רְפָאֵנוּ ה’ וְנֵרָפֵא. הושִׁיעֵנוּ וְנִוָּשֵׁעָה כִּי תְהִלָּתֵנוּ אָתָּה. וְהַעֲלֵה רְפוּאָה שְׁלֵמָה לְכָל מַכּותֵינוּ כִּי קל מֶלֶךְ רופֵא נֶאֱמָן וְרַחֲמָן אָתָּה. בָּרוּךְ אַתָּה ה’, רופֵא חולֵי עַמּו יִשרָאֵל:
Heal us, O Lord, and we shall be healed, save us and we shall be saved, for You are our praise. Bring complete healing to all our wounds, for You are God and King, the faithful and merciful healer. Blessed are You, O Lord, Who heals the sick of his people Israel.
Of all the prayers a human might understand on their own, this is that one people don’t need much help understanding – the prayer for health – refaeinu. It usually elicits the strongest and most visceral emotions in people, and with very good reason. A healthy person wants lots things; a sick person only wants one. Without health, all the blessings in the world fall flat. For most people, it is usually the most relatable and straightforward blessing to connect with.
Eights and Healing
It’s the eighth blessing in the order of the Amida, and number sequences were highly significant to our sages. Eight is closely associated with circumcision, the mitzvah of which falls on the eighth day; and circumcision is closely associated with our ancestor Avraham.
Avraham sat at the entrance to his home on a baking hot day right after his circumcision procedure. The Torah describes how three angels came, each with a purpose. One with good news about Yitzchak, one with bad news about Sodom and Lot, and one Raphael, brought healing. Angels are named for their distinct functions, so Rapha-el literally means the power of God’s healing.
This is our first introduction to God’s healing power, and it is associated with circumcision, unlike, say, a broken arm. Circumcision symbolizes human ability to master our instinct, situated as it is in the site of desire, showing the task of subordinating our faculties and lives to connect with and serve God. In the same way that circumcision reveals meaning and purpose of life, and Rapha-el shows up to heal, the power of healing reveals meaning and purpose in sickness.
Avraham and Sarah, Yitzchak and Rivka, Yakov and Rachel all had something in common – they experienced infertility for a frustratingly long time. A one off can be excused as random and unfortunate, but our matriarchr were infertile across three generations, and we should remember that they were not closely related. Our sages explain that God seeks out the prayers of the righteous – Nisaveh tefilasan shel tzadikim.
Farhi line on the person the prayer makes you. If their model serves as an example for us, it’s that our issues should make us turn to God – Refaeinu hashem.
Magic of Medicine
We live in an age of highly advanced medicine. If our ancestors could see our mastery of the human body, they would call it magic and witchcraft. We should not take for granted how miraculous modern medicine is; but it presents a unique challenge that our ancestors did not have in how to turn to God for healing. In a certain sense, for most of human history, if your kid got sick, all you could do was hope and pray because health outcomes were appallingly bad. Today, people who don’t turn to God have excellent health outcomes; and its not like only people who turn to hashem are healed.
But we still have to recognize God there.
God has allowed doctors to understand microbes, to understand what happens beneath the surface. Today, microscopic surgery allows doctors to perform complex procedures while barely affecting our bodies at all! Our job is to understand is that the doctor and medicine aren’t the source of healing; they are instruments and vehicles, but it is still God acting through them – Rafeinu hashem.
A gentleman came to the Chazon ish asking for a blessing to heal from a particular respiratory disease, and the Chazon ish advised him to move to a particular town, where he covered. Years later, when asked why it had worked, the Chazon ish explained that there’s a halchic dispute about the kosher status of an animal with this illness and whether it will survive or not – treifa. The Chazon ish sent the man to a jurisdiction of the authority who ruled that the animal would survive.
This is an anecdote, it isn’t data, it’s not hard science or good life advice. But its refaeinu hashem vneirofei.
When things suddenly click or work or suddenly not, it’s refaeinu
If you work in medicine, say a short prayer before doing what you do to channel the healing energy. If you’re going to the doctor, do the same. Its not down to the right doctor, the right medicine, the right treatment, or the right timing. That’s all part of it, sure. But we don’t want to be healed by the most famous surgeon; we want healing from hashem – Rafeinu hashem.
When something is wrong, you can treat the symptoms, or you can treat the problem. Treating the symptoms is fine and even necessarry in the short run – because it hurts! But in the long run, you want the treatment to heal the entire problem. It’s not enough to stop the pain; we need healing – vneirofei.
