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Mizmor 041 - In Praise of the Caregiver

(א) לַמְנַצֵּחַ מִזְמוֹר לְדָוִד: (ב) אַשְׁרֵי מַשְׂכִּיל אֶל דָּל בְּיוֹם רָעָה יְמַלְּטֵהוּ ה':
(1) For the musician, a mizmor by David. (2) Praises to the giver of understanding care to the invalid. On the day of evil, Hashem will save him.
NOTE: For a PDF of this mizmor, please click here. This will enable you to print out the entire text of the article. [Rev 6]
Key Concepts of Mizmor 041 - In Praise of the Caregiver
The mizmor is a tefillah in which David, who has been deathly ill, appeals to Hashem to heal him. David is especially concerned because his suffering has been aggravated by the people who came to visit him, ostensibly to comfort him. From their attitude it was evident to David that his visitors did not wish him well. On the contrary they really hated him and hoped to see him succumb to his illness.
The tefillah is structured as a song that is intended to be performed publicly. It is designed to teach the listeners the importance of loving care in the treatment of an invalid.
Navigating Tehillim. This mizmor calls to mind other mizmorim in which David prayed to be healed from illness. In Mizmor 006 he emphasized the harm caused by the ill-will of his enemies and yet he looked for the opportunity to forgive them. In Mizmor 038 he gives extra thought to how his own sins may have contributed to his illness. In the current mizmor David speaks of the important role the caregiver has in promoting recovery from illness.
Exploring the Mizmor
PART 1. THE CONSIDERATE CAREGIVER. David praises those who give understanding care to an invalid. The suffering individual will benefit from their sympathy and especially from their tefillos, if those tefillos are truly sincere.
(א) לַמְנַצֵּחַ מִזְמוֹר לְדָוִד: (ב) אַשְׁרֵי מַשְׂכִּיל אֶל דָּל בְּיוֹם רָעָה יְמַלְּטֵהוּ ה': (ג) ה' יִשְׁמְרֵהוּ וִיחַיֵּהוּ וְאֻשַּׁר בָּאָרֶץ וְאַל תִּתְּנֵהוּ בְּנֶפֶשׁ אֹיְבָיו: (ד) ה' יִסְעָדֶנּוּ עַל עֶרֶשׂ דְּוָי כָּל מִשְׁכָּבוֹ הָפַכְתָּ בְחָלְיוֹ:
(1) For the musician, a mizmor by David. (2) Praises to the giver of understanding care to the invalid. On the day of evil, Hashem will save him. (3) [The caregiver should pray] that Hashem will protect [the patient] and give him life [so that] he will be [once more] happy in the land and not give him over to the wishes of his enemies. (4) Hashem will sustain [the invalid] on his bed of suffering, [but it is] you the caregiver [who] have converted all his lying down in sickness [into kindness and comfort].
PART 2. PLEA TO BE HEALED. In the second part of the mizmor David turns to Hashem with his own tefillah for healing of body and soul. He expresses the bitterness he feels as a result of the hypocrisy of people who pretend to care for his well-being. He is waiting for the day when they will realize how wrong they have been in their attitude towards him.
