Nature & Hashgacha, part 3

So how do we sort of put together the various pieces here in the Ramban? One tension is that the Ramban here with the other Rambans we've looked at in Bamidbar and the Devarim. Another tension is just minei u-vei here. On the one hand, the Ramban says לא על שניתנה רשות לחולה להתרפאות, but rather ניתנה רשות לרופא לרפאות, right? Not lacholeh lehitrapot. So there's a criticism, condemnation, I don't know, of the patient, not of the doctor. It's okay to go to medical school, but not to go to the doctor. But just minei u-vei as the Ramban goes on to say, again, החובל בחברו חייב חמשה דברים: nezek, tza’ar, shevet, rippuy, and boshet. So hachovel bechavero is obligated to pay doctors' bills. I don't know, let's say Rachmana litzlan, a rav in shul has someone who takes an Uber to shul on Shabbos. So the rav should then give him the money to pay for the Uber? He shouldn't be taking an Uber to shul on Shabbos. The rav is obviously not going to underwrite that expense. I don't know if there's no reshut lacholeh lehitrapot, so what's pshat the Torah's mechayev rippuy? No, it should be that hachovel bechavero, you know, he should give him a Sefer Tehillim so he can daven, a Sefer Tehillim and a Sha’arei Teshuvah. Those should be the chamishah devarim. When the Ramban says כי התורה לא תסמוך דיניה על הנסים, again, which seems to echo the yesodos that we had, but in the context in which elsewhere we encounter that in the Ramban, כי התורה לא תסמוך על הנס, and therefore it's l'chatchilah, right? It's l'chatchilah, this is what Hakadosh Baruch Hu was commanding them to have a census, to have so they'll know how many chayalim they have available so they can organize an army, and it's clear that that's true: ופקודיהם לצבאתם בראש אבותם. The כי התורה לא תסמוך דיניה על הנס means and therefore it's our mitzvah l'chatchilah to engage on the natural level. But that havana doesn't seem to plug in the way the Ramban is, okay, so, you know, the Ramban himself in Kuntres Dina d'Garmi has a very important yesod. He says that such a thing, he's talking about lashon chachamim in Shas, that there are leshonos hamischalfos b'talmud. Sometimes the same phrase means two very different things in different contexts. He says the example he's talking about is davar d'goreim l'mamon. When Chazal say לשון דבר הגורם לממון, it doesn't always mean the same thing. It has multiple meanings, leshonos hamischalfos b'talmud. So if there are leshonos hamischalfos b'talmud, there can be לשונות המתחלפות בראשונים ואחרונים. But is that the case? Is that the pshat? Maybe we'll begin as follows. This is a footnote in the Rav's. The latter, the latter referring to Halakhah? No, the latter referring to the art of healing, has always been considered by the Halakhah as a great and noble occupation. Unlike other faith communities, the Halakhic community has never been troubled by the problem of human interference on the part of the physician and the patient, the physician and the patient, with God's will. On the contrary, argues the Halakhah, God wants man to fight evil bravely and to mobilize all his intellectual and technological ingenuity in order to defeat it. The conquest of disease is the sacred duty of the man of majesty and he must not shirk it. From the biblical phrase, and the Rav quotes in translation, רק שבתו יתן ורפא ירפא, through the Talmudic period in which scientific medicine was considered authoritative in situations in which the act of saving of a human life, pikuach nefesh, requires the suspension of the religious law, to the Judeo-Spanish tradition of combining Halakhic scholarship with medical skill, the Rambam and Ramban were doctors, the Halakhah remained steadfast in its loyalty to scientific medicine. It has never ceased to emphasize the duty of the sick person to consult a competent physician. The statement quoted both in the Tur and Shulchan Aruch, ואם מונע עצמו הרי זה שופך דמים, which can be traced indirectly to a Talmudic passage, is a cornerstone of Halakhic thinking. Then the Rav gives a few more mekoros. Nachmanides' observation in Leviticus 26:11 refers to an ideal state of the covenantal community enjoying unlimited divine grace and has no application therefore to the imperfect state of affairs of the ordinary world. Now, where does the Rav get that from? Again, that the Ramban's statement that ein chelek, what did the Ramban say? אין חלק לרופאים בבית השם? What was the lashon? ומה חלק לרופאים בבית עושי רצון השם? So the Rav said look how the Ramban introduces this whole passage: והכלל כי בהיות ישראל שלמים והם רבים. It means we're shleimim and all of us are shleimim. Right? We're talking about in terms of the avodas Hashem of Klal Yisrael, in terms of Klal Yisrael's tzidkus and chasidus, we're talking about a utopian state of affairs, biheyot Yisrael shleimim. And shleimus is sort of the highest accolade and the highest level. veheim rabim, meaning we're not just talking about yechidim. So then לא יתנהג עניינם בטבע כלל. So then ein hachi nami, then the same way tzara'as which is a supernatural phenomenon, it's understood that a dermatologist can't heal tzara'as. So in this utopian society, so that would be true even for those sicknesses which are natural sicknesses. That in the utopian society, the same way tzara'as comes in response we know to draw a line between tzara'as and cheit and the implications of that correlation are that the refuah for tzara'as is not to be found in the doctor's office or in a pharmacy, so בהיות ישראל שלמים והם רבים, that would be true for every machalah. What's true of tzara'as bechol hazmanim is true of every machalah בהיות ישראל שלמים והם רבים. Okay and so that's clearly where the Rav is deriving his the way he's framing the Ramban. But but how do we make our way through the whole Ramban with that with that framework? So what does it mean when so what's this diyuk in

מכאן שניתנה רשות לרופא לרפאות לא אמרו שניתנה רשות לחולה להתרפאות?

