Illness

What are we supposed to think when we are healthy?

The gemara, TB Shabbos 32a, teaches that one should daven that one remains healthy at all times.

אָמַר רַב יִצְחָק בְּרֵיהּ דְּרַב יְהוּדָה: לְעוֹלָם יְבַקֵּשׁ אָדָם רַחֲמִים שֶׁלֹּא יֶחֱלֶה, שֶׁאִם יֶחֱלֶה אוֹמְרִים לוֹ: הָבֵא זְכוּת וְהִפָּטֵר.

In a similar vein, Rav Yitzḥak, son of Rav Yehuda, said: A person should always pray that he will not become ill, as if he becomes ill they say to him: Bring proof of your virtue and exempt yourself.

What should the emotional/spiritual response be to illness?

The gemara, TB Shabbos 32a, explains that a person who is sick should view themselves guilty of some misdeed, which requires them to find protection.

תָּנוּ רַבָּנַן: מִי שֶׁחָלָה וְנָטָה לָמוּת, אוֹמְרִים לוֹ: הִתְוַדֵּה, שֶׁכֵּן כׇּל הַמּוּמָתִין מִתְוַדִּין. אָדָם יוֹצֵא לַשּׁוּק, יְהִי דּוֹמֶה בְּעֵינָיו כְּמִי שֶׁנִּמְסַר לְסַרְדְּיוֹט. חָשׁ בְּרֹאשׁוֹ — יְהִי דּוֹמֶה בְּעֵינָיו כְּמִי שֶׁנְּתָנוּהוּ בְּקוֹלָר. עָלָה לַמִּטָּה וְנָפַל — יְהִי דּוֹמֶה בְּעֵינָיו כְּמִי שֶׁהֶעְלוּהוּ לַגַּרְדּוֹם לִידּוֹן, שֶׁכָּל הָעוֹלֶה לַגַּרְדּוֹם לִידּוֹן אִם יֵשׁ לוֹ פְּרַקְלִיטִין גְּדוֹלִים — נִיצּוֹל, וְאִם לָאו — אֵינוֹ נִיצּוֹל.

The Sages taught: One who became ill and tended toward death, they say to him: Confess, as all those executed by the courts confess. Even if he is dying of natural causes, it is worthwhile for him to consider his death atonement for his sins. The Sages said: When a person goes out to the marketplace where there are fights and disputes, he should consider himself as someone who has been handed over to a soldier [seradiyot]. If his head hurt, he should consider it as if they placed him in a chain [kolar] around his neck. If he climbed into bed and fell ill, he should consider himself as if they took him up to the gallows to be judged, as with regard to anyone who goes up to the gallows to be judged, if he has great advocates [peraklitin], he is spared, and if not, he is not spared.

What are those protective agencies a person can seek out?

The gemara, TB Shabbos 32a, goes on to explain that the protective agencies that help one are repentance and good deeds.

וְאֵלּוּ הֵן פְּרַקְלִיטִין שֶׁל אָדָם: תְּשׁוּבָה וּמַעֲשִׂים טוֹבִים. וַאֲפִילּוּ תְּשַׁע מֵאוֹת וְתִשְׁעִים וְתִשְׁעָה מְלַמְּדִים עָלָיו חוֹבָה וְאֶחָד מְלַמֵּד עָלָיו זְכוּת — נִיצּוֹל, שֶׁנֶּאֱמַר: ״אִם יֵשׁ עָלָיו מַלְאָךְ מֵלִיץ אֶחָד מִנִּי אָלֶף לְהַגִּיד לְאָדָם יׇשְׁרוֹ. וַיְחֻנֶּנּוּ וַיֹּאמֶר פְּדָעֵהוּ מֵרֶדֶת שָׁחַת וְגוֹ׳״.

And with regard to divine judgment, these are a person’s advocates: Repentance and good deeds. The Gemara comments: And even if there are nine hundred ninety-nine asserting his guilt and only one asserting his innocence, he is spared, as it is stated: “If there be for him an angel, an advocate, one among a thousand, to vouch for a man’s uprightness; then He is gracious unto him, and says: Deliver him from going down to the pit, I have found a ransom” (Job 33:23–24).

What should my attitude be to the doctors?

