Thursday, October 1, 2009

Not the Health Care Sermon You Were Expecting

You may have read this in your email in-box, but it’s worth a repeat:
The first Jewish woman President is elected.
She calls her Mother: "Mama, I've won the elections, I’d like you to come to the swearing-in ceremony."
"I don't know, what would I wear?"
"Don't worry, I'll send you a dressmaker"
"But I only eat kosher food"
"Mama, I am going to be President of the United States, I can get you kosher food"
"But how will I get there?"
"I'll send a limo, just come mama"
"Ok, Ok, if it makes you happy.”
The great day comes and Mama is seated between the Supreme Court Justices and the Future Cabinet members. She nudges the gentleman on her right and says, "You see that girl, the one with her hand on the Bible?...Her brother's a doctor!"

How many of us here tonight ever had a parent nudge them toward medical school—successfully or not? And the rest of you…law school, right?

The medical field is a bit of an obsession for the Jewish people. From having the best chicken soup recipe to believing that we know everything about skin cancer because we had a mole in 5th grade, we are a medically focused people. Health care is incredibly important to us.

Now don’t leave just yet. I am not going to talk about politics tonight or the national plan for health care. While it is a good idea to discuss Health Insurance Reform, that is not our topic for this forum. The truth behind the joke of the mother at her daughter’s inauguration is that for us medicine has greater significance than politics.

The Jewish view is that health care is imperative, preventative, and collective. We must care for ourselves when we are sick, we must do everything in our power to stay healthy, and we must take care of those who are sick as a community. Let’s take a look at each of these three facets of Jewish Health care.

Jewish health care is imperative.

Above all else, Judaism teaches that human life is the most important thing there is. Deuteronomy tells us we are to choose life and live (30:19). Genesis tells us we are all created in the Divine image (1:27), which means we need to treat the form our souls inhabit with respect and dignity. Leviticus tells us not to stand idly by the blood of our neighbors (19:16).

Rabbi David Saperstein, director of the Religious Action Center of Reform Judaism, recently cited these texts. From them he points out two central ideals that Judaism adheres to. The first is that an individual’s life is more valuable than anything, and saving the life supersedes almost all else. Second, God has endowed us with the understanding and responsibility to be God’s partner in making a better world. Using our ability to cure illnesses has been a central thought in Jewish history.

From these two ideals—that life is sacred and that we are commanded to protect it—the Rabbis from Talmudic times to today have continually offered requirements for us to fulfill both of them.

The Babylonian Talmud, Tractate Sanhedrin (17b), lists ten things we must have in any city where we would reside. It says:
A Jewish person should not reside in a city where the following ten things are not found: (1) A court of justice; (2) a charity fund; (3) a synagogue; (4) public baths; (5) toilet facilities; (6) a mohel; (7) a doctor; (8) a notary; (9) a shohet; and (10) a school-master. Rabbi Akiba is quoted [as including] also several kinds of fruit [in the list] because they are beneficial for eyesight.
Six items on the Talmud’s list are directly related to health care issues. Public baths because cleanliness helps prevent certain skin afflictions, infections, and bacteria. You know all those signs that tell us to wash our hands? Well, the Talmud knew about that almost 2000 years ago.

Toilet facilities—well, I hope I don’t have to go into detail about why keeping waste away from homes is beneficial. Having bath houses and restrooms also increases the town’s general aesthetic and decreases its environmental impact.

A mohel, because the very first time a Jew has elective surgery, it should be done right.

Having a doctor in town is also obvious, and often when this passage of Talmud is quoted, “doctor” is the only requirement cited.

A shochet is a kosher butcher, which is related to the preventative aspect about health care. We need to get our food from a trusted source—someone who knows the ins and outs of preparation of anything we would put into our bodies. This is also why Rabbi Akiva, like many of our parents, tells us we should eat a little fruit. It’s good for you.

The charity fund is also part of health care. It is the Jewish belief that the public is responsible for helping the poor pay when they cannot afford the best care. The Shulchan Aruch, Joseph Caro’s 16th-century compendium on Jewish Law, takes it a step further. Caro writes that Jewish doctors must cover all costs of treatment when their patients cannot afford to pay. But I promised this would not get political, so we’ll move on.

Six out of ten things we must live near relate to health care. It is a Jewish imperative to take care of our bodies, to get proper treatment when we are sick, and to ensure that our neighbors are cared for as well.

Jewish health care is preventative.

Even before we are required to take care of anything wrong with us, we are required to keep bad things from happening to us.

We believe that God owns everything, including our bodies. Since they are gifts from God, it is our responsibility to care for them. Just as we are obligated to take care of a car on lease or a house we rent, we must take care of that which God has loaned us. Exercising, eating right, getting enough sleep, and maintaining good hygiene are not for appearances. These are religious duties that keep our covenant with God regarding our bodies.

One of the greatest Jewish scholars of all time, Maimonides, was both a rabbi and a physician. Boy was his mother proud!

One of Maimonides’ writings is called Mishneh Torah, a 14-book compendium of Jewish law, philosophy, and practices. Early in this work, in the section call “Laws of Ethics,” he writes:
…when one eats and drinks it should not be done simply for pleasure, or else a person might eat and drink only sugary foods. Rather, pay attention to eat and drink in order to maintain the body health. Therefore, one should…eat things that are good for the body—whether they are sweet or bitter. Also, one should avoid eating that which is bad for the body, even if they are sweet to the palate (Hilchot De’ot 3:2).
Maimonides also speaks out against over-indulging and the sicknesses that can come from it, and he presents a plan for regulating the diet. His nutritional guidelines are almost exactly what the USDA teaches grade school students in the form of the healthy eating pyramid.

