Praying for the Sick

[Adapted from Lev Moshe, by Rabbi Avraham Goldshmidt]

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This work is intended for those who find themselves in serious difficulties—especially life-threatening illnesses—and everyone close to them. In situations like these, is it all too easy fall into discouragement and despair and to abandon hope of ever recovering. And yet, as we will show, this attitude is totally contrary to the Torah. Time and time again Chazal and the Rishonim stress the vital importance of praying for sick people to recover and even say that the main purpose of the mitzvah of visiting the sick is to make sure that we’ll pray for the patient with full fervor.

Thus the Rambam writes (Hilchos Avel 14:6) that when somone goes to visit a sick person he shouldn’t sit on a bed or a chair or a high place or behind the patient’s head, but rather in front of the patient’s head so that he can pray for mercy, and then leave. [The Me’iri, cited below, explains that when the patient sees a visitor sitting in one of these places he is liable to become discouraged since it would seem to him that the visitor has despaired of his prospects for recovery.]

Similarly the Tur writes (Yoreh Deah 335) that one should always pray to stay healthy, since someone who becomes ill uses up the merits he has accumulated in order to be healed. Nonetheless, when someone does become ill, it is a mitzvah for everyone to visit him, as we see that Hashem Himself visited Avraham Avinu at the beginning of Parashas VaYeira. This is a very important mitzvah, since praying for the patient keeps him alive. Also the visitor should do everything he can to provide for the patient’s needs. In particular he should make sure that the patient’s surroundings are clean and healthy.

The Beis Yosef quotes the Ramban to the effect that the purpose of visiting the sick is to clean the patient’s house, provide for his needs, and to keep him company, as well as to pray for him, since someone who visits a sick person without praying for him does not fulfill the mitzvah. The Rema (335:4) quotes this Ramban and agrees that someone who visits a sick person but does not pray for his recovery has not fulfilled this mitzvah.

The Vilna Gaon (ibid. s.k. 7) relates this ruling to the Gemara’s statement (Nedarim 40a) that one should not visit a sick person during the first three hours of the morning or the last three hours of the afternoon, since at these times the visitor will not be sufficiently motivated to pray for the patient. [Early in the day sick people generally appear stronger and less in need of prayer, while at the end of the day they seem weaker and a visitor might think there is no point in praying for them properly.] The Gemara makes the strong statement that visiting a sick person keeps him alive, while failing to visit him kills him by denying him the benefit of the one’s prayers.

Similarly the Rosh writes that not visiting a sick person is a great wrong, since if one had gone to visit he would have prayed for the patient at what might well have been a favorable time for his prayers to be heard; thus his failure to visit may have caused the patient’s death. From these sources we see that the main reasons to visit the sick are: 1) to offer them whatever help one can, and 2) to see and feel their suffering first hand in order to pray for them with all one’s  heart. Thus if someone gives up hope for their recovery or encourages others to do so, he is doing the exact opposite of what the mitzvah is intended accomplish. This is why the Gemara speaks of abandoning hope for the sick as “killing” them, and why it encourages visiting them at the times when one is most likely to be moved to pray for them with full fervor. From this same Gemara, the Me’iri concludes that a visitor must not do anything to discourage patients from praying for themselves, since left to themselves they are naturally inclined to take stock of themselves and their actions and to pray for their recovery with all their might. This accords with the Sages’ dictum that someone who is ill cannot recover until he has been forgiven for all his sins.

The Vital Importance of a Good Attitude

The importance of maintaining a hopeful attitude cannot be overstated. The Sages said (Rosh Hashanah 18b) that sometimes when two people with the exact same illness both pray to be healed only one of them is answered because that one prayed with a full heart while the other one was less optimistic about his chances for recovery and therefore did not pray as intensely.Chazal teach us that despair is never justified in any situation. The Gemara (Berachos 10a-b, based on Melachim II ch. 20 and Yeshayahu ch. 38.) relates that when King Chezkiyahu took desperately ill, the prophet Yeshayahu visited him and advised him to issue his final instructions to his family since a decree for his death had already been sealed. Replied Chezkiyahu: “Begone with your prophesy! From my father’s father I’ve inherited a firm belief that even if a sharp sword is resting on a person’s neck he should not restrain himself from praying to be saved.'' 

