AN INTRODUCTION TO WONDER

INTRODUCTION

“Medicine, then is more than a profession.
Medicine is a worthy calling, a true avocation.
Medicine is a most magnificent obsession.
Medicine requires all the abilities in one's possession
Its influence on life and death's progression
Makes medicine more than a profession”

- Billy F. Andrews

“Medicine has been called both a master and a mistress - a master when it is allowed to possess, oppress, and enslave; a mistress when it preserves the passion by remaining engrossing, intriguing and exhilarating. It is as a mistress that medicine will delight and fulfill the physician”

- Phil R Manning & L. De Bakey

YOU ARE NOT ALONE

“Je le pansai, et Dieu le guarist” (I treat the wounds, but God heals them)

- Ambroise Pare, 16th century French surgeon

It has been nearly five centuries since Ambroise Pare, the great French military surgeon made his most famous remark. Since then, mankind has gone through a series of trials and tribulations, and its most prominent and intelligent figures went from a fervent spirituality and religiosity, best exemplified perhaps by the great Sir Isaac Newton[1] to the criticism of religion but the defence of the idea of God, perhaps best exemplified by Voltaire and several other children of the Enlightenment, to the militant attack on religion and the idea of God, led primarily by three Germans – Ludwig Feuerbach, Karl Marx and Friedrich Nietzsche, to the establishment of the spread of atheism and its corollary, secularism[2] among the intelligent men and women of today, a move triggered, to a great extent, by the ideas of a certain Charles Darwin, without whom it would be impossible to be “an intellectually fulfilled atheist”. Atheism and the neglect of God is the current status quo, and, regrettably, looks set to remain so in the face of so much irrationality and incoherence in the minds of those who believe in God.

Almost all the most popular and intelligent writers of the twentieth century and our time, were, or are, atheist or agnostic. This gives people who believe in God the impression that they may be mistaken in their beliefs, or are upholding an unintelligent, primitive idea, which is never easy for one who does not want to be troubled by the gnawing attacks of the intellect that seeks nothing but the objective truth.

Take for instance Bertrand Russell, a man who, along the course of a very long career, took every opportunity to criticize religion and God, expressing a belief that, “there is no reason to believe any of the dogmas of traditional theology and, further, that there is no reason to wish that they were true”, that, “Religion is something left over from the infancy of our intelligence, it will fade away as we adopt reason and science as our guidelines”, that “it as a disease born of fear and as a source of untold misery to the human race”.

Or the more contemporary Gore Vidal, who regards himself as a “born-again atheist”, who believes that “monotheism as the greatest disaster ever to befall the human race. I see no good in Judaism, Christianity, or Islam, good people, yes, but any religion based on a single, well, frenzied and virulent god, is not as useful to the human race as, say, Confucianism, which is not a religion but an ethical and educational system”.

And most recently, people the likes of Noam Chomsky, who regards the idea of God as “unimportant”, Christopher Hitchens, who recently published the best selling book, ‘God is Not Great’, and the ever-militant Richard Dawkins[3], who does not spare a page in any of his works without an attack on religion or God, most recently his best seller, ‘The God Delusion’.

Along the way we have people the likes of Karl Popper, Richard Feynmann, Linus Pauling, Francis Crick, George Gamow, Steven Weinberg, Isaac Asimov, Carl Sagan, Roger Penrose, Stephen Hawking, John Gribbin, Gore Vidal, Edward Said, Noam Chomsky, and many others whose ideas are less clear, although my impression is that they too were atheist – men the likes of Albert Einstein, Paul Dirac and Erwin Schrodinger.

Can the idea of God be therefore upheld, in the face of this devastating onslaught by those icons of the age? An age when, as with previous times, the innocent idea of God is used and abused by men of all doctrines and creeds – from the totalitarian oppression of the Saudi ‘Islamic’ regime, and the Taliban, who were responsible for the tragic events of the 11th of September 2001. To the blood thirsty, born again-Christian evangelists Neo-Conservatives presiding America, who have killed thousands more, extending the crimes of the Church in previous times to our own century, to the Zionists who make a mockery out of Palestinian blood, in the name of a tribal God and His ‘Chosen people’.

The answer is yes. There can be no poll on justice and truth. The fact that so many intelligent men and women do not believe in God is not evidence that He does not exist. The Qu’ran tells us, “And though thou try much, most men will not believe” (12:103). Similarly, the fact that so many God-professing bigots have abused the idea is not evidence that it is incorrect. God, as the Qur’an quite simply and repetitively tells us, enjoins what is good, and forbids what is bad. There is not a single current political party out there that is not using this most noble of ideas to have entertained the human mind since its inception, to achieve its end target of power and control. All are guilty of treason and abuse of this most beautiful idea, from which sprung all the good that humanity stands for.

The fact of the matter is that there will always be great men and women who believe in God at every time. The important thing for these people is to remember that they are not alone, that their belief in God is not primitive, but has equally been upheld by great men and women who too were aware of atheism (atheism is an extremely ancient idea – upheld by pre-Socratic philosophers like Protagoras and Democritus). Rene Descartes, Isaac Newton and James Clerk Maxwell continuously sung the praises of God, and they were the two most intelligent men of the 17th, 18th and 19th centuries respectively. Even today, mathematicians, who deal with the most complex ideas known to man, and are arguably the most intelligent of all professionals, are the most fervent believers in God our of all professionals, as illustrated by a ‘Nature’ article published a few years ago. Listen to the greatest of them all, the man called ‘Analysis Reincarnate’ by Eric Temple Bell, the incredible Swiss mathematician of the 19th century, Leonard Euler who sang the praises of God throughout his long productive life, saying:

“Every creative act involves a new innocence of perception liberated from the cataract of accepted belief. For since the fabric of the universe is most perfect and the work of a most wise Creator, nothing at all takes place in the universe in which some rule of maximum or minimum does not appear”.

"Though we are very far short of a perfect knowledge of the subject, the little we do know of it is more than sufficient to convince us of the power and wisdom of the Creator. … We discover in the structure of the eye perfections which the most exalted genius could never have imagined....The eye alone being a masterpiece that far transcends the human understanding, what an exalted idea must we form of Him who has bestowed this wonderful gift, and that in the highest perfection, not on man only, but on the brute creation, nay, on the vilest of insects!

"The works of the Creator infinitely surpass the productions of human skill”
If you believe in God – you are not alone. Your belief was, and is still shared by men and women who are of equal, if not greater intelligence than of the atheists and agnostics of our time. In our time, I can think of only a few – Miguel de Unamuno, Martin Gardner, Paul Davies, John Eccles, John Polkingthorne, Mustafa Mahmood, Muhammad Al-Ghazzali, men who went through phases of skepticism, but ended with a faith that, like Pare above, sought, the signs of God everywhere, and sang His praises continuously, not unlike the manner of the believers who God described in the following verses:

“Surely in the creation of the heavens and the earth, and the alternation of night and day, are signs for people of understanding— those who remember God while standing, sitting, and on their sides, contemplating the creation of the heavens and the earth: “Our Lord! You did not create this in vain! Glory to You! Keep us, then, from the torment of the fire! “Our Lord, whomever You cause to enter the fire You have disgraced; and there are no saviors for the unjust. “Our Lord, we have indeed heard someone calling, inviting us to faith— ‘Believe in your Lord’—and we believed. So forgive us our sins, our Lord, and efface our evils; and take our souls with the just. “And grant us what You promised us, our Lord, according to Your messengers; and do not disgrace us on the day of resurrection. For You surely do not break a promise.” And their Lord answered them, “I am never unmindful of the work of a worker among you, male or female. You are from each other. So for those who emigrated or were driven from their homes or suffered harm for My sake, or fought or were killed, I will efface their evils and admit them to gardens below which rivers flow, as a reward from the presence of God. And the finest reward is in the presence of God.” (2:190-200)

When it comes to medicine, my own specialty, it is extremely unlikely to find anything like the above statement by Ambroise Pare, in present day medical journals or textbooks, or uttered by currently practicing physicians or surgeons. The idea of God and religion has become a joking matter, and the majority of people of our time take religion in vain – and none more so than the secularists, who dare not remember God in their daily living, but only if they feel the need to. Atheists, like Dawkins and Hitchens continuously mock, ridicule and insult religion and God, a practice akin to that of many of our ancestors described in the Quran:

“If thou dost question them, they declare (with emphasis): "We were only talking idly and in play." Say: "Was it at Allah, and His Signs, and His Messenger, that ye were mocking?" (9:65)

“And never came there unto them a messenger but they did mock him (15:11)

“And never came there unto them a messenger but they did mock him (40:83)

I cannot help but agree with those people that the majority of religious men and women of our times are the laughing stock of mankind. They have a reverence for tradition, as if it were divine writ. A desire for power and control that the old medicine man wished for, and a general abhorrence for intelligence and reason, and a love of the exterior over the essence of religion. Watching a religious programme on television these days is like watching a comedy of errors, foolishness and unreason, and is often an insult to the intelligence. “Is it halal (religiously permitted) to enter the toilet with my right foot”, “can I call my son ‘Abdi’”, “can I eat with my left hand”. The questions that engage the religious mind these days (and I confine myself to the ‘Islamic world’ here) are so bizarre, that I cannot be sympathize with the atheists general negative conception of religion, which is not helped by the crimes of the followers of the Taliban and other religious parties.