God uniquely understands the causes of our pain, and we ask God for lasting healing – vneirofei.
We asked God to heal us so we could be healed, and then ask for God to save us so we can be saved, which must be different.
Perhaps the first statement is about our physical condition, and the second is about our spiritual condition.
It could parallel helping and saving from the first blessing in the Amida, – Ozer umoshia. Sometimes, God help us do something – Ozer; and other times, God does it all for us – moshia. In that case, healing could mean circumstances where our body utilizes medicine and heals; we joined the healing – refaeinu. But in times where we can’t participate in the healing, we ask God to save us – Vnivasheia.
Sometimes, a person is too frail for a treatment, or its allergic; their body won’t cooperate. Doctors will often say that part of the road to recovery is that patient has to want to get better. Conversely, people speak of elderly people dying because they gave up on life; we need to have a positive mindset towards healing.
Sometime we are too weak to heal or don’t have any fight left in them, and some people don’t want to heal. They truly need to be saved to keep fighting – hoshieinu vnivasheia.
Another element that is different from healing and saving is where they exist in time. Healing is problem that exists in the past and present, and salvation is a solution that exists in the present and into the future.
There’s a mitzvah to visit the sick; our sages teach that if you don’t pray for the sick person while you’re visiting, you haven’t performed the mitzvah yet.
There’s a great story about R’ Yitzchak Hutner, famous for his legendary wit. He was sick in bed, and one of his students came to visit. R’ Hutner asked what he wanted, and the student said he’d come to visit the sick. R’ Hutner responded, “Am I your Lulav? Did you come to shake me?”
Our mitzvah isn’t to check on the sick, but to help them heal. Imagine the doctor checking the charts but not doing anything to treat the patient! Part of healing is our prayer.
It might be hard to wrap our heads around, but if healing is in the hand of god, then the doctor is a cause of healing, but so are you. The doctors skill and experience will inform his treatment, but that is only one dimension of healing, the part that the body needs. But the mind and soul need healing too. If you’re visiting the sick, you’ve only done your job if tomorrow will be better because you came to visit today.
It seems like a tautology – obviously if Hashem saves you, you’ll be safe! But it’s not a tautology at all, because God can heal or save you , and some people don’t want that. We’re not always willing to do what needs to be done to heal or be safe, and it takes something on our end to accept and receive what God has in store for us – vnisvasheia.
A person may refuse chemotherapy because they’re afraid of losing their hair, even though they’re slowly dying. They’re too scared to face the world in a new state. The medicine is there, and it works more often than not, but we might not want to go through the pain required for healing.
Ki shilaseinu ata
We say to God that we’ll recognize God as the source of healing. It almost seems childish at first – are we offering God a gold star?
Everything happens for a reason. While we can’t access the global cosmic why, there is always a local why, the meaning and sense we make out of everything that happens to us. Even if it only comes later, and even if it’s a lesson we don’t want to learn, there is a reason. (EXPLAIN)
One of the reasons that’s generally true is so that we thank God, so in a certain sense, we’re preempting God’s healing with a thank you. Don’t heal us so that we thank you; heal us because we’re thanking you already!
Imperfection and pain in the world has the latent power to bring us closer to God. When we recognize it as such, it neutralizes the sting, and the pain becomes redundant if we have learned the lesson.
If a teacher holds a class back to do their homework before recess, that is fair enough. But if
one day everyone has finished their homework and keeps them back anyway, we recognize the teacher is gratuitously mean; God is not vindictive.
Critically, our praise has to come from the part that’s hurting as well; our whole body owes thanks to hashem.
When a person needs brain surgery and is healed, is the miracle that the brain is healed, or that the brain worked perfectly before and now works perfectly again? Far greater than one-off miracles are the miracle we take for granted every day every day; it’s not the sickness or healing that are the aberration! But sickness, more than anything else, helps us see that starkly.
Every time we say this prayer, we should bring gratitude and praises into our lives, for all of our lives, not just the parts that feel good.
(Requires wider analysis about outcome distributions and probabilistic things
There is no silver bullet
People can do perfect treatment and die
People can be perfectly healthy and drop dead
Bad things happen to good people all the time)
The first word we usually associate with maka – the Ten Plagues.
If you’ve ever bumped yourself, you might have gotten a bruise. It doesn’t always hurt, and if it does, it doesn’t hurt forever. A maka could be the sickness itself, and may be a byproduct of sickness. Whichever it is, we ask for a comptely recovery, for this sickness and Beyond this sickness – Refuah shleima lchol makosienu.