Rashi comments that this tradition refers to the incident (Shmuel II ch. 24) in which Chezkiyahu’s ancestor David saw an angel with a sword drawn over Jerusalem and still prayed to Hashem for mercy. [See also Divrei HaYamim I 21:16.] Metzudas David comments that Chezkiyahu’s illness was life threatening and Rashi adds that until that day no one had ever recovered from an illness. Other commentators say this refers to a different incident in which David fell towards a spear pointed directly at him and prayed to Hashem even though there seemed to be no way of avoiding an immediate death. [Tosafos Rabeinu Yehuda Sirleon based on Shmuel II 21:17 as interpreted in Sanhedrin 95a.]  On the other hand, the Vilna Gaon argues that Chezkiyahu did not mean David (who never actually had a sword resting on his neck) but rather his grandfather Yehoshefat, who once found himself in that very situation at the hands of the forces of Aram and was saved when he called out to Hashem. [Divrei Eliyahu citing Imrei Noam, based on the interpretation of Yerushalmi Brochos of Divrei HaYamim I, ch. 16.] Yalkut Shimoni also discusses this incident and concludes from it that Hashem wants those in danger him to appeal to Him directly rather than to any of the angels, as the prophet Yoel says (3:5), Whoever calls in the Name of Hashem will escape. Indeed, says the Yalkut, at that point Yehoshefat deserved to die and was saved only on the merit of his prayers and his faith in Hashem .

When Are Prayers in Order

Let us reflect for a moment on Chezkiyahu’s prospects at that point. Not only had one of the greatest prophets of all times just told him that a heavenly decree for his death had already been sealed, but he knew on his own that no one in the entire history of humanity until that time had ever recovered from such an illness. (This point will be discussed at length shortly.) Nonetheless, he did not hesitate to pour out his heart in prayer to Hashem, as we read (Melachim II 20:2-3): And he turned his face to the wall and prayed to Hashem saying, “Please, Hashem, remember that I have walked before You with truth and with a full heart and have done what is good in Your eyes. And Chezkiyahu cried greatly.” In response, Hashem informed him through the prophet Yeshayahu (38:5): Go and say to Chezkiyahu, “So says Hashem, the G-d of David your father: I have heard your prayer, I have seen your tears, and I shall add fifteen years onto your days.''

Never Give up Hope

These incidents show clearly that however great the danger a person may find himself in or however grave his illness might be, there is never any reason to dispair of Hashem’s mercies. Even if one has a disease from which no one has ever recovered, Heaven forbid, and even if he knows that a heavenly decree for his death has been issued because of his sins, and indeed, even if the sword is already resting on his neck and needs only a small motion to slice his head off or if he is already falling through the air and is about to be impaled on a spear, in all these cases the supplicant and those around him are required not to give up hope and not to do anything to discourage others, but simply to pray with all their hearts and with the firm conviction that Hashem’s mercies can still save him

Even if someone sees that his prayers do not seem to be answered, he must still not give up hope. The Me’iri writes (Yoma 29a) that one should always pray at great length; and even if he sees that his prayers are not being answered, he should still not give up, for eventually some good will come of them. One should never think that he is causing Hashem pointless trouble. The Sages compared tzaddikim to deer in that just as a deer’s horns keep growing as long as it is alive, with a new shoot branching off every year, so also as long as a tzaddik continues to pray his prayers are answered.

Chezkiyahu’s New Angle

The Yalkut (Malachim II 20) indicates that Chezkiyahu was the first person to ask Hashem to be healed, implying that praying for healing was not part of the belief he received from his ancestors. However, the Gemara in Berachos cited above suggests that Chezkiyahu’s prayer was based on their example, since it says, “Even if a sharp sword ...,” implying that prayers are in order for any less immediate form of danger as well, including illness. Furthermore, this Midrash relates that Hashem was so pleased with Chezkiyahu’s new idea that He granted his request and healed him in its merit.

Nonetheless, this statement raises a number of questions which require clarification. Elsewhere (Pesachim 56a), the Talmud relates that Chezkiyahu concealed the Sefer HaRefuah (“The Book of Healing”, containing cures for all illnesses known at that time) because he felt that the people were becoming too dependent on the cures and not using their illnesses as Hashem intended, namely to move them to reflect on their actions and repent (Rashi on Berachos 10b). Thus it seems clear that even before Chezkiyahu’s time people were asking Hashem to be healed from their illnesses.