Nevertheless, I believe that those men are intelligent enough to realize that it is not God who is to blame for those excesses of mankind. I believe that one who listens to his or her heart and mind will eventually come to the natural, instinctive conclusion that God is.

Which brings me to the first reason for writing this book, and that is, to bring back God back to his rightful place in the medical world, the way people like Pare would have Him.
Over the last century, medicine, particularly in the Western world, has been taught and practiced without any regard to God, or any sense of the divine. God has been displaced, and His glorious name seems to be confined, if that, to ethical discussions and ‘moral’ affairs. God, to who belongs the dominion of the Heavens and the Earth, to whom we are indebted for everything, is discarded, ridiculed, insulted and forgotten, and the consequences of that are only too painful for me to remind the kind reader thereof, but I will attempt to do so. The question of God is, contrary to what Chomsky would have us believe, is not a frivolous question. It is of ultimate importance, for the world without God, a world that neglects Him is bound for failure, as the next section shows.

THE CONSEQUENCES OF THE NEGLECT OF GOD

THE WORLD NEGLECTS GOD

The most prominent characteristic of this time is that, as the historian Martin Gilbert put it, it is an extension of the century of war. There is no peace in this world. This is natural, when the ‘Peace’[4] is going to be neglected. As a result, it is an absolute mess. It is a state of chaos, of lack of security, which can only be redeemed by the remembrance of God, and not a tablet of diazepam or citalopram. As He informs us, “Those who believe, and whose hearts find satisfaction in the remembrance of God: for without doubt only in the remembrance of God do hearts find satisfaction” (13:28). Nearly 150 years on from the day when Charles Dickens wrote the famous introductory lines of his great novel, ‘A Tale of Two Cities’ , the words are more applicable then ever before:

“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us, we were all going direct to Heaven, we were all going direct the other way--in short, the period was so far like the present period, that some of its noisiest authorities insisted on its being received, for good or for evil, in the superlative degree of comparison only.”

It is the best of times in terms of technological and scientific advance, but the worst of times in terms of the degeneration of modern man and all his moral and artistic pursuits.

Albert Einstein put it very well:

“By painful experience we have learnt that rational thinking does not suffice to solve the problems of our social life. Penetrating research and keen scientific work have often had tragic implications for mankind, producing, on the one hand, inventions which liberated man from exhausting physical labor, making his life easier and richer; but on the other hand, introducing a grave restlessness into his life, making him a slave to his technological environment, and—most catastrophic of all—creating the means for his own mass destruction. This, indeed, is a tragedy of overwhelming poignancy”.

The Egyptian Islamic thinker Sayyid Qutb summarized our current state very well too in the introduction to his book, ‘Milestones’. He said:

“Mankind today is on the brink of a precipice, not because of the danger of complete annihilation which is hanging over its head-this being just a symptom and not the real disease -but because humanity is devoid of those vital values which are necessary not only for its healthy development but also for its real progress. Even the Western world realises that Western civilization is unable to present any healthy values for the guidance of mankind. It knows that it does not possess anything which will satisfy its own conscience and justify its existence.

Democracy in the West has become infertile to such an extent that it is borrowing from the systems of the Eastern bloc, especially in the economic system, under the name of socialism. It is the same with the Eastern bloc. Its social theories, foremost among which is Marxism, in the beginning attracted not only a large number of people from the East but also from the West, as it was a way of life based on a creed. But now Marxism is defeated on the plane of thought, and if it is stated that not a single nation in the world is truly Marxist, it will not be an exaggeration. On the whole this theory conflicts with man's nature and its needs. This ideology prospers only in a degenerate society or in a society which has become cowed as a result of some form of prolonged dictatorship. But now, even under these circumstances, its materialistic economic system is failing, although this was the only foundation on which its structure was based. Russia, which is the leader of the communist countries, is itself suffering from shortages of food. Although during the times of the Tsars Russia used to produce surplus food, it now has to import food from abroad and has to sell its reserves of gold for this purpose. The main reason for this is the failure of the system of collective farming, or, one can say, the failure of a system which is against human nature… The leadership of mankind by Western world is now on the decline, not because Western culture has become poor materially or because its economic and military power has become weak. The period of the Western system has come to an end primarily because it is deprived of those life-giving values which enabled it to be the leader of mankind.”

As a result of this neglect of God, we live in the worst of times. This is precisely the Qur’anic viewpoint. God says, “Do not be like those who forgot God so He made them forget themselves. Such people are the deviators” (59: 19). It is natural law that God has declared – those who forget Him, will never remember anything of any benefit to themselves or humanity. They will become followers of desire. God talks about this repetitively:

“Now there hath succeeded them a later generation whom have ruined worship and have followed lusts. But they will meet deception. Save him who shall repent and believe and do right. Such will enter the Garden, and they will not be wronged in aught (19:59)

And Allah would turn to you in mercy; but those who follow vain desires would have you go tremendously astray (4:27)

Restrain yourself patiently with those who call on their Lord morning and evening, desiring His face. Do not turn your eyes from them, desiring the attractions of this world. And do not obey someone whose heart We have made neglectful of Our remembrance and who follows his own whims and desires and whose life has transgressed all bounds. (18:28)

Do not let those who have no faith in it and follow their whims and desires debar you from it or you will be destroyed. (20:16)

Have you seen him who has taken his whims and desires to be his god? Will you then be his guardian? (25:43)

If they do not respond to you then know that they are merely following their whims and desires. And who could be further astray than someone who follows his whims and desires without any guidance from Allah? Allah does not guide the people of the wrongdoers. (28:50)

However, those who do wrong pursue their whims and desires without any knowledge. Who can guide those whom Allah has led astray? They will have no helpers. (30:29)

Have you seen him who takes his whims and desires to be his god–whom Allah has misguided knowingly, sealing up his hearing and his heart and placing a blindfold over his eyes? Who then will guide him after Allah? So will you not pay heed? (45:23)”

The Quranic law is – forget God, you will forget yourself, and you will end up following your desires. It’s a simple law. Without God, life becomes an undisciplined affair.

The majority of human beings do not carry the correct idea of God. Statistics may tell us that the majority of human beings believe in a god, but the truth of the matter is that they have a distorted view of Him (e.g. the ethnocentric God of Judaism, the trinity of St. Paul’s Christianity, and the absurd concept of God ‘The Father’, and the polytheism of Hinduism, not to say the polytheism of the former two) or a distorted view of His teachings (manifest most evidently by traditional Islam as it is taught in this day and age by the various religious institutions in Saudi Arabia and Egypt, the two nations with the most prominent Islamic institutions). Once again, the words of God rule supreme, “And though thou try much, most men will not believe” (12:103).

It is only by a return to God that the mess that is this world will be tidied up, and therefore the medical world. As Harun Yahya concludes one of his works, “All the problems of the world today can end provided that the values of the Quran and the Sunnah, in their original form purified from all bigotry and innovation are introduced to mankind”. Note the purification clauses – it is herein that the Muslims, the carriers of God’s blessed message, have failed. They have contaminated interpretations of both with many corrupt ideas. Only by their eradication will we have success.

Let us look at some of the details of the consequences of the neglect of God in various areas of human life.

MEDICINE

Since this book is primarily aimed at medical professionals, who are affected to a great extent by the neglect of God, perhaps more than any other professionals, I start with a discussion relating to medicine.

Probably the main frustrations of medical professionals these days stem mostly from the increasing politicization of the profession, and also, due to the daily encounter of lifestyle related problems.

Medicine has become so intertwined with political motives and party agendas. In the United Kingdom hardly a day passes by without a statement of sorts being made by some politician regarding the NHS. This has been on an exponential rise over the past year (2008), while England celebrates the 60th anniversary of its declining health care system.

As for ‘the daily encounter of lifestyle related problems’, I can say from personal experience that a great deal of frustration hits the doctor when he or she is dealing with the smoker who does not stop smoking, despite advice, and comes to hospital with his umpteenth exacerbation of COPD in two years.

Or the alcoholic who comes to hospital withdrawing, or following a head injury, or following an acute attack of pancreatitis, or hepatitis.

