Rav Avi: Hello, and welcome to Responsa Radio, where you ask and we answer questions of Jewish law in modern times! I am Rabbi Avi Killip, and I'm here with Rabbi Ethan Tucker, Rosh Yeshiva at Mechon Hadar, a center for higher Jewish learning based in New York City.
Rav Eitan: Hello, Avi!
Rav Avi: Here's a question about shabbat that I think also opens up for us a category that we haven't really gotten to address yet on this program, which is the idea of healing. The person asks: "For the first time in my life, I'm taking several pills a day every day. I've known about a prohibition against taking medicine on shabbat, but I've never investigated it until now. No medications I take are for major medical needs, but they contribute greatly to my overall well-being," he says, "like a sleep aid. So the question is, what is the nature of the prohibition of healing on shabbat, and what are conditions for exceptions? Does the industrialization of the pharmaceutical manufacturing impact this, and swinging back in the other direction, is the rise in popularity of herbal and homeopathic remedies different from medications sold over the counter?"
Rav Eitan: Okay, so this, in my experience, is an area of shabbat law and practice that many people are actually shocked to find exists. Meaning, people think oh, one of the first things I ever learned, if I learned anything about Jewish law, is you can break shabbat to save a life. And they just assume that that trickles down to all forms of healing and therapy and making people feel better -- how could it possibly be that anything like that would be forbidden? And if you want to understand this area, you actually have to completely reverse your entire conception of this entire area of Jewish law and history, actually.
So, let's go back kind of to the beginning, which is that the notion that you would save someone's life on shabbat is itself not at all obvious. Why? Because shabbat, if you think about it in very simple terms, is a death penalty offense in the Torah. In that sense of breaking of shabbat leads someone to lose their life. Why would I violate shabbat to save my or someone else's life only to potentially be culpable? And if you say to me, oh, but you're not culpable because you're saving someone's life, you're just circularly assuming that which we're in theory setting out to prove in this discussion.
Rav Avi: That's such an interesting and excellent point!
Rav Eitan: Well, there you go! So, that's what we're here for. The basic notion that you would justify the violation of shabbat in that sense was actually quite a radical notion, which was signed onto basically wholesale by the early rabbis. But it was not universally accepted in all Second Temple groups, you find in the Book of Maccabees, they seem to have done it by feeling of necessity in the context of a war, but as a legal principle, it's really rabbinic Judaism that develops that. But what that means is, controlling for that override which they and we sign onto, which, for sure, someone's life is at risk, you violate shabbat, actually behind that lies a much broader resistance to the notion that I interfere with the state of the world as it is on shabbat.
And the ban on refuah, on healing, of any sort, actually taps into a whole way of seeing the world which really is very nicely described in one later commentator on the Talmud as you kind of go into a special room called shabbat, you leave everything from the rest of the week out in the hallway, and you shut the door. And there's a sense in which healing any day of the week is a kind of intervention against the divine order, right? Christian Scientists and others are opposed to healing in those kinds of frameworks much more broadly, but Jews had a very deep attachment, certainly in antiquity, to this notion that, but on shabbat, part of the way I experience shabbat is I simply say I'm going to play the hand I've been dealt by G-d. And if that means that I don't feel well, I'm not gonna do anything about that.
And you see this, actually, in passages specifically in the Christian Bible, where one of the radical things that happens there in many of the narratives in the Gospels is healing on shabbat, and you have these representatives of the Pharisees and, you know, what would seem to be proto-rabbinic voices there being shocked that anyone who considered themselves a serious Jew would do that. And it gives us a sense of when the Mishnah and other sources which we'll get to now kind of think about this notion of healing on shabbat, it's against this backdrop and in this cultural context of, well, of course shabbat is a day where you just sort of take what you get.
Rav Avi: So I'm actually a person who is very moved, personally, spiritually, by that idea of shabbat as this moment where we can experience the world as if it were already perfect. But where's the line between taking Advil because I have a headache and drinking a glass of water because I have a headache, and/or why are we eating at all on shabbat, if that's the case?
Rav Eitan: Great, so that's actually a really helpful formulation for getting the different divisions here. So, what emerges more or less where the rabbinic sources kind of try to get to in terms of the classification, they basically divide the world into three kinds of cases. There are people who suffer from what ultimately is referred to as a michush b'alma, that is to say, a discomfort. Let's say a headache, generally falls in this category. It doesn't really stop you from functioning. You're certainly not in any kind of danger. And it's unpleasant, and that's one category of things. And the general approach to that category of things is, you may not do anything about them.
Rav Avi: Anything like don't have Advil, or don't have coffee, or…?
Rav Eitan: Good, right, we'll get to that in greater depth. Here's what you're always allowed to do. You're always allowed to consume something that is ma'achal bri'im, the kind of thing that a healthy person might eat anyway. So, drinking water, having coffee, even chewing on a certain kind of herb that people might eat anyway, even if it has medicinal effect, and even if you're doing it for medicinal effect, but it doesn't look like medicine, it looks like food, basically, that is always acceptable. But anything that is essentially to the naked eye a medical intervention and can't possibly be construed as anything else, for that level of problem, you do not engage in healing and therapeutic activities.
