Psalm 107 recounts a series of deliverances: those who wander in the desert, those released from prison, those recovering from illness, and those who go down to the sea. The same structure recurs in every scenario: a description of the affliction, an outcry to Hashem, salvation, and subsequent thanksgiving. In this lesson, we will examine the third section - the passage of the sick, in which a profound principle is revealed: not only what happens to a person, but when he absorbs the message.
Before examining the verse itself, we must note the scribal markings that appear in this passage - the inverted nuns (the bracket-like isolated nuns). Rashi explains that they serve an exegetical purpose, functioning like the limiting words achin and rakin which exclude certain cases. And what do they exclude? To teach that they cried out prior to the final decree, and therefore were answered; however, if they cried out after the decree, they are not answered. The inverted nuns are like parentheses, as if to say that this crying out is not effective in every circumstance. They cried out - but it depends when. After a decree is sealed, crying out is of no avail; before the decree, an outcry can rescue them from their distress.
אֱוִלִים מִדֶּרֶךְ פִּשְׁעָם וּמֵעֲוֺנֹתֵיהֶם יִתְעַנּוּ׃ - Fools, because of their way of transgression, and because of their iniquities, are afflicted.
Ibn Ezra writes: "The meaning of evilim (fools) - even if they are wise, they are considered fools because of their transgression." This is a fundamental concept discussed extensively throughout Sefer Mishlei. Malbim explains there that when King Solomon speaks frequently about the kesil (fool), he does not mean a person of low intellectual capacity. Certainly, Solomon in his vast wisdom does not seek to mock those who lack mental acuity - what can a person do if he was not endowed with great intellect? Rather, Solomon refers to individuals who may possess formidable intelligence, yet are nonetheless fools - because in their daily conduct, they act foolishly.
Consider a diabetic who eats a four-tier whipped cream cake, fully aware that within fifteen minutes sirens will wail as his blood sugar spikes to life-threatening levels. You might tell me he is a professor, or a doctor - that may all be true, but he is certainly a fool. He cannot see an inch ahead of him and fails to grasp what he is bringing upon himself. A person can be brilliant intellectually, yet utterly foolish in the way he lives his life. This is what Ibn Ezra means: even if they are wise, they are considered fools on account of their transgression. "Fools because of their way of transgression" - they have chosen a path of wrongdoing, and through this path they bring upon themselves "and because of their iniquities, they are afflicted": by virtue of their sinful path, they inflict affliction and suffering upon themselves.
Radak explains that the verse here is speaking of the sick: on account of their transgression and iniquities they fall ill, which results in distress and affliction. Yet one must ask: regarding the captives, we also explained that they fell into imprisonment because of their sins, yet the text did not refer to them as fools. Why, then, does Scripture specifically label the sick person a fool?
Radak answers: Captivity and imprisonment occur all at once. Illness, however, is different - it begins mildly and only progressively worsens day by day. The prisoner had no preparatory phase to take in what was happening; he was seized and captured on the spot. But with the sick person, the folly lies in the fact that the illness began gradually: gentle hints were sent at first, followed by greater discomfort, then more serious medical tests - why, then, did he not wake up during the early stages? That is true folly. They ought to have realized that illness is like an angel sent to urge them to repent, yet they acted like a fool who is oblivious to the harm caused by his own foolishness, and did not return to Hashem. Had they been wise, they would have reflected: "Why has Hashem sent me this sickness? Until now I felt well - what does the Holy One, blessed be He, want from me? What sin must I rectify?"
Yet fools do not take notice until the sickness becomes severe and protracted, until they are utterly afflicted and loathe all food. Only when the doctor throws up his hands in despair do they finally remember that there is a Creator of the world. That is sheer folly, for early signals had been sent that should have stirred them to awaken - and that is why, specifically in the case of illness, Scripture highlights their folly.
The Malbim has a fundamental principle that we studied extensively in Sefer Mishlei, distinguishing between the evil (fool) and the kesil. The kesil can be very intelligent, yet he does not live his life according to his knowledge: he is exceptionally wise, yet he smokes himself to death - where is his wisdom? You are committing suicide! But here the verse says evilim. The Malbim consistently explains that evil is related to the word ulai ("perhaps") - the skeptic. He is the one who constantly asks, "Who says?", "Where is the proof?", "How do you know?", and "No one has ever returned from there." The evil is perpetually in doubt, a skeptical person who claims regarding everything that there is no proof, there is no certainty, why are you so sure?
