There is a dispute amongst the Amora’im and Rishonim with regard to the proper balance between Bitachon, trust in God, and Hishtadlut, human effort. Rav Acha states (Berachot 60a) that when a person is undergoing a medical procedure, he should pray to God, saying, “May it be your will, Hashem, my God, that this therapy should serve me as a remedy, and that you should heal me, for you are God, the faithful Healer, and it is your remedy that is genuine, for it is not the place of people to seek medical treatment, but so they have accustomed themselves.” Rashi (ibid. s.v. She’Ein Darkam Shel Bnei Adam) explains that this prayer is suggesting that one have absolute Bitachon in Hashem, since all matters are decided by Him; prayer can completely replace medical treatment. However, Abayei immediately interjects and cites a teaching from Rabi Yishma’eil’s Yeshiva, explaining that the Torah’s statement (Shemot 21:19) with regard to damage liability, “VeRapo YeRapei”, “And he shall provide for healing,” grants permission to doctors to heal patients. In light of this teaching, Abayei allows room for human Hishtadlut.
This interpretation of the verse, which is accepted as Halacha (see Shulchan Aruch Yoreh Dei’ah 336:1), disproves the notion that man should not attempt to alter his fate. However, the Rishonim still dispute the extent to which one can, or even must, go to in order to be healed from an illness. Rambam famously notes (Hilchot Dei’ot 4:1) that a man must do anything within his power to ensure that he is healthy, both physically and mentally; if he becomes ill, it is impossible “SheYavin O Yeida Davar MiYedi’at HaBorei”, “For him to understand or know any knowledge of the Creator.” The Rambam implies that a man must put in as much Hishtadlut as necessary so that he can properly study Divrei Torah and Divrei Chachmah. On the other hand, Ramban (VaYikra 26:11 s.v. VeNatati Mishkani BeTochechem) contends that in an ideal world, one would not need Hishtadlut whatsoever. Righteousness and prayer would suffice to heal the body from any illness. Ramban mentions the Gemara in Berachot, and he explains the academy of Rabi Yishma’eil specifically granted permission to doctors to heal, but not to patients to seek medical help; while the doctor is not guilty of a lack of Bitachon, the patient undoubtedly is.
Rav Eliyahu Dessler, who lived in England and Israel in the 20th century, writes that while Ramban’s conception of the ideal world is accurate, we do not live in such a world due to the sin of Adam HaRishon. Therefore, we act in accordance with the Rambam, who believes that we should put maximum Hishtadlut into all areas of our lives. The Ramban’s view is not incorrect, but merely inapplicable until the time of Mashiach.
In Parashat Terumah, God’s instructions for the construction of the Shulchan are juxtaposed to His instructions for the construction of the Menorah. The Gemara (Bava Batra 25b) quotes a Pasuk (Kohelet 1:6) that describes the sun and wind as follows:
“Holeich El Darom, VeSoveiv El Tzafon, Soveiv Soveiv Holeich HaRuach”, “[The sun] travels to the south, and turns northward; ever-turning travels the wind”. Rav Yisrael Meir Kagan of Radin, commonly referred to as the Chafeitz Chaim, relates the northward and southward directions to the Menorah located in the south of the Mishkan and to the Shulchan located to the north of the Mishkan, while he explains that the sun relates to a person. Intuitively, everyone wants to face the Menorah, whose flames resemble the spiritual fire of Torah and Bitachon in Hashem. Nevertheless, it is necessary to turn to the Shulchan, whose bread symbolizes physical well-being and Hishtadlut. The Chafeitz Chaim explains the second half of the Pasuk, which describes the continuous northward turning of the sun, as referring to one who completely abandons his Bitachon in Hashem and solely relies on Hishtadlut. Such a person will experience a feeling of “Holeich HaRuach”, “The wind travels”, meaning the complete departure of his spiritual being. Such a person will ultimately regret his decision to neglect belief and only rely on action.
Therefore, while it is important for us to exercise Hishtadlut in everything that we do each and every day, it is imperative that we retain proper Bitachon in Hashem. Let us all take this message to heart and combine pragmatic action with unwavering trust.