(ה) אֲנִי אָמַרְתִּי ה' חָנֵּנִי רְפָאָה נַפְשִׁי כִּי חָטָאתִי לָךְ: (ו) אוֹיְבַי יֹאמְרוּ רַע לִי מָתַי יָמוּת וְאָבַד שְׁמוֹ: (ז) וְאִם בָּא לִרְאוֹת שָׁוְא יְדַבֵּר לִבּוֹ יִקְבָּץ אָוֶן לוֹ יֵצֵא לַחוּץ יְדַבֵּר: (ח) יַחַד עָלַי יִתְלַחֲשׁוּ כָּל שֹׂנְאָי עָלַי יַחְשְׁבוּ רָעָה לִי: (ט) דְּבַר בְּלִיַּעַל יָצוּק בּוֹ וַאֲשֶׁר שָׁכַב לֹא יוֹסִיף לָקוּם: (י) גַּם אִישׁ שְׁלוֹמִי אֲשֶׁר בָּטַחְתִּי בוֹ אוֹכֵל לַחְמִי הִגְדִּיל עָלַי עָקֵב: (יא) וְאַתָּה ה' חָנֵּנִי וַהֲקִימֵנִי וַאֲשַׁלְּמָה לָהֶם: (יב) בְּזֹאת יָדַעְתִּי כִּי חָפַצְתָּ בִּי כִּי לֹא יָרִיעַ אֹיְבִי עָלָי: (יג) וַאֲנִי בְּתֻמִּי תָּמַכְתָּ בִּי וַתַּצִּיבֵנִי לְפָנֶיךָ לְעוֹלָם:
(5) I said, “Hashem, have pity on me! Heal my soul for I have sinned against You!” (6) My enemies speak evil about me, ‘When will he die and his name perish?’ (7) And if [one] comes [to visit] he speaks falsely. His heart is [secretly] storing up [suspicions]. [He keeps the thoughts of] iniquity to himself, [but] when he leaves, he speaks [of them to others.] (8) All my enemies whisper together against me. [While whispering] against me, they are thinking up misfortunes for me. (9) [They whisper] ‘A serious crime is firmly attached to him. Now that he lies ill, he will not get up again.’ (10) Even my close friend, whom I trusted, who ate my bread, has raised his heel against me. (11) But You, Hashem, have pity on me and restore me [to good health] and [so] I will repay them. (12) With this [recovery] I will know that You are pleased with me. For then my enemy will not rejoice triumphantly over me. (13) But as for me, because of my integrity You supported me . You stood me upright before You for eternal life.
PART 3. FINAL BLESSING. David concludes the song with a blessing, which also serves as the conclusion to the entire first sefer of Tehillim.
(יד) בָּרוּךְ ה' אֱלֹקֵי יִשְׂרָאֵל מֵהָעוֹלָם וְעַד הָעוֹלָם אָמֵן וְאָמֵן:
(14) Blessed is Hashem, the G-d of Yisrael from [the beginning of] the World to the [Next] World, Amen and Amen.
Learning the Mizmor
PART 1. THE CONSIDERATE CAREGIVER.
(א) לַמְנַצֵּחַ מִזְמוֹר לְדָוִד:
This song has been prepared for the musician — לַמְנַצֵּחַ , who will perform it. It is a mizmor composed by David  מִזְמוֹר לְדָוִד .
(ב) אַשְׁרֵי מַשְׂכִּיל אֶל דָּל
I sing praises to the one who gives understanding care to the invalid — אַשְׁרֵי מַשְׂכִּיל אֶל דָּל .
בְּיוֹם רָעָה יְמַלְּטֵהוּ ה':
On the day of evil  בְּיוֹם רָעָה  when the patient’s condition is critical, the caregiver should console the patient, telling him that Hashem will surely save him  יְמַלְּטֵהוּ ה' .
(ג) ה' יִשְׁמְרֵהוּ וִיחַיֵּהוּ 
וְאֻשַּׁר בָּאָרֶץ
The caregiver should pray for the patient, asking that Hashem protect him from being overwhelmed by his illness — ה' יִשְׁמְרֵהוּ  and that He give him life — וִיחַיֵּהוּ  so that his recovery will be hastened. He should ask that Hashem restore the suffering person to good health so that he will be once more happy in the land — וְאֻשַּׁר בָּאָרֶץ  without any lingering aftereffects of his illness.
וְאַל תִּתְּנֵהוּ בְּנֶפֶשׁ אֹיְבָיו:
He should even appeal to Hashem to protect the invalid from those who hate him: Don’t give this weak man over to the wishes of his enemies  וְאַל תִּתְּנֵהוּ בְּנֶפֶשׁ אֹיְבָיו , who would be only too happy to see him die.
(ד) ה' יִסְעָדֶנּוּ עַל עֶרֶשׂ דְּוָי
Then surely Hashem will sustain him on his bed of suffering  ה' יִסְעָדֶנּוּ עַל עֶרֶשׂ דְּוָי .
כָּל מִשְׁכָּבוֹ הָפַכְתָּ בְחָלְיוֹ:
But it is you the caregiver who have converted all his lying down in sickness  כָּל מִשְׁכָּבוֹ הָפַכְתָּ בְחָלְיוֹ  into an experience of kindness and comfort.
PART 2. PLEA TO BE HEALED.
(ה) אֲנִי אָמַרְתִּי ה' חָנֵּנִי
As for me — אֲנִי , I have been sick but no one has come to comfort me. So I threw myself upon Hashem’s mercy and I said — אָמַרְתִּי Hashem, have pity on me! — ה' חָנֵּנִי  though I don’t deserve it.
