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illness as metaphor

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illness as metaphor

the prophetic wisdom of those outside the camp

Rabbi Danya Ruttenberg
Feb 13
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illness as metaphor

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This is Life as a Sacred Text, an expansive, loving, everybody-celebrating, nobody-diminished, justice-centered voyage into one of the world’s most ancient and holy books. We’re working our way through Leviticus these days. More about the project here, and to subscribe, go here.

Everyone who is born [able-bodied, and/or healthy] holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.

Susan Sontag, Illness as Metaphor

In Leviticus 13, we are introduced to a strange disease called tzaraat, the specifics of which cannot be mapped onto any diagnostic criteria that we have today. It’s often translated as “leprosy,” but is most certainly not Hansen’s Disease, the illness best known as leprosy in our modern lexicon. It could be translated as “eruption disease” or “scaly disease”— which is how we got the medical confusion. The Septuagint, the 3rd-2nd BCE Greek translation of the Hebrew Bible, translated tzaraat as “lepra,”— aka “rough” or “scaly” in Greek.

Tzaraat can be contracted by human beings, walls, stones or cloth.

It is regarded as highly contagious, that which can spread quickly if not contained.

Someone who has a skin eruption or irregularity that matches the Biblical description of tzaraat is required to go the kohen/priest for diagnosis. If there is uncertainty about their physical status, they are confined to the home for seven days, and then examined again. One who is diagnosed as a metzora (one with tzaraat) must observe a number of the rituals for mourners (rending clothes, bearing head, etc) and warn those in the community that they are afflicted by calling out, “Ritually unclean! Ritually unclean!”

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They must live “outside the camp” (Leviticus 13:46) until the tzaraat is confirmed by a kohen to be resolved and purification rituals are undertaken.

As the theologian Rabbi Dr. Rachel Adler has noted, the biblical conception of tzaraat included

“skin diseases such as eczema, psoriasis, and vitiligo, plus forms of fungus and mildew that attack stone or cloth. What all these conditions have in common…is that their wholeness is being compromised. They are being eaten into, decayed, caused to come apart… I would call tzaraat "disintegration disease."

To the ancient Israelite, the tzaraat sufferer must have looked as if he or she was decomposing while still walking around. That is the source of the stigma.

The word describing the ailment is nega, which is generally used to describe “plague,” with the connotation of “plague from God,” like how God describes sending plagues to Egypt in the Book of Exodus, or afflicting a different Pharaoh with plagues after the whole Avram/Sarai business.

Adler writes,

“Tzaraat is ancient Israel’s version of what I am going to call radical illness, illness that strikes at the root of our being in the world, ravaging our communities, filling witnesses with fear. Radical illness erodes the body and often the self. It takes us and unmakes us. Radical illness seems to us arbitrary; either we do not know how to cure it or why it struck, or we do not know how to contain its spread…. “

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Needless to say, much has been written in recent years on parallels between tzaraat and the COVID pandemic—what it means to rely on a community to self-report signs of illness and take steps to do what must be done to contain the spread; about self-quarantining when there are questions, the importance of self-disclosing a diagnosis to those who may be impacted, the lonely isolation of waiting until it is safe to return to the camp—and, for those who are high-risk, what it means when staying “outside the camp,” in some ways somewhat indefinitely, is safer than being in community.

brown and black abstract painting

Rabbi Elliot Kukla observes that the same language that is used to designate the metzora’s contagious exclusion from society reverberates in notable ways in Rabbinic texts. To be “outside the camp” is to be m’chutz lamachane. And, he notes,

In the Mishna, the earliest layer of Jewish oral law, we find an echo of the word chutz, outside, as a legal category. In the Mishna those who are chutz are excluded from performing certain mitzvot. For example, in Mishna Hagigah we read

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:

“All are expected by the Torah to bring an appearance offering [i.e. invited to bring a sacrifice to the Temple during pilgrimage holidays] chutz (except) for one who is d/Deaf, a shoteh

