M'tzora 5770 Jewish Doctors - Canaan to Haiti Neil Drapkin 17 April 2010

This week’s Torah portion is one of those with limited apparent relevance to our time.  And very little attraction at any time. As you have heard, it is all about leprosy in houses and my first reaction on reading it was to think that this was proof if one ever needed it that Torah was not all min ha’shamayim.

When I was invited to give a sermon today I was of course honoured.   The honour was slightly tempered by the fact that the Rabbis really wanted my daughter to give it, and I was asked because she was unable to accept.  They suggested that the sermon should refer to the wonderful humanitarian response of Israel in sending their fantastic field hospital to Haiti, where it was first in action and was praised by everybody except for the dreadful Baroness Tonge, so I will now try to segue, with the aid of the World Wide Web, from treating leprosy in houses in Canaan to treating earthquake victims in Haiti.

The parasha does demonstrate, or at any rate can be construed to demonstrate that from earliest days Jews were concerned about health, protection of the community and preventing the spread of diseases.  The use of the term leprosy in referring both to people and houses is not as irrational as it seems at first as it is a mistranslation of a word, tzara’ath, which covered a range of diseases thought to be due to moulds and fungi.  Apparently there is no evidence of any cases of true leprosy in biblical times.

Verse 34 in the Sidra reads “When you come to the land of Canaan, which I am giving you as a possession, and I place a lesion of tzara'ath upon a house in the land of your possession”, and Rashi’s commentary reads: “This is good news for them that lesions of tzara’ath will come upon them, because the Amorites had hidden away treasures of gold inside the walls of their houses during the entire forty years that the Israelites were in the desert, and through the lesion, he will demolish the house and find them.”

This suggestion that leprosy in a house was a gift because it meant the walls would be torn down and reveal the treasures hidden there by the previous Amorite owner is astonishing.  Apart from the unlikelihood of this being a frequent occurrence, if you did find hidden treasure I would have thought Exodus 23:4, applied -  “When you come upon your enemy’s ox or donkey going astray, you shall bring it back”. You would then lose your purloined house and the treasure as well.  That really would make you sick!

Let us suppose that these verses were really all about health, and dip into the Jewish record in medicine from the time of Leviticus until today. There is no doubt that the Jews got off to a good start.  There are sensible health rules – isolation of the sick, washing after handling a dead body, not eating dodgy food and so on, to be found in Leviticus, Deuteronomy and Numbers.  It is clear that prevention of disease was an important consideration in biblical times and no doubt gave the Jews an advantage over other peoples with less interested in health matters. In fact their high literacy rate and generally good health would have been of advantage to them in any society, tending to make them rise to the top of the heap but which would not necessarily have made them popular with their neighbours.

There is an interesting theory that true medicine was dependent on the Jewish belief in One God who did not strike people down with diseases on a whim, as was supposed to be the case with the pagan gods, and that any cures delivered by pagans or witchdoctors would have been the result of observation of the effect of various treatments rather than based on scientific enquiry.  Bearing in mind the bizarre medical treatments that were the norm until round about a century ago I am not sure it wouldn’t have been less hazardous to be treated by a witchdoctor doing what he knew worked rather than by a Jewish doctor who based his efforts at curing you on a scientific theory which was almost certainly very wide of the mark.  Did you know that bloodletting continued as a treatment until early in the 20th century, by which time the number of untimely early deaths lying at the door of its practitioners must have run into many millions.  The practice is thought to have started before the Exodus so maybe those witchdoctors weren’t so reliable after all. 

Probably the most bizarre medical theory ever is reported by Montaigne. In his essay “On bad means to a good end” he writes “We are subject to a surfeit of humours which serves no purpose and is harmful.  The humours themselves may be good” – and now Montaigne puts in brackets – “and the doctors fear them particularly; they say that since nothing within us stays stable, health when perfect can be too positive and vigorous and should be tamed and diminished by the art of medicine for fear that our nature, being unable to remain fixed in any one place yet having no possibility of further improvement, should suddenly collapse in disorder ; that is why they prescribe for athletes purgations and bleedings so as to draw off that superabundance of health”.  And no doubt the doctors made a substantial charge for these services.

