DOCTORS AND HEALING
The verse in our parashah, "Heal, he shall heal" (אֵּפַרְא יֹּפַרְו), is the primary biblical source for the concept of medical treatment by a physician. The context of the verse is that one who injures another must pay for their medical expenses). From this, the Sages derived the principle that "permission has been granted to the physician to heal."
The basis for this teaching comes from the repetition of the verb “to heal” (verapo yerapeh - אֵּפַרְא יֹּפַרְו). Whenever there is such repetition in the Torah, it requires explanation—why is the verse repeated? In this article, we will examine seven explanations from the Midrash regarding this double expression. Through these interpretations, we will gain a deeper understanding of the nature of healing (with implications for other areas as well). We will correspond these seven interpretations with the seven emotional attributes of the heart (middot): Loving-kindness (chesed), might (gevurah), beauty (tiferet), victory (netzach), acknowledgment (hod), foundation (yesod), and kingdom (malchut). Building this partzuf—i.e., a model or framework—will allow us to delve into the inner meaning of healing both physically and spiritually.
LOVING-KINDNESS: NATURAL HEALING AND CONVENTIONAL MEDICINE
Let us begin with the sefirah of loving-kindness. In the phrase verapo yerape (אֵּפַרְא יֹּפַרְו), the first verb form (verapo) is referred to as the source (רֹקוָמ) form, while the second (yerape) is an active causative form. In Hebrew grammar, verbs can appear in a light/simple form (p a’a l) or a strong/intensive form (p i ’e l). The word verapo is closer to a simple form (although, grammatically, it could also be a p i ’e l), while “you shall heal” (yerape - אֵּפַרְי) is clearly a more intensive form.
From this, we derive an important principle in healing: A physician should begin with lighter, more natural treatments before resorting to stronger, more aggressive medical interventions. If the lighter, natural healing methods are effective: wonderful! If not, one must proceed to more intensive treatments, such as those utilized by conventional medicine (e.g., chemical/ pharmaceutical interventions).
According to the Torah, two months are particularly associated with healing. The month of Iyar (רָּיִא) is connected to natural healing, as the month’s name is an acronym for “I am Havayah, your Healer” (-הוהייִנֲא ָךֶאְפֹר). The word “Your Healer” (ָךֶאְפֹר) suggests a lighter, or easier form of healing. The month of Elul (לּלוֱא) is associated with conventional medicine, as it is the month of repentance (teshuvah), which brings healing to the world, as in the verse “He shall return, and he shall be healed” (ֹא לוָפָרְב וָׁשְו).
Thus, the Torah’s message in these two words, “verapo yerape” is: First, attempt to use lighter methods to heal. If they work—excellent! If not, proceed to stronger, more intensive treatments.
APPLICATION TO EDUCATION AND PERSONAL GROWTH
This principle applies not only to healing the body but also to education and personal development. One should always start with gentle methods—kindness, encouragement, and easy techniques. If these approaches work—great! If not, more rigorous and structured methods may be necessary. This reflects the essence of the sefirah of loving-kindness—beginning with kindness and gentleness, while being prepared to increase discipline if needed.
MIGHT: COMPLETE HEALING VS. HEALING WITH SIDE EFFECTS
The second interpretation belongs to the sefirah of might. When HaShem—the ultimate Healer—heals, He does so completely, one hundred percent, without any negative side effects. However, when a human heals, often in curing one issue, they create another problem. This raises a dilemma for the physician: why should I enter this challenge? Perhaps it is better not to treat the primary illness at all due to potential side effects.
The Torah teaches that when HaShem heals, it is entirely good and without consequences. However, in the end, a human physician must take a risk and treat the illness, even knowing that side effects may arise—and often will. Despite this, the physician must still address the more serious, fundamental illness. If side effects occur afterward, they must be treated as well. The sages refer to side effects metaphorically as "weeds." and if weeds appear, the physician must heal them as well.
This is the second interpretation: “Heal” (verapo - אֹּפַרְו) means, if you can heal without side effects, all the better. But even if you know the illness is severe, and that treating it will cause side effects, do not be discouraged from healing. The Torah commands: “you shall heal” (אֵּפַרְי)!
This interpretation aligns with might because might relates to actions that may involve negative consequences, requiring extra strength and resilience to address them as they arise.
BEAUTY: THE SOURCE OF HEALING IS WITH HASHEM, AND ITS IMPLEMENTATION IS THROUGH THE PHYSICIAN
The third interpretation, corresponding to beauty (tiferet), is that the source form, verapo (אֹּפַרְו) refers to God—one must first believe that healing comes from God, which is true for everything and is relevant in any case when one person helps another—the source of the help is actually God. Before a physician acts, they should pray to God for success, that the procedure will be smooth, and perhaps even that God will heal entirely on His own so that the physician is not needed. The first step is to lift one's eyes to God in prayer and to ask for mercy, the inner dimension of the sefirah of beauty. One must first pray and seek mercy, and only afterward proceed with action.
This is the meaning of the verse: verapo (אֹּפַרְו)—pray and ask for mercy; yerape (אֵּפַרְי)— refers to the action carried out by a human being.