Or the heroin addict coming for an injection of the analogous morphine while acting out that he is in tremendous abdominal pain, or the more honest DVT or leg cellulitis.

What about all those who are not prepared to face their ‘sadness’, those who are prepared to commit suicide because ‘they had an argument with their boyfriend (or girlfriend)’.[5] What about the 16 year old girl, who is coming with an ectopic pregnancy, predisposed to by her smoking and previous STD. I can go on and on. This is the bread and butter of the daily practice of every single medical professional. Because of these lifestyle diseases, patients present to medical professionals, and he or she is expected to take the burden and ‘look after’ these patients (sometimes at the expense of patients who are ill due to diseases that they have not brought upon themselves), until they have been safely discharged, and until they return yet again with the same presentation a few weeks or months later.

I may be accused in saying this of being judgmental. That is a fair criticism, but I ask, how could one not be judgmental in the face of all this. Medical professionals are human beings, not robots, and it is the nature of human beings to judge a certain situation to be bad or good. Provided the treatment you offer does not differ between patient and patient, then every medical professional has that basic natural human right to express a like or dislike towards certain habits. The best medical professional (and human being) is one who can completely dissociate his or her judgments about a certain belief or habit from the human being carrying that belief or habit. This I don’t find very difficult, because I have never had any personal relationships with any of my patients.

Needless to say, it is the job of the medical professional to help those patients acutely. But his or her role does not just stop there. He or she ought to try to prevent future problems from occurring; this is simply because, our elders said, prevention is better than cure. Not that cure is available for all problems; infact we are yet to devise a cure for anything in medicine, except perhaps some infectious diseases.

Alas, prevention advice is rarely successful. Smoking remains widespread, despite all attempts at reducing the incidence of this horrible habit. Only the diagnosis of a terminal or serious illness, like cancer or a heart attack, forces the patient to believe that smoking kills, and to stop smoking afterward. Alcohol abuse and sexually transmitted diseases are on the rise, the latter reaching epidemic proportions, and leading the BBC not unrecently to state that, “There is widespread concern throughout the medical profession that increasing levels of promiscuity coupled with failure to take precautions is leading to an explosion in the numbers of STIs in the UK”.

In addition, there are some disorders for which there is no ‘prevention’ advice. These include depression, anxiety, and a whole host of other psychiatric problems, as well as suicide. These extremely important disorders have become a huge burden. A recent ‘Guardian’ article announced two years ago:

“Depression, anxiety and other forms of mental illness have taken over from unemployment as the greatest social problem in the UK, a health economist warns today…. Around 15% of the population suffers from depression or anxiety, says Lord Layard, emeritus professor at the Centre for Economic Performance of the London School of Economics. The economic cost in terms of lost productivity is huge - around £17bn, or 1.5% of UK gross domestic product. "There are now more than 1 million mentally ill people receiving incapacity benefits - more than the total number of unemployed people receiving unemployment benefits," he writes in the British Medical Journal.”

The connection between the neglect of God and those problems is there for all who attempt to understand why these problems occur. Why do people smoke, why do they drink excessively, why do they act promiscuously and become slaves to their sexual passions as soon as they have been introduced to the subject of sex? Why do they get so depressed, and are prepared to commit suicide, and forsake their entire lives for a relationship difficulty, or other ‘petty’ matter? Why is it that humanity has come to act so mindlessly, with the doctor eventually carrying most of its burden? Why is it that minds and hearts cannot rest, with a great number of people on anxiolytic medication, and sadness so prevalent, with so many on antidepressants?

Sigmund Freud tried to explain all the actions of humanity as being due to the conflict of psychological impulses and sexual desires. Karl Marx tried to reduce them to the struggle of dialectical materialism, saying in the preface of one of his books, “It is not the consciousness of men that determines their existence, but their social existence that determines their consciousness”, that the prime triggers for human behaviour are the struggle for wealth and economic power. Bertrand Russell tried to reduce all of human behaviour as the struggle for power of all types.

None of these, I feel, explains human behaviour in our contemporary world well. When a girl is taking a paracetamol overdose, is she thinking of ‘power’, of ‘money’, of ‘sex’? Of course not. Her behaviour cannot be explained in those terms. And neither can the young chap who is taking a heroine overdose, or getting drunk[6], or smoking away despite his asthma, all different forms of suicide. Albert Camus was not that wrong when he stated “there is but one truly serious philosophical problem and that is suicide”. In many ways, we can rephrase that and say, “there is but one truly medical problem, and that is suicide”. But that would be a great exaggeration, not without an element of truth however.

Their behaviour can only be explained in three words – loss, forgetfulness and neglect. They are at loss regarding their purpose in life – no one with a sense of purpose in life will consider suicide. They are forgetful of their duties to others. They are neglectful of logic, reason and common sense, and when man turns away from those, his only refuge is his animal instincts and desires. There is no third route.

In their neglect, and in becoming the slaves of their passions, the everyday man and woman living here in England (and I am sure it is not very different in other nations) has become no different to the beasts.[7] He or she works, eats, drinks, copulates, defaecates, sleeps but rarely thinks. Bertrand Russell put it brilliantly, saying, “Most people would rather die than think; in fact, they do so”.

But why are people lost, forgetful and neglectful? Why is rational thinking so uncommon? Why has it become an almost cumbersome activity for some? What is it that makes a person like Bertrand Russell state, “It has been said that man is a rational animal. All my life I have been searching for evidence which could support this”?

It is all due to the neglect of God, or a pathetic idea of Him. A society devoted to Him, to His remembrance, and the realization of His wishes, will never fail or stutter. A society that realizes that the purpose of life (which, all three Abrahamic religions teach) is the worship of God[8] will never fall prey to its passions.[9]

Of course, there are many who are fulfilled by medicine – the joy they derive from seeing the recovery of the health of others is the greatest source of happiness of their lives. Such an attitude was epitomized, in our time by the late Michael De Bakey, a man whose story we recount in a later section. The sight of the grateful patient, whose doctor is the lucky recipient of a material gift, or a grateful smile, is one of the most beautiful things any one can encounter.

Such joy is probably experienced to the greatest extent and most frequently by the surgeon, who, using the minimum of tools (they are arguably the most clinical of doctors – we are yet to devise an instrument that can adequately describe a lump or any other mass for that matter) [though by no means always] proceed to heal the surgical defect, with a much quicker recovery rate than most other specialists. Compare this to the physicians, the medical consultants, whose daily practice seems to be confined to the encounter, on their ‘post-take’ ward rounds, of acute exacerbations of ‘chronic diseases’ (such as myocardial infarction (or acute coronary syndrome - an acute exacerbation of a chronic inflammatory (atherosclerotic) process), the acute exacerbation of COPD or asthma, of Crohn’s disease or ulcerative colitis, diabetic ketoacidosis or HONK), and in their clinics with the chronic picture of these diseases. There is no healing here – just control, sometimes coming at the price of iatrogenic damage. And the control often comes after months and months of experimentation, trial and error. Compare this to the immediacy with which good surgeons achieve their desired outcomes (of course, the story is very different with the technically-incompetent surgeon, but those are mostly filtered out by the extremely efficient and progressive surgical tutoring systems in place throughout the world).

But the vast majority of us are not surgeons, and therefore will not be able to achieve that great joy and fulfillment that men like De Bakey experience on a daily basis. And if things continue as they are, the unhappy, joyless doctor will remain the norm, the one who would nod in agreement with anything that Arthur Schopenhauer, the philosopher of pessimism has to say, or even the more balanced Bertrand Russell, who despite his occasional optimism, was led to say, “The secret of happiness is to face the fact that the world is horrible, horrible, horrible....” This tide of unhappiness is beginning to engulf the medical professional, as a BMJ article a few years ago showed:

“Doctors are unhappy. They are not all unhappy all the time, but when doctors gather, their conversation turns to misery and talk of early retirement. The unhappiness has been illustrated in a plethora of surveys and manifests itself in talk of a mass resignation by general practitioners from the NHS. The British government is rattled by the unhappiness of doctors, recognising that a health service staffed by demoralised doctors cannot flourish. It has responded by trying to hand more control of the service to frontline staff.”

A point reiterated by Raymond Tallis:

“There is mounting evidence that doctors are increasingly unhappy with their professional life. The rising levels of job dissatisfaction are striking. Of doctors graduating in 1974, the majority were reasonably content with their lot, though the prospect of the early retirement many were planning may have had something to do with this. In contrast, 25 per cent of the 1995 cohort had only a lukewarm desire to continure in medicine, and only 13 per cent still had a strong desire to be doctors. These alarming figures may be due to the greater expectation of happiness, and specifically of job satisfaction, of the more recent generation; but they will also be due to alterations in the working life.