These skeptics doubt and do not believe that what befell them - the distress and the danger - is from Hashem. He says: look, even tzaddikim underwent such things, Rabbi So-and-so also fell ill with such a disease - so what does that prove? Why do you connect this to sins? In this way, he doubts everything that happens to him: who says it is from Hashem?
And from where do his doubts stem? "From the way of their transgression [pesha]" - because he became so accustomed to transgression that it became a way of life, a routine. And the verse continues: "and because of their iniquities [avonot] they suffer." The Malbim has already explained in several places the difference between pesha and avon: pesha is rebellion - a person transgresses against Hashem, rebelling against Him. Avon is the distortion of the intellect. A person begins with desire and sin; in the next stage it becomes pesha, since he acts knowingly and willfully; and in the third stage it becomes avon - intellectual distortion, where he actually constructs an ideology that this is how things ought to be: "There are several alternative ways to build a family; who says a family must conform to the traditional definition? There are other ways too."
And this is the most dreadful of all. For as long as one merely sins, or even rebels, there is still hope that he will do teshuvah. But once he has built a platform and a pseudo-ideology for it, pretending that there is logic behind all this corruption - how can he be rectified? After all, in his mind this is how it should be, this is the right thing, and the progressive path is the upright path, while anyone who disagrees is outdated, holds archaic views, and must be condemned with the harshest epithets. That is what happens when one arrives at avon: the intellect becomes distorted and constructs an ideology around the corruption. Therefore: "Fools, because of the way of their transgression" - that is where it began; "and because of their iniquities they suffer" - what intensifies the suffering and affliction? The fact that he has sunk into avon, constructing an ideology around his sin.
כׇּל־אֹכֶל תְּתַעֵב נַפְשָׁם וַיַּגִּיעוּ עַד־שַׁעֲרֵי מָוֶת׃ - Their soul loathed all food, and they reached the gates of death.
"All food" - the Radak explains that this includes everything, even delicacies. Even if you bring the sick person the finest dish, he has no appetite and no desire to eat, as is the way of an ill person who finds food repulsive. "And they reached the gates of death" - they reach the state just prior to death. And the Malbim adds: just as they were stricken with spiritual illness and refused healthy spiritual sustenance, so too physically their soul loathed all food that nourishes the body - for their physical sickness stemmed from their soul's sickness, from their iniquities. Thus, they find themselves in distress for the third time.
וַיִּזְעֲקוּ אֶל־יְהֹוָה בַּצַּר לָהֶם מִמְּצֻקוֹתֵיהֶם יוֹשִׁיעֵם׃ - Then they cried out to Hashem in their distress, and He saved them from their straits.
יִשְׁלַח דְּבָרוֹ וְיִרְפָּאֵם וִימַלֵּט מִשְּׁחִיתוֹתָם׃ - He sent His word and healed them, and delivered them from their destructions.
When they reach the gates of death, they cry out to Hashem, seeing that flesh-and-blood doctors cannot save them. They cry out and repent. Then, "He sent His word and healed them" - the Malbim explains: this refers to physical healing; "and delivered them from their destructions" - this refers to the corruption of the soul.
Radak explains: the healing of physicians is performed through physical action, whereas Hashem's healing is not. Therefore it says, "He sends His word" - His word meaning His will. A doctor needs medication, but with the Holy One, Blessed be He - by the word of Hashem the heavens were made; the moment He willed it, "Let there be light," and there was light. Therefore, with Hashem, it is sufficient that "He sends His word and heals them." And "rescues them from their pits" (mishchitotam) - He delivers their soul from the pit (shachat), meaning the grave, just as Elihu said, "And his soul draws near to the pit." Radak further explains that this derives from the concept of destruction (hashchatah): He saves them from reaching ruin and corruption.
In the sefer Tehillot Shmuel, he cites Shir Maon and asks: why does the verse say "His word" (devaro)? After all, dibbur is always a harsh expression, whereas amirah is a gentle expression, and here the verse speaks of granting healing - it would have been more fitting to say "He sends His utterance (ma’amaro) and heals them," as in "He sends His command (imrato) to the earth." Indeed, the Maharchu writes in Etz HaDaat Tov that devaro always denotes an angel - "messengers of wind... who fulfill His word," and likewise, "And Hashem put a word in Balaam’s mouth." However, Tehillot Shmuel explains the harsh tone of dibbur: there are accusing angels who do not want this person to be healed, and the Holy One, Blessed be He, must silence these accusers - which requires harsh speech. This is "His word," and through this, "and heals them."
