Sacred Nephrology in Parashat Tzav and The Power of Two

Tzav, Leviticus 6:1−8:36

D'Var Torah By: Cantor Jill Abramson

A dear friend of mine has a young adult son who needs a new kidney. He suffers from rapidly progressing kidney disease. Without a new kidney, he's facing a lifetime on dialysis -- a path familiar to far too many. The best option is finding a donated kidney.

Usually, kidneys come in pairs and human beings can live normal, healthy lives with one kidney as with two. As a result, some people make the choice to donate one of their kidneys to another person, so both may continue to live.

Our Torah portion, though in a very different context, mentions pairs of kidneys as well. This week we have arrived at Parashat Tzav, meaning "command," which is part of a series of parshiyot in Leviticus outlining the laws and procedures for different sacrifices. Tzav describes (among other sacrifices) a "guilt offering," which is made as reparation for a transgression. The guilt offering divides the offering into parts that are completely burned and "turned to smoke on the altar," and the rest is meant to feed the priests. (Lev 7:6) The parts "turned to smoke" and sacrificed to God included the kidneys.

"...The two kidneys and the fat that is on them at the loins; and the protuberance on the liver, which shall be removed with the kidneys. The priest shall turn them into smoke on the altar as an offering by fire to God; it is a reparation offering." (Lev 7:4)

In other words, some of the animal was meant to feed the priests and some was completely sacrificed and received by God. As such, we learn that the kidneys were part of a precious gift.

My friend's son needs a precious gift of a kidney. And when someone you love needs a kidney, (or donation of another organ for that matter ) there is no gift more precious. Sadly, among those who wait, people of color are disproportionately at risk for kidney failure. According to the National Kidney Foundation, Black Americans are almost 4 times more likely and Latinx people are 1.3 times more likely to have kidney failure compared to White Americans.

While modern medicine has taught us about the kidney's function, our rabbinic sages understood the kidneys in metaphorical terms. In the Talmud, (Berachot 61a) the rabbis describe the kidney's function as one of giving guidance. They explain that "a person has two kidneys, one of which counsels a person to do good, and the other counsels that person to do evil." In particular, the Talmud describes the kidneys as being the place where God gives humans wisdom (Rosh HaShanah 26a) and in the Midrash, we read that Abraham was taught the Torah by his kidneys (Bereishit Rabbah 61:1). Our sages apparently knew the importance of kidneys. Our kidneys counsel us towards good and evil. Our kidneys give us wisdom. Our kidneys teach us Torah. These holy texts about the fact that we have two kidneys remind us that our bodies are holy, that we can choose holiness at every crossroads.

Also compelling, is that when referring to animal sacrifice, the Torah is clear: an animal to be sacrificed is required to have two kidneys. Why is the Torah being so specific? Perhaps it is to teach us that if two kidneys are required, so too when it comes to human organ donation, the person who offers a kidney is required to have two kidneys.

Animal sacrifice in Parashat Tzav was an obligation. Making sure that the kidneys were turned into smoke and offered to God was a part of that obligation. Today, we are not obliged to sacrifice our kidneys. Jewish law would never require anyone to sacrifice their kidneys, because you shouldn't have to risk your own life to donate a kidney. But if you have two healthy kidneys, you don't have to risk your own life at all. If you have two kidneys, you can donate one of them. And rather than risking your own life, what you are doing is saving a life. What a mitzvah. Not an obligatory command, but a free-will offering.

I think of those who are waiting for organs or other life-saving or life-extending medical treatments. I'm mindful of those struggling through cycles of chemotherapy and other treatments, and I think about those with two kidneys who are considering the possibility of sacrificing one that another person might live. We think of the Psalmist who says, "From out of the depths I cry out to you." (Ps. 130: 1). So many are crying out from deep places waiting for life-sustaining gifts.

May all those who wait be blessed with strength and fortitude. May those who are care-givers be blessed with compassion, skill, and patience. May those who are considering giving the gift of life by giving up a kidney, find courage and conviction to do so. O Holy One of Wisdom, may those on all sides of this life-sustaining equation of organ donation, be blessed with the gift of life, karov b'yaimeinu, soon within our day. Amen.

Note from the Author: If you are considering kidney donation, please contact the Zweig Family Center for Living Donation at Mount Sinai Hospital in Manhattan (212-659-8024). The kidney need not be a match. It will go into a donor bank, allowing a loved one to receive a suitable kidney in exchange.

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