In the USA, where morale among doctors is also low, the most important factor is loss of professional independence. What made medicine a profession in the modern sense of the term, in the authonomy they enjoyed in their everyday work, meant that they were not organisation men. Ronald Dworkin observes, “They did not have to be backslappers or joke-tellers or handshakers; they did not have to get along with their boss or be shrewdly political…they answered to no one but their patients”. Now, “they must please some faceless bureaucrat without a medical education before ordering a test”. They are forced to become organisation men; and “since they get little more out of their work than a paycheck, the money is much more important to them, and they try increasingly to make more of it”. This is what happens “when the medical profession is shorn of its transcendent qualities – its mistique, its notion of duty, its code of honour – and made into a rational economic enterprise”.”






POLITICS

Politically, we are not only threatened by religious fundamentalism and terrorism done under the name of religion (and I put American foreign policy, which is based on the ideas of Christian Evangelism under this category), but also by irreligion. Hasn’t the Chinese government, since 1949 been “officially atheist, which viewed religion as emblematic of feudalism and foreign colonialism.” If atheism was a blessing, then how why do we have what Jampal Chosang, the head of the Tibetan coalition stated recently, that, “China had introduced "a new form of apartheid" in Tibet because "Tibetan culture, religion, and national identity are considered a threat" to China”. Hasn’t Russia endorsed no official religion (in communist times, it was atheism), and then turned to attach the Chechnyans, in not one, but two wars since the demolition of the USSR. The impact of politics on medicine I have discussed elsewhere.

ECONOMICS

Economically, the following story says it all. Only a few days ago, on the 19th of July 2008, I came across an article in ‘USA Now’ by the economist Thomas Haffner, entitled, ‘A Defeated and Conquered Nation’, which he introduced saying, “Americans have been defeated in an economic war with consequences as meaningful and damaging as if having lost a military war”. A day later, in the British broadsheet paper, the ‘Independent’ we were informed by journalist Margareta Pagano, under the heading, ‘Recession next year: forecaster says things can only get worse’, that, “The UK economy is heading for recession next year and unemployment could top two million by 2010”. A day later, Ambrose Evans-Pritchard tells us in another British broadsheet, ‘The Daily Telegraph’, that, “The global economy is at the point of maximum danger”.

POVERTY, WATER AND FOOD CRISIS

As a result of political greed and economic collapse, poverty and famine is rife, due to our lack of wisdom and foresight, and other factors, such as natural disasters and disease. They have led to the current ‘Water Crisis’, through which it is estimated that, “Not only are there 1.1 billion without adequate drinking water, but the United Nations acknowledges 2.6 billion people are without adequate water for sanitation (e.g. wastewater disposal)”, with its great impact on human welfare, particularly human health. It is felt by experts that:

“Waterborne diseases and the absence of sanitary domestic water are one of the leading causes of death worldwide. For children under age five, waterborne diseases are the leading cause of death. At any given time, half of the world's hospital beds are occupied by patients suffering from waterborne diseases.[6] According to the World Bank, 88 percent of all diseases are caused by unsafe drinking water, inadequate sanitation and poor hygiene.”

They have also led to the current food crisis; the year 2008 has been labeled by economists as ‘The Year of Global Food Crisis’. Kate Smith and Rob Edwards, writing in a recent issue of the ‘Sunday Herald’, a Scottish broadsheet, report:

“It is the new face of hunger. A perfect storm of food scarcity, global warming, rocketing oil prices and the world population explosion is plunging humanity into the biggest crisis of the 21st century by pushing up food prices and spreading hunger and poverty from rural areas into cities. Millions more of the world's most vulnerable people are facing starvation as food shortages loom and crop prices spiral ever upwards. And for the first time in history, say experts, the impact is spreading from the developing to the developed world.”

The economic crisis has led to escalating health care costs – with many people unable to pay for their medication, thus instigating a vicious circle of poverty – as illustrated in the last issue of the Global Competitiveness Report, a yearly report published by the World Economic Forum, “poor access to affordable health care makes individuals less resilient to economic hardship and more vulnerable to poverty.” The following picture is worth a thousand words; it is taken from the ‘Statistics’ section of the WHO website:


The economic crisis will also have negative effects on crime rates; hardly a month passes by these days in England without hearing about two or three victims, usually in their teens, of ‘knife crime’ – so far in 2008 there have been 22 victims, the youngest aged 14, and the oldest aged 42. Writing under the headline, ‘Crime rates expected to soar as economic difficulties deepen, fall in car theft and robberies could be short-lived, officials warn’, Alan Travis, home affairs editor of ‘The Guardian’ said (on Friday July 18th 2008), “The credit crunch threatens to bring to an end the longest recorded period of falling crime in living memory in England and Wales, Home Office criminologists said yesterday…government officials predicted the economic slowdown would lead to "upward pressure" on levels of property crime, such as burglary and car break-ins.” The American economist Steven D. Levitt described living in the United States in the early 1990s, saying:

“Anyone living in the United States in the early 1990s and paying even a whisper of attention to the nightly news or a daily paper could be forgiven for having been scared out of his skin. The culprit was crime. It had been rising relentlessly—a graph plotting the crime rate in any American city over recent decades looked like a ski slope in profile—and it seemed now to herald the end of the world as we knew it. Death by gunfire, intentional and otherwise, had become commonplace. So too had carjacking and crack dealing, robbery and rape. Violent crime was a gruesome, constant companion. And things were about to get even worse. Much worse.”

Crime rates are increasing everywhere, and security is a very difficult to attain these days, or it comes at a very huge price. And insurance companies, as many of my friends will tell you, come to do their job very slowly, very reluctantly and often at very high prices.

The following picture (courtesy of the CIA World Factbook) is worth another thousand words; it shows the percentage of populations who are living below their nations’ poverty line, and is truly shocking:


As explained by Randy Charles Epping, a financial advisor based in Zurich in his book, ‘A Beginner’s Guide to the World Economy’:

“Economic and political misjudgment can be blamed for much of the Third World's poverty, but an important factor has also been the population explosion. Many developing countries have seen their populations double in as little as twenty years. This growth was due mainly to lack of birth control and declining mortality rates, resulting from improved medical care.

Extreme poverty in the Third World has forced many parents to create ever larger families, hoping that their children can work and increase family income. But the economic opportunities are often not available, and unemployed children and their parents end up moving into already overcrowded cities, in a fruitless search for work.Many underdeveloped nations have found themselves in a vicious circle of poverty and overpopulation, with no hope in sight. The flood of poor families into major cities puts enormous strain on the economic infrastructure. Shantytowns in such cities as Bombay, Sio Paulo, and Shanghai have become glaring reminders that the world economy has left behind many of the world's poor.

Saddled with enormous debt payments, hyperinflation, surging populations, and mounting unemployment, many Third World countries struggle just to keep their economies afloat. Sometimes, with no money available for investment, even the infrastructure, such as roads and water systems, literally falls apart.

The solution for many overburdened governments is to simply increase debt in order to keep the money flowing. However, this often results in rampant inflation, which ends up eroding most of these efforts, and creates an ever-widening gap between the Third World's poorest and richest economies.”

MEDIA CORRUPTION

I love the way Epping refers to the crimes of our many politicians as ‘misjudgments’! This brings me nicely to another aspect of our ugly world that fills me with pessimism – the corruption of the media. This is something that has been spoken and written about extensively of late, especially by the great Noam Chomsky. I find the following explanation of Chomsky’s ideas on the Wikipaedia online encyclopedia extremely helpful and do not hesitate to quote it in full:

“Another focus of Chomsky's political work has been an analysis of mainstream mass media (especially in the United States), which he accuses of maintaining constraints on dialogue so as to promote the interests of corporations and the government.

Edward S. Herman and Chomsky's book ‘Manufacturing Consent: The Political Economy of the Mass Media’ explores this topic in depth, presenting their "propaganda model" of the news media with several detailed case studies in support of it. According to this propaganda model, more democratic societies like the U.S. use subtle, non-violent means of control, unlike totalitarian systems, where physical force can readily be used to coerce the general population. In an often-quoted remark, Chomsky states that "propaganda is to a democracy what the bludgeon is to a totalitarian state" (Media Control).

The model attempts to explain such a systemic bias in terms of structural economic causes rather than a conspiracy of people. It argues the bias derives from five "filters" that all published news must pass through which combine to systematically distort news coverage.

The first filter, ownership, notes that most major media outlets are owned by large corporations.

The second, funding, notes that the outlets derive the majority of their funding from advertising, not readers. Thus, since they are profit-oriented businesses selling a product — readers and audiences — to other businesses (advertisers), the model would expect them to publish news which would reflect the desires and values of those businesses.