In the sefer Emet Kneh, Rav Mazuz notes that the Masorah marks "twice in the Masorah" regarding the phrase "He sends His word" (yishlach devaro). The Masorah represents the work of the post-Talmudic Masoretes, who counted every phrase in Tanach and noted how many times it appears. When it says "three in the Masorah," the phrase appears three times; when the letter lamed appears, it stands for leita, meaning there is none other like it - a unique phrase in all of Tanach. There is the Masorah Gedolah, which details all the locations, and the Masorah Ketanah, which merely tallies their count without listing them. Here, the Masorah notes it appears twice: once, "He sends His word and heals them," and once, "He sends His word and melts them" - in Psalm 147, "He blows His wind, the waters flow."
It is an established principle that when the same phrase appears in two places, it indicates a deeper connection between them. The Ba’al HaTurim frequently builds on this, citing the Masorah and connecting disparate verses to explain how they both touch upon a single theme. Rav Mazuz explains this connection based on medical advice: one who swallows a pill should swallow it with water, for swallowing it dry can cause chemical burns or even ulcers, as it fails to dissolve properly and settles in the stomach. The pill must dissolve so it disperses properly throughout the body. This is the allusion: "He sends His word and heals them" - how? By way of "He sends His word and melts them (ve-yamsaim)": dissolve the medication in water, and then "rescues them from their destructions" - it will not harm your stomach, but will bring about a complete recovery.
He further explains that "and rescues them from their destructions" (mishchitotam) refers to the harmful side effects of medications, or to the corruption of doctors. Beginning with medications: the Rambam states that every drug benefits one area while harming another. A person takes a medication that helps one condition, but causes damage elsewhere. Someone once went to a doctor to get medication for a fungal infection. The doctor prescribed a medication, and then instructed him to take a second pill as well. When asked why and what purpose it served, the doctor replied: "The first medication damages the liver, and the second one protects the liver." The patient responded: "Neither the first nor the second! I will manage with the infection and not endanger my liver. Listen to what you are saying: take a medication that will harm your liver, and then take another to treat it! One can live with a fungal infection; why inflict internal damage on oneself?" This is precisely what the Rambam meant: every earthly medicine benefits one thing and harms another, though sometimes the benefit outweighs the harm. Such is mortal medicine. But with the Holy One, Blessed be He - "He sends His word and heals them, and rescues them from their destructions": there is no ruinous side effect in His cure; it causes no harm whatsoever, but brings pure and complete healing.
One can also explain "and rescues them from their corruption" as referring to unscrupulous doctors. At times doctors can act with great corruption: prescribing a specific drug simply because they were asked or paid to promote it, not because it is genuinely the best option. Sometimes the drug is experimental, or the doctor is a partner in its research and has a vested interest in promoting it.
A story was told of someone whose family member fell ill and was hospitalized for a long time. Every time the family tried to speak with the head of the department, a senior professor, they could never get a proper answer: they would catch him in the hallway, and he would mutter a curt half-sentence and walk away. Their father lay there for an extended period while the staff tried one medication after another with no improvement. Finally, someone whispered to them that they needed to schedule a private consultation with him. They raised two thousand dollars and booked the appointment. Only then did it emerge that there was already an innovative, experimental treatment for their father’s illness with a very high success rate and a strong chance of recovery. The professor had never mentioned this until that day, simply because they had not scheduled a private consultation and paid him. "And rescues them from their corruption!" Such conduct is corrupt, even murderous: pay me and I will save him; don't pay and you will never know. Come to my private clinic and you receive care; fail to do so, and your father and others may die. Regarding this the verse declares: may Hashem send His word and heal us, and rescue us from the corruption of such physicians.
It has often been pointed out that violence against medical staff, and violence in general, is something Judaism completely abhors. Yet one cannot place all the blame solely on the perpetrators. Often, when family members encounter condescension and callous indifference toward a suffering patient - not from all doctors, for most are upright professionals, but from certain individuals - one can at least understand the boiling point, even while completely condemning and discouraging such reactions. When a person's parent or child is lying in critical condition, and the family is in extreme emotional distress, and they are met with cold disdain - what can be expected? In such painful situations, we must pray to the Holy One, Blessed be He, to save us, and in doing so rescue us from the corruption of such physicians.
The sefer Panim Yafot explains "and deliver them from their corruptions" in another way: the Holy One, blessed be He, heals the disease through a cure that is itself the destructive agent, yet within it lies healing. The Holy One, blessed be He, heals bitter with bitter: He takes a bitter oleander branch, throws it into the water, and the water sweetens. We must perform an action that succeeds according to nature; with the Holy One, blessed be He, even something contrary to nature heals. So we find with Chizkiyahu who had boils; and with what did they heal him? With a cake of figs. Yet the Gemara states that a cake of figs is harmful to boils. Indeed, when a person does this, it is harmful; but when it is by the word of Hashem, the cake of figs is what will heal. The Holy One, blessed be He, heals bitter with bitter to show that it is beyond the natural order. And this is "and deliver them from their corruptions": Hashem's healing rescues you even when the item itself is destructive, and from that very same thing your cure will come.
