In God We Trust

Mikeitz 5780

It happened at the end of two years…”

(Bereishis 41:1)

Parshas Vayeshev concludes with Yosef’s plea to the Sar haMashkim to remember him, and help him procure a release from jail. The Sar haMashkim forgot about Yosef’s plea, and he languished in the jail for an additional two years. At the end of the two years, Paroh dreamt his famous dreams, beginning an astonishing sequence of events that culminated in Yosef being appointed ruler of Mitzrayim.

Rashi (40:23) quotes Chazal who explain that Yosef was punished with an additional two years in jail in Mitzrayim because he had placed his trust in the Sar haMashkim. “Fortunate is the man who has relied upon Hashem and has not turned to the arrogant ones” (Tehilim 40:5) – Yosef should have placed his trust in Hashem, and not the “arrogant ones”, namely, the Egyptians.

Certainly, Yosef was permitted to make some form of Hishtadlus in order to escape the Egyptian jail. His mistake, as implied by Rashi and explained by many other commentaries[1], was not that he attempted some Hishtadlus but that he trusted that the Sar haMashkim would be the key to his freedom. Yosef should have remembered that salvation emanates purely from Hashem and not from human beings.

The balance of Hishtadlus versus Bitachon is an age-old question which comes particularly to the fore in the realm of medical treatment. The Ramban, on the one hand, famously asserts that a Ba’al Bitachon has no need for doctors for “what role does a doctor play in the home of one who fears G-d?” On the other hand, there are many who disagree with the Ramban, arguing that Hashem created a world in which people fall ill and require the assistance of doctors to cure them.

The following is a quote of a little-known Medrash (Medrash Temurah Chapter 2) that appears to describe medical treatment as a natural process similar to tending to plants.

“R’ Yishmael and R’ Akiva were once walking in the courtyards of Jerusalem accompanied by another man. They met a sick person who said to them:

“Rabbosai, tell me how I will be healed?”

They replied: “do such-and-such until you recover”.

He asked: “and who struck me (with illness)?”

They answered: “haKadosh Baruch Hu.”

He replied: “[If so] you are intervening in a realm that is not your own. He struck [me with illness] and you are healing me! Are you not countering His will?”

They asked: “And what work do you do?”

He answered: “I work the land, indeed, here is a sickle in my hand.”

They asked: “And who created the vineyard?”

He answered: “HaKadosh Baruch Hu”.

They exclaimed: “You are intervening in a realm that is not your own. He created it and you are cutting it down!”

He replied: “Do you not see that sickle in my hand? If I wouldn’t have plowed the land, weeded it, fertilized it and hoed it, it wouldn’t have produced anything!”

They answered: “Foolish one! From your work, do you not hear what is stated (Tehilim 103) “Man, his days are like a tree”. Just as a tree, if one doesn’t hoe and fertilize and plow, it will not grow, and if it grows but isn’t watered or fertilized, will not live, but will die, so too is the human body – the fertilizer is the (equivalent of the) medicines or the types of Refua and the man who works the land is (equivalent to) the doctor.


We can derive an important principle from this Medrash. Though sickness is sent from Hashem, it is still a function of the natural world, just like the growth of the plants and trees. Medical treatment and the use of medications are just a part of guarding one’s health. Therefore, far from countering Hashem’s will in the world, a doctor, on the contrary, acts as His messenger to heal the sick and save lives.

The Zohar (Devarim 299:1) writes similarly:

“Lest you will say, since Hashem decreed that a person will be sick, nobody should try (and save) him – it is not so – for King David said (Tehilim 41) “Fortunate is the person who acts wisely with the destitute” – “the destitute” is a person who is lying in the hospital, and if the doctor acts wisely with him, Hashem will bless him.”

The Zohar also asserts (ibid. 304:2) “all Refuos in the world are in the hand of Hashem, but there are some that are effected through a messenger.”

In other words, if it has been decreed that a person will die, no Refua in the world will help him. However, when Hashem has decreed that a person take ill as a punishment or warning, then Refua may help.

Sometimes a person is struck by illness on condition that he will be healed by a certain doctor and through specific medications. The Gemara (Avodah Zara 55a) explains that for this reason diseases are known as “Ne’emanim” – reliable ones, for they are, so to speak, reliable in completing their mission. When they are sent to afflict a particular person, they are made to take an oath that they will not leave him until a particular day, through the treatment of a particular doctor, and through the administration of certain medications.

It follows, therefore, that Refua does not contradict the will of Hashem. Rather, it precisely His will that a sick person be cured through a certain doctor and medications or treatments. The doctor is merely fulfilling his Shlichus according to a plan that has been set in advance.

This perspective on the role of a doctor is truly fascinating. A doctor does not interfere with or combat the will of Hashem by medical intervention – on the contrary, he acts as a Divine emissary, sent to provide healing and relief.

This may also alter the perspective of the patient who may sometimes find himself torn between two worlds. In one, he exerts himself heavily in Teshuva, Tefila and Tzedaka to accrue merits and forestall the difficult decree that has fallen upon him, and, in the other, he must search for the best possible medical treatment. At times, he may feel that he is living a contradiction – on the one hand relying on Hashem and on the other hand, on medical intervention.

Realizing that medical intervention is also part of the spiritual blueprint of the world, and that his doctor is, in fact, a Shliach of Hashem sent to heal him, may resolve the contradictions in his mind. He must certainly act in the spiritual dimension in order to earn salvation, but his actual cure may not arrive in miraculous fashion. Rather, it will arrive through the hands of the Shliach of Hashem – the Rofei Ne’eman.

This perspective may also help him avoid despair if the doctor informs him of difficult news about his condition. It is said “a doctor has permission to heal, but not to despair”. If a person recognizes that the doctor is merely acting as an emissary of Hashem and that, ultimately, his cure is only in Hashem’s hands he will never despair. “Even if a sharp sword is resting on a person’s neck – do not despair of mercy” (Berachos 10a).

[1]See the Ha’amek Davar, for example.

Yossi Sprung

Yossi Sprung

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