In addition, the news media are dependent on government institutions and major businesses with strong biases as sources (the third filter) for much of their information.

Flak, the fourth filter, refers to the various pressure groups which go after the media for supposed bias and so on when they go out of line.

Norms, the fifth filter, refer to the common conceptions shared by those in the profession of journalism.

The model therefore attempts to describe how the media form a decentralized and non-conspiratorial but nonetheless very powerful propaganda system that is able to mobilize an "élite" consensus, frame public debate within "élite" perspectives and at the same time give the appearance of democratic consent.”

The corruption of the media has not just affected our journalism. Leaving the Western media world aside, I don’t know when the last time I watched a decent Arabic movie was. Are not the songs of today a far cry from the enchantments of Farid and Fairuz, Om Kalthoom, Abdel Halim, Abdel Wahab and others? Even the serials – they have lost their innocence and simplicity; compared to previous times, when serials, the comedies and soap operas used to host at most twenty actors, now they have become an example of extravagance and excess – the costs of some reaching millions of dollars, with the wages of some Arab actors and actresses reaching millions. Of course, this corruption, and treatment of everything as an industry, which has taken the joy out of everything in life, has affected all that media covers, from football to horse racing. I recall reading an interview with Zionist media mogul Rupert Murdoch, who owns ‘Sky’ and other major media, published in ‘The Guardian’ a year ago, entitled, ‘Murdoch: How I changed football’. He indeed has, and has made it ugly. Is it just, or humane that footballers (and these men are not prophets or people who render any great service to humanity) get paid so much, for the very noble and civilized act of kicking a ball around. ‘The Encylopedia of British Football’ reveals to us that, in September 1893, Derby County made the controversial move of proposing “that the Football League should impose a maximum wage of £4 a week. At the time, most players were only part-time professionals and still had other jobs. These players did not receive as much as £4 a week and therefore the matter did not greatly concern them. However, a minority of players, were so good they were able to obtain as much as £10 a week.” Goodness knows what those first footballers would think if they were brought back from the dead a hundred years later, to find out what their colleagues are earning nowadays, or cast an eye on the list of the highest earning footballers in the world today (note that the earnings are annual and without considering the footballers’ commercial interests, advertising involvement etc); we are told that Ricardo Kaka of AC Milan earns about 9,000,000 € a year, his compatriot Ronaldinho over 8,520,000 € and Frank Lampard of Chelsea FC 8,160,000 €.

BUT THERE IS HOPE, I HOPE

Nevertheless, I live in hope that all of these things will change. I recently completed a book on the Palestinian problem, one of the most difficult problems of our time, which many have come to regard as insoluble. I introduced it with a message of optimism, stating that truth and justice is a promise from God, and that moroseness and pessimism have no place in Quranic moral values.

As much as circumstances could lead me to believe, I cannot think that my life and practice so far is futile. Perhaps I have become attached to it, by virtue of having studied it for six long years in medical school, and having practiced and earned my living from it over the past three years. But I don’t think that entirely explains why I have a great hope in medicine, and a deep attachment to it. It remains, regardless of what I have mentioned above, a quite beautiful world.

GOD AND THE BEAUTIFUL WORLD OF MEDICINE

As everyone who knows me knows, I never wished to be part of this world in my youth, and always wished I would enter university and study the more intellectual fields of philosophy or physics and philosophy. Having entered it, owing to parental persuasion, I tried to philosophize it, and this is what has kept me going to this day. Despite its current ugliness, most of which I had not known about until I started working and beyond, I now know that medicine, stripped of its political and economic cloak is, as I say, a beautiful world, worthy of all our attentions, and that its study, besides being of immense human and societal benefit, could be of great comfort to one who believes in God, for His majesty shines everywhere within it.

Soon after he discovered his One Lord, the great prophet Ibrahim described God as ‘the Healer’, in Arabic, ‘Al-Shafi’, saying to his people, “Do you see these idols that you worship. You and your ancestors. I am against them, for I am devoted only to the Lord of the universe. The One who created me, and guided me. The One who feeds me and waters me. And when I get sick, He heals me” (26:76-82). God is inextricably connected with the healing process, something Ibrahim, in his great insight (PBUH) realized at a very early stage. It is this same quality that was described by Pare thousands of years later in his aforementioned statement, “Je le pansai, et Dieu le guarist (I treat the wounds, but God heals them)”.

But anyone with the idea of God as the most perfect of all beings will realize that there is much else that medicine can teach besides that of the idea of God as the Healer. As Pare and other religious explorers of the human body realized, the study of the human body and its diseases can reveal to us much about the ingenuity of God’s design. To quote one of Islam’s finest scholars of the past, Abu Hamid Al-Ghazzali, who wrote in his ‘Alchemy of Happiness’:
“An important part of our knowledge of God arises from the study and contemplation of our own bodies, which reveal to us the power, wisdom, and love of the Creator. His power, in that from a mere drop He has built up the wonderful frame of man; His wisdom is revealed in its intricacies and the mutual adaptability of its parts; and His love is shown by His not only supplying such organs as are absolutely necessary for existence, as the liver, the heart, and the brain, but those which are not absolutely necessary, as the hand, the foot, the tongue, and the eye. To these He has added, as ornaments, the blackness of the hair, the redness of lips, and the curve of the eyebrows.
Man has been truly termed a "microcosm," or little world in himself, and the structure of his body should be studied not only by those who wish to become doctors, but by those who wish to attain to a more intimate knowledge of God, just as close study of the niceties and shades of language in a great poem reveals to us more and more of the genius of its author”.
He is the Creator, the great Designer, and Great Architect of the Human Body. He is the Master, the most Beautiful, whose grandeur and artistry is immanent in all of His Creation, and very vividly in the human body, in health and disease. For without disease, would we have known health? Without the human capacity to suffer illness, would humans have entertained the idea of the study of the human body, at least as seriously as we do now? I think not, for human beings are driven chiefly by necessity. The study of disease provides a great opportunity to learn about normal human anatomy and physiology, and the great genius that is present in every single such aspect. This was highlighted by the great Charles Horace Mayo, founder of the Mayo Clinic, in a statement he made to the American College of Surgeons at the turn of the century, saying, “Disease at times creates experiments that physiology completely fails to duplicate, and the wise physiologist can obtain clues to the resolution of many problems by studying the sick” and the greatest medical writer of our time, Arthur Clifton Guyton, in the introduction to one of his fine physiology books, saying:

“A small but important part of this text presents not only knowledge that has come from basic experiments in animals, but also knowledge that has come from human experiments, especially unplanned experiments caused by disease. Literally thousands of human experiments proceed each day in the fields of high blood pressure, congestive heart failure, gastrointestinal disturbances, respiratory disease, and so forth. The physiology of these abnormalities is discussed briefly, partly because study of the diseases themselves can be enlightening, but even more because they give important insights into basic physiological concepts”.

With the intoxication of the love of God, akin to that of the great mystics of the past, there would be no need to get drunk, and thus we are spared the thousands of admissions that we see every day with alcohol related problems. Ignoring the very wise injunction in the Quran about the prohibition of alcohol consumption given in the verse, “Oh You who believe! Wine and gambling, stone altars and divining arrows are filth from the handiwork of Satan. Avoid them completely so that hopefully you will be successful. Satan wants to stir up enmity and hatred between you by means of wine and gambling, and to debar you from remembrance of Allah and from prayer. Will you not then give them up?” (5:90-91), I am sure that neither Jesus nor Moses (PBUT), nor the great Rabbis and teachers of Judaism and Christianity would not endorse the attitude many people have towards drinking. Even if such religions allowed for excessive drinking, it would never occur to the mind of a strong believer in them, since there is no reason to drink excessively, an attitude usually triggered by a misunderstanding of life events and the purpose of life, and again, the neglect of God.

With a firm belief in God, we would be spared of much mental illness. In this Godless world, it is the firm conviction of many prominent thinkers and physicians that much of the misery and melancholy of modern man is caused by an incorrect or inappropriate conception of the meaning of life and the lack of a grand worldview. Professor Alexis Carrel, for example (the famous French vascular surgeon and Nobel Prize winner wrote many books on the spiritual crisis of modern man, where he blamed capitalism and consumerism for the present suffering of mankind (he was also a great critic of communism for that matter). In his ‘Reflections on Life’, Carrel said:

“Modern society has been preoccupied with material values. It has neglected fundamental human problems, which are both material and spiritual. Not only has it not brought us happiness but it has shown itself incapable of preventing our deterioration. The conquest of health is not enough. We must also bring about in every individual the finest development of his hereditary power and of his personality, for the quality of life is more important than life itself”

A contemporary psychiatrist, Dr. Victor Frankl also made the following testimony about his practice, “More and more of our patients are crowding out our clinics and consulting rooms complaining of an inner emptiness, a sense of total and ultimate meaninglessness of their lives.” This is increasingly due to a lack of reflection on the deeper questions of life, brought on by the exhilarating pace of our materialistic, consumerist culture. Here the words of Socrates are most apt, “The unexamined life is not worth living”. Life without deep examination of the questions that matter is utterly unworthy, because it causes too much distress and pain. Not reflecting on God would lead to a huge vacuum in one’s life. As Blaise Pascal put it, “There is a God shaped vacuum in the heart of every man which cannot be filled by any created thing, but only by God, the Creator”. A contemporary professor of philosophy, William Lane Craig put it well too, “Modern man thought that when he had gotten rid of God, he had freed himself from all that repressed and stifled him. Instead, he discovered that in killing God, he had also killed himself”.

