Tazria- Mezorah: Diagnosis

Much of these parshioth  deals with the identification of disease.  The passage of time, and with it, the alterations in  the prevalence of various diseases, makes it impossible to associate  tzoraas with a modern disorder.  But principles of health care  are seen in the process that is described. 

The person afflicted with tzoraas shows the lesion to the Cohein, A person does not diagnose herself.  only the designated, presumably trained observer can make the diagnosis.  An objective outsider is needed.  The affected person may exaggerate the abnormality because of anxiety; or minimize it so that he can avoid the difficult situation. 

The trained Priest using  a set of criteria to determine whether or not the lesion fits  the diagnosis. The visual criteria: color, quality of the hair, etc., are also embedded in a special diagnostic language. The lesions have names: seais, bahereth, etc that convey properties that are lost on the uninitiated.  The secret language of doctors, in our times, adds to their mystique.  It takes some  background to understand  the significance  of the abl oncogene or JAK2.  But these names convey meaning in terms of the prognosis and teatment of disease to the cognoscenti. 

Since Virchow, in the mid 1800's, the microscopic appearance has become the accepted methodogy for diagnosis. To classify disease, a biopsy is needed to obtain a microscopic  view. This current tradition ( which may soon  be supplanted by molecular analysis) makes us look askance at diagnoses made by visual inspection ( although dermatologists make such diagnoses quite accurately).  As our understanding of the molecular mechanisms of disease improves, we may feel the same inadequacy about a microscopic diagnosis that has not had gene sequencing and immunologic characterization. 

The parsha recognizes that doubt about the nature of a lesion will arise.  Provisions for  re-examination are outlined.  It is the spread and/or the persistence of the lesion that identifies its severity. Perhaps these principles should be applied more broadly in modern medicine.  Our predictions about the behaviors of certain diseases leads to their treatment.  But sometimes, a diagnosis that sounds terrible- leukemia, lymphoma- can be associated with a long, symptom free course.  Sometimes the interventions are more destructive than beneficial,   There is  sometimes a place for watching the course  before deciding on treatment,  

There is no substitute for careful observation. 

Shemini: procedure

Why should I be surprised by the death of Nadav and Avihu?  They didn't follow the prescribed procedures.   Would I be surprised if a patient took his chemotherapy incorrectly and died?  Would it be a surprise  if a person were exposed  to insensible  radioactivity  and died as a result?  When I took organic chemistry in college,  I was afraid to go to the lab, lest someone fail to follow instructions and cause an explosion or release toxic fumes. Originality in a dangerous  endeavor  can be fatal. 

In matters of belief, variation in practice has resulted in millions of deaths.  The battles between Catholics and Protestants, Sunni and Shiites , Capitalists and Communists.... differences that are almost  imperceptible to those outside,have killed millions of believers on both sides.  Thus, the introduction of a variation in the ritual, as Rabbi Eliezer  ( quoted by Rashi) puts it: 'acting without consulting the legal authority (Moshe)'  is a capital offense. 

I have just returned from a Passover program.  The majority of participants were of Persian descent.  Their prayer service, Sefardic, is different form my usual Ashkenazic liturgy.  There is no war here.  I can pray with them.  I recognize their Jewish validity, they recognize mine. 

The problem specified in the story of Nadav and Avihu is the introduction of strange fire.  We understand that fire is not matter; it is an ongoing, catalytic process, a conveyance of sufficient heat to maintain the chemical reactions that generate heat.  What is a strange fire?  It is a new catalytic process, a new way to generate an alternative self renewing process, something that can, under the wrong circumstances, cause a meltdown. 

Variation is tolerable.  Novelties introduced in a state of impaired judgement are dangerous. The risk of a meltdown is not tolerable. 

Avadim hayinu le'pharaoh bi'mitzraim

Avadim hayinu le'pharaoh bi'mitzraim

There is a great deal of extra detail,  redundancy , here.  It would have been enough to say that we were slaves.  Specifying  Egypt  would have sufficed to identify the ruler as Pharaoh.   What do the extra words convey?  A couple of thoughts.

 My father was a literal slave to the Nazi  taskmasters in  Treblinka.   That was a very literal enactment of the phrase.  Remembering my parents' seder reminds me that they believed that  Hakodesh Baruch hu  personally liberated and rescued them from  the horror.  

Drashically, we can see  the  personal liberation in these words.  The key is Pharaoh.  This word appears,  as an adjective  in other parts of the Torah.  It describes the people when they insisted on making the golden calf.   It most commonly describes unruly hair.   Perhaps that  is a good translation : out of control.  The phrase now comes to mean: we were slaves to our random, diverse  desires.  

At the same time,  we were in Mitzrayim, we were in a narrow place, constrained, limited.  We could not satisfy the desires to which we were enslaved.  We were like drug addicts. The quest to fulfill the desire  consumes all of our energy.  Liberation is too remote a concept. We dealt with desire and constraint.  

The mitzvoth taught limitations to desire. The new, self imposed  constraints  liberated us so we could confront the problem of subjugation,  and proceed to liberation.   This is the story of Malcolm X,  Buddha,  etc. One cannot deal with liberation until her mind is liberated from distracting, diverse passions.  This is one way in which Hakodesh Baruch hu liberated us, and all future generations by giving mitzvoth that generate freedom  from a self imposed slavery that prevents liberation.

There is not contradiction in liberty and serving Hashem .  The Divine service requires the liberation  of the rules.