One the one hand, one needs to realize that Hashem provided humanity with wisdom and innovation obliged us to listen to the advice and regimen provided by doctors even though every intervention carries risk. This is clear in TB Bava Kama 85a. It is clear that those who are qualified are seen as agents of Hashem’s will and one must listen to them.

דְּתַנְיָא, דְּבֵי רַבִּי יִשְׁמָעֵאל אוֹמֵר: ״וְרַפֹּא יְרַפֵּא״ – מִכָּאן שֶׁנִּיתַּן רְשׁוּת לָרוֹפֵא לְרַפּאוֹת.

As it is taught in a baraita that the school of Rabbi Yishmael says: When the verse states: “And shall cause him to be thoroughly healed [verappo yerappe]” (Exodus 21:19), it is derived from here that permission is granted to a doctor to heal, and it is not considered to be an intervention counter to the will of God.

On the other hand, one needs to remember that that their skill and success is in the hands of Hashem. King Asa missed this idea and died in II Divrei Hayamim 16:12

וַיֶּחֱלֶ֣א אָסָ֡א בִּשְׁנַת֩ שְׁלוֹשִׁ֨ים וָתֵ֤שַׁע לְמַלְכוּתוֹ֙ בְּרַגְלָ֔יו עַד־לְמַ֖עְלָה חָלְי֑וֹ וְגַם־בְּחָלְיוֹ֙ לֹא־דָרַ֣שׁ אֶת־יְהוָ֔ה כִּ֖י בָּרֹפְאִֽים׃

In the thirty-ninth year of his reign, Asa suffered from an acute foot ailment; but ill as he was, he still did not turn to the LORD but to physicians.

וַיִּשְׁכַּ֥ב אָסָ֖א עִם־אֲבֹתָ֑יו וַיָּ֕מָת בִּשְׁנַ֛ת אַרְבָּעִ֥ים וְאַחַ֖ת לְמָלְכֽוֹ׃

Asa slept with his fathers. He died in the forty-first year of his reign

What am I achieving by visiting the sick?

Visiting the sick is both a mitzva between oneself and Hashem and between oneself and others.

TB Sotah 14a

אֶלָּא, לְהַלֵּךְ אַחַר מִדּוֹתָיו שֶׁל הַקָּדוֹשׁ בָּרוּךְ הוּא: מָה הוּא מַלְבִּישׁ עֲרוּמִּים, דִּכְתִיב: ״וַיַּעַשׂ ה׳ אֱלֹהִים לְאָדָם וּלְאִשְׁתּוֹ כׇּתְנוֹת עוֹר וַיַּלְבִּשֵׁם״ — אַף אַתָּה הַלְבֵּשׁ עֲרוּמִּים. הַקָּדוֹשׁ בָּרוּךְ הוּא בִּיקֵּר חוֹלִים, דִּכְתִיב: ״וַיֵּרָא אֵלָיו ה׳ בְּאֵלֹנֵי מַמְרֵא״ — אַף אַתָּה בַּקֵּר חוֹלִים. הַקָּדוֹשׁ בָּרוּךְ הוּא נִיחֵם אֲבֵלִים, דִּכְתִיב: ״וַיְהִי אַחֲרֵי מוֹת אַבְרָהָם וַיְבָרֶךְ אֱלֹהִים אֶת יִצְחָק בְּנוֹ״ — אַף אַתָּה נַחֵם אֲבֵלִים. הַקָּדוֹשׁ בָּרוּךְ הוּא קָבַר מֵתִים, דִּכְתִיב: ״וַיִּקְבֹּר אוֹתוֹ בַּגַּי״ — אַף אַתָּה קְבוֹר מֵתִים.

He explains: Rather, the meaning is that one should follow the attributes of the Holy One, Blessed be He. He provides several examples. Just as He clothes the naked, as it is written: “And the Lord God made for Adam and for his wife garments of skin, and clothed them” (Genesis 3:21), so too, should you clothe the naked. Just as the Holy One, Blessed be He, visits the sick, as it is written with regard to God’s appearing to Abraham following his circumcision: “And the Lord appeared unto him by the terebinths of Mamre” (Genesis 18:1), so too, should you visit the sick. Just as the Holy One, Blessed be He, consoles mourners, as it is written: “And it came to pass after the death of Abraham, that God blessed Isaac his son” (Genesis 25:11), so too, should you console mourners. Just as the Holy One, Blessed be He, buried the dead, as it is written: “And he was buried in the valley in the land of Moab” (Deuteronomy 34:6), so too, should you bury the dead.