A number of other sources [Sefer Maor Einaim on Ein Yaakov, Berachos 10a; Tosafos, Bava Basra 16b; Bava Metsia 87a; Da’as Zekeinim MiBaalei HaTosafos and Bartinura on Bereishis 21:15] reveal that various degrees of illness existed as early as the time of Avraham Avinu, including minor pains, potentially dangerous illnesses, and unquestionably terminal illnesses. According to the Rambam’s Peirush HaMishnayos, the Sefer HaRefuos contained cures for all but the last category, while according to Rashi it was effective for all kinds of illness.

The Chazon Ish (Sefer Emmunah u’Vitachon ch. 5) discusses a question raised by the Rambam as to why Chezkiyahu was justified in concealing the Sefer HaRefuos, since a person has a right to be healed just as he has a right to eat. To this the Chazon Ish answers that the right to healing cannot be compared to the right to food, since Hashem uses illness to stimulate people to reflect on their wrongdoings and correct their ways. However, this can be expected only of a select few, and therefore healing practitioners are allowed to use their skills to heal those who are not capable of dealing with their illnesses through introspection and repentence. Nonetheless, the Gemara reports (Sanhedrin 94) that the spiritual level in Chezkiyahu’s time was exceptionally high, and so he was legitimately concerned that allowing the general public access to the Sefer HaRefuos would encourage spiritual laxness. In a similar vein, the Ramban writes in Parashas Bechukosai that for those few who truly and deeply trust Hashem to provide for all their needs, it is wrong to resort to the healing professions. [Translator’s Note: In the present time, we are not allowed to put this strategy into practice without the permission of a competent Rabbinic authority.]

Along these lines, the Maharsha (Bava Basra 16b) suggests that the precious stone worn by Avraham Avinu around his neck (which had the power to cure any sick person who saw it) was concealed after Avraham passed away for the same reason, so that people would have to ask Hashem for mercy.

Above we cited Rashi’s interpretation that Chezkiyahu was referring to the incident in which David saw an angel with a sword drawn over Jerusalem to destroy it. It may be asked, however, why could Chezkiyahu not have been referring to the incident (Shmuel II 12:14-22) in which David prayed for the recovery of the son born to him by Bas Sheva, who had taken desperately ill. This incident seems to have more in common which Chezkiyahu’s situation than the one suggested by Rashi even though David’s prayers there were not answered. However, in order to understand Chezkiyahu’s innovation we will suggest that three different cases which might occur

1)  A decree of illness without death—for such decrees the Sefer Refuos and prayers for   mercy can effect a cure

2) A decree of death for a person—this is the situation which the belief Chezkiyahu received from his ancestors taught that prayers for mercy could be effective

     3) A decree of death in which the fatal illness had already taken hold—before Chezkiyahu no one had ever thought that prayers for mercy could be effective in such a situation, and he showed that even then a combination of prayers and merits could effect a cure. [Indeed, in such a situation, Yaakov Avinu had prayed not to be healed but only for several additional days of life so that he could gather his sons for his parting blessings and rebukes. Thus Chezkiyahu might have refrained for asking for mercy out of fear that to do so would be to disparage Yaakov’s prayer; but this did not deter him since he believed that Hashem’s mercies could be aroused in any situation whatsoever. (Cf. Yalkut Melachim II 20.).]


The above discussion reveals an important principle: Even though we find a number of times earlier in Tanach that it was considered impossible to annul existing decrees, since the time of Chezkiyahu, we have the power to overturn any decree through prayer—accompanied by tears and trust in Hashem—and to heal any illness and allow the sick to remain alive for long and happy years. Thus the Chovos HaLevavos (Shaar HaBitachon ch. 4) ascribes Chezkiyahu’s recovery to his trust in Hashem and writes that when someone trusts the Creator, he can be healed from any illness by any means Hashem sees fit, or even without the use of medicine or any of the other strandard procedures of healing. [Translator’s Note: It should be noted that elsewhere the Chovos HaLevavos writes that it is foolish to trust in Hashem unless one is also doing one’s best to fulfill Hashem’s will for him, i.e. by keeping Torah and mitzvos to the best of his ability.]

