Prayer book, shawl
Prayer book, shawlISTOCK

The young Israeli patient I visited in the isolation room at the Dana Farber Cancer Institute in Boston in the late 1970s was very ill. Ravages of the disease and its harsh treatment were clearly evident.

Diagnosed with a uniformly terminal disease, he had traveled to this renowned center in the Longwood Medical Area to be treated with a newly developed regimen of aggressive therapy. This world-famous academic hub is the medical campus where Harvard Medical School and many of its affiliated hospitals are all located. Major breakthroughs in medicine were developed here, including the first curative treatment of leukemia, the first kidney transplant, the first use of an electrical current to restore heart rhythm. It was here that creative man leaped forward with innovative advances that saved lives.

At the time I was a post-doctoral research fellow at Harvard Medical School. Our family resided several houses from the Rav’s daughter’s home where the Rav was living, and our Maimonides community was fortunate to be able to spend eight to ten hours with the Rav every weekend in prayer and in learning. The creative gesture so central to the Rav’s philosophy of halakhic man is a prime characteristic of biomedical research, and my oscillation between the universe of cutting edge biomedical research and the world of Torah learning with the Rav, while worlds apart, was harmonious. With the Rav often expressing curiosity about aspects of my research, I began to intuit that the work might not be merely creative but in fact a religious gesture.

A central theme in the Rav’s weltanschauung is his emphasis on halakhic man’s creative gesture. Ish haHalakhah’s mission and continuous challenge are to heal and repair a purposely flawed world, for in the creation process a modicum of chaos was formed prior to the world’s creation and deliberately injected into both organic and inorganic matter, including into man himself.[1]

“Man himself symbolizes, on the one hand, the most perfect and complete type of existence, the image of God, and, on the other hand, the most terrible chaos and void to reign over creation.”[2] In order to enable man to cope with his inexorable chaos and sin, the tool of repentance was also created prior to the world’s formation (Pesahim 54a).

In a reference to creative introspection in “Eight Chapters,” Maimonides states: “The perfect man needs to inspect his moral habits, weigh his actions, and reflect upon the state of his soul every single day. Whenever he sees his soul inkling toward one of the extremes, he should rush to cure it and not let the evil state become established” (chap. 4).

Max Scheler, an early proponent of positive creative repentance, points out that modern philosophy, on the other hand, sees in retrospection and repentance mostly a negative, superfluous, “uneconomical” act due to disharmony of the mind and ascribed to lack of thought, sickness or various illusions..[3]

Emulating Maimonides, the Rav emphasizes an essential continuous remodeling, a re-creation of the sinner’s self as being a healthy, critically indispensable creative process. “Halakhic man is engaged in self-creation, in creating a new ‘I.’ He does not regret an irretrievably lost past but a past still in existence, one that stretches into and interpenetrates with the present and the future.”[4]

The Rav’s perspective on repentance is related to Scheler’s definition of creative repentance and to Henri Bergson’s distinction between subjective, qualitative time-perception versus chronos, quantitative objective time. Both Scheler and Bergson ascribe to the principle of memory and experiential plasticity. The concept of plasticity, the property of being easily molded and remolded, has received intense scientific attention in the last decade, especially as related to the field of memory and neuroscience.

The presumed inability of the brain to generate new cells or to establish new neural networks is currently vigorously challenged and has indeed been proven incorrect. The process by which man can modify imprinted memories to affect his present and future behavior pattern is currently under scientific investigation. Epigenetic biochemical modifications of DNA and changes in neural networks triggered by ongoing experiences have been documented to alter both content and intensity of memories. The association between past triggering stimuli and the resurfacing of memories and behavior patterns has been shown to be moldable utilizing imaging and histological techniques. Previous memories can be reinforced, intensified, modified, or completely erased.

We no longer look at our genetic makeup and the mature brain as a fixed template that predicts our phenotype, and no longer are our memories an unalterable code. Rather, increasingly, biochemical data support the idea that they are templates upon which environmental and emotional stimuli can impact. Biochemical changes in the brain triggered by environmental and behavioral patterns were identified in identical twins raised in different environments. Scientists have defined conditions in which terminally differentiated cells, such as mature skin cells, which we assumed could never return to their embryonic pluripotent stem-cell status, have in fact definitively reverted and reprogrammed to evolve into new cell types. Recent reports have described the astonishing generation of live mice from skin cells reengineered to be ova.

If cells can revert to their embryonic state, if gene expression can be reprogrammed, if the brain can generate new nerve cells and establish new neural networks, the view of repentant man as a biologically defined new self is viable.

David Anderson from the California Institute of Technology describes a fascinating neuro-anatomical observation. The center in the brain that orchestrates emotion is the amygdala. It communicates with the hypothalamus, which houses the cells that control instinctive behavior like parenting, feeding, mating, fear, and fighting. Anderson found that a nucleus of cells within the hypothalamus contain two distinct populations of neurons: one that regulates aggression and one that regulates mating. About 20 percent of the cells in this nucleus are active both during mating activity and during aggressive behavior, which suggests that these two circuits are linked. How does the brain regulate these mutually exclusive behavior patterns? Anderson found that depending on the specific stimuli applied to this area it can trigger either mating activity or aggression.

Perhaps creating a new self through “repentance from love” (On Repentance, pp. 163) is associated with using mechanisms previously utilized for aggression and fear for productive activity such as love and fertility. A similar idea is found in the Babylonian Talmud (Shabbat 156a): “He who is born under Mars will be a shedder of blood. Rabbi Ashi said: Either a surgeon, a thief, a slaughterer, or a circumciser.” Through biochemical processes induced by the intense experiences of the teshuvah process – confession, sacrifice, remorse, shame and a commitment to a new I – a new self can emerge.

* * *


A decade after I visited the seriously ill young man at the Dana Farber Cancer Institute, the facility where chaos reigns and where creative man is faced with overwhelming challenges, I attended a scientific conference in Tiberias, burial place of Maimonides. I learned that a daily minyan was available at a nearby archeological site of an ancient synagogue on the shores of the magnificent Sea of Galilee. I was welcomed by a group of yeshiva students from Bnei Brak who had been coming weekly to maintain a minyan at this historical site.

Following services I was approached by a bearded man, who inquired: “Are you Dr. Goldberg?”

Since I had never practiced medicine in Israel I was surprised to be addressed as a physician.

“Do you remember me?” he asked. “I am that patient you visited at the Dana Farber so many years ago. I am healthy, married and have several children.”

“The Prophets and the Torah as well recognized a strong connection between sin and illness on the one hand and between repentance and healing on the other” (On Repentance, p. 80).

Through the creative gesture both the body and the spirit can be remodeled and healed.

Notes:

1. See Rabbi Joseph B. Soloveitchik, Halakhic Man (Philadelphia, 1983), p. 102.

2. Halakhic Man, p. 109.

3. Max Scheler, On the Eternal in Man (New Brunswick, NJ, 2010), p. 36.

4. Halakhic Man, p. 113.

Prof. Itzhak D. Goldberg is professor of clinical radiation oncology at the Albert Einstein College of Medicine and the chairman of Angion Biomedica Corporation. This article was first posted in 2019..