Tazria/Metzora – Seeing and Acting

An upcoming Bar Mitzvah told me that he and his mother were discussing possible Bar Mitzvah portions a couple years ago and they were thinking […]

An upcoming Bar Mitzvah told me that he and his mother were discussing possible Bar Mitzvah portions a couple years ago and they were thinking about a potential date, and his mother said, “Anything except for the portion about skin disease.” Well this is that week – the one full of details about tza’ra’at – skin disease. It is often translated as leprosy – scholars will say that it is really something called Hansen’s Disease, and anyone who read through the portion will say it is simply gross.

And that is where the fun begins – we dig deeper. We look for symbolism, values that underlie the description, messages that emerge from close reading – and this transforms into an extraordinary portion. This morning, I want to look at a repeating words – for any time an author repeats a word over and over – he or she is calling attention to a concept. In chapter 13, where the description of skin disease begins, there is a word that is repeated in almost every single line. It is the verb resh, aleph, hey – to see. It is used in different ways: it talks about the one who sees, the one who is seen, what is seen, and we the readers see the seeing. Seeing becomes a lens through which we come to understand illness and how society responds to illness.

Initially, the priest sees the skin ailment – but if you read carefully – you will see that the priest sees not just the disease, but the person. (p. 653 – verse 3) – when he sees it – v’ra’ei’hu. The “it” is not necessarily the skin disease. Look at the commentary at the bottom of the page. “One commentator reads this as ‘when the priest sees him.’ The priest is to examine the whole person, not only the diseased limb. He is to see what is whole and healthy about the person, not only what is afflicted.” When we read carefully, we learn that our job is to be like the kohen and truly see someone who is ill – seek to understand what the experience is like for them, to see other aspects of them so they are not solely defined by their illness. We resist our tendency to depersonalize sickness, and reduce it to categories and symptoms. V’ra’ei’hu – See him/her – it is such important advice as we create an ethic of caring for the ill.

Now lets go further in our understanding of seeing. Most of the description about the tza’ra’at involves the kohen who sees, identifies, diagnoses and attempts to reintegrate the person into society. There is a whole ritual of the person standing before community – it is as if the community too needs to see the person. The focus is on our imperative to see. Too often, we close our eyes to the person who are afflicted. Our job is to be the kohen who sees, helps and recreates society. Read the book, Mountains Beyond Mountains, by Tracy Kidder, and you will understand what it means to be a person who sees. The subject of the book Dr. Paul Farmer – is truly a modern kohen – someone who sees, understands what he is seeing and uses what he see sees how to act thoughtfully.

I have told a small piece about Dr. Farmer’s story in the past, but today would like to go deeper and learn from him about what it means to see. The book describes how as an undergraduate at Duke University in the early 1980s, he used money he won in a student essay contest to take a trip to Haiti. He joined a group of public health workers – and had his first experience with how different life, and particularly medical care, is in one of the world’s poorest nations. The people he met and the conditions he saw changed him. What he saw stoked his curiosity and he began to learn and explore – everything about Haiti – it’s language, art, music, literature. He became determined to make a difference and as he began studying to be a doctor at Harvard Medical School he would commute back and forth to Haiti, as he began to develop his understanding that his life’s purpose was bringing medicine to people without doctors.

Paul Farmer understood that medical care could only succeed if you understood the circumstances, society and culture where you seek to help. With a small group of people, he began a health census – how many were living in different place? what was the mortality rate? what was the history of illness – vaccinations, access to medical help? Walking from village to village, down gullies and up mountainsides, along paths half-covered in underbrush – he observed and sought to understand to understand. It was through these observations, that Paul Farmer came to understand the great importance of water to public health, he began in the communities: vaccination programs, protecting water supplies and sanitation, training people to administer medicines and give classes on health and family planning. He realized the importance of education and establishing schools. Listen to his words: “Clean water and health care and school and food and tin roofs and cement floors, all of these things should constitute a set of basics that people must have as birthrights.” Saving lives begins with seeing – the reason ra’ah is repeated so often in our portion is that healing begins with seeing the entire situation.

