Can there be an end to disease, and if so, or even if not, what would that mean for our humanity and our spirituality?

To explore a Jewish answer to that question, we first have to look back to a historical perspective about Judaism’s view on disease and on the healing process more generally. The earliest stages of Jewish thought held some beliefs that are very different from our understandings today. These most ancient perspectives hold that sickness and healing are at their root mysterious; the ancients had some idea about how disease was spread and how injuries could be repaired, but they came with the underlying belief that the functions of the body were essentially unknowable, that they were held securely in the hands of God, the ultimate source of life and death. Not only can’t we mere mortals understand the mysteries of the body, but for us to explore them, to immerse ourselves in them too deeply, is insubordinate; it is disrespectful to intervene in human healing, because that’s God’s domain. God has a plan for the human race, and for each individual human body, and to try to change that plan through the magical art of medicine is an act of trespass against God’s territory.

That’s the most ancient layer of Jewish thinking, and we see it most commonly throughout the five books of the Torah. Childbirth, disease, illness and death are awesome and frightening, and they were attended by the ancient priests, not by physicians. Those priests still held to the first principle that human life is paramount, that one can undertake nearly any action necessary to protect human life, but this usually meant instituting legal protections to prevent accidents, encouraging people to be cautious about their safety, and so on.

Several hundred years later, a refinement on this point-of-view arises—this one from the prophet Isaiah. Isaiah envisions a world that is virtuous and godly, and he articulates the idea (doctors in the room: do not say this to your patients!) that disease is a sign that a person is sinful, and that healing indicates that one’s repentance has been accepted. Imagining a world that is redeemed and perfected, he says:

“And none who lives there shall say, ‘I am sick.’ It shall be inhabited by those whose sin has been forgiven.”

We don’t blame people’s illness or diseases on their sins anymore, but Isaiah’s writing does add one new dimension to Jewish thought by proposing that disease is the enemy of faithful Jewish life in the exact same way that sinfulness is. And this tiny crack will become the opening that later thinkers will peel open to transform the way we think about illness and recovery.

That opening will become the way that centuries later, rabbis and jurists and doctors will overturn the notion of medicine as spiritual trespass and conclude that physicians are permitted to practice medicine. They arrive at that conclusion not in spite of Isaiah’s position, but because of it. They reason that since we already have a standing principle that human life is meant to be protected and preserved, and we have another one that the end of disease is parallel to the end of faithlessness, so we can conclude that people with the right training and skill are permitted—even compelled—to minimize disease, to heal illness, because by doing so, they become God’s partners in bringing about Isaiah’s vision of a redeemed world.

This remains the dominant viewpoint for most of the rest of Jewish medical ethics and philosophy: humans are permitted and encouraged to fight disease, to cure illness, without limitation. Disease is the enemy, and health is the sign of God’s favor, so the ideal horizon for Jewish medical ethics is the eradication of disease. And, from one perspective, we can conclude that we’re doing pretty well. Medical advances, vaccinations, improvements in community sanitation and food safety all have reduced the incidence of disease and accidents dramatically. On Yom Kippur, we expressed our anxiety about who would die by fire, and who by water. Statistically, over the last century alone, the number of people dying in fires and by drowning has gone down 90 percent. So maybe what this means is that we are making real spiritual progress, and the kingdom of God may be right at hand.

The morally neutral view

But there is a dissenting view, another way of understanding our relationship with disease and illness, and it’s one that was specifically relevant during the holiday of Sukkot. This perspective holds that disease is not morally wrong, it’s the morally neutral result of all kinds of organisms—viruses and bacteria and cancer cells—all doing their best to survive and replicate, just as they were created to do. The nature of life is that it is finite; illness and death are just a part of the package.

This is especially resonant on Sukkot because it is a view articulated by a different book of the Bible that doesn’t get read or appreciated nearly enough, the book called Kohelet, or in English, Ecclesiastes. Ecclesiastes is probably best known as the author behind the No. 1 hit single that goes: “A time to be born, a time to die; a time to plant, a time to reap,” and so on. Ecclesiastes wrote that, even though Pete Seeger has collected all the royalties.

Ecclesiastes’ take on disease and health, illness and recovery is very different from everything we’ve heard so far from the Torah, from Isaiah, from the medieval legalists, and his writing is really unusual and really fascinating. And as it turns out, Ecclesiastes is the book specifically designated for reading during Sukkot (just like we read Esther on Purim). His innovation is that he not only accepts, but embraces, the fact that all of us will die.

Humans are just like animals, he says (paraphrasing Ecclesiastes 3:19-22):

“Both came from dust and both return to dust, and no one knows what is held for us beyond the grave.”

There is little sense struggling to eradicate disease, and there is certainly no sense in trying to understand disease as a moral or spiritual function—sometimes good people suffer horribly; sometimes the wicked flourish (paraphrased), and so, he says, we should eat and drink and be merry.

All of us will die, because that’s what happens to everything that lives. And because all of us will die, it’s a waste of time for us to be overly preoccupied with pushing away disease, with preserving life at any cost; instead, we should concentrate on how we conduct ourselves during the time that is given us and enjoy the limited time we have.

All is vanity!

You might know Ecclesiastes’ other No. 1 lyric: Vanity of vanities—all is vanity! A better translation might be: Everything is fleeting—nothing is permanent! (Following Rabbi Rami Shapiro’s wording from his 2010 translation.) Life is short and impermanent; nothing substantive or tangible will be left of it after it is gone. Life is impermanent and much of it is out of our control, but to Ecclesiastes, to quote the software engineers, this quality of life is a feature, not a bug. This is the way life was intended to be; our mortality and impermanence is what God deliberately encoded into the world.

We are porous vessels, permeable to the outside world and the influences of our environment, our mates, our personal choices. That is what makes us susceptible to disease—but it is also what makes us susceptible to joy and purpose. Like all animals, we will die, but the fact that we know we will die is what makes us different from the rest of the animal kingdom, and we can use that insight to help us craft lives of meaning.

Ecclesiastes says, sure, we can focus on the fact that people get hurt or sick and then get better, but by focusing only on that, we miss the point of being alive. And by ignoring the fact that in real life, sometimes the sick don’t get better, sometimes the chronic illness does prevail, sometimes the struggling organ fails, by ignoring that and holding only to Isaiah’s metaphor about illness as a spiritual malady, we may come to the mistaken conclusion that contracting illness or disease means that we have failed spiritually.

But Ecclesiastes, who is our guide to the season of Sukkot, says no—our porousness and vulnerability is why we were put here on earth in the first place. That’s why God made us mortal as we are, and in the face of that truth, to eat and drink and be merry is not hedonism but spiritual resistance.

An irrelevant question

Ecclesiastes refuses to answer the question about an “end to disease” at all. He tells us: this is an utterly irrelevant question, because illness and recovery, weakness and healing, are all just a part of the deal, all just a part of the package that comes with being human, and there is no sense of hoping for purpose beyond that. The hunt for an end to disease, Ecclesiastes suggests, is the ultimate “vanity of vanities.” Instead of focusing on that question, we should concentrate our time and our energy on making our days on earth full of joy, and meaning, and learning.

(This post is part of Sinai and Synapses’ project Scientists in Synagogues, a grass-roots program to offer Jews opportunities to explore the most interesting and pressing questions surrounding Judaism and science. This post is adapted from a Sukkot sermon delivered at Congregation Emanu-El in Houston, TX. Reprinted at ORBITER with permission.)

Rabbi Oren Hayon is the Senior Rabbi at Congregation Emanu-El in Houston.