This is true even if the patient has reached the very threshold of death. Thus the Reshash (Berachos 60a) suggests that even someone who is about to die should not say, “If I die, let my death be an atonement for all my sins,” since this would leave an opening for the Satan to incriminate him. [Translator’s Note: The Reshash there cites the Ramban’s objection to the text of the final confession cited in the Tur and Shulchan Aruch. In reply, the Reshash refers to Chezkiyahu’s statement (Berachos 10a), “Even if a sharp sword is resting on a person’s neck, he should not restrain himself from praying for salvation,” which implies clearly that a person is never justified in thinking that his death, however imminent it may appear, is ever inevitable, and therefore one should always be wary of leaving an opening for accusatory forces. In the Ramban’s defense, however, we may suggest that this confession is not meant to imply that the confessor considers himself about to die, but merely to express his wish that whenever his death comes, as it must eventually, it will be an atonement for all his sins. In this light, the confession can be seen as a declaration of the patient’s faith that every aspect of his existence—in this world as well as in the next—is in Hashem’s hands.] We see this also from another incident related in the Gemara (Bava Basra 11a) in which Benyamin HaTzaddik was saved from imminent death and granted an additional twenty-two years of life on the merit of having kept alive a woman and her seven sons during a famine.

Talmud Yerushalmi relates the incident with Chezkiyahu in a somewhat different fashion. There Chezkiyahu says in the name of his grandfather that someone who has bad dreams or visions should cling to prayer, tzedakah, and teshuvah, and be saved. This point is echoed by the commentary Iyun Yaakov (Berachos 10b) who writes that even if one has had bad dreams and finds himself in a situation where a sharp sword is resting on his neck, he should still not give up hope and continue to pray to be rescued

Koheles Rabba (5:4) offers a number of strategies for someone who has had bad dreams or worrying visions. These include prayer, teshuvah, tzedakah, fasting, changing one’s name, behavior, or place of residence. In addition, this Midrash contains an interesting account of Chezkiyahu’s reply to Yeshayahu’s warning to put his affairs in order because he was about to die:

Yeshayahu, the custom in the world is that someone who goes to visit a sick person should reassure the patient that heaven will have mercy on him. A doctor who goes to see a patient tells him what to eat and drink and what not to eat and drink, but even if someone sees that the patient is about to die, he should never upset him by telling him to give final instructions to his family, and you’re telling me to give final instructions to my family because I am to die and not to live. So I will not listen to what you tell me but rather to what my ancestor said: ‘For with many dreams and affectations and empty words; fear G-d.”” Immediately he turned his face to the wall and prayed

In the end, Hashem sent Yeshayahu to Chezkiyahu to tell him that the decree against him had been rescinded. When Yeshayahu asked how he could do that after what he had said earlier, Hashem answered, “He is a humble person and accepts what you tell him.

A similar account appears in Bereishis Rabba (46); and there Eitz Yosef comments that these three tactics—prayer, teshuvah, and tzedakah—have special powers to bring people close to Hashem and through these people can merit to Hashem’s special Providence. The Yerushalmi (Taanis 2:1) also speaks of prayer, teshuvah, and tzedakah, and Pnei Moshe comments that these three things are required on fasts in order to stir people to accomplish the purpose of the fast.

Sifri (Ve’Eschanan 29) concludes that if Moshe Rabeinu, who had been told directly and decisively by Hashem Himself that he would not enter Eretz Yisrael, nonetheless did not restrain himself from entreating Hashem to rescind His decree, certainly people in other situations should not let themselves be deterred from praying to be saved, whatever danger they may face. This Midrash then derives the same conclusion from the incident of Chezkiyahu, who said that even if a sharp sword is resting on a person’s neck he should not restrain himself from asking Hashem for mercy

Perhaps we can say that Chazal used the expression “a sharp sword resting on one’s neck” as a convenient way of referring to any situation in which a person faces imminent certain death, either because of a Heavenly decree or because of a life-threatening illness. According to this, it seems that the belief Chezkiyahu received from his ancestors, which was phrased in terms of “even if a sharp sword is resting on a person’s neck,” referred to Divine decrees, and Chezkiyahu extrapolated from it to conclude that even if someone has already been stricken with a fatal disease and is in imminent danger of death, he should still not abandon hope of arousing Hashem’s mercies through prayer

[It should be noted that the Midrash Tanchuma (Parashas VeEschanan) states that Moshe Rabeinu, rather than Chezkiyahu, was the first to teach that prayer is appropriate even in cases of fatal illness. The Midrash derives this from the fact that even after Moshe had issued final instructions to his heirs (the Jewish people) and began to arrange for the distribution of his estate (i.e. the portions of Reuven, Gad and part of Menashe on the east side of the Jordan River), he nonetheless continued to entreat Hashem to rescind His decree and allow Moshe to enter Eretz Yisrael. Therefore, says the Midrash, certainly anyone with a fatal illness should not be discouraged from asking for Hashem’s mercies. Seemingly this Midrash does not accord with the one cited earlier, which states than Chezkiyahu was the first to teach that even someone with a terminal illness should continue to pray.]