Despite their very limited ability to cure anything, the Jews developed a great respect for doctors from a very early time.  In apocryphal Ecclesiastes (180 bce), Joshua ben Sirach attributed the earthly role of the physician to the divine purpose. "Honour the physician," he wrote, "according to thy need of him with the honour due unto him because verily the Lord hath created him."  It’s a bit enigmatic but the gist is clear and things haven’t changed much; pretty well every Jewish mother would go along with the sentiment.

Probably the most famous Jewish doctor was Maimonides who was born in Cordoba about 1135 CE. He trained as a doctor there, and in Fez in Morocco.  From there he went to Palestine and eventually settled in Egypt. Medicine was only one of his many accomplishments but he seems to have been very good at it. It is said “he displayed in his interactions with patients attributes that today would be called intercultural awareness and respect for the patient's autonomy.”  Is there a suggestion here of the roots of psychoanalysis, and also of the current practice, not always welcome, of a GP asking the patient to choose between a variety of treatments?  He gained widespread recognition and became court physician to the Egyptian royal family. After his day’s work at the palace he went home to what we would know as a GP’s surgery for the local population. In his writings he described many diseases and emphasised moderation and a healthy life style. Although he went along with the theory of the four humours (blood, yellow bile, black bile and phlegm) he based his treatments on his own observation and experience, going back to the sensible part of the tradition of the ancient witchdoctors. 

Jews had been influential in various aspects of medicine throughout the ages.  For example there was Isaac Judaeus, who lived in Tunisia around 1000 c.e whose book on Pharmacology, translated into Latin, was the foundation for most of the subsequent medieval works on the subject.  Later there was the famous Roderigo Lopez, who became court physician to Queen Elizabeth 1, though whether or not we should claim him as a Jew depends on how one feels about Marranos and whether you believe he was attempting to poison his Royal employer.  Another story demonstrating the reputation of Jewish doctors says that while he was imprisoned in a tower in Madrid in the 1540s, disabled by syphilis and further weakened by an abscess in his scalp, the French king Francis I asked his captor, the Holy Roman Emperor Charles V, to send his finest Jewish physician to attempt a cure. At some point after the doctor arrived, Francis, asked him if he was not yet tired of waiting for the messiah to come. To his annoyance he was told that his healer was not actually Jewish, but a converso who had long been a baptized Christian. Francis dismissed him, and arranged to be treated by a genuine Jew, brought all the way from Constantinople.

Jews have continued to be drawn to medicine, as doctors, patients and fully paid up hypochondriacs, right up to today. The percentage of Jewish doctors in the UK is hard to establish but is probably similar to that in the States, where 14.9 % of Jews are doctors compared with 1.9 % of total population.  But this is nothing like the situation in Europe in 1933, when 50% of Berlin’s doctors and 60% of Vienna’s were Jews.  Jewish medical presence in the UK seems to have developed first in Scotland, and to have been imported to England from there and from Europe during the 19th and early 20th Century.  There have been many distinguished Jewish doctors and in our own time Lord Winston is outstanding.

The real hothouse of Jewish medical advances has been in Israel. Cardiology, genetics, neurology and ophthalmology are but a few of the medical sciences benefiting from advanced Israeli technology. In recent years Israelis have developed heart tissue and pacemakers from stem cells, created muscle tissue that the body doesn’t reject, and invented an electronic monitor that can diagnose cancer. Israeli scientists developed the first fully computerized, non-radiation required, diagnostic instrumentation to detect breast cancer. Israeli researchers invented a pill-sized camera that helps doctors diagnose cancer and digestive disorders. Then there’s the new device that helps those with heart failure – an artificial blood pump.  And out of necessity, the Israelis have developed expertise in setting up highly efficient field hospitals, in order to deal with terrorist attacks.  It is this speciality, developed out of desperate necessity, that is now benefiting the victims of disasters world wide.  For this, even her enemies should bless Israel.