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, a minor, a tumtum (one without clearly defined sexual characteristics), an androgynos (one with both male and female sexual characteristics), women, enslaved people who have not been freed
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, those with physical impairments, one who is blind, old, and one who cannot walk up on foot.” (Mishnah Hagigah 1:1)

To me there is a rich resonance between the way the word chutz is used in the Bible in reference to [the metzora] being sent outside the camp, and in the Mishna in reference to those who are excluded from appearing at the Temple during pilgrimage holidays. Like [someone] with [a] horrible skin disease, those who are excluded from this rite are the ones we don’t want to see during our most public holy occasions.

Who don’t we want to see?

Who do we (“we” here being the Rabbis, being the voice of authoritative, defining Judaism—that is, structural power) leave behind?

Who is told to wait on the margins of the camp, or to stay behind on the sacred journey, until or unless they can conform to concepts of “regular” or “normal” or “safe”?

Disabled people, people who don’t fit the usual binary gender categories

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, women, youth, the elderly, and those who are the most explicitly oppressed. And, of course, those who are sick.

The ones we don’t want to see during our most public holy occasions.

Those who threaten the existing order, the existing power structures and systems—how much would be different if these people, and their needs—and gifts—were at the center.

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Kukla continues:

I see myself on this list of people who are excluded. As a gender-ambiguous transgender person, I identify with the tumtum, the person whose sexual characteristics are indeterminate. In my professional life I work as a rabbi at the Bay Area Jewish Healing center and serve people struggling with illness, grief and death, so I also see pretty much all of my clients on this list—the people I serve each day are mentally and physically ill, disabled, and aging. As someone with parents, lovers, community members and friends I also see most of my loved ones here, many of whom are old and many of whom live with chronic disability. And, finally, as a human being I see my future.

Throughout our lives most of us will cycle through illness and health; ability and disability—and all of us will age. We will grow lame and loose; we will lose bits of our memories, eyesight, hearing, skin cells, teeth and inches. I see all of us and all parts of us on this list of outsiders. We are the lepers.

Tzaraat may be a radical illness, as Adler writes—”striking at the root of our being in the world..tak[ing] us and unmak[ing] us.” But, Kukla notes, our being in the world was never a stable category in the first place.

We were, are, always on the precipice of being unmade, struck at our root, in some way or another.

To be sure, those who are able-bodied are only temporarily so, and do not know when, how, in what way that status will change. That is part of it.

But perhaps in a deeper way, we know that there are plagues that may strike arbitrarily, causing us to be simultaneously dead and not-yet-dead. (For, of course, the reason the one with tzaraat performs acts of mourning is that they are enacting their own death—they are a walking corpse, decomposing before the eyes of their neighbors.)

What is the wisdom that one gains through the process of rehearsing one’s own death?

What kinds of knowing are present among those who are m’chutz lamachane/outside the camp?

Those who are sent out from the spaces where norms are presumed, or were never brought in to the spaces of communal norms know things. Understand things. They see things from the margins that can’t be perceived from the center; they know what’s really happening while everyone else gone off on the pilgrimage.

Dominant power fears those who are unmade and remade—who remind them that there are other ways of being and doing—for all the reasons those with that power fear it in themselves.

If they can just keep the differences from spreading—the gender expansiveness, the demands for a world with more accommodations, the observations that the systems here harm more than they hurt—if we can force those people outside the camp, label them unclean, get them out of our sight, we can continue on as we have been.

They will do everything in their power to avoid being struck at the root, unmade. To hide all of the cracks and harm of this world, all of the ways our collective wholeness has already been compromised—eaten into, decayed, caused to come apart.


