In refa-einu we say: Refa-einu Hashem veneirafei hoshi-einu venivashe-a ki sehilaseinu otoh. Ostensibly, why is the phrase ki-sehilaseinu otoh inserted here? It doesn’t appear in any of the other bakashos! And what does it mean; what is its impact?
But actually, there seems to be a prior question. Why do we say veneirafei and venivashe-a? Why not simply refa-einu and hoshi-einu? (It strikes one as tautologous.) I think that refa-einu...veneirafei means that G-d should heal us (our afflictions); and when He does, we will actually be healed. There are two things: experiencing a cure and emerging cured. Some instances of administering medication (therapy) have (or may have) an initial beneficial impact, yet don’t endure, or don’t fully restore the patient to his erstwhile health. To have this latter happen is to transcend the curative phase itself. It is to have the cure be established/instated, such that the patient is not (is no longer) subject to relapse or is not in imminent danger. A vital transformation of the condition has occurred. When we say refa-einu Hashem veneirafei, we ask that He heal us and we thereupon proclaim that the cure that He will have effected in us will be confirmed as a lasting and state-changing (veneirafei) event. It won’t remain an effectless cause (in a manner of speaking). It will be a consummate restoration. And because it will, we have cause to praise Him – ki sehilaseinu otoh. (Or perhaps we should put in the reverse: We have cause to praise Him; therefore, it will last.)
Let’s reflect for a moment on asking for refu-a. A contrast with the other bakashos is discernable. In chaneinu we ask the receive a hashpo-a, an influence, of da-as. In hashiveinu, we ask to have our repentance accepted (see preceding post). In other words, we ask that acceptance be forthcoming. In selach lanu, we ask to receive forgiveness. And in re-ei ve-anyeinu we seek an effusion, or an infusion, of protection and redemption. But what do we seek in refa-einu? Seemingly something different. Removal. Removal of symptoms. Removal of damage, injury, trauma, decay, or the causes of symptoms. Removal isn’t an influential phenomenon. It is not a positive force. On the contrary, it implies reversal and undoing of something already obtaining: an existing condition. Suppose it occurs. What is the impact? It might be momentary, fleeting, ephemeral, and local in its reach. Insofar forth, its impact is severely limited. Its incidence alone does not guarantee lasting restoration. Therein lies the praiseworthiness of Hashem’s salvation. Let Him administer the cure, and it proves transforming. It doesn’t merely treat a disturbance; it is nurturing and life-extending. It isn’t superficial; it is root-apprehending. It doesn’t stop at the surface; it is all-pervasive and deeply penetrating. It is, indeed, life-infusing.
So we ask: Heal us O L-rd. When You have done this, we will have been cured – not superficially but systemically. You will have gone beyond treating the symptom to restoring our health: reverting us to our pre-afflictive condition. This can only be, because You are the One to Whom we owe praise. For You continually bestow kindness upon us.