Simon Says, April 3, 2020

     This week’s Torah portion, Shemini, contains the episode when two of Aaron’s sons are killed by the God. The Torah portion begins with the details of the eighth day (the final day) of the ordination of the priests. The Torah painstakingly details the ritual including slaughtering the animals, putting blood on the altar, and Aaron’s blessing of the people. The ceremony ends when fire comes forth from God and consumes the last sacrifice, and the people prostrated themselves and shouted.

     Then (we don’t know how much time has passed), the older sons of Aaron, Nadav and Avihu, offer a sacrifice in some unexplained manner, and they get consumed by fire from God. The Torah doesn’t say where they erred; the Torah only says that they offered “alien fire” to God. Our sages have spent many lifetimes pondering what Nadav and Avihu did wrong, but there is a lesson applicable to the times that we are living through.

     In medicine, as in religion, attention to detail, attention to ritual, is very important. You can not today form a company that makes a compound of leaves the rhododendron plant and market it as a cure of breast cancer. The FDA only approves a drug after the drug has gone through clinical trials and proves its efficacy.

     This coronavirus pandemic is scaring us, and it well should. The coronavirus disease, covid-19, is more contagious than the common strains of the flu and more lethal, and there is no vaccine as of yet. (An aside: in the late 1700s, Edward Jenner used a solution of cowpox to inoculate people against smallpox, and he coined the word, “vaccine,” from the Latin word for cow, vacca.) The mortality rate in Spain and Italy is approaching ten per cent., and people around the world are desperate.

     The human body contains 30 to 40 trillion (that begins with a “T”) cells, and it is a wonder that anybody lives to be more three minutes old. Bill Bryson’s latest book, The Body, has a chapter on the immune system, and a layman would be forgiven if he (or she) thought that the immune system was so complicated that it didn’t work. It goes without saying that drugs to target a particular illness must be developed and tested before rushing out to administer them.

     Some malaria drugs, hydroxychloroquine and the closely related chloroquine (that’s a quote; I wouldn’t have a clue what the relationship is), were touted by the President as being a cure of covid-19, and the New York Times reported today (April 2) that the drugs look promising in treating covid-19, at least in small clinical trials. The Times reports today also that FDA approved “an experimental stem cell therapy derived from human placentas will begin early testing in patients with the coronavirus.”

     I am not a scientist, but we will need to profit from the lesson of Nadav and Avihu: in our hour of desperation, we need to follow ritual and attend to detail. Otherwise, the people that we want to help, will end up like Nadav and Avihu.