From the perspective of a believing Jew, everything comes from Above. If a person becomes ill, this is to be seen as something sent from Heaven. One might therefore think that it is forbidden to turn to a doctor, for if G-d brought the illness upon a person, how could it make sense to go to a doctor to heal it?
Yet, in our Torah portion it is stated: “he must (pay all) his medical (fees)” (Exodus 21:19), which teaches that a doctor is permitted to administer treatment (Bava Kamma 85A)
From this verse, however, we learn only that a doctor is permitted to heal. Does this also imply an obligation? Our Sages derive this by kal vachomer (a fortiori reasoning) from the verse: “And you shall return it to him” (regarding returning a lost object). If one is obligated to return a person his lost property, all the more so one is obligated to restore his health.
From this, it follows one must do everything possible to heal a person’s illness.
Spiritual Illness
Just as there is physical illness, there is also illness in the service of G-d—the spiritual realm. When there is a deficiency in a person’s spiritual work, he is considered “ill”.
Here there are several levels: there is a “dangerous illness,” a “non-dangerous illness,” and then a higher level, for which it is said that “ill” in Hebrew corresponds to the numerical value 49, because the person has already attained forty-nine “gates of understanding”. His “illness” is that he lacks the fiftieth gate—meaning the highest possible level of spiritual perfection.
Obligation and Permission
The differences between these “illnesses” also determine the degree of obligation to engage in their “healing.” Some spiritual afflictions carry a full obligation (chova) to attend to them, while others are merely a case of “permission (reshut) to heal,” but not a strict obligation.
When the “illness” manifests as a failure to observe Torah and its commandments, the “healing” is obligatory. A Jew who does not study Torah and does not perform its commandments is in the category of a “dangerous illness,” and it is the duty of anyone who can save him to engage in his “healing.”
However, when the “illness” manifests as the person not yet having reached the peak of perfection, still missing the fiftieth gate of understanding, this is described as “permission to heal.” It is a permission, not an obligation, because engaging in this matter is not within everyone’s capacity.
Prioritize Others First
From this we also learn another instruction: when a Jew is called upon to spread Judaism and influence another Jew to fulfill the commandments, he may sometimes reply that he is concerned about his time, and he wishes to dedicate it to his own personal spiritual ascent, in order to reach the “fiftieth gate”.
He must understand, however, that the demand to “heal” another is an obligation, for it is a “disease” that one is commanded to address. His personal aspiration to attain perfection is indeed correct and praiseworthy, but it is considered “permission” in contrast to the obligation he has toward another Jew, who is in a much lower spiritual state.
A person must first attend to matters of obligation and only afterward may he engage in matters of permission. Then G-d will grant him success in his personal spiritual work as well, until he reaches the “fiftieth gate”.
(the Rebbe, Likkutei Sichot, Volume 2)