רְפָאָה נַפְשִׁי כִּי חָטָאתִי לָךְ:
Heal my soul for I have sinned against You!’ — רְפָאָה נַפְשִׁי כִּי חָטָאתִי לָךְ . I know that once my soul is healed, my body will be healed as well.
(ו) אוֹיְבַי יֹאמְרוּ רַע לִי
Sadly, the pain that I am suffering is aggravated by those who come to visit me. They pretend to be my friends, but they are really my enemies  אוֹיְבַי  and they are happy to see me in trouble. Not only that, they speak evil about me  יֹאמְרוּ רַע לִי , the exact opposite of their assurances.
מָתַי יָמוּת וְאָבַד שְׁמוֹ:
In effect, they are saying, When will he die and his name perish?”  מָתַי יָמוּת וְאָבַד שְׁמוֹ . They hope my sickness will get worse and that I will soon die because of it. Not only that, they want my ideals and the memory of what I have stood for to perish with me.
(ז) וְאִם בָּא לִרְאוֹת 
שָׁוְא יְדַבֵּר
And if  וְאִם  one of my false friends comes to visit  בָּא , it is only to see — לִרְאוֹת  how bad off I am. He pretends to be distressed by my condition, but his pretense is obviously hypocritical and he speaks falsely — שָׁוְא יְדַבֵּר . Even if he goes through the motions of praying for my recovery, it is a false prayer, for he doesn’t mean it.
לִבּוֹ יִקְבָּץ אָוֶן לוֹ 
יֵצֵא לַחוּץ יְדַבֵּר:
But I can tell that while he is with me his heart is secretly storing up suspicions — לִבּוֹ יִקְבָּץ . He thinks that because of my sins I myself am to blame for my illness. However, he keeps these thoughts of iniquity to himself — אָוֶן לוֹ  for he would not speak of them in my presence. Yet when he leaves, he speaks of them — יֵצֵא לַחוּץ יְדַבֵּר  to my other false friends.
(ח) יַחַד עָלַי יִתְלַחֲשׁוּ כָּל שֹׂנְאָי
In fact, all my enemies — כָּל שֹׂנְאָי  whisper together against me — יַחַד עָלַי יִתְלַחֲשׁוּ . When they are out of earshot they tell each other that my condition is hopeless and I am not likely to survive.
עָלַי יַחְשְׁבוּ רָעָה לִי:
Even while whispering against me — עָלַי they are actually involved in thinking up  יַחְשְׁבוּ  new accusations and new misfortunes for me  -רָעָה לִי that they hope will bring me down.
(ט) דְּבַר בְּלִיַּעַל יָצוּק בּוֹ 
וַאֲשֶׁר שָׁכַב לֹא יוֹסִיף לָקוּם:
They whisper to each other: A serious crime — דְּבַר בְּלִיַּעַל  is firmly attached to him — יָצוּק בּוֹ  and he will have to suffer for his sin. Now that he lies ill — וַאֲשֶׁר שָׁכַב , he will not get up again — לֹא יוֹסִיף לָקוּם !”
(י) גַּם אִישׁ שְׁלוֹמִי אֲשֶׁר בָּטַחְתִּי בוֹ 
אוֹכֵל לַחְמִי הִגְדִּיל עָלַי עָקֵב:
Not only those who I knew hated me, but even the person who I thought was my close friend — גַּם אִישׁ שְׁלוֹמִי whom I trusted — אֲשֶׁר בָּטַחְתִּי בוֹ , the one who sat at my table and ate my bread — אוֹכֵל לַחְמִי , has betrayed me. Now that I am no longer able to be of value to him, he has become self-important and has raised his heel against me — הִגְדִּיל עָלַי עָקֵב  to trample me.
(יא) וְאַתָּה ה' חָנֵּנִי וַהֲקִימֵנִי 
וַאֲשַׁלְּמָה לָהֶם:
They are saying I will not get up again. But You, Hashem — וְאַתָּה ה' , I ask that You have pity on me and restore me — חָנֵּנִי וַהֲקִימֵנִי  to good health. They have spoken ill of me, but I will repay them — וַאֲשַׁלְּמָה לָהֶם  by showing them that they misjudged me.
(יב) בְּזֹאת יָדַעְתִּי כִּי חָפַצְתָּ בִּי
With this — בְּזֹאת  recovery I will have all the vengeance I need, for if my foe cannot triumph over me I will know — יָדַעְתִּי  that You are pleased with me — כִּי חָפַצְתָּ בִּי , and my enemy will realize it as well.
