Yoma 83

The heart knows the bitterness of the soul.

Fasting is a core element of the Yom Kippur experience. While challenging at times, fasting contributes to the seriousness of the day and allows us to focus on our spiritual, rather than our physical, needs.

But as we saw yesterday on Yoma 82, there are circumstances where it’s not only permitted but obligatory to eat — particularly if a life is at stake. So how sick would you have to be in order to eat? Would you seek out advice? From friends and family? A rabbi?

The Talmud addressed this question in a mishnah that we read a few days ago:

If a person is ill and requires food due to potential danger, one feeds him according to the advice of medical experts who determine that he indeed requires food. And if there are no experts there, one feeds him according to his own instructions, until he says that he has eaten enough and needs no more.

Makes sense. If you are sick on Yom Kippur, you can eat if your doctor says you can. And if you are unable to consult with a medical professional, you can use your own discretion. Sounds like we are ready to move on to the next topic.

Not so fast. On today’s daf, the Gemara cites another source for us to consider: Rabbi Yannai teaches that if a sick person feels the need to eat, they can eat even if their doctor says it is OK for them to fast. Why? Because of the verse in Proverbs 14:10, which states: “the heart knows the bitterness of the soul.” That is, a person understands their own condition even better than a doctor.

Rabbi Yannai goes on to say that if a doctor says a person should eat and they choose not to, we feed the person anyway based upon the doctor’s advice. Why don’t we listen to the sick person in this case? Because illness clouds judgement, so we rely on medical advice and insist that the person eats.

For the Gemara, it’s problematic that Rabbi Yannai seems to be contradicting the mishnah by allowing a sick person to eat based on their own assessment even when doctors are present. So the Gemara suggests that the mishnah is talking about a case when a sick person wants to fast. In such circumstances, experts can overrule the patient and require that they eat. 

“But isn’t this obvious?” asks the Gemara. In matters of life and death we are lenient, so we don’t need the mishnah to teach us that a doctor can instruct someone to eat if they are sick on Yom Kippur.

So maybe the mishnah is talking about a case where a sick person wants to eat and its purpose is to teach that experts, when they are available, are required to make eating permissible. But this doesn’t sit well with the Gemara either, which cites an opinion that rejects this approach in even stronger terms than Rabbi Yannai:

Any instance where an ill person says: I need to eat, even if there are a hundred expert doctors who say that he does not need to eat, we listen to his own option and feed him, as it is stated: The heart knows the bitterness of its soul. (Proverbs 14:10)

This conversation emerges, in part, from the fact that the mishnah differentiates between cases when experts are present and when they are not, while Rabbi Yannai focuses on whether the sick person wants to eat or fast. The Talmud is trying here to square two sources that are speaking about related, but not identical, things. At the same time, the Talmud is motivated to codify into law that which the mishnah does not specifically allow — permission for a sick person to self-determine when they are too sick to fast.

In the end, the Talmud applies the first part of the mishnah to a case where the sick person wants to fast and the latter to a case where a sick person wants to eat. Doctors can intervene in the former, but the patient can determine the best course of action in the latter — no matter how many experts weigh in on the matter.

So if you are sick on Yom Kippur and feel the need to eat, don’t worry about what others say. You are free to do what you think is best. But if you choose to fast and a doctor instructs you otherwise, listen to your doctor.

Read all of Yoma 83 on Sefaria.

This piece originally appeared in a My Jewish Learning Daf Yomi email newsletter sent on July 3rd, 2021. If you are interested in receiving the newsletter, sign up here.

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