Mishna Torah, Hilchos Avel 14:1

מִצְוַת עֲשֵׂה שֶׁל דִּבְרֵיהֶם לְבַקֵּר חוֹלִים. וּלְנַחֵם אֲבֵלִים. וּלְהוֹצִיא הַמֵּת. וּלְהַכְנִיס הַכַּלָּה. וּלְלַוּוֹת הָאוֹרְחִים. וּלְהִתְעַסֵּק בְּכָל צָרְכֵי הַקְּבוּרָה. לָשֵׂאת עַל הַכָּתֵף. וְלֵילֵךְ לְפָנָיו וְלִסְפֹּד וְלַחְפֹּר וְלִקְבֹּר. וְכֵן לְשַׂמֵּחַ הַכַּלָּה וְהֶחָתָן. וּלְסַעֲדָם בְּכָל צָרְכֵיהֶם. וְאֵלּוּ הֵן גְּמִילוּת חֲסָדִים שֶׁבְּגוּפוֹ שֶׁאֵין לָהֶם שִׁעוּר. אַף עַל פִּי שֶׁכָּל מִצְוֹת אֵלּוּ מִדִּבְרֵיהֶם הֲרֵי הֵן בִּכְלַל (ויקרא יט יח) "וְאָהַבְתָּ לְרֵעֲךָ כָּמוֹךָ". כָּל הַדְּבָרִים שֶׁאַתָּה רוֹצֶה שֶׁיַּעֲשׂוּ אוֹתָם לְךָ אֲחֵרִים. עֲשֵׂה אַתָּה אוֹתָן לְאָחִיךְ בְּתוֹרָה וּבְמִצְוֹת:

It is a positive commandment of Rabbinic origin to visit the sick, comfort mourners, to prepare for a funeral, prepare a bride, accompany guests, attend to all the needs of a burial, carry a corpse on one's shoulders, walk before the bier, mourn, dig a grave, and bury the dead, and also to bring joy to a bride and groom and help them in all their needs. These are deeds of kindness that one carries out with his person that have no limit.
Although all these mitzvot are of Rabbinic origin, they are included in the Scriptural commandment Leviticus 19:18: "Love your neighbor as yourself." That charge implies that whatever you would like other people to do for you, you should do for your comrade in the Torah and mitzvot.

What must I do in order to fulfil this mitzva?

TB Nedarim 40a tells how Rabbi Akiva visited a sick student and took care of all the physical needs of his ill student.

אָמַר לְהוּ: לֹא כָּךְ הָיָה מַעֲשֶׂה בְּתַלְמִיד אֶחָד מִתַּלְמִידֵי רַבִּי עֲקִיבָא שֶׁחָלָה. לֹא נִכְנְסוּ חֲכָמִים לְבַקְּרוֹ, וְנִכְנָס רַבִּי עֲקִיבָא לְבַקְּרוֹ, וּבִשְׁבִיל שֶׁכִּיבְּדוּ וְרִיבְּצוּ לְפָנָיו, חָיָה. אָמַר לוֹ: רַבִּי, הֶחֱיִיתַנִי. יָצָא רַבִּי עֲקִיבָא וְדָרַשׁ: כׇּל מִי שֶׁאֵין מְבַקֵּר חוֹלִים כְּאִילּוּ שׁוֹפֵךְ דָּמִים.

Rav Ḥelbo fell ill. There was no one who came to visit him. Rav Kahana said to the Sages: Didn’t the incident involving one of the students of Rabbi Akiva who became sick transpire in that manner? In that case, the Sages did not enter to visit him, and Rabbi Akiva entered to visit him and instructed his students to care for him. And since they swept and sprinkled water on the dirt floor before the sick student, he recovered. The student said to Rabbi Akiva: My teacher, you revived me. Rabbi Akiva went out and taught: With regard to anyone who does not visit the ill, it is as though he is spilling blood, as it could be that the sick person has no one to care for him. If there are no visitors, no one will know his situation and therefore no one will come to his aid.

We see from here that part of visiting the sick includes:

Is there a spiritual impact of visiting this sick?

