Friday, April 1, 2011

A Thought on the Parsha


In parashat Shmini, after the Mishkan was dedicated, the Kohanim were given the charge to "distinguish between the holy and the profane, and between the ritually impure and the pure" (Vayikra 10:11).   That is, they must protect the Mishkan from those who are ritually impure and thus they must know all the laws the pertain to ritual purity and impurity.   For this reason, the Torah, having briefly dwelt on the impure animals at the end of last week's parasha, now devotes itself at length to these laws of impurity, and focuses in this week's parasha on the laws of tzara'at, a form of skin disease (clearly not leprosy), which can also adhere to clothing or homes, and which renders the person or the object impure.
When a person believes that he or she has tzara'at, or his or her house has tzara'at,  the impurity is not automatic.  A Kohen must come, assess the condition, and render it pure or impure:  "And the Kohen shall see it and declare it to be impure." (Vayikra 13:4).  In some cases, if the Kohen is uncertain as to the nature of the spot, he puts the person in seclusion for a week, and then checks the spot again and either gives it another week or declares it pure or impure: "... and the spot did not spread on the skin, the Kohen shall make it pure" (13:6), "... and behold the lesion has spread on the skin, the Kohen shall make it impure, it is tzara'at" (13:8).   The model here is very much that of a doctor that looks for certain indicators, and will decide whether there is or is not a problem, or whether more time is needed to determine, i.e., "Call me back if the problem persists".   The difference is, that the Kohen is not just an uncoverer of fact, but one who creates the reality.   Through the declaration of the Kohen the spot becomes halakhic tzara'at.  It is completely pure until the Kohen declares it to be otherwise.
In stark contrast to the active and critical role of the Kohen is the way the Torah describes the person with the tzara'at.  A close reading of the verses shows that this person has been reduced to an object.   He is no longer an agent or actor in his own right; he is rather an object of scrutiny by the Kohen.  Consider: "A person, when there is on his skin a spot.. shall be brought to Aharon the Kohen or one of his sons the Kohanim." (Vayikra 13:2).  The spot is not occurring to the person qua person; it is rather something that appeared on his skin.  The person is not choosing to go to the Kohen, and not even going to the Kohen, he is rather being brought (by others?) to the Kohen.   He - or rather, his skin, or the spot - is a thing to be brought to the Kohen for the Kohen's scrutiny.  And notice the next verse: "And the Kohen will see the spot" - the spot! not the person! - "... and the Kohen will see it, v'ra'ahu  and impurify him, vi'timei oto." (verse 3).  The object of the two verbs here - seeing and impurifying -are referred to in the third person masculine.  They can be referring either both to the spot or both to the person, or - as the above translation would have it, the spot is seen and the person is declared impure.  (All of the above possibilities exist in various English translations).  The message is that at this stage the person and his spot are more or less interchangeable -he is his condition, and that is how he is being seen by the Kohen.
This implicit framing runs throughout the parasha.  The person is never coming on his own, but is always being brought to the Kohen (see verse 13:9, 18), and the Kohen is always looking at the spot, not at the person.  The only time the person appears active - ever so briefly - is in verse 13:16, "If the healthy flesh once again turns to white, the he shall come to the Kohen... and the Kohen will purify the spot, he is pure."   When there is a chance of recovery -of no longer being a patient, as it were - the person becomes an actor and approaches the Kohen on his own.  On the other hand, when the person is declared as a to have tzara'at, and must engage in a series of practices appropriate for a metzorah, the Torah does not primarily describe the metzorah as engaging in these practices, but rather emphasizes that these acts as something happening to him: "And the one with tzara'at who has the spot, his clothes shall be torn and his head-hair shall be wild, and on his lip shall he veil himself, and "impure, impure" he shall call out." (Vayikra 13:45).   He is active primarily to call out or bemoan his state.  The actions that he undergoes are seen mostly as not something he is doing but something happening to him.
What is the message here?  On the one hand, we could approach this through the lens of Hazal that tzara'at comes as a punishment for lashon ha'ra, for evil speech.  Seen this way, it is the tit-for-tat punishment of a person who has libeled another person, perhaps to the point of dehumanizing him, who has made this other person an object of ridicule rather than respecting his tzelem E-lohim, has treated him like a thing, rather than as a person and a member of society.   As a just punishment, this slanderer is cast out of society, and is treated as an object for someone else's inspection, and is subject to the judgment of others just as he made others subject to his judgment.  
This explanation is a good one, but I do not think that it does full justice to what is being described here.  First of all, the Torah never states that this condition is a punishment for lashon ha'ra.  Secondly, the Torah - or the Kohen - is already treating this person as an object of inspection even before he is impure, even if he is determined to be pure!    There is something more going on here than a punishment for sin.
What the Torah is describing here is not a punishment, but a sad, yet perhaps necessary, consequence of the doctor-patient relationship.  For a doctor to be fully objective and to carefully weigh the evidence in front of her, she has to bracket the humanity of the person sitting in front of her.   She has to objectify the patient, focus on the symptoms as they present themselves, in order to render the best medical judgment.   This need for objectification is explained nicely in the following article:

Modern, scientific medicine has historically objectified people as patients. Indeed, the "modern" and "scientific" elements of it rely on objectification. Modern medicine is founded upon objectification: People become case studies. Their complicated life stories are aggregated into statistics. They're assigned to control or experimental groups, and their individuality melts away.

