There’s a healthy amount of trepidation I feel as a Rabbi preaching a sermon on medical issues in a congregation with plenty of doctors. So this is my obligatory disclaimer: I am not a doctor. Any advice dispensed from the bimah is not valid medical advice. This is where my rabbinic authority ends.
Having said that, rabbis throughout the ages have brought Jewish wisdom and Halakhah to a range of social and scientific issues and phenomena. And in some cases, rabbis have been doctors – the great Maimonides comes to mind. There is a careful balance to be struck between having anavah – humility – as a rabbinic teacher and moral chutzpah to bring Judaism to bear on the human condition. For if we (any of us) did not have that chutzpah, Judaism would be rendered morally irrelevant. ‘Shemirat guf’, the guarding of our body and health, is a mitzvah d’oraita, a Torah commandment, incumbent upon us all.
In this week’s Parashah, there is a strange episode featuring venomous snakes. After Miriam’s and Aaron’s deaths, the people become even more disheartened. Their trust crumbles. They complain bitterly about the lack of sustenance – physical and spiritual. God, in turn, afflicts them in a unique way in Chapter 21: God sends ‘burning’ (seraph) snakes, meaning they were venomous. They struck at the people and falling ill, they repent. Moses devises a form of antidote to the snakebites in the form of a copper (or bronze) snake (the ‘nechushtan’) mounted on a pole that seems part sympathetic magic (to recast an image of the thing that ails you) and part placebo effect. Regardless, it works and the people are healed.
For the medic or the astute observer, the depiction of the nechushtan sounds suspiciously familiar to that of the rod of Asclepius: the Greek mythological depiction of a snake coiled around a staff, which has become a universal symbol of medicine. This is depicted, among others, on the flag of the World Health Organization. Asclepius was the ancient Greek god of healing and medicine and there was apparently a sacred practice for the healing temples to cultivate ‘sacred snakes’ (non-venomous) that would occupy the temple precinct. At minimum, there seems to be some shared cultural understanding between snakes and healing in the ancient Mediterranean basin.
In and of itself, this is an interesting occurrence in the Biblical text. But in context of a preceding passage, I think this imagery can serve as useful moral commentary on ethics in our own time. This is the incident of Moses striking the rock, only one chapter earlier. Usually, this passage gets interpreted in light of disobedience, anger and rebellion. The people complain and Moses loses his patience. However, I propose a different focus as the Torah gives us a reason for Moses’ and Aaron’s failure: ‘Vayomer Adonai el Moshe v’el Aharon ya’an lo he’emanthem bi le’hakdisheni l’eini b’nei Yisrael lachen lo tavi’u et hakahal hazeh’ – ‘And the Eternal said to Moses and Aaron, ‘because you did not trust in Me enough to sanctify Me in the eyes of the Children of Israel, you shall not lead this congregation…’ (Num. 20:12).
What is the connective tissue between the incident with the rock and the incident with the snakes? Loss, illness and lack of trust.
One of the scourges of the contemporary age is the breakdown of trust. The measles, believed to be nearly eradicated two decades ago, has reared its head in a new national epidemic as vaccine hesitancy is on the increase. As the Lancet reports in a recent article from May 2019:
Vaccine hesitancy, which is defined by WHO as a “delay in acceptance or refusal of vaccines despite availability of vaccination services”, has been reported in more than 90% of countries in the world.
“In many areas, immunisation for measles, a vaccine-preventable disease that was largely eliminated following widespread use of the measles-mumps-rubella (MMR) vaccine, has decreased to less than the 95% threshold set by WHO as that required for herd immunity.… In the USA, the percentage of children aged 19–35 months who received the MMR vaccine slightly decreased from 91·6% in 2011, to 91·5% in 2017, with very low rates of coverage reported in some communities (eg, 60% in ultra-Orthodox Jews in the state of New York where a measles outbreak is ongoing). Similar trends elsewhere have resulted in a 30% rise in measles cases worldwide—even in countries such as the USA, where measles had been eradicated in 2000—prompting WHO to declare vaccine hesitancy one of the ten biggest threats to global health.”
The purpose of this sermon is not to facilitate the false equivalency of a vaccine polemic, nor to promote any particular policies in response to this global development. Any Halakhic authority who rules with moral integrity and intellectual honesty will point to evidence-based science regarding the efficacy and safety of vaccines and the Halakhah is universally clear on our Jewish religious and civic obligation to vaccinate (being an intrinsic ethical issue; not necessarily a government issue). What is of greater interest when refracted through the lens of Torah is this issue of trust and the breakdown of trust.
Vaccine hesitancy is not a cause but a symptom of our societal breakdown of trust, and this breakdown is manifested more broadly than just the area of vaccines. In a world rife with power and contradiction, it is hard for individuals to discern all the facts and to extrapolate from different matrices of power. There is distrust towards government, towards the pharmaceutical sector, towards experts, towards the corporate world, agribusiness… and sometimes not without cause. We need, then, not only a conversation on facts but a conversation on why our trust has eroded and how that civic trust can be restored. We need to thinka bout how critical thinking can be used for the common good and to hold powerful actors to account while fostering civic duty and responsibility in all of us.
Paul Ward is a professor and head of public health at the College of Medicine and Public Health, Flinders University, Australia, who writes about how to approach vaccine hesitancy in British newspaper, The Guardian:
Evidence shows that it is very difficult to change behavior among parents who actively refuse vaccination. Providing the correct information on vaccines improves knowledge but does not improve intent to vaccinate, indicating that simply correcting myths about vaccines in information campaigns or public health interventions may not be effective in changing vaccination behaviors.
“In my field of public health, we actively aim not simply to blame people for their behaviors, but rather to understand the social, cultural, economic and cultural reasons that underpin their behaviors in the first place. This approach has been called “the causes of the causes”. We can then advocate for changes to the underlying factors which create the reasons for the behaviors, which moves the focus away from the individual and on to the social and political determinants of behavior.
…The times when we were simply, even blindly, expected to trust people because they were in positions of power has gone… Across many countries and cultures, this unquestioning of power has been somewhat eroded, and in some cases broken. Nevertheless, most of social life could not happen without trust – as humans, we cannot personally perform every function ourselves, and therefore we need other humans to perform those functions for us… If we trust, we believe that the other person will do their best for us, and we will cooperate in a social relationship on that basis. Trust is a judgment, not a decision based on facts.”
Perhaps Moses’ failure as a leader was not his lack of anger management but his inability to convey and engender trust. Only one Parashah ago, we witnessed rebellion against authority, and although Korach’s motives were self-serving, the appeal to equality and transparency which he cannibalized is a noble one. Instead of condemning each other’s lack of trust, perhaps we should raise trust, like a ‘nes’, a standard. Perhaps the ‘nechushtan’ was effective because it was public, transparent and universal: all could find healing beneath its bronze stare, without judgment and discrimination, with full access to the facts.
The implications of this sermon stretch way beyond this sermon itself. Yet, if we believe Judaism to have a valid claim in the marketplace of ideas, we must engage with these pressing issues. Reflect on the healthcare decisions that the Jewish tradition has historically valued. Teach and model critical thinking. Question lack of transparency. Embrace evidence-based empiricism but most of all; trust that the large majority of human beings seek goodness for themselves and others, so that we can truly talk to each other and find healing: not only from preventable communicable illness but from the rifts that are tearing our culture asunder.