Yes, one does lighten the load of illness. This is true of a person who shares the same zodiac of the ill person. TB Nedarim 39b

אָמַר רַבִּי אַחָא בַּר חֲנִינָא: כׇּל הַמְבַקֵּר חוֹלֶה, נוֹטֵל אֶחָד מִשִּׁשִּׁים בְּצַעֲרוֹ. אָמְרִי לֵיהּ: אִם כֵּן לִיעַלּוּן שִׁיתִּין וְלוֹקְמוּהּ! אֲמַר לֵיהּ: כְּעִישּׂוּרְיָיתָא דְּבֵי רַבִּי, וּבְבֶן גִּילוֹ.

Rav Aḥa bar Ḥanina said: Anyone who visits an ill person takes from him one-sixtieth of his suffering. The Sages said to him: If so, let sixty people enter to visit him, and stand him up, and restore him to health. Rav Aḥa bar Ḥanina said to them: It is like the tenths of the school of Rabbi Yehuda HaNasi, who said that each of one’s daughters inherits one-tenth of his possessions. His intent was that each daughter would receive one-tenth of the remainder after the previous daughter took her portion. Here too, each visitor takes from the ill person one-sixtieth of the suffering that remains, and consequently a degree of suffering will always remain with the ill person. Furthermore, visiting is effective in easing the suffering of the ill person only when the visitor is one born under the same constellation as the ill person.

When can I start visiting the sick?

Family and close friends can go immediately but others should wait 3 days before going.^[1] In general, one should only go if it helps the person and is not a burden upon them.^[2] If it is a sudden issue, one may go right away.

Can I visit a few times a day?

Yes, as long as it is not a burden on the sick person.^[3]

Are there restrictions about what time of day I can visit?

Yes. Outside of hospital/nursing home regulations, ideally, one should not visit in the 1^st 3 hours of the day because the person is usually more upbeat, or in the last 3 hours of the day because the person is more down.^[4] Many are not makpid on this today.^[5]

One should be careful about visiting those who have intestinal issues because of their dignity nor those who have trouble speaking and will be burdened by trying to speak.^[6]

Do I achieve anything by a phone call?

Of course a call is better than no call, but a visit is always better than a call.^[7]

Why don’t I say a bracha on bikur cholim?

There are a few reasons:

1. One doesn’t say a bracha on a mitzva which one is always obligated in.^[8]
2. One does not say a bracha which is dependent on another person accepting the favor.^[9]
3. One only says a bracha which is unique to the Jewish experience not a universal mitzva.^[10]

When I daven for the sick, may I use any language?

In the presence of the patient one may use any language. If not in their presence, one should daven in Hebrew.^[11]

What if I don’t know their full Hebrew name?

If one doesn’t know their full Hebrew name one may still daven for them using their first and last name. In their presence one does not need to use their name to pray for them.^[12]

Can I visit the sick on Shabbos?

Yes, as long as it won’t make one terribly and sad and ruin Shabbos.^[13]

Can I daven for the sick on Shabbos?

Yes, but if they are not in mortal danger one should add the phrase: שבת היא מלזעוק.^[14] If they are in mortal danger, one need not add that phrase.^[15]

Can I visit someone I have a really bad relationship with?

It depends. If one can ask permission and get it, that would be ideal to avoid it seeming like one is gloating. It can be an opportune moment to help make amends.^[16]

What if the person is terminally ill? Do I continue to daven for them?

There are times that a person is suffering terribly and there is no possible recovery, there is room to stop davening for them actively.^[17] I would suggest that instead of davening for a רפואה שלימה – a full recovery, one changes it to daven for רחמי שמים – mercy from heaven, which can take many different forms.

What is the reward for visiting the sick?

The gemara, TB Nedarim 40a, teaches that the reward in this world is avoiding lust and suffering and in the world to come avoiding certain aspects of suffering.