Rav Avi: So, when we think about that even outside of the realm of shabbat, it's a helpful way of thinking about the difference between what does it mean to be a healthy person and to be in the midst of doing some sort of healing practice, that you eat your fruits and vegetables just because that's what makes you a healthy person, that's not some medical…
Rav Eitan: That's right, so you get some kind of complicated discussions around this in contemporary literature around vitamins, right? Are vitamins a medical intervention, or are they, nah, everyone's eating vitamins all the time, and therefore there's no problem? And there's certainly a viable claim that vitamins are, for many people, just a reasonable dietary supplement. They're just, like, part of your normal menu, and so even if I'm taking a vitamin C because my doctor told me you're experiencing some low levels of X and you should do it, or vitamin B12, let's say, for a deficiency, it won't really appear as a medical intervention.
Rav Avi: Well, vitamins are certainly something in our society that healthy people eat.
Rav Eitan: That's right. So that's category one. You've got this sort of low-level discomfort, and pretty much the guideline is, you can eat and drink stuff that looks to the naked eye like it's normal, and not stuff that looks like a medical intervention. The next category up is what is called choleh kol haguf, someone who is sick in their entire body. So here I would say, as opposed to, like, a headache, here we're dealing with someone who has a fever, let's say, or is kind of knocked out in bed in some way.
Rav Avi: Such an apt description of a category, feeling sick in your entire body.
Rav Eitan: Right? You can't -- and where does it hurt? Everywhere, right? And it's this feeling, I would say functionally also what this category gets at, and the way I've often described it to people, you can't do your normal day, right? The things -- a headache, or other things, you know, you go into work, and someone says how are you feeling, and you're like, I'm doing alright, but I have a headache. As opposed to, I can't come in today, I'm sick. Right? That's sort of the category, roughly, of that second group. So respect to that group of people who are sick in their entire body, the way that comes out more or less is as long as you are violating only a rabbinic prohibition, as long as you do it in an unusual fashion -- maybe we'll be able to explore that in a later podcast, what that means -- as long as you do it in a non-typical way, you're allowed to violate rabbinic restrictions for someone of that level.
And if you have someone who's not Jewish around, you can actually ask them to violate Biblical prohibitions, so you can have them cook you a bowl of soup to make you feel better. But they're not in danger, doesn't warrant full violation of shabbat by a Jew, but there is a notion that, well, something where there's not really a full-blown prohibition of shabbat and you do it in enough of an unusual way, then it's okay to violate shabbat in that way for that person.
Rav Avi: So that's gonna end up practically with, let's say the person who had the flu is gonna take their cold medicine, maybe without a drink of water or something?
Rav Eitan: So there, what a lot of poskim will say is the act of swallowing something is not even really an action in the sense that we think of it kind of with our hands and doing it in that way. And if -- I want to come back to this -- if we think of the prohibition on healing as only being a rabbinic prohibition, then many poskim will say, well, if you're at that level of sick, so then what's at stake with taking medicine? Just a rabbinic prohibition. And there's not, like, a normal or an abnormal way to swallow something. You're just swallowing it and it's not like doing something like a craft or some sort of activity, lighting a fire the way you do with your hands.
And in general, that will be a very conventional way that people will think about medicine. They'll say if it's really not that big a deal, you shouldn't take the medicine, and if you're feeling sick in your entire body, like it will really mess up your whole regime for the day, well then certainly it's not a major problem to take medicine. Now, the third category obviously is the category of danger, and those people you do whatever you need to do, Jewish, full-blown violation of Biblical prohibitions, you do all of that. The question, what it really comes down to, is in terms of the distinction between categories one and two, the michush b'alma, the sort of just nagging headache but that doesn't really slow you down that much, and the cholei kol haguf, someone who's sick in their entire body.
The navigation of how lenient or strict to be with those categories really actually comes down to how much you understand the essence of this prohibition to still be in force. So in the way I set it up for you, kind of explaining the origins of this, I think this was understood by most early Jews to basically be a Biblical-level prohibition -- that is to say, the act of healing was something that was a significant intervention against the kind of static state of shabbat that ideally a person is in. And from that perspective, and it's a perspective I generally adopt with myself with respect to my own practice, I try to avoid taking medicine on shabbat when I basically feel like it's annoying but it won't really affect me in a deep way, and I try to channel that as an experience of, okay, here's what it's like to be dealt a certain hand and just to sort of deal with it and sit with it.
But the problem is, the Talmud in one place discussing this as part of its kind of general categorization of everything that's forbidden on shabbat into the 39 archetypal categories of labor, indicates that, oh, well, why is healing forbidden on shabbat? Because you might end up grinding medicine in order to produce things to heal with. And once it formulates it that way, it makes the entire category derivative of another concern, and guts any first-order problem with healing. Healing is only a problem because it might lead you to do the real thing we're afraid of, which is grinding stuff into power.
Rav Avi: So don't actually crush a pill, but other than that, everything would be okay.
