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Rabi Eliyahu Roman, Shlita, points out that we refer to Hashem in Eight different ways in the bracha--Hashem, Sehilaseynu, Atta, Kel, Melech, Rofeh, Ne’eman and Rachaman.  Certainly NO COINCIDENCE, but also highlighting for us how important it is for us to have Kavannah in this bracha--we are seeking Refuos for ourselves and others, and we have the opportunity to implore Hashem, pleading with Him based on various aspects of His attributes!  HaRav Yonasan Eibeschutz, Z’tl in the Sefer Ya’aros Devash adds the following three pointers when reciting the bracha:


a.  One must have in mind all cholei Yisroel, joining in their pain with them--for we are all one nefesh and guf--and if a part of us hurts, we hurt.


b. In fact, one should daven for the rishei Yisroel who are sick as well--so that he does not die a rasha, but instead is healed so that he can have the opportunity to do Teshuva.  Not only will this help him, but it will make the one guf of K’lal Yisroel moves towards completeness, and will also remove rischa, a time of anger and din, upon the world engendered by the passing of a rasha in that state.


c..  One should especially daven for Talmidei Chachomim who are weakened and suffer through their studies and support of K’lal Yisroel.  In fact, the Mishna Berurah (Shulchan Aruch Orach Chaim 115: seif katan 1) brings from the Sefer Seder HaYom that the Ikar Kavannah in Refa’einu is our pleading with Hashem that He heal us so that we will be healthy and strong to learn Torah and perform all of the Mitzvos--enabling us to fulfill our role--and our potential--in this world!  What can be more important-more crucial?!  Let us truly focus this week!



The Bracha begins with the words Refaeinu Hashem V’Neirafeh, even though it is based on the Posuk in Yirmiyahu ( 17:14 ) which is actually written in the singular.  This teaches us that we are to join together the tza’ar of all cholim who need a Refuah, asking Hashem to have mercy upon all cholim (the Sefer Yesod Veshoresh Va'Avodah writes that one is mekayem a Mitzvas Aseh of VeAhavta LeRayacha Komocha for every person he davens for in the bracha).  We additionally emphasize with the words Refaeinu Hashem that the Refuah comes only through Hashem and that all else is merely the medium (or to those not in the know, the disguise) of Hashem’s Refuah.  After these first vital words, we importantly continue with the crucial words Hoshieinu V’Nivasheiah.  The Kuntres Avodas HaTefillah writes that with these potent two words we ask that Hashem save us from anything that causes or brings about sickness--i.e., that we be saved from becoming sick.  Chazal (Shabbos 32A) teach that a person should always ask for mercy that he not become sick, for if he does become ill, then “Omrim Lo Haveh Zechus V’Hipateir”--they tell him show us what Zechusim you have to become well.  It is therefore extremely essential that we have proper Kavannah in the first five words Refaeinu Hashem V’Neirafeh, Hoshieinu V'Nivasheiah--first davening for all those who are ill to become well, and then davening for those who are not ill to stay well.  One’s poignant and pointed prayer here demonstrates here not only his great Emunah in Hashem Yisborach, but also his Ahavas Yisroel--in wanting to do away with the tza’ar of others (including his own) and in bringing happiness to us all--at all times!  



HaRav Chaim Friedlander, Z’tl, explains why this Bracha follows after HaShiveinu, Selach Lanu and Re’eh (Nah) V’Anyeinu.  By following this order, we recognize that all sicknesses and all cures come from Hashem--as we recognize that we must first do Teshuva, then ask Hashem for forgiveness, then ask that our suffering serve as atonement, and only then can we legitimately plead with Hashem that He send the Refuah.  With this, we additionally demonstrate that the medications and therapies we undertake are the means in this world to achieve Hashem’s Refuah; we go to the internist, specialist or physical therapist with this in mind, and we take the pills, medications or shots by this understanding.  That is why we begin with the two words that tell it all--Refaeinu Hashem--Heal us Hashem! 