In the past history of the West (and to this day in many other parts of the world), religious faith provided man with the grand worldview, and there is evidence that that is the reason why psychiatric disorders are a lot less common, or are far less symptomatic in religious people (18-21). The great Swiss psychiatrist Carl Gustav Jung (1875-1961) was even led by this evidence to write, “Religions are systems of healing for psychic illness”

And let’s not mention sparing the world the burden of sexually-transmitted diseases, alcohol and drug-related problems, and other diseases of excess, which as I mention above, have inflicted even doctors and those aspiring to be doctors. With the idea of God fixed firmly in one’s mind, can we imagine those problems? I certainly can’t. Can one imagine in a God-conscious society, children deposit their parents in nursing and residential care homes, and not ask about them except until the time of inheritance comes, a not too infrequent occurrence in this day and age in the United Kingdom, or a residential care home nurse force a 90 year old man, who she does not wish to look after for a night, to go to hospital, who she cunningly ‘diagnosed’ with ‘worsening confusion’ when the poor man has remained in a chronic confusional state (we call it dementia) for years? I think not. Respect for one’s parents is an axiom of all religions – it is part of the Ten Commandements, and the Quran repetitively tells us:

“We have instructed man to be good to his parents. His mother bore him with difficulty and with difficulty gave birth to him; and his bearing and weaning take thirty months. Then when he achieves his full strength and reaches forty, he says, ‘My Lord, keep me thankful for the blessing You bestowed on me and on my parents, and keep me acting rightly, pleasing You. And makemy descendants righteous. I have repented to You and I am truly one of the Muslims’” (46:15)

“Remember when We made a covenant with the tribe of Israel: ‘Worship none but Allah and be good to your parents and to relatives and orphans and the very poor. And speak good words to people. And perform prayer and give the alms.’ But then you turned away–except a few of you–you turned aside” (2:83)

“Worship Allah and do not associate anything with Him. Be good to your parents and relatives and to orphans and the very poor, and to neighbours who are related to you and neighbours who are not related to you, and to companions and travellers and your slaves. Allah does not love anyone vain or boastful” (4:36).

It is my hope, and indeed my main aim in this book, to show that God is alive and apparent in everything in medicine. I hope to use medicine as a medium, so to speak, of my deepest and most strongly felt belief – that God is, and very much so. In His reverence and praise, we have the kind of religious activity that Carrel describes in the following words:

“Religious activity assumes various aspects, as does moral activity. In its more elementary state it consists of a vague aspiration toward a power transcending the material and mental forms of our world, a kind of unformulated prayer, a quest for more absolute beauty than that of art or science. It is akin to esthetic activity. The love of beauty leads to mysticism. In addition, religious rites are associated with various forms of art. Song easily becomes transformed into prayer. The beauty pursued by the mystic is still richer and more indefinable than the ideal of the artist. It has no form. It cannot be expressed in any language. It hides within the things of the visible world. It manifests itself rarely. It requires an elevation of the mind toward a being who is the source of all things, toward a power, a center of forces, whom the mystic calls God. At each period of history in each nation there have been individuals possessing to a high degree this particular sense. Christian mysticism constitutes the highest form of religious activity. It is more integrated with the other activities of consciousness than are Hindu and Tibetan mysticisms. Over Asiatic religions it has the advantage of having received, in its very infancy, the lessons of Greece and of Rome. Greece gave it intelligence, and Rome, order and measure.

Mysticism, in its highest state, comprises a very elaborate technique, a strict discipline. First, the practice of asceticism. It is as impossible to enter the realm of mysticity without ascetic preparation as to become an athlete without submitting to physical training. Initiation to asceticism is hard. Therefore, very few men have the courage to venture upon the mystic way. He who wants to undertake this rough and difficult journey must renounce all the things of this world and, finally, himself. Then he may have to dwell for a long time in the shadows of spiritual night. While asking for the grace of God and deploring his degradation and undeservedness, he undergoes the purification of his senses. It is the first and dark stage of mystic life. He progressively weans himself from himself. His prayer becomes contemplation. He enters into illuminative life. He is not capable of describing his experiences. When he attempts to express what he feels, he sometimes borrows, as did St. John of the Cross, the language of carnal love. His mind escapes from space and time. He apprehends an ineffable being. He reaches the stage of unitive life. He is in God and acts with Him.

The life of all great mystics consists of the same steps. We must accept their experiences as described by them. Only those who themselves have led the life of prayer are capable of understanding its peculiarities. The search for God is, indeed, an entirely personal undertaking. By the exercise of the normal activities of his consciousness, man may endeavor to reach an invisible reality both immanent in and transcending the material world. Thus, he throws himself into the most audacious adventure that one can dare. He may be looked upon as a hero, or a lunatic. But nobody should ask whether mystical experience is true or false, whether it is autosuggestion, hallucination, or a journey of the soul beyond the dimensions of our world and its union with a higher reality. One must be content with having an operational concept of such an experience. Mysticism is splendidly generous. It brings to man the fulfillment of his highest desires. Inner strength, spiritual light, divine love, ineffable peace. Religious intuition is as real as esthetic inspiration. Through the contemplation of superhuman beauty, mystics and poets may reach the ultimate truth.”

I do not agree with Carrel regarding his bias towards ‘Christian mysticism’, but agree with the main thrust of his argument otherwise. I would much rather he said, ‘ deep reflection about God’ rather then ‘mysticism’, a word that has come to have several negative connotations of irrational behaviour and thoughts of late, such as whirling Dervishes and talking with spirits. I wish mysticism was looked upon like Bertrand Russell over 50 years ago, when he said, “The mystic emotion, if it is freed from unwarranted beliefs, and not so overwhelming as to remove a man wholly from the ordinary business of life, may give something of very great value - the same kind of thing, though in a heightened form, that is given by contemplation. Breadth and calm and profundity may all have their source in this emotion, in which, for the moment, all self-centred desire is dead, and the mind becomes a mirror for the vastness of the universe”, but the world, at large, has become too irrational to take such reasonable men seriously.

One of my main aims through this work is to show that medicine can be a great path to God, as a mystical activity so to speak (in the sense of Russell and Mustafa Mahmood), in a similar sense that Paul Davies, one of the most popular scientific writers of our time, believes that science provides a truer path to God than religion. I do not agree with this entirely of course, but can see exactly why he, coming from a Christian background, with its rather unbelievable depictions of God, would say something like that. As far as I am concerned, only two religions provide a truthful picture of God – deism and Islam, the latter being the only uncompromising monotheistic ancient religion. Islam, correctly portrayed, is the most powerful stimulus to medical enterprise. The fact that ‘Islamic countries’ have such poor medical facilities is not evidence that Islam is fruitless, but rather evidence that what they preach and practice are very different, that true ‘submission to God’ is yet to take place in the hearts of their people.



AIMS OF THIS BOOK

Thus the aims of this book are five. Firstly, it is an attempt to bring back God into the world of medicine, to write a medical textbook where His Glory and intelligent design is highlighted, and His Praises are sung for the first time in the English language, and with that, the greatest delight to the monotheistic soul. It aims to show that we can learn so much about Him from its study, in the spirit of the following reported Hadith Qudsi, “"God says, ‘I was a hidden treasure, and I wished to be known, so I created the creation, through it I will be known”. In the first chapter of this work, I aim to show the flaws of the current approaches to this fascinating subject, and how it ought to be approached most appropriately.