So l'chora what the Ramban is revealing here is is something hafla v'fela. On the one hand on the one hand it's true that בהיות ישראל שלמים והם רבים ein hachi nami so again don't give him don't give him a blank check to pay the doctor give him the Shaarei Teshuvah and give give him the give him the Sefer Torah. Me'idach gisa in a world and at most periods in Jewish history that has been the real world where Yisrael are not sheleimim v'heim rabbim individuals who are sheleimim but but not v'heim rabbim but not on on this massive scale so then the din is that if a person lives in a reality which isn't the reality of sheleimim v'heim rabbim so then avada there's a chiyuv there's a chiyuv refuah. Now what the Torah is so how does that shtim with the Ramban's diyuk of מכאן שניתנה רשות לרופא לרפאות and not lacholeh lehisrapos? Ramban is saying that that that phrase is is an intentionally dialectical phrase that the Torah is telling us both sides of the coin. On the one hand the very din of verapo yerape as as the Rav alludes to here right the very din of verapo yerape from the biblical phrase of verapo yerape halacha remains steadfast in its loyalty to scientific medicine. On the one hand the very chiyuv of ripui again the Torah is not paying for the Uber for someone who's taking an Uber to shul on Shabbos. So clearly the din of verapo yerape endorses the fact that the nachbal is going to the doctor. It's endorsing the fact that the nachbal is going to the doctor. On the other hand simultaneously the Torah is the Torah says it in a way that implies the Ramban's diyuk of ניתנה רשות לרופא לרפאות and not lacholeh lehisrapos because the Torah also wants us to know yes we're endorsing it for all those times of history the majority of history when it's not ישראל שלמים והם רבים so then we're endorsing it but don't misunderstand that endorsement. Don't think that that endorsement represents the ideal in an ideal world. No it represents the l'chatchila in a b'diavad world. וזה כלל גדול רבותי what l'chatchila in a l'chatchila world is not necessarily l'chatchila in a b'diavad world and could be assur in a b'diavad world and what's l'chatchila in a b'diavad world is not necessarily l'chatchila in a l'chatchila world and maybe assur in a l'chatchila world. Say that three times fast. Okay and the Ramban is saying that's the Ramban what's so nifla here in the Ramban is the Ramban is saying the same phrase is telling us both. The same phrase the etzem din without the diyuk before you get to the diyuk of of that the Torah she-be'al peh reveals to us in the phrase. The the very din itself is a an unqualified endorsement. Again if you're underwriting it obviously you're endorsing it. It can't be oh well we're going to indulge his but me'idach gisa it's said balashon not lacholeh lehisrapos because the Torah is telling us about the other level that exists also so the Torah in the same phrase is telling us about what the hanhaga is in the non-utopian mitziyus and what the hanhaga is. And in the v'achai you see that from the Ramban, the end of the Ramban, right when the Ramban compares the din of of the chiyuv ripu'i of hachovel l'chavero, take a look at the end of the Ramban here rabotai.

ועל כן האנשים הנצים שהכו זה את זה באבן או באגרוף יש על המכה תשלומי הרפואה כי התורה לא תסמוך דיניה על הנסים כאשר אמרה כי לא יחדל אביון מקרב הארץ.