What, then, is the third word of the Bracha V’Neirafeh?  The Zohar and the Mekubalim (brought in the Sefer Baruch Sheamar and in the Sefer Sifsei Chaim) write that there are Refuos which come through Malachim following Hashem’s direction, which the Posuk alludes to with the words “Yishlach Devaro V’Yirpaeim”--Hashem sends His word and heals them (Tehillim 106).  We, however, plead that our Refuah not come through any heavenly intermediaries, but directly from Hashem because only the Refuah that comes from Hashem is a Refuah LeOlam, a permanent Refuah, while the Refuah that comes from a Malach may allow the sickness to recur.  Accordingly, the V’Neirafeh is an intensification of our request that Hashem heal us--so that we have a Refuah LeOlam!

Finally, we note that we conclude the bracha with the words of request V’Rachaman Atta.  The Sefer Baruch Sheamar explains that the word Rachaman, as opposed to Rachum is a special indication of great Rachamim, and uses the phrase “Tamid Darko Lechach--this is Hashem’s way.”  So, not only is Hashem All-Capable of a complete and permanent Refuah, but He is a Rachaman--always mercifully ready to provide it!



We have thus far touched upon the first two phrases of the bracha:  Refaeinu Hashem V’Neirafei and Hoshieinu V’Nivasheia.  The next words continue “Ki Sehilaseinu Atta”--because our whole praise will be You.  We may suggest that with this phrase we mean to indicate that we will give Hashem heartfelt praise, we will demonstrate our Hakaras Hatov to Hashem, upon achieving our Refuah.  We thus affirm that we will not “forget about” the Shira that is due to Hashem, and that we will be sure to express our Hoda’ah after this tribulation is over with (as one does in a Seudas Hoda’ah, or other form or proclamation of Hakaras Hatov).  We then continue with the term V’Ha’alei Refuah Shleima L’Chol Makoseinu.  The word VeHa’alei--and raise up--not only indicates that we raise ourselves up as a result of the illness, but that we appreciate that in healing us Hashem will do something more than might otherwise happen in the ‘natural’ course of events.  Moreover, the Sefer Sifsei Chaim adds that this applies not only to particular illnesses, but LeChol Makoseinu--anything that a person feels that he has been smitten by--to all of our tzaros and difficulties which have affected us.  Here especially we specifically ask for a Refuah Sheleima--so that now that we have ‘risen’ to the occasion and we are hopeful that Hashem will provide the Refuah for the makka--it will once and for all be a Refuah Sheleima--a complete, final and ultimate healing.  Let us importantly attempt to take each precious phrase of this bracha to its inestimable power and potency!


The concluding statement of the Bracha is “Ki Kel Melech Rofei Ne’eman V’Rachaman Atta” with these words, we demonstrate that Hashem provides a Refuah as Kel (an All-Merciful One), as Melech (an All-Powerful One), and as a Rofei Ne’eman V’Rachaman (a Trustful and Merciful Healer).  The Sefer Baruch Sheamar notes that the terms Ne’eman and Rachaman from a human perspective would seem contradictory, for in most circumstances to be a trustworthy healer he must prescribe medications, regimens, or treatments which could costly, time consuming, painful, and perhaps c’v damaging in other areas.  On the other hand, one who is compassionate will not prescribe the full amount of bitter medication or difficult regimen, and accordingly may not bring about a full healing or recovery.  Hashem Yisborach, however, can bring His Middas HaRachamim (as we had previously noted the term Rachaman indicates intense Rachamim) to prevent Yesurei HaGuf while simultaneously still providing a complete, whole Refuah.  Thus, with Hashem, the two words Ne’eman and Rachaman can be read together and go hand-in-hand--and are in fact connected with a conjunctive ‘vav’!  We then conclude the bracha with the words Rofei Cholei Amo Yisroel, while the bracha of Asher Yatzar refers to Hashem’s healing of Chol Basar--everyone--all of His creations.  The specific reference to Amo Yisroel here, and not to all creatures, may refer to the special Hashgacha Pratis that we have in being healed over all the other nations of the world.  HaRav Schwab, Z’tl, adds that when Jews ask Hashem for healing, we ask not only for a Refuas HaGuf, a physical healing, but for a Refuas HaNefesh, a healing from our spiritual sicknesses as well.  Therefore we conclude the Bracha with thanks to Hashem for allowing and providing for both physical and spiritual healing!