Medical research as we understand it would be unthinkable without objectification. The techniques I just mentioned are necessary to doing science right, following professional standards. The alternative - drifting in a sea of anecdata - would yield few useful results.

That's the positive side.  However, objectification is no fun at the receiving end.  How many people as soon as they go to a hospital, are made to suffer small indignities, and can have small pieces of their identity stripped away.  How many people all of a sudden stop being "Mr. So-and-So," or "Mrs. So-and-So," or "Dr. So-and-So," and become Jon, Ellen, Fred while all the nurses and doctors retain their professional identities and titles?    The same article points out these negatives as well, and how there has been improvement in this realm in recent years:

Singling out medical research would distort the picture, because patients also came to be treated as objects in ordinary practice. This was especially true in teaching hospitals... in early-twentieth-century Germany were forced to undergo repeated exams by clumsy medical students, and how they were paraded naked in front of a whole auditorium full of observers while in labor. American obstetrics was no better: Women were strapped down while in labor and knocked out, whether they wanted it or not.

Over the past 40 years, under pressure from consumer advocates, feminists, and medical ethicists, medical researchers and practicing doctors have become a lot more sensitive to problems of objectifying patients. Patients with cancer are no longer kept ignorant of their diagnosis and prognosis. These days, expectant mothers are often encouraged to write birth plans...  One index of objectification is condescension... [a]nd personally, I've seen a major decline in patronizing attitudes among medical practitioners.

So this is what we find by the person who must "be brought" to the Kohen.  He loses his personhood, becomes objectified, is subject to procedures and requirements that are placed on him, and only regains his humanity when he starts to become pure.  Actually, this is brought out strikingly when one contrasts the end of the parasha to the beginning of next week's parasha.  Tazria ends on this note: "This is the law of the spot of tzara'at..." (13:59) - it is the laws of spots.  Metzorah opens thusly: "This is the law of the metzorah on the day that he becomes pure..."  (14:2).  No longer are we dealing with the spot, the disease, but rather with the metzorah, the person.  Now, it is true, that he is still at the beginning of becoming better, so "... and he shall be brought to the Kohen." (ibid.).  But once the Kohen determines that he has healed, this person becomes a full actor, "And the Kohen shall command to take for the one purifying himself..." (verse 5), and finally, "And the one purifying himself shall launder his clothes, and shall shave his hair, and shall bathe in water, and shall be pure, and then he shall come into the camp..." (verse 8).  He is reentering society and is no longer "sick," and has no become once again a person and an actor.

So, while the Torah is describing the somewhat inevitable objectification that occurs in a patient-doctor relationship, we may ask whether we find a similar change to that which has occurred recently in contemporary society, as was noted above.  Is there indication that the person with the spot was seen more as a person, and less as an object?   The answer is, that exactly this reframing is found in Hazal.  Hazal state, for example, that because of the mitzvah "Guard yourself regarding the spot of tzara'at" (Devarim 24:8) that a person is not allowed to cut off a spot that might be tzara'at and is required to show it to a Kohen (Makkot 22a).  This transforms the person into an agent!  The person is no longer being brought to the Kohen, he is bringing himself to the Kohen!  And, the Rabbis famously interpret the verse, "On the day it will be shown to the Kohen" (Vayikra 13:14) as follows:  "There are days that he may see and days he may not see.  From here they said: A groom who has a spot is given the seven days of the wedding feast [before he has to show it to the Kohen]... And similarly, during a Festival, he is given the seven days of the festival" (Moed Katan 7b).  This person is no longer look at like an object.  He is a person, with an entire life that exists outside of the clinical context, and the Kohen has to be sensitive to these realities, to the person in front of him, before he can decide how or whether to proceed.  Just like, one may add, when doctors see the full person in front of them, and not just the condition, they listen better, inquire more, contextualize more and are more able to render the correct diagnoses.

Let us always strive to give the best judgment that we can of others and of others' work when that is what is asked of us.  But at the same time, let us never forget the humanity of the person, that we are dealing with an actor and an agent and that we must engage that person as such, even when in our most professional and objective mode.   And certainly if a person is ill must we be sensitive to this.  For not only does the path to recovery allow a person to regain his or her humanity, but it is the regaining and retaining of that humanity that allows for recovery to begin.

Shabbat Shalom!

No comments:

Post a Comment

Note: Only a member of this blog may post a comment.