כִּי לֹא יָרִיעַ אֹיְבִי עָלָי:
For then my enemy will not be allowed to rejoice triumphantly over me — כִּי לֹא יָרִיעַ אֹיְבִי עָלָי .
(יג) וַאֲנִי בְּתֻמִּי תָּמַכְתָּ בִּי 
וַתַּצִּיבֵנִי לְפָנֶיךָ לְעוֹלָם:
But as for me — וַאֲנִי , surely it was because You saw my essential integrity — בְּתֻמִּי  that You supported me — תָּמַכְתָּ בִּי  and healed me when I fell ill. You have seen that in contrast to my deceitful enemies I have been truthful with all men. Accordingly, You stood me upright before You  וַתַּצִּיבֵנִי לְפָנֶיךָ  for eternal life — לְעוֹלָם .
PART 3. FINAL BLESSING.
(יד) בָּרוּךְ ה' אֱלֹקֵי יִשְׂרָאֵל 
מֵהָעוֹלָם וְעַד הָעוֹלָם אָמֵן וְאָמֵן:
Blessed is Hashem — בָּרוּךְ ה' , the G-d of Yisrael  אֱלֹקֵי יִשְׂרָאֵל , Who has enabled me to complete this first sefer of Tehillim. May His blessings flow to all our days from the beginning of the World to the Next World  מֵהָעוֹלָם וְעַד הָעוֹלָם , I now affirm this as true by saying Amen  אָמֵן  and I invite everyone who hears my words to say Amen  וְאָמֵן  with me!
Living the Mizmor
Listed below are some of the lessons that you can draw from this mizmor, as well as some of the thoughts you might have in mind when you say the words of the mizmor as a tefillah, expressing your devotion to Hashem.
Lessons for Life - Your Behavior.
[41:2] SENSITIVITY. – אַשְׁרֵי מַשְׂכִּיל אֶל דָּל – “Praises to the giver of understanding care to the invalid.” When you care for an invalid, you should be sensitive to his needs. This is a great mitzvah.
[41:2] – בְּיוֹם רָעָה יְמַלְּטֵהוּ ה' – “On the day of evil, [console the patient by telling him that surely] Hashem will save him.
[41:3] CONCERN. – ה' יִשְׁמְרֵהוּ וִיחַיֵּהוּ – “[Pray] that Hashem will protect [the patient] and give him life.” Show your concern for an invalid and help him by praying to Hashem for his recovery.
Tefillos for Life - Your Refuah.
[41:5] HEALING  ה' חָנֵּנִי רְפָאָה נַפְשִׁי כִּי חָטָאתִי לָךְ – “Hashem, have pity on me! Heal my soul for I have sinned against You!” When you ask Hashem to heal your illness, acknowledge your sins against Him. In that way you will demonstrate that the purpose of your suffering has been served and the time has come for healing.
Tehillos for Life - Contemplation of Hashem.
[41:14] BLESSED  בָּרוּךְ ה' אֱלֹקֵי יִשְׂרָאֵל מֵהָעוֹלָם וְעַד הָעוֹלָם אָמֵן וְאָמֵן – “Blessed is Hashem, the G-d of Yisrael from [the beginning of] the World to the [Next] World, Amen and Amen.” May Hashem’s blessings of kindness continue to flow throughout space and time.
Sources
The primary sources used in the interpretation of the verses of this mizmor are listed below.
א - המאירי, מאיר טוב
ב - רש"י, אבן עזרא, רד"ק, המאירי, רשר"ה
ג - אבן עזרא, בן־רמוך, אבן יחייא, נר לרגלי
ד - רד"ק, בן־רמוך,
ה - רש"י, רד"ק
ו - אבן עזרא, רד"ק, נר לרגלי, מאיר טוב
ז - רש"י, בן־רמוך, אלשיך, מאיר טוב
ח - רש"י, רד"ק, מאיר טוב
ט - רד"ק, המאירי
י - אבן עזרא, רד"ק, בן־רמוך, ספורנו, נר לרגלי
יא - רד"ק, רשר"ה
יב - רש"י, רשר"ה
יג - רד"ק, המאירי, מאיר טוב
יד - רד"ק, ספורנו, אבן יחייא, מאיר טוב