ASHER YATZAR: A BLESSING FOR EVERY BODY

Rus Devorah (Darcy) Wallen, LCSW, CIMHP

The Zohar on Parshas Vayishlach teaches that a person is obligated to praise Hashem and give thanks for miracles and kindnesses He has shown us. But perhaps one of the great spiritual problems of being human is that we tend to reserve the word “miracle” for occasions involving splitting seas, dramatic rescues, and events that would make excellent movie trailers. Meanwhile, astonishing things are happening inside us every second, with absolutely no soundtrack.

Your heart contracts. Your kidneys filter. Your lungs exchange gases. Blood finds its way through tens of thousands of miles of vessels. Nutrients move in, waste products move out, electrolytes are regulated, temperature is adjusted, blood pressure is continually modulated, oxygen reaches tissue, carbon dioxide leaves it, and billions upon billions of cells somehow participate in the exquisitely choreographed business we casually call “being alive.”

And most mornings we wake up and say, “Where’s my coffee?” Judaism, however, has been trying to interrupt that magnificent obliviousness for thousands of years. Rabbi Meir teaches in Menachos 43b that a person is obligated to recite one hundred blessings every day, deriving this from the verse, “And now, Israel, what, mah, does Hashem your God ask of you?” (Devarim 10:12). Chazal read mah creatively as me’ah, one hundred. One hundred daily interruptions from our automatic pilot. One hundred little bells ringing through consciousness saying: Notice this. Notice this, too. And this. I don’t think of a brocha merely as saying “Thank You” one hundred times. A brocha trains perception. It is spiritual attentional retraining, a Torah form of mindful awareness.

Psychology has spent considerable time in recent decades rediscovering what Torah has embedded into ordinary Jewish life for millennia: attention changes experience. What we repeatedly notice becomes more cognitively available. Gratitude practices can increase awareness of positive experiences that were already occurring but had slipped beneath the brain’s threshold of significance. The blessing does not manufacture the gift. It helps us stop missing it. Gratitude appears to engage networks involved in attention, valuation, emotion, and reward, gradually making the good more available to perception rather than merely waiting for something dramatic enough to seize our attention.

Ben Zoma gives us a marvelous version of this idea in Brochos 58a. He considers a simple piece of bread and marvels at how much labor the first man, Adam HaRishon, would have needed before he could eat it: plowing, planting, harvesting, threshing, winnowing, grinding, sifting, kneading, baking. Ben Zoma observes that he simply awakens and finds all of this labor already performed for him. To remain open, mindfully present, continuously grateful, I tell my clients: “Track it back!” Pick something almost insultingly ordinary. Your cup of coffee. Track it back. Who purchased it? Who stocked the grocery-store shelf? Who drove the truck? Who loaded the truck? Who packaged the beans? Who roasted them? Who harvested them? What soil grew the coffee plant? What rain fell there? Who built the machinery? Who manufactured the cup? And we haven’t even gotten to the milk or sweetener yet. Keep tracking it back and eventually the ordinary collapses under the sheer weight of how extraordinary it actually is.

And then there is Asher Yatzar. Of all the blessings Chazal could have created, they gave us a brocha for going to the bathroom? There is something so Jewish about this. We do not require stained-glass windows, mountaintops, or celestial music before something becomes holy. We can meet Hashem right after the restroom. The Gemara in Brochos 60b records the blessing of Asher Yatzar after relieving oneself, and the Shulchan Aruch devotes unusual attention to explaining its meaning.

“Blessed are You, Hashem, our God, King of the universe, Who formed the human being with wisdom and created within him many openings and many cavities. It is revealed and known before Your Throne of Glory that if one of them were to be ruptured or one of them blocked, it would be impossible to survive and stand before You. Blessed are You, Hashem, Who heals all flesh and acts wondrously.”

Reading it slowly, it speaks of openings that must remain open, structures that must remain closed, hollow spaces, channels, containment and boundaries, flow, pressure, elimination. The whole organism depends not merely upon possessing the right parts, but upon those parts maintaining relationships with one another within very narrow physiological tolerances. That is homeostasis, one of the central principles of physiology. Life is not static stability. It is continual, exquisitely regulated adjustment.