Additional Note:  HaRav Schwab notes that in the final words of the bracha there is not comma after the word Cholei, and that the four words Rofei Cholei Amo Yisroel should be read together as one statement.



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This week we focus on the Eighth Bracha of Shemone Esrei--Refaeinu--heal us of our physical ills.  We have just completed asking Hashem to heal our spiritual ills with the Brachos of Hashiveinu and Selach Lanu.  Although our physical sickness arises from spiritual reasons (whether as a test, punishment or purification for the next world), we still must ask for a separate physical healing from Hashem--over and above our previous spiritual requests.  HaRav Chaim Kanievsky, Shlita, explains that there are particular times when yisurim leave a person (citing Avodah Zara 55A), and that the timing of their removal is affected by our zechuyos and tefillos.  The first phrase of our Bracha, Refaeinu Hashem VeNeirafei is based directly upon the Pasuk:  “Refaeini Hashem VeEirafei” (Yirmiyah 17:14).  HaRav Chaim notes that we repeat the term of VeNeirafei to remind ourselves that if Hashem Himself does not heal us--all of the doctors in the world cannot heal us, and nothing that they do can effect our complete Refuah without Hashem’s gifting it to us.  In each Tefillah, each and every one of us asks for Refaeinu--even if we may not feel sick at the moment--because: (a) we are davening for all of K’lal Yisroel; (b) we are davening that we not get sick; and (c) there is no one who does not have some kind of health issues--and all health issues--from the most minor and on--can be healed by Hashem and only by Hashem! 


The next phrase in the Bracha is “Hoshi’einu VeNivashe’ah--save us and we will be saved”.  How does salvation fit into the Bracha of Refaeinu?  We provide two approaches.  HaRav Chaim Friedlander, Z’tl, explains that, as we noted yesterday, one interpretation of Refaeinu Hashem VeNeirafei is that we ask Hashem to prevent us from becoming ill.  This is because the most chashuv of those involved in medicine search for ways and means for their patients not to get sick--preventive medicine; setting a person on the path of continued healthy living.  The second step, if needed, is Hoshi’einu VeNivashe’ah--if we c’v do become ill, please heal us from the illness--for only if You heal us will we be truly healed.  HaRav Schwab, Z’tl, in Rav Schwab on Prayer, provides a second perspective on Hoshi’einu VeNivashe’ah.  He writes that we ask Hashem with these words to save us from the non-physical or spiritual diseases of which we are aware:  Emotional disturbances such as fears, apprehensions, frustration and bitterness.  These illnesses are the result of one's lack of Bitachon in HaKadosh Baruch Hu.  If a person does not have Emunah in Hashgacha Pratis (that HaKadosh Baruch Hu knows him personally and watches over him) he can be beset with all kinds of fears and worries.  The cure for this disease is Emunah and Bitachon.  It is for this reason that we turn directly to HaKadosh Baruch Hu in this Tefillah of Hoshi’einu VeNivashe’ah--please help us bolster our Emunah and Bitachon.  If someone has true Bitachon, he will lose all his fears and apprehensions.  When one realizes that whatever happens to him is not an accident, but rather, the will of HaKadosh Baruch Hu, his fears and worries dissipate.  If he is convinced that HaKadosh Baruch Hu has a purpose for any difficulty that he may face, he will be totally accepting of it, as this is a part of the educational process that he must go through.  The Navi (Yeshayahu 33:14) declares in the Name of Hashem that only the sinners will tremble, but those who have Bitachon in HaKadosh Baruch Hu will not fear.  Reinforcing one's Emunah and Bitachon requires a great deal of help from HaKadosh Baruch Hu, and for this we are Mispallel: Just as Yirmiyahu HaNavi was Mispallel Refaeini Hashem VeEirafei Hoshi’einu VeIvashe’ah” (Yirmiyahu 17:14) for his own Refuas Hanefesh for known and unknown spiritual ailments--so too, do we, each and every member of Klal Yisroel, ask HaKadosh Baruch Hu to cure us of them!”