Then he began to work on a state of the art clinic. Again, his words reflecting on his early experiences in Haiti: “There were all vital young people. If there had been a decent clinic or hospital in the area, they could have been treated even after the system fails at primary prevention. Every step of the way, these young people could have been saved.” The book is about how he succeeded not only in Haiti, but around the world in bringing healing. He began an organization called Partners in Health (PIH) Partners in Health, promotes healthcare for the poorest of the poor in Haiti, Rwanda, Russia, Peru, Mexico, Western Africa. Their mission, Paul writes, is both “medical and moral” – to provide high-quality healthcare to poor communities and say that healthcare is a human right. PIH works to cure drug-resistant tuberculosis among prisoners in Siberia and in the slums of Lima, HIV in Lesotho, cholera in Haiti, AIDS in Malawi, and serves more than 800,000 people in 41 health centers in Rwanda. Dr. Farmer has brought awareness and healing to the Ebola crisis in Western Africa. Currently, PIH serves millions people throughout the world – recruiting doctors from the U.S. and other nations to run clinics and treat patients. They also train local health workers to care for patients, build medical facilities and community infrastructure to make sure water and sanitation systems are in place, and raises money to purchase more advanced medical equipment.

Let me share one more detail about tza’ra’at in painting the picture of a community which heals. In Chapter 14:3 – p. 660. “When it has been reported to the priest, the priest shall go outside the camp.” Again look at the commentary at the bottom of the page: “He is not to wait until people come to him with their concerns but must go to where the people are.” One of the reasons the book about Dr. Paul Farmer is called Mountains Beyond Mountains is that the authors describes a day that he and Paul Farmer walked for hours and hours to a small village with no road access to treat one ill patient. True healing comes when you go outside the camp – directly to the person who needs you.

They had been walking for hours and Tracy Kidder, who was accompanying him as he wrote the book, asks, “We getting close?” Paul Farmer stopped and pointed to a hilltop in the distance. “Wait’ll we get over that ridge. Then I’ll break it to you.” They walked and walked with Paul greeting people in different villages they passed through who he knew from treating them or them coming to the clinic in the past. Finally they come to a small hut and Paul Farmer examines the man he came to treat. He begins with a thorough history, seeking to understand the type of tuberculosis, whether it has spread, and what its source was. He used the visit to understand the broader system of what was going on. In describing the trek, Paul Farmer said, “I’m glad we came, because now we know how grim it is and we can intervene aggressively.” This is why the kohen had to go outside the camp – healing is being an anthropologist, diplomat, administrator, epidemiologist all woven together. Paul Farmer makes the hikes for the same reason that the High Priest goes outside the camp – because each life matters and unless you see it, you will not understand it.

And when you go out to people, you bring healing, comfort. Tracy Kidder writes this about Paul Farmer and medicine in general: “If you do the right thing well, you avoid futility. His patients tend to get better. They all get comforted. And he carries off, among other things, images of them and their medieval huts. These refresh his passion and authority, so that he can travel a quarter of a million miles a year and scheme and write about the health of populations….His basic message is simple: This person is sick, and I am a doctor. Everyone, potentially, can understand and sympathize, since everyone knows or imagines sickness personally. And it can’t be hard for most people to imagine what it would be like to have no doctor, no hope of medicine.” Small gestures matters and it begins with going out and being present.

This portion about skin disease challenges us to become a community that brings healing by seeing and going out to people who are ill, and treating them in ways that weave them back into society, while seeking to understand what is necessary to bring healing about. As we think about how best to do that here and abroad, we turn to the modern day Kohanim like Dr. Paul Farmer who remind us that religion isn’t just reading about this imperative – it is acting. May we believe and create, as Dr. Paul Farmer has, a world where every human being has access to healthcare. May we, like Paul Farmer make a difference.

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