Sometimes after a sicknss, people change. They’re cautious, afraid, still feeling the effects of being ill. They have a different outlook, a different approach, and sometimes it’s for the worse. Some athletes aren’t the same after an injury, too afraid to give their all the way they once did.
It’s a normal response, so we ask god for an uplifting healing as well – Haaleh refua shleima. Part of a full recovery is raised spirits, to make up for what they missed. We can notice the symptoms of illness, we can treat the illness itself, but there’s also the place they’re in, the headspace they occupy. If that’s not healed too, there’s a residual sickness that needs healing – Refuah shleima lchol makosienu.
Everything happens for a reason, and sometimes, people decide that the reason is they are bad or cursed, and are being punished; that hashem is hurting them. We need to eliminate that thought, because God is not gratuitously cruel, God is graciously compassionate and merciful – Ki kel melech rofei Neeman vrachaman ata
The formula of the Amida prayers is the blessing itself, then the statement of the bracha, then the Bracha. Ki kel is the statement
Ki kel goal vchazak ata also
You can add whatever you want to your prayers, and the best time is before the final statement.
If God withholds things from us to build a relationship, then turning to God is part of the process of getting what we need.
When someone has trouble having children, or digestive issues, or mental health issues, its all under the category of healing – refaeinu.
For all the stories of magical cures, magical healing, and old women having babies, there are many unfortunate stories of the people who did not get those things. We need constant reminding that God is our trustworthy healer – rofei neeman.
Sometimes the sickness is better than the healing. Sometimes the healing isn’t worth being better. We pray for our healing to be the kind where we feel gods compassion.
We conclude our prayer affirming that God heals all the sick of Israel. In the similar public prayer for healing on Shabbos, we pray for healing for particular loved one among the other sick people of Israel – Bsoch shaar cholei Yisrael.
When you stand alone in prayer, your prayers are evaluated alone. But when pray for and wit others, your healing prayers aren’t personal – you’re asking for communal healing, healing with a greater purpose.
If you’re praying about a sickness that stops you from taking your place in Israel and doing what you need to do as part of Israel, then your healing is not about you; it’s a matter of national importance! If you see your life as a tool to sanctify heaven, then your health is one of the tools to sanctify heaven.
For most of our history, every tehilim was stained with tears. Our prayers matter. When someone is on the waiting list for a kidney transplant, they mean their prayers. If someone was approved for a surgery they couldn’t afford, but got to apply for a grant that would cover it, how persuasive would they be?
Our prayers hit different when we believe them. When we say them like they’re true.
Only they are true, whether it’s for ourselves, our loved ones, or ourselves. Our prayers for healing are true whether for sickness or heartbreak.
If you are well, may you continue to be well, and bring God’s healing into the world – Raph-El / refaeinu hashem. Bring joy, happiness, and healing that uplifts others.
God can save us, and God can help us. If you can do the work, doing the work can be good for you; being saved is a last resort, and you don’t want that.
We think we want easy, pain-free lives, but that’s not always what’s best for us, and that’s not for us to choose. There are some kinds of pain we need to learn to live with.
We don’t get to choose our ordeals, but the Gemara says that when they come, we should look inwards – yefashfesh bmaasav. It’s cruel to say it to others, but in a certain sense, perhaps it is the only way to respond. We can’t know why bad things happen to us, but we can ask ourselves what we’re going to do about it.
In a story about a deadly snake terrorizing a town, the Gemara concludes that it’s snake venom that kills people; their sins do. R’ Chaim Vittal teaches that it is beyond disgraceful to tell people that their suffering is because of their sins, whether in general or particular; it’s unknowable and entirely beyond human comprehension. That suffering could be something that substitutes for something worse, or cleanses a person in some way by who they become as a result – yisruim shel ahahah.
But our sages teach us that there’s an element of sin to our suffering. Sin is universal – ein tzadik ba’aretz. No one has the ability or wisdom to know how sin results in which real world consequences, but maybe it’s a little hook that opens the door, and that’s enough.
If you imagine a tall steel fence around a property, but there’s a gap in the fence two feet wide. The fence can be tall, strong, and thick, but the property isn’t secure. It doesn’t matter how much is secure if there’s a little section that’s compromised; there’s a way in.
May you never know the pain of removing someone’s name from your prayer list because they have passed. May you only experience the joy in removing someone from that list because they have healed.