Why do the best of doctors go to Gehinnom according to the Maharsha?

Question

Says the final Mishnah in Kiddushin 82a:

טוב שברופאים לגיהנם

The best of doctors go to Gehinnom

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The Maharsha is puzzled by why this should be the case:

יש לפרש טוב שברופאים דהיינו שמחזיק עצמו לטוב ולמומחה שברופאים שאין כמוהו וסומך ביותר על המחאתו מתוך גאוותו ולפעמים הוא טועה בטבע זה החולה וממית את החולה ברפואותיו בדבר שמזיק לחולה זה אבל יש לו לישא וליתן עם שאר הרופאים כיון שהוא סכנת נפשות:

There is to explain that “the best of doctors” refers to those who hold themselves in such high regard and expertise of the doctors that there are none like him, and he relies too much on his own experience because of his arrogance. Sometimes he will make a mistake in the natural way of things and will kill a sick person by trying to heal him with something bad for him. Rather, he should consult with other doctors regarding things that could lead to death.

This seems a little strange to me: At best, the doctor can only be faulted for accidentally killing a person. It’s not like he intended to kill the patient. Why should that outweigh all the (presumably) many more lives that he’s saved?

Answer 1

I am reminded of an insight I heard from R' Aharon Lichtenstein zt"l.

Shaul was assigned the job of killing all of the tribe of Amaleiq. He led a war that almost did it; but he left one person -- Agag, their king -- alive. Shemuel told him that as punishment, Shaul would lose the throne; he would be a one-king "dynasty".

Rav Lichtenstein taught that it was not saving Agag that was the great sin that carried such a punishment. Rather, by not killing Agag, Shaul proved that killing everyone else wasn't to fulfill the mitzvah. If he wasn't following G-d's command to kill EVERYONE, then killing the rest of Amaleiq was simply genocide.

I read the Maharsha you ask about similarly. Notice the Maharsha mentions two things: arrogance, and the inevitable mistake. If a doctor acted purely to help others, then he wouldn't be considered guilty for any mistakes. To the extent that a doctor acts for the sake of their own ego, the actions in which they erred also had that element of for their own ego. And they are guilty to whatever extent they harmed someone else out of a pursuit of self aggrandizement. Even if it's also along with other, purer, motives, that element of petty motive leading to harm needs purging in gehennom.

Answer 2

TL;DR- "the best of doctors go to Gehinnom" is ONLY referring to supremely haughty & arrogant doctors

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The Tiferes Yisrael writes about this in his commentary to the last mishnah of Maseches Kiddushin.
He begins by stating:

נ"ל דאין מאמר זה גנאי לרופא רק שבח הרופא המומחה

This statement ["the best of doctors go to Gehinnom"] isn't embarrasing for a doctor- on contrary! It's to praise the doctor

The Tiferes Yisrael then brings up a lengthy parable (which will be used to make his point later):

Parable: a king dispatched a calligrapher to draw Moshe Rabbeinu's face so his advisors could deduce what kind of person Moshe was

After Moshe Rabbeinu took the Jews out of Egypt, the nations of the world wondered who was this person that had all these great miracles done for him. One person-- the King of Aravi-- was eager to find out and dispatched an expert calligrapher/ facepainter to draw Moshe's face and bring back to him for his expert advisors to decipher. When the artist returned with the drawing, the king gathered all his wise men and told them to tell what Moshe's face depicted to learn his nature and character traits. All of the wise men responded: "this guy is arrogant, craves money, and is deeply flawed." The king was aghast, didn't believe it and drove his chariot into the camp of Israel to see Moshe for himself. Upon seeing Moshe he was taken aback because the artist's drawing was an exact rendering of what Moshe looked like (and thus so were his advisors categorizations of Moshe). The king couldn't believe it and told this to Moshe, to which Moshe replied:

"You're advisors and sages are right- for had I not been involved in being an Eved Hashem, I would be all the things they said. However I conquered all those traits of mine and channeled them into being a man of God, therefore for this I cherished and honored the heavens above and in the earth below. "

The Tiferes Yisrael takes this idea and applies it to "the best of doctors go to Gehinnom"

ועל פי זה נבין היטב שבח הרופא ממאמר זה. ש"מ שהטוב הזה אין כוונתו כשר, רק מי שחושב את עצמו שהוא המומחה היותר טוב שברופאים, הוא מעותד לגיהנם. דבגאותו זאת סומך על ידיעתו בספק ואינו מתיעץ עם חביריו, כראוי למי אשר בפיו ובקולמסו מונח חיים או מות. וגם ברוב גאונו אינו מסתפק שמא יטעהו דמיונו, ואינו חושש לעיין היטב בספרי הרפואות קודם שיתן להחולה סמי רפואה קודם שידע מהן שלא יוכלו להזיקו כראוי, לילך לאט לאט בענייני סכנת נפשות.

In this sense, we can well understand how the doctor is praised [in our mishnah], [...] we can learn from here that "the best" referred to in our mishnah isn't referring to his skills, rather it's referring only to a supremely arrogant doctor who thinks he is the top expert of all the doctors-- that's the doctor who's going to go to Gehinnom. Since due to his arrogance, when in doubt- he relies solely on his own knowledge instead of consulting with his colleagues, and he believes only his words will determine whether a person will die. And also in his "abundant" expertise he doesn't think he'll be mistaken, isn't worried about studying medical textbooks before he administers (potentially harmful) medicine that may not treat the patient properly and in fact put him in a life-threatening situation.

BOTTOM LINE: To be a doctor, one needs tremendous wisdom, creativity, and diligence etc... as well as some potentially less savory traits. Moshe Rabbeinu also had a lot of potential flaws, but didn't give into them and instead channeled them for the good. "The best of doctors go to Gehinnom" is only referring to doctors who utilize their gifts and traits in an arrogant, careless, and haughty manner.