Your kidneys alone contain roughly a million filtering units in each organ, continually participating in the regulation of fluid volume, electrolytes, acid-base balance, and waste removal. The urinary system is constantly maintaining remarkably sophisticated conditions compatible with life while you are busy wondering whether somebody responded to your recent text

The Alter Rebbe makes the idea even more startling. In Shulchan Aruch HaRav, Orach Chaim 7:4, the first Lubavitcher Rebbe’s Code of Jewish Law, he writes that there is no minimum amount requiring Asher Yatzar: even after passing a single drop of urine, one makes the blessing. Why? Because if the opening were unable to release even that drop, the obstruction itself could cause distress, and therefore one is obligated to give thanks. One drop. Torah is teaching us to reduce the threshold at which we notice a miracle. The morning after my “Stroke of Good Fortune,” I understood this blessing differently. I had experienced a CVA on Shavuos morning in 2017. The first night in the hospital was noisy, uncomfortable, and frankly rather hellish, far from anything one might romantically imagine a “healing environment” to be. The loud nurses on the unit taught me a linguini recipe post-midnight. But morning came.

And I was alive. I needed, somehow, to get back to me. I asked whether I could stand up and wash. There was no shower in the Neuro IC Unit because most patients there simply could not get out of their beds to do so. So, I asked for privacy. I took care of myself as best I could. Then I washed in the way a Jew washes in the morning, with a cup and alternate pourings on each hand three times, and I began saying my morning brochos (blessings). When I reached Asher Yatzar, the second blessing, I sobbed. Not delicate tears, intensely, overwhelmingly, uncontrollable tears…Because suddenly the words were no longer liturgy. They had become an integration of my Torah perspective, my own physiology, anatomy and future imagery. The words reverberated…“If one of them were to be blocked…” Blocked!

I had just experienced what happens when blood supply to part of the brain is interrupted. In an ischemic stroke, a clot or other obstruction blocks blood flow through a cerebral vessel. In a hemorrhagic stroke, a blood vessel leaks or ruptures. In either case, brain tissue can be injured because its exquisitely regulated vascular environment has been disrupted. I am not suggesting that Chazal were writing a neurology textbook or that the anatomical language of Asher Yatzar was specifically referring to cerebral vasculature. Probably not. But standing there the morning after a stroke, the physiological resonance was almost overwhelming.
Blocked. Ruptured. Unable to stand before You. I was standing. That word alone became a prayer.

And suddenly I was reminded of the story Dr. Kenneth M. Prager, a physician at Columbia, wrote so movingly about Asher Yatzar. As a yeshiva child, he remembered finding the bathroom blessing almost comically incongruous. Only years later, in medical school, did pathophysiology teach him how much must go right for an ordinary trip to the bathroom to remain ordinary. After caring for patients whose lives revolved around dialysis machines, colostomies, and urinary catheters, he began reciting Asher Yatzar himself with new sincerity. He eventually came to understand the blessing as gratitude not merely for elimination, but for overall health, noting that its language refers broadly to the catastrophic consequences of bodily structures becoming blocked or ruptured. In one especially poignant case, he watched a young man (Josh) with a severe cervical spinal cord injury gradually regain function and, unexpectedly, regain the ability to urinate without catheterization. Prager suggested that the young man recite Asher Yatzar. He did. Prager wept. Only afterward does he reveal the final detail, Josh is my son. “Physicians especially, who are exposed daily to the ravages that illness can wreak, must sometimes feel the need to express thanks for being well.”

Perhaps Asher Yatzar asks us to recognize another category entirely: the miracle of the possible continuing to happen. We cannot take anything “natural” for granted. There is another beautiful layer in the very last words, Rofei chol bosor umaf’li la’asos, “Who heals all flesh and acts wondrously.” The Rema, in Orach Chaim 6:1, explains the “wonder” as the mysterious joining together of body and soul, physical matter and neshama. These two utterly different dimensions somehow inhabit one human being and function as one living person. That interpretation moves me tremendously.

B’CHOCHMAH: THE WISDOM WITHIN THE BODY

After my stroke, there was one word in Asher Yatzar that took on an entirely new meaning for me: b’chochmah, “with wisdom.” “Asher yatzar es ha’adam b’chochmah,” Hashem formed the human being with wisdom. I began thinking that there may be several ways to hear those words. The first is perhaps the most obvious: Hashem, in His infinite wisdom, created the human being. The chochmah belongs to the Creator. Indeed, the Shulchan Aruch describes the creation of the human body as a “wondrous wisdom,” and Tosafos points to the extraordinary Divine foresight involved in preparing Adam’s sustenance before creating him. A second interpretation goes in another direction: the human being himself was created with chochmah. The Maharsha, commenting on Brochos 60b, understands the phrase as telling us that Adam himself was endowed with wisdom. Human beings do not merely exist; we can understand, discern, anticipate, choose, create, and reflect upon the One who created us.

