of Salomon’s Song Garden in B’erot, there is a steep cliff. Therefore, we had to take precautionary action and have a fence built, to mitigate the danger of young children running quickly without stopping at the end of the plot. “Just as the Torah commands us to make a fence on the roof… so, too, regarding any obstacle which could cause mortal danger, there is a positive commandment to remove it… If one does not remove it, but leaves those obstacles constituting potential danger, one transgresses a positive commandment and negates a negative commandment ‘You shall not spill blood’” (Rambam, Mishneh Torah, Laws of the Murderer and Protecting Life 11:4).

Preventing Spiritual Disease 
The mitzvah to remember what happened to Miriam is another preventative mitzvah in Parashat Ki Tetze. Rashi explains, that keeping this mitzvah prevents the spiritual disease of tzara’at.
 

:ספר דברים פרק כד פסוק ט זָכוֹר אֵת אֲשֶׁר עָשָׂה הָשֵּׁם אֱלֹהֶיךָ לְמִרְיָם בַּדֶּרֶךְ בְּצֵאתְכֶם מִמִּצְרָיִם

“Remember what Hashem your G-d, did to Miriam on the way, when you went out of Egypt” 

(Devarim 24:9).

If you wish to take precautions against being stricken with tzara’at, then do not speak לָשׁוֹן הָרַע/lashon hara – ‘slander, derogatory remarks. Remember what was done to Miriam, who spoke against her brother [Moshe], and was stricken with lesions [of tzara’at] (see Bamidbar 12:1-16). [Sifrei 24:141]; (Rashi, Devarim 24:9). How do we fulfill the mitzvah of remembering what Miriam did according to halacha? Our rabbis rule, that it is not enough to remember, we must also read or speak about what happened to Miriam (Sifrei on Parashat BeChukotai). Some rabbis rule that this verse should be read out loud after the daily morning prayers (Sefer Charedim, chapter. 4). Others rule that once a year is sufficient, at the Shabbat Torah Reading (Magen Avraham 60). The Ari HaKadosh wrote, that when we recite the words “to thank You” in the blessing preceding the Shema every morning, we should remember that our mouths were intended not only to praise and thank G-d, but also to refrain from speaking lashon hara. This, too, is a way of remembering the lesson we are taught through Miriam.

The Relationship Between Health and Observing Torah and Mitzvot
Even if today the disease of tzara’at no longer exists, when we work on elevating our speech, we obtain not only better relations with people, but we also enjoy greater general health. Negativity, judgmentalism, and complaining increase cortisol levels (the stress hormone), which causes damage both to memory and the immune system. Jon Gordon, in his book, The No Complaining Rule, explains how negative speech is toxic and affects the surroundings, similarly, to being around second-hand smokers. 

Three Dimensions of Preventative Measures

It is interesting to note, that the three mitzvot in Parashat Ki Tetze, associated with preventive medicine, can each be linked to one of the dimensions of human endeavor. The law of the Rebellious Son relates to the dimension of thought, as it is totally hypothetical, never occurring in reality. The mitzvah to remember Miriam relates to the dimension of speech, as it must be enunciated, and it is all about rectifying speech. The mitzvah of constructing a rail on our roof, corresponds to the dimension of action. Thus, our Creator, has provided us with the best handbook of how to live healthy, wholesome lives and gain optimal health in all dimensions, be it physical, emotional, or spiritual.