Nahmanidean Historical Determinism and Medicine

Recently my Greek psychiatry professor asked us about the Hanukkah story. “Are you guys from Israel?” he started. After some discussion pertaining to Corona statistics he went for it: “And that holiday you just celebrated, what is the story?” A friend of mine piped up with an answer that cleverly avoided any tactless mention of the ‘Greek defeat.’ After a short discussion debating the identity of the Seleucid dynasty within the mythos of modern Greek identity he asked a rather different question: “How old is Judaism?”

What a question!

Within my international medical program taking place in Cyprus many nationalities, religions and mixed identities meet. In this particular lecture hall every continent and all Abrahamic religions were represented. Surely I could argue that the development of Judaism was dynamic and that the current form developed through complex historical pathways and that one could point to various checkpoints along the way. Certain thinkers or academics point to certain defining moments in our long history as definitive.

But as I sat there debating the merits of a multiplicity of possible responses to a fellow classmate raised his voice from somewhere else in the lecture hall. He was part of the Lebanese student representation. ‘Interesting that a gentile should answer a question about Judaism,’ I remember thinking. But upon internalizing his answer I understood that every child in my Jewish elementary school in Toronto would have stated the same simple fact. ‘Who was the first Jew?’ is another way to phrase the chronology question.

“Abraham started Judaism,” was his answer. “It is thousands of years old.”

HISTORICAL DETERMINISM – THE QUESTION

As we begin to review the Book of Exodus in the synagogues worldwide I believe it is important to seize the opportunity to discuss an often overlooked connection the Jewish nation finds with our forebears of Genesis, those proto-Jews, Abraham included. The great Medieval Biblical scholar and Rabbinic leader, Nahmanides (Ramban), wrote in his prologue to the Book of Exodus:

Scripture has concluded the Book of Genesis, which is Sefer ha-Yetzirah, the Book of Creation… and the happenings or experiences of the patriarchs, which are like an act of creation regarding their progeny, as all their experiences are symbols or paradigms – patterns which allude to and anticipate whatever the future hold in store for them. And after Scripture finished the story of creation, it began another book pertaining to the implementation of those allusions and those symbols.

Nahmanides developed a theory of homiletical interpretation of the patriarchs. This theory pertains to two planes of drush: 1) interpretation of later books of the Bible, like Exodus, trailing behind the footsteps of the original progenitors of our people; and 2) interpretation of real world events within the context of our forebears. This approach is condensed into Nahmanides’ oft sited phrase ma’aseh avot siman la’banim – the acts of the fathers are symbolic to their sons.

This principle is what the Rav, Rabbi Joseph B. Soloveitchik Z”L, coined ‘Nahmanidean determinism.’ In his book Abraham’s Journey, the Rav pointed out a philosophical inconsistency in this idea:

What historical role, then, was assigned to the Children of Israel throughout the generations? Were they no longer free to shape their own destiny, to determine their own history?… The prophets exhorted the people, preached to them, and urged them to mend their ways to placate God’s wrath and be saved from destruction and catastrophe…. Judged from the standpoint of Nahmanidean determinism, the Jew could never have escaped the bitter experiences of disaster and hurban, since these tragic events were symbolically produced on the historical stage at the time of our patriarchs and thus were predestined as inevitable.

Here the Rav took this principle to its logical extreme in the form of predetermined calamity and punishment. This philosophical debate pits the principle of a just God punishing the wicked against the concept of predestined evil. The injustice of a condition such as predestined evil can be extended to predestined righteousness as well. What place does our free will take in a world that has been preordained as a Purim Spiel?

The answer lies in Halakhic logic. To the Rav, interpretation of Biblical narrative contains the spiritual and moral threads of our nation, not only its factual history. Within this context, “Halakhic logic, unlike classical logic, is an n-valued logic…. Each event was predetermined by the symbolic acts of the patriarchs. Yet in every generation, how to interpret the event is up to the individual or to the people as a whole. The Jew is free to choose from many alternative interpretations of the event.” In other words, the traditional Talmudic ‘poly-semantic approach’ employed by Biblical legal exegesis (midrash halakha) is just as true in regards to the creative historical interpretation as well (midrash agaddah). Interpretation of events both within later books of the Bible and within later Jewish history influence and are influenced by our patriarchal interpretations. We are both guided and guide understanding of our ancient manuscripts.

