Modern Leprosy

Rabbi Melanie Aron

Saturday, April 21, 2007

Modern Jews, reading the sections of Leviticus that make up Alec and Josh’s Torah portion often feel a bit superior. After all we now know a lot more about leprosy, today usually known by its more scientific name, Hansen’s disease, than they did in Biblical times. Most of the skin diseases described in Leviticus are not leprosy and leprosy itself is not really that contagious. What the Bible called leprosy of houses was mold and was not related to most skin diseases. The fear of the disabled and physically ill that we find in many places in the Bible, seems misplaced, and the exclusion of the disabled from privileges such as the priesthood is offensive to our more modern understanding.

Despite our recent medical advances, we should probably be more humble. It has really only been in the last century and a half that a person who was treated by a physician did better than one who wasn’t. Before Joseph Lister demonstrated the effectiveness of antiseptics, most surgeries were not done in sterile environments and the infections that resulted were quite often fatal. Until the discovery of penicillin in 1938, physicians could monitor their patients and provide support, but could do little to actually cure their disease. Even today, there remain areas of medicine, where we are still operating relatively in the dark.

In particular, in the area mental illness, the way we behave today is in many ways similar to the pre-modern approach to physical illness where stigma and fear dominated. Often in the past we have been wrong in our understandings of certain mental illnesses and their causes and as result acted in ways that added to the suffering of those who are ill and their families. Strategies of blaming family members and in particular mothers and calls to stronger will power have been destructive. Though treatments have advanced in the last decade, there is still much we do not know. As I understand it, we are on the cusp of understanding the complex interplay between genetics and environment in this area and of being able to treat the biological basis of many mental illnesses. Still even with our contemporary limitations, treatment is helpful to between 70-90% of the mentally ill, depending on the particular illness. Perhaps in part because of the effectiveness of contemporary drug treatment and therapy, those who have a mental illness and are doing well with it, are invisible to our society.

In his D’var Torah Josh reminded us of the pain caused to those we ostracize and exclude and Alec spoke of the contribution that the lepers in his Haftarah made to the well being of the whole Israelite community.

In our own generation, the mentally ill are often those treated as lepers in our communities and I fear that after the tragedy this week in Virginia, that will only be more so. Though we know intellectually that the mentally ill rarely hurt others and that they are themselves much more likely to be victims of violence, will this knowledge be able to overcome the media images of the last few days? It is important to remember that the mentally ill are us. 6% of all Americans suffer from a mental illness and mental illness effects 1 in 5 American families. Many people who we remember for their important contributions to world events, leaders like Abraham Lincoln and Winston Churchill, suffered from severe depression. Various contemporary public figures like Mike Wallace, Dick Cavett, Jim Carrey and Amy Tan have come forward to speak and write about their struggles with depression and many others who suffered from bipolar disease and other mental illnesses have made outstanding contributions in all areas of the arts and sciences. Overcoming the stigma that still accompanies mental illness is important for many reasons among them the concern that it prevents individuals from seeking treatment. A recent study estimated that 67% of adults and 80% of children who would benefit from medical services for depression and other mental illnesses do not seek this help.

The Reform movement nationally has taken a strong stance on mental health parity in health insurance. We have also attempted within our congregations to find ways of providing the same support to families dealing with mental illness as we provide for those dealing with cancer, an illness which was stigmatized just a generation or two ago. Already in ancient times, the authors of our prayers recognized that health includes health of body and spirit. Each time we pray for healing using our traditions ancient words, we pray that we may be granted refuat hanefesh urefuat haguf, health of spirit and health of body. Ken Yehi Ratzon, so may it be God’s will.