Rav Eitan: Other than that. It should be okay, even if the Talmud would say, well no, for that reason we don't allow you to get into that zone at all, it might still be because it's in the context where most medicine is in fact being made by people crushing something up in a way that would be forbidden as a physically transformative act on shabbat. Now here's where it's really interesting thing, where you can sort of see the contemporary values instincts playing out through how people treat that analysis in the Talmud.
I think the people who, and the poskim, right, the rabbinic authorities, and I would put, like, myself kind of in this camp, who fundamentally still identify with the ban on healing and think it encodes a meaningful value, they will say, yeah yeah yeah, the Talmud said that, but, like, even if that's not common today, that people are grinding their own medicine and there's lots of medicines that aren't even in a solid form and they weren't made that way, et cetera, et cetera, still, the rabbis made this decree and we have to stick by that decree. And that's their sort of formal language of saying, we actually think this healing thing still matters. Whereas others who have been so won over by the saving a life on shabbat paradigm that they can barely even understand healing to be forbidden anymore will double down on that explanation of the prohibition and will say, you see? The Talmud says this only has to do with fear of grinding.
So now that that's been handed over to specialists in a regulated pharmaceutical industry, and certainly if I take as my kind of frum medication to be particularly shabbat-observant, only liquid suspensions and not pills, and other things that move me away from that, then we can be lenient even for the headache person to allow them to take this medicine on shabbat, because why should they suffer and be in misery on shabbat for fear of violating a prohibition that they'll never come to violate?
Rav Avi: And what's your answer to that side?
Rav Eitan: Well, I -- look. I think on some level that approach loses something about the power of accepting the world as it is, which in this case comes at some degree of personal discomfort, but which I think is an aspect of what shabbat is actually calling on us to experience, which is not just about, you know, I think this is -- are you prepared to say that shabbat is not just about increasing your pleasure and joy in life, but it's actually a rigorous spiritual discipline which overall takes you to much higher elevated places, but that sometimes that actually requires some degree of work, and not, right, I'm right on board with someone is already, they're laid up in bed, they should pop that Advil right away.
But when you're talking about something that's really on the level of discomfort and consciousness but not debilitating in any way, I think there's something lost there. Now, I won't judge those people, because as I said to you, the whole way of thinking about shabbat as something that you supercede for saving someone's life is itself a kind of innovative and radical read of the Torah, and so it's not crazy to take that the next step further. But I think what's sometimes odd for people, if you ever put a copy of the gospels in front of people like that and have them read some of the passages around healing, they can get a little bit of vertigo, feeling like they are identifying with the ultimately Christian voices in that story more than what seem to be the rabbinic forebears.
Rav Avi: I'm curious from the perspective of really trying to raise up that idea of not needing healing on shabbat or acting in a way as though we didn't need healing on shabbat, how praying for healing fits into or doesn't fit into that phenomenon when we find people who sometimes come to shul, show up at synagogue on shabbat, purely for the sake of praying for the healing of themselves or another person.
Rav Eitan: Yeah. Well, I think that's probably the most exquisite and painful example of this balance, because of course that prayer for healing on shabbat says in it, shabbat hi milizok urefuah kra lavo, which means, it's shabbat, we shouldn't really be screaming about this and praying for it, but nonetheless we hope this person will get better very soon. And the insertion of that apology for praying for healing is really an intense way of saying we feel stuck here, we have this sort of basic human urge to want to do something about this person who's sick, and in this case not in a medically therapeutic way, but in a spiritually therapeutic way, to kind of lay that out there.
And yet, we recognize that the whole spiritual practice of shabbat that we're doing on some level hinges on being able to just take things as they are. I think that's a beautiful way of some degree of balance, and I think that would be, on some level, my summary thought on this, would be if you're in the context of rabbinic thinking and teaching and practice on this, you are doomed to be trapped in that balance in the negative sense, or in the positive sense called on to somehow hold those two together. One the one hand there's nothing more important than human life; on the other hand, shabbat actually demands a level of restraint and kind of refraining from engaging in the world that may also sometimes not be the most comfortable thing.
Rav Avi: Great. So we're glad you know, and we hope it never comes up.
Rav Eitan: Hope so too. I think there's some interesting issues that are raised here -- if people are interested in thinking about them more, a piece that I wrote and is online on our website at mechonhadar.org both in written and audio form, called Shamor and Zachor tries to actually play out these two different models of shabbat where one of the examples that I engage with here is this question of healing and the world as it is. It might be of further interest.
Rav Avi: So it sounds to me like this answer to the particular question in terms of the sleep aid would probably be, it depends how non-functional you would be the next day with or without the sleep aid, and in terms of the manufacturing, we talked about different implications of pills versus maybe liquid versus, you know, grinding your own medicine. And on the herbal homeopathic remedies, I'm assuming that that falls somewhere in the category of food that you would eat versus food that you would not normally eat?
Rav Eitan: Yeah, I think the more it would look like something you would normally have, the more innocuous it is for these purposes. But again, what you said about the sleep aid, a person's gotta really assess how much is this affecting the entire state of the wellbeing of my body, and how much is it an isolated thing?
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