Similarly, the Yerushalmi (Berachos 9:5) indicates that it was Moshe Rabeinu’s prayers that saved him even though Pharaoh’s sword was actually resting on his neck. The Talmud concludes its discussion there by citing the verse (Devarim 4:8), Who is like Hashem, our G-d, in all our calling to Him, suggesting that Moshe was saved as a result of calling to Hashem. This suggestion is strengthened by the fact that shortly afterwards the Talmud there cites the same verse in relating the story of a Jewish child whose prayers saved the ship he was on in a storm after the prayers of all the non-Jewish passengers had been ineffective.

Elisha was also Cured

The Gemara (Sanhedrin 107b) states that before Elisha no one ever took sick and recovered, but when Elisha fell ill, he asked Hashem for mercy and recovered. Elsewhere (Bava Metsia 87?) the Gemara concludes that Elisha’s illness was a fatal one. If so, asks the Yafeh Einayim,  how could the Midrash (cited above) say that Chezkiyahu (who lived after Elisha) was the first person to be cured from a fatal disease? In answer, the Riaf (Ein Yaakov ch. 7) posits that Elisha’s cure was effected through natural means using the Sefer Refuos (as discussed above), while Chezkiyahu, since he had already concealed the Sefer Refuos, did not have access to this means of natural healing and must therefore have been healed directly by Hashem as a result of his prayers.

We can also posit a further distinction between the situations of Elisha and Chezkiyahu. Even though Elisha’s illness was potentially fatal, his death had not yet been decreed. Chezkiyahu, in contrast, was not only terminally ill but was also under a decree of death, as we see from Yeshayahu’s injunction to give his final instructions to his family since he was about to die. Thus, such a recovery, from a decree of death which had already come to the stage of a life-threatening illness, was an entirely new form of miracle in Chezkiyahu’s case

The Anaf Yosef (Bava Metzia 87) offers a different interpretation. In his view, Elisha’s recovery was the result of a specific miracle which was done only for him, while Chezkiyahu prayed that all the sick people in the world be cured through natural processes, without miraculous intervention. Another difference is that Elisha’s recovery was never complete and that while he did not die, from then on he lived and functioned in a state of less than full health

To summarize the above discussion, while there are a number of differing explanations as to what exactly was the new feature of Chezkiyahu’s recovery and how it differed from previous cases, all interpretations agree that Chezkiyahu did something which none of his predecessors had done, namely to pray for Hashem’s mercy even though his illness was totally desperate and he had absolutely no hope of survival, and his recovery was proof that fervent prayers to Hashem accompanied by sincere and copious tears can overturn any decree and bring about a recovery from any and all illnesses.


Thus we have proven, based on a number of sources in Tanach and Rishonim that however desperate a person’s situation may seem, however serious his illness may seem and however imminent death or other catastrophe may loom in a given case, prayers are always called for and, if only they are fervent enough and accompanied by sufficiently deep and sincere tears, there is always a real possibility that they will turn the tide, that Hashem will listen and be moved to rescind His decree

This is not to say that Hashem will always do so. Sometimes one’s prayers may not be as copious or sincere as they could be, or sometimes Hashem might see fit to act of considerations beyond our understanding and not respond to our prayers because He knows that that is really to our ultimate good. Nonetheless, as the prophet Yeshayahu told Chezkiyahu (Berachos 10a), “What business do you have delving into Hashem’s secrets? You must do what you are required to and Hashem will act as He sees fit.” Clearly as long as we have light in our eyes and breath in our lungs we must persist in entreating Hashem to save us, however hopeless and helpless our situation may seem from our limited perspective. May Hashem in His infinite mercy do kindness to all Jews in any and all forms of difficulty and rescue them from any and all harm.