Bikur Cholim – Visiting the Sick

Visiting the sick (or the “not yet well,” as we like to call the temporarily afflicted) is one of the characteristic acts of kindness that define the life of a Jew. It is a simulation of divine chesed. The Talmud (Sotah 14a) cites the verse (Devarim 13:5) that “You shall follow G-d,” and explains: “Can a person really follow the divine presence, which is a consuming fire? Rather, follow G-d’s ways…just like G-d visits the sick, so too you should visit the sick.”
Thus, bikur cholim is an important mitzvah, but – like all mitzvot – it has a precise form and methodology. Often, people with the best intentions can stumble and inadvertently fail to fulfill the commandment properly, or, in the worst case, actually exacerbate the choleh’s predicament. It is important to know that the essence of the mitzvah is to inquire after the choleh’s needs, and especially to pray for his/her recovery. To leave without offering a specific blessing – “G-d should have mercy on you and all cholei Yisrael,” or “May Hashem send you a speedy refuah shleima from Heaven” – does not fulfill the mitzvah.
Beyond the technicalities of the mitzvah is the realization that the choleh is a human being, and not merely – like a lulav, so to speak – a cheftza shel mitzvah, the vehicle through which the commandment is performed. I have heard from cholim who understand well the importance of the mitzvah, the willingness of people to perform it and the necessity to recognize guidelines and limitations. It is not always easy for the “healthy,” so to speak, to empathize with the choleh.
Thus, one overcome by serious illness needs time to adjust to the new reality, the challenge that G-d has sent his/her way. And it is a challenge; as is well known, we cannot always control what happens to us but we can control our reaction to it. Every stage in life is part of our mission to fulfill the destiny that G-d has set for us. Some cholim want to explore the spiritual dimensions of their illness, but others do not. One should be guided by the choleh, and not be too intrusive as to the spiritual state of the person unless the person raises the matter. Granted, the essential mitzvah is to tend to the physical needs of the person, but refuat hanefesh is often a part of a person’s recovery or his way of coping. That matter, nonetheless, is best raised by the choleh.
Even regarding the personal needs of the choleh, each person is different. Someone who is homebound can still be functional – and talk on the phone, daven, give tzedaka, learn Torah and even comfort others. Some look for ubiquitous companionship and others prefer time for solitude or just recovery. The time frame for visits should be determined by the choleh, although Chazal state that one should not visit in the first three or last three hours of the day – early morning or late evening. (The laws of Bikur Cholim are found in the Shulchan Aruch, Yoreh Deah, Chapter 335.) If the choleh says that “now is not a good time,” we must respect that – and certainly not say: “You are depriving me of the opportunity to do a mitzvah!” It is best not even to call early in the morning or late at night. One should first ascertain whether the timing of the visit is appropriate for the choleh – but also for the choleh’s family, which is also great impacted by the illness of their loved one. They too need chizuk – and sometimes just space and a life away from caretaking.
Thus, the choleh’s relatives should always be greeted not with the “pity face” but b’sever panim yafot, with a smile and pleasant countenance. They need not be reminded by your expression of their pain, nor do they need to be distracted from it. The worst reaction – not common but not uncommon either – is to avoid eye contact, to make believe that they are not really there. That reaction – seemingly cold even from otherwise thoughtful people – is an unconscious attempt to avoid causing pain, and even to avoid identifying with that pain that will someday be theirs as well. But little is as painful as that – as if not the illness but the sadness is infectious. Sometimes, the best approach is just to say “hello” with a smile, or send a card or message with simple words that you are thinking of them, davening for them, etc. Certainly, one can call and leave such a message on the answering machine – and do not at a later stage confront the choleh accusingly and ask why your call wasn’t returned? Not every call can be reciprocated. And if you have not called, do not tell the choleh that you didn’t call because you “know that they have others looking after them.” That might be true but it is not relevant, and just an attempt to assuage guilt.
Above all – be normal (a good rule for life in every event). That is hard to do because, again, it can be psychologically painful to see oneself in the position of the choleh and so we try to escape from having any association with that quandary. (Death often evokes a similar reaction in people.) That such is common does not make it acceptable, so, be normal, and supportive to the extent welcomed.