But after my stroke, I began hearing a third possibility in those words. This is my own little chidush (novel approach): perhaps the body itself was created with chochmah. Adam comes from adamah, earth. The earthly, physical human organism is not simply inert matter waiting for the conscious mind to tell it what to do. Hashem placed extraordinary regulatory and restorative capacities within the flesh itself. The body “knows,” not consciously, of course, but biologically, how to move toward equilibrium, protection, repair, and survival. Cut the skin and an elaborate sequence of clotting, inflammation, tissue formation, and remodeling begins without our issuing a single instruction. Blood pressure shifts when we stand. Body temperature is continually regulated. Blood glucose, oxygen, carbon dioxide, electrolytes, pH, fluid balance, and thousands of other variables are continually monitored and adjusted. The immune system detects threats. Bones remodel under stress. Neural networks can reorganize after injury. Following a stroke, surviving regions and networks of the nervous system can participate in neuroplastic changes that allow functions to be relearned, compensated for, or reorganized. We do not consciously conduct this orchestra. We can support it, challenge it, nourish it, rehabilitate it, or unfortunately interfere with it, but the capacity for adaptation is already written into the organism.

Science calls much of this homeostasis, repair, adaptation, immune regulation, and neuroplasticity. I hear another word beneath all of them: chochmah. Not magic, and certainly not an unlimited capacity for self-healing. Bodies can become ill, regulatory systems can malfunction, inflammation can become chronic, repair mechanisms can fail, and some damage cannot be reversed. Torah does not require us to romanticize biology. On the contrary, the very existence of medicine recognizes our obligation to assist the body when its own capacities are insufficient. But medicine itself continually reveals how much of healing consists not of replacing the body’s wisdom, but of creating conditions in which that wisdom can operate: restoring blood flow, stabilizing chemistry, removing infection, supporting damaged tissue, providing rehabilitation, nourishment, movement, sleep, and time.

That is what began to strike me after my stroke. My brain had been injured, but almost immediately my body was also trying to survive the injury, stabilize itself, reorganize, compensate, and heal. Rehabilitation was not something being imposed upon a passive piece of flesh. It was a collaboration with capacities Hashem had already placed inside the organism. So perhaps b’chochmah can be heard on three levels. Hashem is wise. Hashem created the human being capable of wisdom. And Hashem created the body itself as an embodiment of wisdom, carrying within it systems that continually bend toward life.

The Abudraham’s beautiful commentary on Asher Yatzar almost seems to stand at the doorway of this idea. He walks through the structures of the human body with astonishing detail, considering the eyes, ears, nostrils, mouth, teeth, tongue, esophagus, windpipe, lungs, heart, stomach, liver, intestines, kidneys, spleen, bones, muscles, blood vessels, joints, skin, brain, hands, legs, and more, describing how each serves the preservation and functioning of the human being. To me, modern physiology makes that ancient observation even more breathtaking. We now see molecular, cellular, vascular, neurological, and biochemical details that the earlier commentators could never have observed, yet the deeper astonishment remains exactly the same.

Asher yatzar es ha’adam b’chochmah. Perhaps the chochmah is not merely in how the body was made. Perhaps some of the chochmah is still happening. Because after my stroke I was not merely interested in getting a neurological system to function better. I wanted to get back to me. The body is not transportation equipment for the “real” person. Torah does not treat embodiment as some embarrassing inconvenience we endure while waiting to become spiritual. We serve Hashem with bodies. We hug with bodies. We dance with bodies. We comfort people with voices generated by lungs, vocal cords, and exquisitely coordinated cranial nerves. We make Shabbos with hands. We learn Torah with brains. We give tzedakah with fingers. We kiss children. We make soup for somebody who is sick. The neshama needs a guf in order to place love into circulation.

That, according to the Rema, is itself part of the peleh, the wonder. Perhaps this is also why the Alter Rebbe explains that although the original Talmudic obligation of Asher Yatzar follows relieving oneself, it became customary to say it every morning because each day a person becomes, in a sense, a newly created being.
A newly created being. That one lands differently after a stroke. Every morning since then has been, in some sense, rehabilitation. Not simply rehabilitation of muscle, movement, or neurological pathways, but rehabilitation of perception. To notice. To track it back. To refuse to let familiarity anesthetize wonder.

