Based on Ahavas Chesed vol. 3 chapter 3

The mitzvah of bikkur cholim – visiting the sick – is another form of chesed for which one receives the profits in this world, while the principle is reserved for him in the Next World. Accordingly, our Sages have a lot to say about this mitzvah.

The gemara in Sotah (14a) discusses Deuteronomy 13:5, which tells us to follow God. How is this possible, they ask? After all, Deuteronomy 4:24 tells us that God is a consuming fire! The answer, we are told, is that it means to follow God metaphorically, by emulating His attributes. Just as He clothes the naked (Gen. 3:21), so should we; just as He visits the sick (Gen. 18:1), so should we; just as He consoles mourners (Gen. 25:11), so should we; and just as He buries the dead (Deut. 34:6), so should we.

Exodus 18:20 says, “teach them the way on which they should walk.” The gemara in Baba Metzia (30b) teaches that this refers to performing acts of chesed. As we have discussed, chesed can be performed with one’s money, but also with one’s actions. The gemara understands “the way on which they should walk” to refer to action-based forms of chesed, like visiting the sick and burying the dead.

There is no prescribed measure to the mitzvah of visiting the sick; it is fulfilled even by a great person visiting a regular person, even many times a day so long as it’s not an imposition on the patient. Friends and relatives should visit as soon as one falls ill, while acquaintances should wait three days. (This is done so as not to officially declare a person to be “sick” prematurely.) If a person falls truly sick suddenly, then anyone can visit right away.

The Shulchan Aruch (YD 335:8) rules that one should not visit someone who is suffering from intestinal distress, as this can be embarrassing. One should likewise not visit those suffering from pain in their eyes or heads, or anyone else for whom visitors would be difficult. In such cases, one should not impose upon the patient, but one should still visit the home in order to inquire about the person’s wellbeing and to see if there’s anything the visitor might be able to do to help out around the house.

When visiting a sick person, one should listen to him talk about his illness and then pray for his recovery. If one fails to pray for the patient, he has not properly fulfilled the mitzvah. Therefore, one shouldn’t visit patients early in the morning; since sick people are generally better then, the visitor won’t get a true idea of his condition, which will impair the quality of his prayer. For similar reasons, one shouldn’t visit at the very end of the day, as at that point the patient is often at his worst. This might mislead the visitor into thinking the patient is a “loss cause,” which would discourage him from praying. But if these are the only hours available for one to visit, then he should come at these times rather than not visit at all.

When praying for the patient’s recovery in his presence, one may do so in any language as the Shechinah (God’s “presence”) rests near the patient’s head. When doing so not in the patient’s presence, one should pray in Hebrew, which is the language of the ministering angels. In the latter case, he should specify that he is praying for the patient’s recovery among all the sick people of the Jewish community, which increases the chances of a favorable response. The text of the prayer when recited on Shabbos specifies that we don’t cry out on Shabbos but that we are confident that the patient’s recuperation is imminent.

The gemara (Nedarim 40b) teaches that the mitzvah of bikkur cholim saves one from the punishments of Gehinnom. This is derived from Tehillim 41:2: “Happy is the one who considers the needy; Hashem will save him on his day of trouble.” One who visits the sick is also rewarded in this world, as the next verse continues, “Hashem will protect him and preserve him, and he will be happy in the land” – “Hashem will protect him” from the yetzer hara, “and preserve him” despite afflictions, “and he will be happy in the land,” meaning that others will be honored through him.

Conversely, let’s discuss those who decline to visit the sick. The gemara (Nedarim 40a) details an incident in which one of Rabbi Akiva’s students fell ill. Rabbi Akiva showed his care for the patient, who credited his teacher for his recovery, but the other Rabbis neglected to visit him. Rabbi Akiva told them that those who fail to visit the sick are tantamount to murderers, since what they could provide might be exactly what the patient needs to pull through.

As in so many ways, this mitzvah is an area in which recent generations have become lax. This is especially true when it comes to visiting patients of lower social stations, a phenomenon that the Chofetz Chaim is at a loss to explain. While the mitzvah of bikkur cholim applies to everyone who falls ill, it’s probably even more important when it comes to needy people, because the perception that no one cares can only exacerbate the situation.

Consider the indigent patient: He can’t afford healthy food. He can’t afford proper medical care. In the winter, his apartment is poorly heated. He’s already in a precarious position. A kind word, a friendly face, an expression of concern could make the difference between the will to live and utter despondency. Regarding the eglah arufah ceremony performed when a murder victim is found, the gemara (Sotah 46b) explains that ignoring a person’s needs is equated with actively committing murder. This is certainly also the case when it comes to caring for a needy patient.

But if someone gives a sick person encouragement and keeps him from spiraling into depression, he deserves tremendous reward from Heaven! In such a case, one not only fulfills the mitzvah of visiting the sick, he is credited with saving a life. As the gemara in Baba Basra (9b) teaches, the reward for uplifting a person with words of encouragement is even greater than for assisting that person financially.

The Chofetz Chaim acknowledges that many communities have indeed formed bikkur cholim societies, a practice that he wishes were universal, as it can be truly life-saving. Neglecting the needs of poorer patients violates the prohibition against standing by idly while another person’s life is in danger (Leviticus 19:16). [In truth, bikkur cholim societies are probably more ubiquitous now than in the Chofetz Chaim’s day, a development that would no doubt please him.]

The Shulchan Aruch (YD 355:7) writes that a sick person is encouraged to get his affairs in orders – to repay his debts, etc. This is done after three days, unless the patient is particularly ill. In some communities, the practice is to have the patient recite Vidui (the confession of sins, which is a component of the repentance and atonement process). It is crucial, however, to inform the patient that this is the standard operating procedure for all sick people; in this way he won’t read too much into it and worry that death is necessarily imminent. The Chofetz Chaim urges that this approach be adopted everywhere.

Without the assurance that this is done for everyone as a matter of course, it would be better not to do so at all unless the patient actually is dying. Even then he should be assured that many people who recite Vidui don’t end up dying. The patient is not instructed to recite Vidui in front of people who might start to cry, as this will make things even harder for the patient. The patient is also advised to seek forgiveness from anyone he may have wronged, whether financially or verbally.

One who encourages a sick person to do teshuvah is fulfilling an angelic role in that he is sparing the patient the punishments he might otherwise endure in Gehinnom. Wise people will know to comfort the patient with their words, calming his mind by telling him that the Vidui and teshuvah might save his life. And even if they don’t, he will enter the Next World cleansed of his sins so that he might take his place in Gan Eden. If the patient is a wealthy person who didn’t properly fulfill his obligation in tzedakah, he should also be encouraged to commit to making up the deficit upon his recovery.

Get handy, colorful chesed "cheat sheets" in A Universe of Chesed!