It is very helpful when friends offer to help, but the help should be specific rather than generic – not “can I do anything for you?” or “Please let me know if I can do anything for you” – but specific: “I am going to X Market. What can I get for you?” Or, “can I cook for you [or for your children]?” Can I drive you to the doctor?”
And, of course, whatever you commit to doing – do! Offer to do anything in your comfort zone – but then follow through. Do not say you are cooking, and then (well, of course you will cook, but) expect the spouse to pick it up. Do not offer to drive and then cancel (absent some exigency, of course.) Offering and reneging is worse than not offering at all.
If the choleh accepts your favor, then certainly be discreet. If you drive the person to the doctor, then the patient trusts you. Do not share personal information about the choleh’s condition with others. That is always the prerogative of the choleh. First and foremost, always respect the person’s privacy and dignity.
Visits should be kept brief. Do not stay too long, unless the choleh specifically requests it. Offer chizuk rather than pity, and don’t visit if your visit will make the choleh feel worse. (“Your illness has hurt our friendship and ruined my life!” or “You are not the same person!”) When appropriate, offer words of chizuk or Divrei Torah and even drop off reading material that can enrich the life of the person.
If the choleh wishes to speak about his/her illness, then by all means be receptive and listen, but do not ask about specific symptoms, prognoses or other medical issues unless the information is volunteered. The choleh might be uncomfortable discussing certain matters. If you have a valid reason to suggest a different medical protocol, then do so, but do not suggest that the choleh change doctors in mid-treatment, as that can shake the patient’s confidence and undermine his psychological state.
What should you talk about with the choleh? Certainly tell them what is happening in your life, but do not complain about having to do errands or activities that the choleh would love to be doing but for the illness. If you see the choleh (or relative) in shul davening with kavana, it would be rude and improper to interrupt them for a general inquiry about their welfare. They, especially, need those moments of solitude with Hashem.
Understand, as well, that each person handles illness in a unique and subjective way. There are people whose true needs are known to them only in retrospect, whether they required more support or less. That applies to both the choleh and the family. And just as we would not criticize someone who is public about the illness, so too we should not castigate (even behind closed doors) someone who wants to remain private. There is no one right way, although Chazal do state that it is preferable to inform people of one’s troubles so they can pray for you (Sotah 32b). But, ultimately, the choice is personal, and we must always recall that the illness is not the person and does not define the person. The person remains a human being entitled to respect and consideration, and has a life beyond the illness also.
And perhaps our main contribution to the welfare of the afflicted is to daven for them, to always have them in our thoughts and prayers. Davening helps – it helps the choleh but it also helps others develop a closer, more intimate connection with Hashem. That might be one reason why visiting the sick is a mitzvah whose fruit we consume in this world but whose principal remains for the world-to-come. It is a mitzvah that is not as easy as it looks, and in which we can all easily fall short, but one that properly done invariably makes us better people. With good intentions and even better words and deeds, we can bring great comfort to all cholim, as we pray to Hashem to bring them – and all cholei Yisrael – a refuah shleimah, a complete and speedy recovery.

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2 responses to “Bikur Cholim – Visiting the Sick

  1. Rambam, Hilchot Ebel, Chapter 14, Paragraph 4:

    All [Jews] are required to visit the sick; even a very important person is obligated to visit a sick person who is considered to be less important. We should visit the sick many times each day, and whoever [visits the sick] more is more praiseworthy, on the condition that the sick person is not troubled by his visits. All those who visit the sick are considered as if they removed [one 60th] part of the sickness. And all those who do not visit the sick are considered as if they shed blood.

  2. That is something that everyone should do and how one should act and one should know this naturaly. Thank you for speaking to this subject.