The next phrase in the Bracha is “Ki Sehilaseinu Atta--for You are our praise”.  The obvious question is:  “What does our praise have to do with our beseeching Hashem for Refuos?!”  Firstly, we note once again that the source for these words are Yirmiyahu HaNavi (17:14), who exclaims Refaeini Hashem VeEirafei Hoshi’einu VeIvashe’ah Ki Sehilasi Atta.  HaRav Chaim Kanievsky, Shlita, explains that we are asking for a Refuah--in order for us to sincerely praise Hashem.  Indeed, the Siddur Tefillah L’Moshe (which presents HaRav Kanievsky’s notes on Tefillah) brings a Midrash which states that one who desires to relate the praises of Hashem will be granted additional years of life.  HaRav Chaim Friedlander, Z’tl, expounds upon this theme from a slightly different perspective:  A classic question asked by many commentators is--how can one daven to be healed from illness as, after all, everything that Hashem does is for our good--and the illness has come as a punishment to expunge sin, or for some other meaning-filled purpose.  HaRav Friedlander brings the Sefer Nefesh HaChaim (II:11), in which HaRav Chaim Volozhiner, Z’tl, writes that the one who is ill is essentially, when praying for a Refuah in the most pristine form, davening that the Tza’ar HaShechina--the Tza’ar that Hashem feels when the human being feels pain, be relieved by the healing of the human being.  In a remarkable sense, then, the person is being mevater the illness which is best for him in order to relieve the Tza’ar HaShechina (see Sanhedrin 46A).  Why is the choleh then, in fact, healed?  It is because he feels the Tza’ar HaShechina to such a great extent--that the Kavod Shomayim which was impinged by his aveirah is now rectified.  Moreover, when people see that he is healed, they will recognize Hashem’s Chesed to him, and a Kiddush Hashem will result.  With this uplifting background in mind, we understand Ki Sehilaseinu Atta as--‘it is a praise to Hashem for all those around the ill person to raise their voices in song and thanks for the Chesed He does with the person who was ill.’  The Rabbeinu Yonah provides the following Mashal to better understand this:  A doctor sees someone who, because of his personal negligence, was critically injured, and severely reprimands the person for bringing himself to such a serious state.  The sick person responds--“You are very right, and I was very wrong--but you now have the opportunity to show everyone what an excellent doctor you really are.  Through my own fault, all will recognize your greatness and expertise.”  With the words Ki Sehilaseinu Atta, we humbly admit to Hashem that although we may have brought ourselves to a sorry state--all know that only You can bring a Refuah--and all will then recognize Your unparalleled greatness.  Please--from my past misdeeds--may there come out a Kiddush Shem Shomayim--causing those around me to praise You!




The next phrase in the Bracha is “VeHa’aleh Refuah Sheleima LeChol Makkoseinu--bring complete recovery for all of our ailments”.  HaRav Chaim Kanievsky, Shlita, notes that the word VeHa’aleh--and bring upon us, indicates that the Refuah is not being created now, but that it is already in existence, and now just has to be brought to its current location.  This is absolutely the case, he notes--for Hashem does not bring any makkah upon us unless He has already has a Refuah prepared.  Furthermore, HaRav Chaim notes, we ask here for a Refuah Sheleima--so that there is no aftermath or after-effects from the treatments or medication itself.  We also ask for a Refuah not only from sicknesses, but also from all makkos--which are the other things that can do us harm [as the Pasuk (Devarim 28:61) teaches, “Gam Kol Choli VeChol Makkah”].  We then implore Hashem to heal us as a ‘Melech Rofei Ne’eman V’Rachaman’--for a king must heal his subjects just as he must feed them--and in our case, moreover, Hashem is not only the King--but the expert Rofei as well, Who knows exactly how to heal us!  What is the meaning of the words ‘Ne’eman’?  HaRav Chaim Kanievsky teaches that it likely means that when Hashem heals, it is a healing that will last.  The term ‘V’Rachaman’ (Especially Merciful One) teaches us that Hashem can heal the sickness earlier than was expected and additionally that Hashem can arrange for one to experience less pain than what might have otherwise been ‘naturally’ anticipated.  The term ‘Ah-ta’ teaches us that despite Hashem’s Greatness as a Melech, Rofei, Ne’eman and Rachaman--we still have a personal and direct relationship with Him, and He allows us to refer to Him as ‘You’!


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