When God was trying to convince Moses to take up the prophet of Israel gig at the Burning Bush, and Moses was being unsure if he could handle the workload, God gave him a party trick:

“God said to him further, “Put your hand into your bosom.” He put his hand into his bosom; and when he took it out, his hand was mitzoraat like snow!” (Exodus 4:6)

Here, tzaraat is a symbol of prophecy.
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The final stage of purification at the end of tzaraat involves the same kind of anointing with oil, dabbing the same ridges of ear, thumbs, toes as took place with the ordination of kohanim/priests. There is an honoring, there. An elevation.

The Torah knows that bringing wisdom from the outside into the center is a momentous thing that must be honored appropriately.

That lifting up those who have been disenfranchised is a holy, holy act.

That the learnings and understandings from those who have been marginalized are critical to every way forward we may possibly have as a society.


We must not resist that moment of being unmade. We must understand that our times with tzaraat—whether we are visitors or more permanent citizens of the land of the chutz—are times of prophecy, times of understanding, times when, if we have not yet, we can begin to grasp on a deeper level what has been happening to the walls and the rugs in this place all along—times when we see what the system looks like and who is left behind.

They may be times of suffering, too. Not every affliction is skin-deep. Some eruptions hurt.

But if our own experiences being struck do not help us to understand the larger framework, to see what has been growing on the stones of our house all along, then perhaps we have missed the work entirely.




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Sending a big pile of blessings and goodness your way.

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Tameh! Tameh! Could also be translated as “ritually impure” (but that has a moralistic connotation that is problematic) or “everyday state.” We’ll get more into tumah soon, don’t worry.

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This translation of Mishnah Hagigah 1:1 includes some of my adaptations of the translation from the Kukla piece.

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This word is a Rabbinic slur that is applied to people with various types of disabilities, mental health conditions, and/or unusual behavior. Thank you to Rabbi Ruti Regan for the clarification on this point.

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In the ancient Jewish world, slavery was not what we think of with regards to the horrors of American chattel slavery, or other atrocities worldwide. Which is not to apologize for it—people were not given wages for their work, they were not free, it should not have existed and thank God it no longer exists. But just to note that many of the laws dictating treatment of those who were enslaved parallel those dictating the just treatment of hired workers. By the Exile—after the disastrous Bar Kochba revolt of 132-136 CE—the practice had basically died down and was eventually explicitly outlawed. (And yes, there were Jews involved in the unspeakable Transatlantic slave trade, particularly but not only in Brazil and Suriname, and this is a piece of our history our community must yet grapple with and take responsibility for. HOWEVER Jews were NOT disproportionately involved in the Transatlantic slave trade, nor the primary actors in it, and assertions to the contrary are antisemitic conspiracy theories.)

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Though you will note the presence, here, of two sex/gender categories that are not cisgender male or cisgender female—who, though exempt (like women!) from this mitzvah, continue to be regarded as part of the community and meriting consideration in Jewish legal taxonomies. The Rabbis also discussed the aylonit—someone who was assigned female at birth but did not develop female secondary sex characteristics at puberty, and saris hama—someone assigned male at birth but who does not develop male secondary sex characteristics at puberty. They also talk about the saris adam, who was assigned male at birth but whose sex characteristics change through human intervention. This is the book you want to get (or check out of the library) to go deep on this, and here’s a fabulous set of resources online.

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Notably, Miriam is also a prophet; she (but not her brother Aaron, who is not a prophet!) is struck with the same snowy tzaraat in Numbers 12. This parallel is pretty much never mentioned (that is, I’ve never heard it) while the Rabbis are intent on blaming gossipy women for their own suffering. Ahem.

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21 Comments
Tre Sheppard
Feb 13Liked by Rabbi Danya Ruttenberg

Just extraordinary. I’m so grateful for these words and thoughts... I found myself weeping as I read at my desk. Thank you Rabbi.

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Dennis Fischman
Feb 14

The haftarah for Parshat Tazria-Metzora supports your idea that being outside the camp is a source of special knowledge, and that it should be used for the benefit of the whole community. https://www.sefaria.org/II_Kings.7.4?lang=bi

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