יוֹדוּ לַיהֹוָה חַסְדּוֹ וְנִפְלְאוֹתָיו לִבְנֵי אָדָם׃ - Let them give thanks to Hashem for His lovingkindness, and for His wonders to the children of man!
וְיִזְבְּחוּ זִבְחֵי תוֹדָה וִיסַפְּרוּ מַעֲשָׂיו בְּרִנָּה׃ - And let them slaughter sacrifices of thanksgiving, and recount His works with joyful song.
Once again the thanksgiving returns, but the Malbim, as well as the Radak and other commentators, point out that in the previous rescues it did not say, "And let them slaughter sacrifices of thanksgiving, and recount His works with joyful song." Why specifically here, in the rescue from illness, do the sacrifices and the recounting with joyful song appear?
The Malbim explains: The halachah is that when a person experienced two miracles, when he makes a blessing over one miracle he must also give thanks for the second miracle. Thus the Gemara brings the case of that man at the inn of Aravot, who was saved from a camel and saved from a river; whenever he arrived at the place where he was saved from the camel, he would give thanks for the rescue from the camel and also for the rescue from the river, and when he reached the site of the river, he would also give thanks for the rescue from the camel. That is to say, when you give thanks at the place where a miracle was performed for you, mention also the miracle that occurred for you in another place.
According to this, one who was released from prison should have given thanks also for the miracle of the rescue in the wilderness, since according to the Malbim all the miracles in this chapter speak of one individual who underwent all these experiences: he was in the desert and was saved, he was in prison and was saved. However, as noted, he still did not fully recognize Hashem's kindnesses - "fools because of the way of their transgression" - and gave thanks only for the miracle from which he was saved at that moment. But now, after being saved a third time, from illness as well, "let them give thanks to Hashem for His lovingkindness" and "let them recount His works" - also regarding the previous miracles: he gives thanks for the present kindness and recounts the deeds that preceded it as well. Furthermore, until now he had not brought a thanksgiving offering, and now it says, "And let them slaughter sacrifices of thanksgiving" in the plural - multiple sacrifices, for the earlier miracles as well. Here the realization hits home: he begins to absorb just how immense Hashem's kindnesses are toward him, and realizes that he did not fulfill his thanksgiving properly on the first two occasions. Now he offers complete thanksgiving, recounting all the deeds together and offering sacrifices for all of them together.
The Radak explains in a different manner why "and let them slaughter sacrifices" is said here and not regarding the rescue from the wilderness or from prison: because sick people experience a protracted return to health. The sick person recovers slowly. And just as the Radak explained above that someone who enters prison enters in a single moment, and whoever leaves leaves in a single moment, so too the sick person: he gradually deteriorated, and he gradually emerges from the prison of his illness and slowly recovers. Because of this, says the Radak, they vow sacrifices as they regain strength little by little. When he experiences an improvement: "If Hashem helps and I manage to walk on my feet, I will bring such-and-such an offering." When he experiences further improvement: "If I am able to leave the house, I will bring such-and-such an offering." And when his health is fully restored, he brings all the offerings he obligated himself to bring. That is why it says specifically here, "And let them slaughter sacrifices of thanksgiving, and recount His works with joyful song." The Radak adds that it is very possible that seafarers, desert travelers, and prisoners also slaughter sacrifices; but among the sick this is most common, as the gradual progress prompts vows of offerings and sacrifices, which is why the verse mentions this matter specifically in connection with the sick person.
The section concerning the sick in this chapter teaches that illness is not merely an affliction, but a messenger. A person is called a "fool" not because he lacks intelligence, but because he received early, gradual messages and failed to awaken from them, and because he is doubtful and skeptical, failing to recognize that everything comes from Hashem - and this stems from the "way of their transgression" that became routine, and from "their iniquities," which represent a distortion of the intellect that constructs an ideology around spiritual corruption. When he reaches the very gates of death and a physician of flesh and blood gives up hope, he cries out - and Hashem "sends His word and heals them": a cure that requires no physical action but only will, a cure devoid of destruction like human medications, and a cure that can even emerge from bitterness. Then, when the realization finally hits home, complete thanksgiving arrives: not only for the most recent miracle, but a recounting of all the deeds together and sacrifices of thanksgiving for all His kindnesses in their entirety.