Secondly, it is an attempt at demonstrating that there is a lot more to medicine than the dull, exploitative world that I have described here and elsewhere. Besides being philosophically and theistically intriguing, I propose to show that medicine can be aggrandised as Alexis Carrel, the great French surgeon proposed nearly a century ago, into a true multidisciplinary field, involving all professions and all of knowledge. As he states in his wonderful ‘Man the Unknown’:

“Medicine is the most comprehensive of all the sciences concerning man, from anatomy to political economy. However, it is far from apprehending its object in its full extent. Physicians have contented themselves with studying the structure and the activities of the individual in health and in disease, and attempting to cure the sick. Their effort has met, as we know, with modest success. Their influence on modern society has been sometimes beneficial, sometimes harmful, always secondary…Medicine has been paralyzed by the narrowness of its doctrines. But it could easily escape from its prison and help us in a more effective manner. Nearly three hundred years ago a philosopher, who dreamed of consecrating his life to the service of man, clearly conceived the high functions of which medicine is capable. "The mind," wrote Descartes in his ‘Discourse on Method’, "so strongly depends on temperament and the disposition of bodily organs, that if it is possible to find some means which will make men generally more wise and more clever than they have been till now, I believe that it is in medicine one should seek it. It is true that the medicine now practiced contains few things having so remarkable a usefulness. But, without having any intention of scorning it, I am confident that there is no one, even among those whose profession it is, who does not admit that everything already known about it is almost nothing in comparison with what remains to be learned, and that people could be spared an infinity of diseases, both bodily and mental, and perhaps even the weakening of old age, if the causes of those troubles and all the remedies with which nature has provided us were sufficiently well known." Medicine has received from anatomy, physiology, psychology, and pathology the more essential elements of the knowledge of ourselves. It could easily enlarge its field, embrace, in addition to body and consciousness, their relations with the material and mental world, take in sociology and economics, and become the very science of the human being. Its aim, then, would be not only to cure or prevent diseases, but also to guide the development of all our organic, mental, and sociological activities. It would become capable of building the individual according to natural laws. And of inspiring those who will have the task of leading humanity to a true civilization. At the present time, education, hygiene, religion, town planning, and social and economic organizations are entrusted to individuals who know but a single aspect of the human being. No one would ever dream of substituting politicians, well-meaning women, lawyers, literary men, or philosophers for the engineers of the steel-works or of the chemical factories. However, such people are given the incomparably heavier responsibility of the physiological, mental, and sociological guidance of civilized men, and even of the government of great nations. Medicine aggrandized according to the conception of Descartes, and extended in such a manner as to embrace the other sciences of man, could supply modern society with engineers understanding the mechanisms of the body and the soul of the individual, and of his relations with the cosmic and social world…Men grow when inspired by a high purpose, when contemplating vast horizons. The sacrifice of oneself is not very difficult for one burning with the passion for a great adventure. And there is no more beautiful and dangerous adventure than the renovation of modern man.”

This same belief has been expressed by many other physicians and surgeons throughout the ages, although sadly it is not as commonly expressed in this day and age, thanks to the decline in our reflective faculties. The great Irish surgeon, Abraham Colles, whose name is immortalised in the all too common Colles fracture, remarked in his ‘Treatise of Surgical Anatomy’, “Be assured, that no man can know his own profession perfectly, who knows nothing else; and that he who aspires to eminence in any particular science must first acquire the habit of philosophising on matters of science in general.” The famous (and brilliantly named) neurologist Sir Russell Brain described the world of medicine in the following words in an article published in the ‘Lancet’ in 1953:

“Medicine alone takes as its province the whole man…It is concerned with…man in all the complexity of his body and mind from his conception to his last breath; and its concerns extend increasingly beyond his sicknesses, to the conditions which make it possible for him to lead a healthy and a happy life”.

William Osler, the great Canadian physician put it like this in an essay ‘Chauvinism in Medicine’, in his ‘Aequanimitas’, “In no profession does culture count for so much as in medicine, and no man needs it more than the general practitioner.”

Although my aims are a far cry from the megalomaniac dreams of Carrel, I do indeed aim to show that medicine is wider than commonly thought. I hope to use medicine as a carrier, if you like, of other interesting fields of knowledge, to entertain the reader, and place medicine within the wider scheme of things. I wish to exhibit medicine as an integral part of scientific, philosophical, social and political life, not as the isolated speculations and practices of random physicians. I will attempt to connect the various medical problems that I discuss with aspects of everyday life, to show that medicine is connected with some of our deepest notions about life. In this way, medicine would be regarded as something that transcends traditional boundaries and an intellectual, as well as practical, exercise and art. I hasten to add that this is not a foreign idea, and that I think that it is this magnificent fusion of medicine, art and science that is the secret for the great success of the ‘Oxford Handbook of Clinical Medicine’, the world’s best selling pocket medical handbook – a book that, in its latest (7th) edition together with the medical knowledge of our time, begins its figures not with a picture of an ECG or chest X-ray, but with a picture of the constellation of Orion as its first figure, saying:

“Like the stars, ideals are hard to reach, but they serve for navigation during the night…We choose Orion as our emblem for this navigation as he had miraculous sight (a gift from his immortal lover, Eos, to help him in his task of hunting down all dangerous things) – and as his constellation is visible in the Northern and the Southern hemispheres (being at the celestial equator), he links our readers everywhere”.

And moves on to discussion of historical medical figures like James Paget (“who would regularly see more than 60 patients a day”) and Sir Dominic Corrigan (“who was so busy 160 years ago that he had to have a secret door made in his consulting room so that he could escape from the ever-growing queue of eager patients”), and concludes it with a quote from Shakespeare’s ‘Macbeth’:

“However busy the ‘on take’, your period of duty will end. For you, as for Macbeth:

Come what come may,
Time and the hour runs through the roughest day”

It even has an entire page devoted to ‘Medicine, Art and the Humanities’, discussing the likes of Arthur Connan Doyle, William Carlos Williams, Somerset Maugham and Anton Chekhov, George Bernard Shaw and Sigmund Frued, as well as fictional characters like Dr. Watson and Dr. Faustus. It moves on in the next few sections to quote the likes of Václav Havel, the Czech writer and dramatist, and the last President of Czechoslovakia and the first President of the Czech Republic, Marcel Proust, the great French novelist, “that life long all knowing patient”, even Enid Blyton – author of the ‘Famous Five’. And from then on, the names of Thomas Hobbes, Wilfred Owen, Sylvia Plath, Charles Darwin, Alexander Pope, William Wordsworth, Albert Camus, Carl Friedrich Gauss, and many others are scattered throughout its pages. The point of all this is just what I have said – that there is more to medicine than meets the eye.

Another of its aims is to reinforce the fun factor in medicine. By viewing medicine within the wider context, looking at its impact on history, famous figures, and vice versa, we learn much that is fascinating. Teaching with the 'fascinating case' has a long tradition in medical education and has a popularity that extends beyond medical audiences. At their best, such stories serve more than a didactic purpose - they provide a glimpse of the diversity of human experience and the moral and social dimensions of illness.

In particular, I have tried to incorporate as many artists’ depictions of disease as I possibly could, in the firm belief that, being naturally endowed with a greater power of description than most other people, their views of disease are those that would be most vividly recalled by the reader. Take for instance Anton Chekhov’s (also a medical man) description of his bouts of haemoptysis due to the tuberculosis that eventually killed him. Fyodor Dostoyevsky’s struggles with epilepsy, Benjamin Franklin’s gouty agonies, Jane Austen’s descriptions of her presumed Addisonian crises, and Ludwig von Beethoven’s tears of anguish over his deafness. Nothing that I have read in the medical textbooks available at present compares to the power of the images by which those greats portrayed their illness. This work is full of extracts from their works or statements, in the hope that they will have a similar impact on the reader.

In addition, realising that some figures, typically associated with certain symptoms, had, or possibly had (after all, there is much conjecture in all of history, let alone medical biography) certain disorders, may reinforce the rarer aspects of some diseases. For example, much is written at present of the possibility of Beethoven (a figure immortalised to the layman by his majestic music and deafness, and from the medical perspective with his ascites and multiple paracenteses) suffering from sarcoidosis. On knowing this, one immediately learns three things about sarcoidosis – that it is a multisystemic disorder, that it can affect the liver (though it is certain the alcohol did the greater part of the damage), and also hearing – more specifically the vestibulocochlear nerve. Knowing that his autopsy showed renal calculi will also help recall sarcoidosis as an important cause of hypercalcaemia.