This interpretation can be compared to another example of a double verb used in a commandment. The Torah states, “Set, you shall set a king over yourself ” (som tasim – יםִׂשָּם תֹוׂש), which the sages explain as “som—above, tasim—below.” Meaning, first establish your faith above, and then you will receive permission from Him to heal here below. The very notion that permission needs to be granted to the doctor to heal provides a centering point for all that the doctor does. It provides a proper psychological stance for the physician and his work: first, acknowledge that God is the healer, and then receive His appointment to heal.
VICTORY AND ACKNOWLEDGMENT: EXTERNAL HEALING AND INTERNAL HEALING, INJURY BY MAN AND INJURY BY HEAVEN
The fourth and fifth interpretations are interconnected, as victory and acknowledgment usually work in unison (just like the two feet, which represent these sefirot in the human form).
Ibn Ezra states that the permission and empowerment given to a physician to heal applies only to external ailments, whereas internal illnesses can be healed only by God, “the Healer of all flesh, Who performs wonders.” In truth, this view was not accepted as halachah, and the Shulchan Aruch rules that a physician has the ability to heal even internal ailments. Nevertheless, we can derive a hierarchy of priorities from this distinction and interpret the verse accordingly: Ve r a p o (אֹּפַרְו)—one should first attempt to heal external ailments without interfering with the internal organs. However, if external treatment is ineffective, one must proceed and use available means to examine the body's interior—such as X-rays and similar techniques (which act as the physician’s penetrating gaze, which sees deep into the body and soul of the patient)—and use internal healing.
A similar interpretation is that Ve r a p o (אֹּפַרְו) refers to treating ailments caused by men to others, while Ye r a p e (אֵּפַרְי) teaches that even illnesses or afflictions sent by God may be treated by a physician.
Victory is the first sefirah that extends "outside the body," symbolizing external diseases, which should initially be treated by a human physician (who is also external to the patient's body, unlike the Almighty Who is internal as well). On the other hand, acknowledgment is associated with the verse “My splendor [hod] has turned into destruction," symbolizing ailments caused by the person themselves—these must be treated first.
As Rebbe Nachman famously said, "If you believe that damage can be done, believe that it can also be repaired"—meaning that what was turned into an ailment (הָוָּד) by improper conduct can be restored to splendor (דֹהו).
FOUNDATION: PAID HEALING
The sixth interpretation is more practical. Some commentaries explains that if the Torah had only written verapo (אֹּפַרְו) and not verapo yerape (אֵּפַרְא יֹּפַרְו), one might have thought that healing should like Torah study be given for free. Teaching Torah is an act of kindness and a mitzvah, so perhaps a physician should also work without payment.
If such a thought could arise, it means there is a valid reason for it; perhaps it would be fitting for a doctor to work without charge. Therefore, the Torah uses the double expression to teach that a doctor is permitted to take payment.
A Torah teacher, too, ideally should teach for free. However, if teaching consumes their time to the extent that they cannot engage in other work, they are permitted to receive payment. The same applies to a physician.
In fact, verapo yerape instructs that not only is it allowed for a doctor to receive payment, but in some cases, it is even preferable. The Talmud states that a doctor who is not paid will not be effective in his healing—he must be compensated so that he is fully invested in the treatment and will heal with the strength that God has given him. If a doctor is skilled, he is paid more.
The sefirah of foundation is associated with the reward and punishment that needs to be given to the doctor. It reflects the “righteous person who is the foundation of the world” who in merit of his righteousness receives reward or the opposite.
KINGDOM: NEVER GIVE UP
The seventh interpretation connects back to the first—one must attempt healing through multiple approaches. The responsibility a physician carries is immense, as a mistake in treatment can cause harm, God forbid. It is not easy for a doctor to take risks and attempt different treatments. Many doctors tend to try the first treatment option that comes to mind, and if it does not work, they give up, saying they cannot help with this condition advising the patient to seek another doctor instead.
The double expression verapo yerape teaches that healing itself must involve repetition; if one method does not succeed, try again and again. A doctor must persist, and as we said in the interpretation associated with loving-kindness, treatment should include both conventional and natural methods. The doctor has a true responsibility to heal the patient (of course, if the doctor recognizes that another physician is more specialized in a particular treatment, it is a mitzvah to refer the patient to them).
We should point out that “try again and again” is not just an instruction for the doctor, it is also said to the patient. If the first doctor was unsuccessful, should the patient give up? No. The Torah commands: "And you shall guard your lives very carefully"—one must keep trying. The true healer is God alone, and one must persist in seeking healing from His messengers—human physicians—until, with God’s help, he will finally be healed.
- loving-kindness-chessed דֶסֶח natural and conventional Medicine
- might-gevurah הָרּבוְּג side effects
- beauty-tiferet תֶרֶאְפִּת God is source of healing, doctor is His messenger
- victory-netzach חַצֶנ external and internal medicine
- splendor-hod דֹהו healing by man, healing by God
- foundation-yesod דֹסוְי paid healing
- kingdom-malchut תּכוְלַמ do not despair of finding a cure