So when the Torah says כי לא יחדל אביון מקרב הארץ, so what's that the basis for? That's the basis for mitzvas tzedaka, right? Now, that metzius is a b'di'eved metzius, right? The idea, the utopian metzius is כי לא יהיה בך אביון. Also a posuk in I think also in Re'eh, right? כי לא יהיה בך אביון כי ברך יברכך השם. So the ideal metzius, in the utopian metzius, there's no mitzvas tzedaka. In the world that בעווננו הרבים ובעוונות אבותינו הרבים has existed throughout most of Jewish history, which is the non-ideal world, so then it's כי לא יחדל אביון מקרב הארץ. It's not כי לא יהיה בך אביון, it's not the metzius of כי לא יהיה בך אביון, it's instead it's the metzius of כי לא יחדל אביון מקרב הארץ, and then it's על כן אנכי מצוך לאמר פתוח תפתח את ידך. So you're supposed you're supposed to be giving tzedaka. So hu hadin, hu hata'am. In the ideal world, in the world of כי לא יהיה בך אביון, in that world also is לא חלק לרופאים בבית אוצר רצון השם. There's no there's no doctor on call in beis otzar retzon Hashem in the in the ideal world, just as in the ideal world it's כי לא יהיה בך אביון. In the actual metzius which we have created, which we have which we have created, which obviously falls short of that ideal, in the world of כי לא יחדל אביון מקרב הארץ, so just as there's a mitzvas tzedaka, so there's also a chiyuv of of ripu'i. But the Torah wants us to know just as there are two psukim, just as there's a posuk of כי לא יחדל אביון and אפס כי לא יהיה בך אביון, so so too מניה וביה ורפא ירפא the Torah is telling us about both. In that ideal world, if someone someone does go see a doctor, is that an aveira? That's the criticism that the Ramban says, that's what he was indicted, כי בחליו לא דרש השם כי ברופאים. Is so is that also in the ideal world if someone does give tzedaka, would be an aveira? It wouldn't, there's not going to be an ani, you're not going to have a hechi timtza. The hechi timtza doesn't exist. In the ideal world, there can be a cheit, there can be אדם מצד עצמו יכול לחטוא. In the ideal world, there can be a cheit, so you can have the metzius. But mima nafshach, if there's an evyon there's an evyon, if there isn't there isn't. So I don't think the case exists. Would the din of appointing commanders also apply in in an ideal world? It does, and the difference being that the ideal world, again, refers to the ideal Jewish society. In the ideal Jewish society, I mean Chamas still exists, Amalek still exists until the Achris hayamim. So in that sense it's it's not parallel. Right, in the ideal Jewish world, so when you talk about internally within within Jewish society, so internally within Jewish society there wouldn't be an occasion for mitzvas tzedaka, and internally within Jewish society we wouldn't have we wouldn't have have doctors. But we would still we would still until והיה בהניח השם אלקיך לך מכל אויביך מסביב, until mechiyas Amalek, there would still be this encounter and you would still have a fartshante tzoros baruch Hashem. Except besides the midbar, was there ever such a time? I don't know, things were pretty good bi'yemei Dovid u'Shlomo, things were pretty good bi'yemei Chizkiyahu, both למדו לאויר שבשמים. Has it been that way subsequently? Presumably the answer's yes. I mean that's what the Ramban is saying, that's why that was the standard b'zman hamikdash. It was the standard. It sounds like the Ramban is just making a point that that it has existed. Is it a mesorah that Chizkiyahu was the first person to recover from an illness? First person to recover from an illness? Yeah when he davened, he was the first person to recover from an illness? I don't know. I don't know. The other point in terms of the Ramban's havanah in Rav Yosef. So the question is, is a yachid there are this next question about to talk about there are mekomos in the achronim in this. Is is a yachid allowed to I'm not sure exactly how Ramban sees shleimus habriyos but without looking in a mirror is a yachid is a yachid allowed to say that he's gonna follow this ideal hanhagah of the Ramban betoras yachid even recognizing that it's it's not l'rabim. So one would think no. But then the question is what does the Ramban mean with his גמרא ברבין רב יוסף? Again so the way the Ramban understands that גמרא ברבין רב יוסף is that Rav Yosef didn't need the hakazos dam. It wasn't that he like Rashi says, Rashi's havanah in the Gemara wasn't that he didn't allow himself the prerogative of having the uman make a house call, it's rather that even though again according to what was then the understanding of medicine it was a basic need but but Rav Yosef was above that. So I don't know but maybe the answer's as follows. The question is did they in that medical context did they think that there were indications when a person needed hakazos dam? So the answer to that question is certainly partially yes. The question is whether it's entirely yes. It's certainly partially yes. In the sense that that's why they they tried to treat infection. They they figured if you drain the blood so then the infection will leave the body. And that's why they this isn't a criticism it's just a description. That's why they they killed people in their attempt to heal people because obviously if you just bloodlet and bloodlet you just make the person weaker and weaker and then the body can't even whatever natural ability Hakadosh Baruch Hu gave the body to push back against the disease if you just weaken the person by constantly bleeding a person. And some historians think that's how George Washington died because they they did excessive hakazos dam when he had an infection. So the answer's certainly partially yes. Im timtzei lomar maybe the pshat is that they saw certain indications of what what they thought indicated the need for hakazos dam and that Rav Yosef didn't experience them. And that it wasn't that Rav Yosef chose said I'm gonna operate on that but the Ramban is illustrating that as what Hakadosh Baruch Hu did for Rav Yosef as a yachid is what Hakadosh Baruch Hu does for society as a whole when it's rabbim v'shamnah. So the question is was this sort of Rav Yosef's conscious decision that I'm gonna be noheig al pi the Ramban? Or no, the Ramban is saying this as an illustration of no, Rav Yosef just felt himself he felt himself that whatever again whatever the indications were that were considered to identify when and how much hakazos dam. When that society doesn't exist, even Rav Yosef can't say that's going to be my hanhaga. If you don't say like that, then maybe there is room to say. But so if you're Rav Yosef, then you can contemplate the pshat in this Ramban. But for everyone else, make sure the medical checks happen today.