A most vital Jewish axiom is expressed in the words of our Parsha. The verse tells that if two men are fighting and one strikes the other and inflicts a wound, he must pay for the doctor bills, “Virapoh Yirapay, He must surely heal him” (Shemos 21:19). The Gemara in Bava Kama (85b) learns from these words: “From here we see that one is permitted (and required) to go to a doctor to be healed.” Rashi (1040-1105, ad loc.) explains: “We do not say that inaction is required because Hashem is the One that inflicted this person with a medical issue and Hashem will be the One to cure him on His own.” Rather, the one who inflicted the damage must pay for a doctor to treat the patient.
It is a fundamental Jewish understanding that when one is in need of medical attention he or she pursues all earthly venues to receive the best treatment. Doctors are messengers of Hashem to bring about healing. The Chofetz Chaim brings out the powerful lesson inherent in Rashi’s words. How can Rashi call the case of the verse to be one of “Hashem inflicting the person with a wound.” The two men were fighting and one punched the other, where is the Divine Hand here (literally)?
The answer is that all that happens to a person is decreed by Hashem. Any pain or joy that comes to a person is precisely accounted for. No one can bestow any good or any harm on anyone else without Hashem’s approval. Hashem uses the conduit of good people to bring out good things in the world and He uses evil people to bring out bad things into the world. The man who got punched and damaged was decreed in heaven to suffer that pain, regardless of how it would be carried out. The man who threw the punch was the conduit for that job. He is not innocent though, for he has freewill; he did not have to be the messenger to carry it out, and thus he will be punished from Hashem for his actions and he must pay for the medical bills accordingly. But the point here is that no one has anything transpire in his or her life without Hashem’s decree. Now, if someone, Heaven Forbid, does get hurt or is suffering from an illness, he or she is required to pursue medical treatment.
The Chofetz Chaim zt”l points out a most beautiful observation here. When Hashem describes that He brings healing to us, it states, “I am Hashem, רֹפְאֶךָ (Rofechah), your doctor (Shemos 15:26).” It is written with a Fay Rafah, a Soft Letter Fay and only one letter Fay. When a human medical doctor is discussed in our Parsha, it states, “ וְרַפֹּא יְרַפֵּא(Virapoh Yirapay), He shall surely heal you” (Shemos 21:19). The letter Pay is used in Hard Dagush (stressed with a dot) form and appears twice. This contrast expresses that when Hashem heals someone, it is effortless and speedy, like a Soft Fay; when a doctor attempts to heal someone, it can often be lengthy, challenging and with much effort and strain, represented by the Pay Dagush, Hard Pay and its repeated appearance.
This is why we pray in Shmoneh Esrei, “Rifainu Hashem V’neirafay, Please You heal us Hashem and we will be fully healed.” Both words contain the Pay Rafah. We also state in Asher Yatzar, “Rofay kol Basar, U’mafli La’asos, You [Hashem] heal people in a wondrous fashion.” May Hashem protect us and send a speedy recovery to all those in need.