To the Rav, there is no strict historical determinism but rather spiritual context given to us by the Divine Torah to understand our current predicaments.

THE MEDICAL PROFESSIONAL APPROACH

Far from me to argue with the words of the Rav, I would like perhaps to augment them slightly; to add what I can to what a great mind has already built. I believe my question and approach to the issue raised above concerning historical determinism can best be illustrated through analogy. Say you are a physician approached by an ailing patient with a rather broad and intermingled clinical profile. You see elements of a number of pathologies including both inherited diabetes mellitus type 1 and also trace forms of parkinsonisms, also seemingly inherited. However, you are an endocrinologist and specialize in one of these two forms of pathologies. You will therefore diagnose the diabetes and prescribe a treatment regimen based around this disease. You note perhaps that there appears to be a more complex pathological profile and admit that the patient will require further investigations by other specialists within the medical community.

The analogy goes as follows: The events of Jewish history are the clinical presentation; the ‘pathologies’ that present themselves in Jewish history are inherited from the patriarchs. The various ‘specialists’ are those people who interpret these clinical signs and relate them to our Biblical narrative. In this analogy the various specialists are expert within their respective fields and a wholesome interpretation can only be made with the combined efforts of a full medical – i.e. homiletical – community.

What I like so much about this medical professional approach is the decisive nature of these historical pathologies. A complicated clinical picture with a multitude of pathologies may lend itself to interpretation but the diagnosis must be limited to the actual real world sickness. It would be erroneous to diagnose an illness that the patient does not have in reality and even worse to prescribe a treatment algorithm based on that mistake. The ‘Halakhic logic’ of the Rav when used to interpret ma’aseh avot, those travails and successes of our ancestors recorded in the Divine text, must fit the real siman la’banim, the signs and symptoms of our reality that we face as a people.

Judgment of free will happens here after proper diagnosis and implementation of a treatment. Despite the inheritance of a pathological condition, we can choose to follow our treatment and be healed or to ignore it and be punished by living through it. This is what was meant by our Sages (e.g. Tr. Yoma 72b) by calling the Torah a ‘drug of life.’ We can use our Torah as guidance to moral and spiritual healing. This requires honest and proper homiletical interpretation of our ailments. Torah can also, chas v’shalom, become a ‘drug of death,’ if we stray beyond the real world interpretation of our spiritual and moral successes and failures.

This philosophical conceptualization of historical determinism balanced with free will was well formulated by Rabbi Eliyahu E. Dessler in his monumental work Mikhtav Me’Eliyahu, translated to Strive for Truth! by Rabbi Aryeh Carmell.

Our true heritage is a nexus of pure tendencies which aid us to attain truth and justice in our lives…. So long as these good middot and refined tendencies are active within us, Hashem sees in the profundity of His wisdom that the lifeline that links us with our saintly forefathers is still intact. There is still hope that we may choose the way of teshuva (repentance) and remedy our wrongs. (Volume II, page 65)

Our heritage can flow through us in thought and deed. When we decide to follow in the positive footsteps of our patriarchs we carry their zechut, their great acts of creation that led to the very establishment of our nation. However, this extends conversely to acts – ma’aseh avot – which should not be inherited either by future generations or our own generation that we have the power to prevent. We are endowed by the possibility of teshuva to return to those positive acts of creation and to turn away from and be healed from those acts of destruction. But this process begins with proper interpretation of our legacy in the Book of Genesis, the book of creation.

It is my sincerest hope that we reach a full understanding and management of the current Coronavirus pandemic and the same for our spiritual and moral profile. In the later category we have and will have much work to do. Our heritage guides us in the direction of a ‘House of Prayer for all the nations’ on the Temple Mount, the heart of Israel both spiritually and nationally. Despite this there is no freedom of religious expression there for all nations. This status quo must be changed. In my own interpretation of his words I think the Rav had something similar in mind when he wrote: “One should be ready when summoned by history to oppose or to reject the status quo, be it cultural or socio-political, to answer in the affirmative ‘Hinneni, Here am I.’ Each individual should possess the strength to pitch his tent on one bank of the river while society lives on the other [, as Abraham did of old].”