A note regarding over-indulging: Judaism often appears to give mixed messages about eating and drinking. We sanctify with wine. We use bread at our meals. We encourage certain foods for certain holidays, such as jelly donuts, hamantashen, and blintzes—none of which are considered healthful. On Purim we are even commanded to drink alcohol until we cannot tell the difference between Haman and Mordechai. Do not think that this means we are to put our health at risk.

Anyone who cannot physically or psychologically handle sweets or alcohol or any other type of food is forbidden to take part in these practices. We are allowed to use grape juice in place of wine. We can replace our sugary confections with a piece of fruit. If we can handle it, then we are permitted to celebrate according to the dictum, “Everything in moderation, including moderation.” If we cannot, it constitutes a danger to our health, and according to the Shulchan Aruch, “One should avoid all things that might lead to danger, because avoiding a danger to life is more important than complying with a ritual” (Yoreh De’ah 116:5).

Knowing that we are to avoid danger easily gives us understanding of what Jewish law says about smoking. We have known the dangers of smoking for years, and the negative effects it has on our health, even if we are only bystanders. Cigarettes are the only products legally sold to us that, if used the way they are intended, will kill the users. It’s only a matter of when.

We are commanded to do whatever we can to avoid the need to receive medical treatment. Eat right, exercise, maintain good hygiene, use alcohol sparingly, and stay away from cigarettes and recreational drugs. We do what we can to prevent the need for health care.

Jewish health care is collective.

Health care is a communal concern. When someone in our community is sick or in need of healing, we react together. When we pray, our daily liturgy is full of prayers that thank God for our health or asking God to keep us healthy. We recite Mi Shebeirach for the sick when the Torah is open to demonstrate its severity. There is a prayer for healing in the Amidah, as a part of Asher Yatzar, and elements of health and protection in Haskiveinu. We thank God for giving strength to the weary and lifting up the fallen.

At Temple Sinai when we recite Mi Shebeirach during a Shabbat morning service, we read a list of names. These are people who might have asked for our prayers and people who might have been put on the list by our partners. If anyone ever feels they need us to pray for their healing, we will absolutely say a Mi Shebeirach for you. All you have to do is let us know you are in need.

Do we believe that God miraculously grants healing to the sick? That by praying the sick will be healed? Not necessarily. But we do believe that there is great power in community, and that together our prayers do reach God. If our prayers do nothing else, then they give comfort to the sick. Comfort helps to relieve stress, and less stress means more healing. So maybe our prayers can be effective.

We add to our prayers with action. The morning blessing Eilu Devarim reminds us that Bikkur Cholim, visiting the sick is one of the duties whose worth is immeasurable. Bikkur Cholim, is a central Jewish value. Rabbi Litwak, Cantor Kruk and I visit partners in the hospital or at their homes regularly. Our caring community does it as well. Spending time with someone who is sick is an easy way to show that we care, and it brings a little light into a dark time.

The practice of Bikkur Cholim is exemplified in a Midrash:
When Abraham was circumcised and was in pain from the circumcision, God told the angels to go and visit him. But before they arrived, God came in first, as the Torah says, “And God appeared to [Abraham] and after that, “He lifted his eyes and saw three men approaching” (Tanhuma Vayera 2).
Abraham circumcised himself at 90 years old. He was in a great deal of pain, and God came to visit him. The 41st Psalm tells us that “Adonai supports one who lies on a sickbed.” So it is not just biblical characters that merit God’s attention, but anyone who is ill. Like the poem about the footprints in the sand, God is with us when times are hardest. If Bikkur Cholim is important enough of a duty for God to practice it, think about how much more so is it incumbent upon us to visit the sick. In fact, when we sit with someone who is ill, we are representing God.

We can also help by healing with our feet. In a few weeks, the weekend of October 16th, we will hold our second annual Pink Shabbat for breast cancer awareness. We will pray for those who a re struggling with breast cancer, rejoice with those who have survived it, and remember those who have succumbed to it. On Friday evening, October 16th, we will have a special Shabbat service here in the sanctuary. On Saturday morning we will join the Susan G. Komen Race for the Cure. We will meet bright and early for a very brief Shabbat service in the amphitheatre at Bayfront Park in downtown Miami. After services we will attend the Survivor Ceremony, followed by the 5K Run or Walk for the Cure.

Temple Sinai is currently the only Jewish organization sponsoring this event. Even though the Race for the Cure is on a Saturday, we feel that participating falls under the guidelines that saving a life supersedes all else. We hope you can join Team Sinai, put your pink on, and walk with us. More details are on flyers in the Bloom lobby.

Whether we are praying, visiting, or walking, we respond to issues of healing as a collective—a strong caring community—emissaries of God.

Not everyone can be the doctor that would make our mothers so proud. But everyone can and should be a part of the healing process. It is imperative for us to be healers. It is crucial that we keep ourselves healthy through preventative measures. We face health issues as a collective.

May this year be a year of good health for all of us and our families.

A year of providing necessary care.
A year of maintaining our health with our good habits.
A year of caring for each other and staying active in our caring community.