Q Why do doctors play such a prominent role in Judaism? - B.D., Chicago A Someone recently told me that every Jewish family needs at least one doctor - and one rabbi. I think that he was simply trying to patronize me. Frankly, I myself have bemoaned the lack of a doctor in my immediate family, especially a pediatrician! Nonetheless, despite the sociological fixation with Jewish doctors, our tradition has at times expressed an ambivalent attitude toward medicine and its practitioners. Judaism clearly emphasizes saving lives, with the most explicit biblical injunction the commandment "You shall not stand over your brother's blood" (Leviticus 19:16). This verse, however, most directly applies to ad hoc cases of saving a person from a precarious situation, such as saving one from drowning (Sanhedrin 73a). Similarly, the Torah exhorts, "Live by the commandments" (Leviticus 18:5), thereby enjoining us to violate almost all prohibitions to preserve life (Sanhedrin 74a). Perhaps the most explicit biblical commandment relating to medicine, however, stems from tort law. In detailing remunerations owed for battery assault, the Torah states, "He shall surely be healed," thereby obligating reimbursement for medical expenses (Exodus 21:19). The sages derive from this verse that a physician has permission to treat the wounded (Bava Kama 85a). The necessity of this biblical license to heal stems from a potential belief that one may not interfere with God's choice to strike the patient. While God's decisions remain inscrutable, we must continue to heal the patient (Tosafot). The patient's right to seek the physician's treatment, however, remains subject to greater scrutiny, as his resort to naturalistic means might reflect a lack of trust in God and His healing powers. King Asa was severely criticized for his overreliance on natural medicine, to the exclusion of prayer and self-reflection (II Chronicles 16:12). The Talmud relates that the sages praised King Hezekiah for concealing a "Book of Cures," because, some believe, the book was too effective, rendering supplications superfluous (Pessahim 56). The Torah, moreover, refers to God as the great healer who prevents sickness to those loyal to Him, which might indicate that the righteous do not require medical intervention (Exodus 15:26). Indeed, according to one Babylonian sage, Rav Aha, the entire enterprise of medicine was initially undesirable, with prayer as the preferred response. Once, however, humans resorted to medical intervention, Rav Aha composed a prayer to recite before medical treatment (such as bloodletting, the preferred remedy in his era!), so that a person will remember that all rehabilitation depends on God (Brachot 60a). This theme was later adopted by Nahmanides, himself a doctor, who contended that in truly righteous eras, medicine would not be necessary, and further implied that even today the pious may rely solely on faith to heal them (Leviticus 26:11). So shocked by this statement was Rabbi Haim Soloveitchik (d. 1918) that he contested that these words were forged. The more dominant strand of Jewish thought, however, embraced medicine as the tool God provides humans to heal themselves. "One may not rely on miracles," the Talmud exclaims (Shabbat 32a), but must rather use all resources to keep ourselves alive (Otzar Hamidrashim p. 580). The sage Abaye rebutted the sentiment of Rav Aha, stating that the requirement to compensate for tort rehabilitation contains an implicit endorsement of medical treatment (Tzitz Eliezer 5:20). Not surprisingly, Maimonides, the great scholar of both Torah and medicine, deemed medical treatment as a mitzva (Perush Lemishnayot Nedarim 4:4), a position later codified in law (Yoreh De'a 336:1). He further contended that King Hezekiah buried the "Book of Cures" because it was quackery that endangered lives. He derided those who abstain from medical treatment as hypocrites for consuming food, a natural resource, no different from medicine, which God provides for us (Perush Lemishnayot Pessahim 4:9). Nonetheless, the sages remained concerned with the spiritual pitfalls of medicine, best encapsulated by their declaration, "The best doctors are destined for Gehenna (hell)" (Kiddushin 4:12). Some commentators believed this scathing remark criticizes the "God complex" phenomenon when physicians become overly confident and arrogant, attributing to themselves healing powers. Others understood it as a censure of the overcommercialization of medicine, to the point where the poor might not get treated. Alternatively, it might criticize medical malpractice stemming from negligence, laziness or the haughty refusal to consult with other experts. These potential spiritual pitfalls notwithstanding, medicine remains both praiseworthy and a mitzva. To maintain the appropriate perspective on their vocation, many physicians recite daily a short prayer, erroneously attributed to Maimonides, which reads, in part: You have blessed your earth... with healing substances... You have chosen me to watch over the life and health of Your creatures... Support me, Almighty God, in these great labors that they may benefit mankind, for without Your help not even the least thing will succeed... Do not allow thirst for profit, ambition for renown and admiration, to interfere with my profession, for these are the enemies of truth and of love for mankind and they can lead astray in the great task of attending to the welfare of Thy creatures. Amen. The writer, on-line editor of Tradition, teaches at Yeshivat Hakotel and edits the Text & Texture blog (Text.Rcarabbis.org). Submit a question to: JPostRabbi@yahoo.com.