Today I am about one hundred pounds, yes, 100 lbs., lighter than I was at the time of my stroke, and in many ways healthier, stronger, and happier. However, I would certainly never prescribe a stroke as a wellness intervention. The side-effect profile is atrocious. But I remain profoundly grateful for what I have come to call “My Stroke of Good Fortune,” because it forced me into an encounter with truths I had known intellectually but had never known in my bones. Or my arteries. Or my neurons.

Asher Yatzar has become, for me, much more than a bathroom blessing. It is a blessing about dependence and resilience, vulnerability and wonder. It reminds us that health is not one thing. It is millions of tiny processes cooperating quietly enough that we usually never hear them. Until one of them stops. Maybe the spiritual practice is not to wait until then. Maybe we learn to hear the orchestra while it is still playing. One hundred brochos a day. One cup of coffee tracked backward. One drop that can leave the body. One alveolus exchanging oxygen and carbon dioxide exactly as it was designed to do.

One morning when we open our eyes and discover that body and soul have somehow agreed, once again, to spend another day together. “Boruch Atah Hashem, Rofei chol basar u’Maf’li la’asos. Blessed are You, Hashem, the Healer of all flesh, Who does wondrous things.” And really, if we are paying attention, wondrous is hardly a strong enough word. For more details about “My Stroke of Good Fortune,” Shavuos 2017.

REFERENCES
Abudraham, D. (14th century). Abudraham: Weekday prayers, morning blessings (sec. 10). Discussion and detailed description of the structures and functions of the human body in connection with Asher Yatzar.
Aderinto, N., AbdulBasit, M. O., Olatunji, G., & Adejumo, T. (2023). Exploring the transformative influence of neuroplasticity on stroke rehabilitation: A narrative review of current evidence. Annals of Medicine & Surgery, 85(9), 4425–4432. https://doi.org/10.1097/MS9.0000000000001137
Babylonian Talmud. (n.d.). Berachot 58a. Ben Zoma’s reflection on the many stages of labor required to produce bread and other necessities of life.
Babylonian Talmud. (n.d.). Berachot 60b. The text and institution of the Asher Yatzar blessing.
Babylonian Talmud. (n.d.). Menachot 43b. Rabbi Meir’s teaching that a person should recite one hundred blessings each day, based on the homiletic reading of mah as me’ah.
Centers for Disease Control and Prevention. (2024, October 24). About stroke. U.S. Department of Health and Human Services.
Deuteronomy 10:12–13. The biblical source used in Menachot 43b for the teaching concerning one hundred daily blessings.
Eidels, S. E. [Maharsha]. (17th century). Chiddushei Aggadot on Berachot 60b. Commentary on the phrase asher yatzar es ha’adam b’chochmah.
Fowler, S., Roush, R., & Wise, J. (2013). Concepts of biology. OpenStax. See Section 16.1, “Homeostasis and Osmoregulation.”
Isserles, M. [Rema]. (16th century). Gloss to Shulchan Aruch, Orach Chaim 6:1. Explanation of umafli la’asot, “Who acts wondrously,” as referring to the wondrous union of the physical body and spiritual soul.
Karo, Y. (1565). Shulchan Aruch, Orach Chaim 6:1. Discussion of the wording and meaning of the Asher Yatzar blessing, including the wisdom embodied in human creation and the openings and cavities of the body.
National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Your kidneys & how they work. National Institutes of Health.
Prager, K. M. (1997). For everything a blessing. JAMA, 277(20), 1589. https://doi.org/10.1001/jama.1997.03540440023012
Schneur Zalman of Liadi. (n.d.). Shulchan Aruch HaRav, Orach Chaim 6:1; 7:4. Discussion of Asher Yatzar as a morning acknowledgment that a person has become, in a sense, a newly created being, and the requirement to recite the blessing even after passing a minimal amount of urine.
Wood, A. M., Froh, J. J., & Geraghty, A. W. A. (2010). Gratitude and well-being: A review and theoretical integration. Clinical Psychology Review, 30(7), 890–905. https://doi.org/10.1016/j.cpr.2010.03.005
Zohar. (n.d.). Vayishlach, 173b. Teaching that a person should praise and thank the Holy One, blessed be He, for miracles and kindnesses performed on one’s behalf.