אָמַר רַב: כׇּל הַמְבַקֵּר אֶת הַחוֹלֶה נִיצּוֹל מִדִּינָהּ שֶׁל גֵּיהִנָּם, שֶׁנֶּאֱמַר: ״אַשְׁרֵי מַשְׂכִּיל אֶל דָּל בְּיוֹם רָעָה יְמַלְּטֵהוּ ה׳״, אֵין דַּל אֶלָּא חוֹלֶה, שֶׁנֶּאֱמַר: ״מִדַּלָּה יְבַצְּעֵנִי״, אִי נָמֵי מִן הָדֵין קְרָא: ״מַדּוּעַ אַתָּה כָּכָה דַּל בֶּן הַמֶּלֶךְ בַּבֹּקֶר בַּבֹּקֶר וְגוֹ׳״. אֵין רָעָה אֶלָּא גֵּיהִנָּם, שֶׁנֶּאֱמַר: ״כֹּל פָּעַל ה׳ לַמַּעֲנֵהוּ וְגַם רָשָׁע לְיוֹם רָעָה״.

Rav said: Anyone who visits the ill is spared from the judgment of Gehenna, as it is stated: “Happy is he that considers the poor; the Lord will deliver him in the day of evil” (Psalms 41:2). In this verse, the term poor [dal] means nothing other than ill, as it is stated in the prayer of Hezekiah when he was ill: “He will cut me off from the illness [middalla]” (Isaiah 38:12). Alternatively, it may be derived from this verse in which Jonadab asked his sick friend Amnon, son of King David: “Why, son of the king, are you so sick [dal] from morning to morning?” (II Samuel 13:4). And the term evil means nothing other than Gehenna, as it is stated: “The Lord made everything for His own purpose, and even the wicked for the day of evil” (Proverbs 16:4), and the ultimate punishment of the evildoer is Gehenna.

וְאִם בִּיקֵּר מָה שְׂכָרוֹ? מָה שְׂכָרוֹ?! כִּדְאָמַר: נִיצּוֹל מִדִּינָהּ שֶׁל גֵּיהִנָּם! אֶלָּא: מָה שְׂכָרוֹ בָּעוֹלָם הַזֶּה —

And if one visited the ill, what is his reward? The Gemara wonders at that question: What is his reward? It is as Rav said: He is spared from the judgment of Gehenna. Rather, the question is: What is his reward in this world?

״ה׳ יִשְׁמְרֵהוּ וִיחַיֵּהוּ וְאֻשַּׁר בָּאָרֶץ וְאַל תִּתְּנֵהוּ בְּנֶפֶשׁ אֹיְבָיו״. ״ה׳ יִשְׁמְרֵהוּ״ — מִיֵּצֶר הָרָע, ״וִיחַיֵּהוּ״ — מִן הַיִּסּוּרִין, ״וְאֻשַּׁר בָּאָרֶץ״ — שֶׁיְּהוּ הַכֹּל מִתְכַּבְּדִין בּוֹ, ״וְאַל תִּתְּנֵהוּ בְּנֶפֶשׁ אֹיְבָיו״ — שֶׁיִּזְדַּמְּנוּ לוֹ רֵיעִים כְּנַעֲמָן שֶׁרִיפּוּ אֶת צָרַעְתּוֹ

Rav continues: His reward is as it is written: “The Lord will preserve him, and keep him alive, let him be called happy in the land; and deliver not You him unto the greed of his enemies” (Psalms 41:3). He elaborates: “The Lord will preserve him” from the evil inclination; “and keep him alive” and spare him from suffering; “let him be called happy in the land” means that everyone will be honored from their association with him; “and deliver not You him unto the greed of his enemies,” so that companions like those who counseled Naaman to seek a cure for his leprosy from Elisha (II Kings 5:3)

1. Shulchan Aruch YD 335:1 ↑

2. Shulchan Aruch YD 335:8 ↑

3. Shulchan Aruch YD 335:2 ↑

4. Shulchan Aruch YD 335:4 ↑

5. Aruch Hashulchan YD 335:8 ↑

6. Aruch Hashulchan YD 335:4 ↑

7. Igros Moshe YD I:223 ↑

8. Ohr Zarua, Hilchos Birkas Hamotzi 140 ↑

9. Responsa Rashba I:18 ↑

10. Responsa Binyamin Zeev 169 ↑

11. Shulchan Aruch YD 335:5 ↑

12. Orchos Rabbeinu I:64 ↑

13. Shulchan Aruch OC 287 ↑

14. Shulchan Aruch YD 335:6 ↑

15. Shulchan Aruch OC 288:10 ↑

16. Aruch Hashulchan YD 335:6 ↑

17. Igros Moshe CM II:73:1 ↑