Awareness of how celebrities have endured certain diseases can help in several other ways. The following extract, from Bower and Waxman’s ‘Lecture Notes On Oncology’, summarises these well; although it relates mainly to oncology, it can certainly be applied to other fields too:

“Celebrities influence public perceptions and behaviour inordinately, and this is true in oncology as elsewhere. Celebrities with cancer have contributed in three main ways; personal accounts bring patients’ experiences into the limelight, reports of celebrity patients increase public awareness and may encourage health-seeking behaviour such as stopping smoking, and celebrity patients may support cancer charities and encourage donations. Prominent examples of patient’s perspectives include John Diamond’s account in 'C: because cowards get cancer, too' and Ruth Picardie’s 'Before I say goodbye', both moving accounts by accomplished journalists. Celebrity patients can influence the treatment choices that the public make. Following Nancy Reagan’s mastectomy for localized breast cancer in 1987, there was a 25% fall in American women choosing breast-conserving surgery over mastectomy. Her husband’s successful surgery for Dukes’ B colon cancer while president in 1984 increased awareness and propelled the warning signs of colon cancer into the media. Successful cancer treatment is often most widely publicized, and no article describing Lance Armstrong’s cycling victories seems complete without a mention of his treatment for metastatic non-seminomatous germ cell tumour, or of his two children conceived with stored sperm banked prior to chemotherapy. Other celebrity patients have used their wealth and fame to establish and support charitable projects to support cancer research and treatment, including Bob Champion, the steeple-chase jockey treated for testicular cancer in the 1970s, and Roy Castle, a lifelong non-smoker who was diagnosed with lung cancer in 1992. Of course, no one is immune to cancer, even rock stars whose deaths are traditionally associated with suicide and substance abuse”.

The fourth aim of this work is to oppose the current trend of increasing ‘scientification’ and complexity of medicine and the basic medical sciences. I have been to many medical lectures, where the speaker spends an hour or so dealing with the scientific minutiae of diseases. I always found nearly all of these lectures extremely dull. But this is not a criticism of the speakers; it is a natural consequence of the increasing ‘specialisation’ of medicine. Unless complicated scientific ideas are grounded in philosophical concepts or aspects of everyday life, I find them a lot less exciting or indeed memorable. By relating them to the questions of life that matter most to us, many of which are essentially the substance of philosophy, they will inevitably be a lot more memorable, and much more stimulating. I aim to analyse, as well as synthesise medicine, as I have studied it, into a coherent whole. I cannot help but quote the great (though at times controversial) Alexis Carrel again on this issue:

“Still more harm is caused by the extreme specialization of the physicians. Medicine has separated the sick human being into small fragments and each fragment has its specialist. When a specialist, from the beginning of his career, confines himself to a minute part of the body, his knowledge of the rest is so rudimentary that he is incapable of thoroughly understanding even that part in which he specializes. A similar thing happens to educators, clergymen, economists, and sociologists who, before limiting themselves entirely to their particular domain, have not taken the trouble to acquire a general knowledge of man. The more eminent the specialist, the more dangerous he is. Scientists who have strikingly distinguished themselves by great discoveries or useful inventions often come to believe that their knowledge of one subject extends to all others. Edison, for example, did not hesitate to impart to the public his views on philosophy and religion. And the public listened to his words with respect, imagining them to carry as much weight on these new subjects as on the former ones. Thus, great men, in speaking about things they do not thoroughly understand, hinder human progress in one of its fields, while having contributed to its advancement in another. The daily press often gives us the dubious benefit of the sociological, economic, and scientific opinions of manufacturers, bankers, lawyers, professors, physicians, whose highly specialized minds are incapable of apprehending in their breadth the momentous problems of our time. However, modern civilization absolutely needs specialists. Without them, science could not progress. But, before the result of their researches is applied to man, the scattered data of their analyses must be integrated in an intelligible synthesis.

Such a synthesis cannot be obtained by a simple roundtable conference of the specialists. It requires the efforts of one man, not merely those of a group. A work of art has never been produced by a committee of artists, nor a great discovery made by a committee of scholars. The syntheses needed for the progress of our knowledge of man should be elaborated in a single brain. It is impossible to make use of the mass of information accumulated by the specialists. For no one has undertaken to coordinate the data already obtained, and to consider the human being in his entirety. Today there are many scientific workers, but very few real scientists. This peculiar situation is not due to lack of individuals capable of high intellectual achievements. Indeed, syntheses, as well as discoveries, demand exceptional mental power and physiological endurance. Broad and strong minds are rarer than precise and narrow ones. It is easy to become a good chemist, a good physicist, a good physiologist, a good psychologist, or a good sociologist. On the contrary, very few individuals are capable of acquiring and using knowledge of several different sciences. However, such men do exist. Some of those whom our scientific institutions and universities have forced to specialize narrowly could apprehend a complex subject both in its entirety and in its parts. So far, scientific workers devoting themselves, within a minute field, to prolonged study of a generally insignificant detail, have always been the most favored. An original piece of work, without any real importance, is considered of greater value than a thorough knowledge of an entire science. Presidents of universities and their advisers do not realize that synthetic minds are as indispensable as analytic ones. If the superiority of this kind of intellect were recognized, and its development encouraged, specialists would cease to be dangerous. For the significance of the parts in the organization of the whole could then be correctly estimated.”

The final aim of this work is to show that, just like the world needs submission to God (Islam), the medical world needs Him. In a truly Islamic world, governed by the principles of truth and justice, the patients would be better, the doctors would be better, and overall, we will all lead happier lives.

In short, this book is a set of intellectual, scientific, philosophical and religious ruminations over medical topics, and is full of attempts at finding out ‘why’ things are as they are. It will aim to remain true to the strictest philosophical traditions of the past, where philosophy was defined not as an ivory-tower field, isolated from reality, but, as defined by some, as “the study of humans and the world by thinking and asking questions. It is not part of science, because it is not an observation of things in the real world to find out how they work. Philosophy tries to answer important questions by coming up with answers about real things and asking "why?”. Philosophy encourages people to ask the reason behind everything. It is the speculation bit; when believed firmly without wavering and no scientific evidence, it is labeled faith. If strong scientific evidence abounds, it becomes science. In that sense, no one defined philosophy better than Sir Bertrand Russell, when he said in the introduction to his magnificent monument, and arguably the best introductory philosophy book, ‘The History of Western Philosophy’:

“Philosophy, as I shall understand the word, is something intermediate between theology and science. Like theology, it consists of speculations on matters as to which definite knowledge has, so far, been unascertainable; but like science, it appeals to human reason rather than to authority, whether that of tradition or that of revelation. All definite knowledge -- so I should contend -- belongs to science; all dogma as to what surpasses definite knowledge belongs to theology. But between theology and science there is a No Man's Land, exposed to attack from both sides; this No Man's Land is philosophy. Almost all the questions of most interest to speculative minds are such as science cannot answer, and the confident answers of theologians no longer seem so convincing as they did in former centuries...The studying of these questions, if not the answering of them, is the business of philosophy”.

The medical professional is in an extremely privileged position, in that he or she is engaged in some of the deepest philosophical questions that trouble mankind, sometimes much more directly than the philosopher himself. For who is it who diagnoses the beginning of life, and has the first encounter with death. Who is it who oversees the birth of a child, and his or her growth and development? Who is it who sees man at his frailest, and bears witness to God’s statement, “Man was created weak” (3:28)[10]

However, if I were to mention my biggest hope from this work, it is to reawaken this beautiful thing called the sense of wonder, which is numbed so often by being adults who have seen things so regularly without contemplation over them, is the chief aim of this work. If one were to retain the sense of childlike wonder over medicine, and common disorders, I am sure medicine will advance at a far more staggering rate than it is, and certainly imparting that sense of wonder to its students would only excite them and motivate them to practice it with true passion. Too often students and practising health professional treat medicine as ‘just another job’, forgetting its noble ideas and all that it stood for since its conception, probably with the birth of man. They forget that there is more to medicine than utility and paying the bills. The great French mathematician Henri Poicare once remarked regarding the work of the scientist:

“The scientist does not study nature because it is useful; he studies it because he delights in it, and he delights in it because it is beautiful. If nature were not beautiful, it would not be worth knowing, and if nature were not worth knowing, life would not be worth living”.

In like fashion, the medical professional, especially the doctor, ought not to study medicine, or keep abreast of its progress simply because it is useful, but because it is a great source of delight, because it is it beautiful. And to paraphrase Poincare, if the human body was not beautiful, it would not be worth knowing, and if the human body was not worth knowing, life would not be worth living. Man was created to know, and worship via that ability to know. Hence the very first word in the Holy Quran was, “Read” (96:1). Know. Acquire knowledge.

There have been many descriptions of the ideal doctor, and I will not bore the kind reader with them, many of which are attributes of angels, not of human beings. But to me, the ideal doctor is quite simply, one who combines knowledge and wisdom with humanity. He displays what Phil R Manning described, “An inquiring, analytical mind; an unquenchable thirst for new knowledge; and a heartfelt compassion for the ailing – these are prominent traits among the committed clinicians who have preserved the passion for medicine”. Barton Childs described this physician quite brilliantly saying, “The best of all worlds is attained in the doctor who cleaves to the Oslerian ideal in practice and the Garrodian in thinking” – William Osler was the founder of bedside medicine as we know it now, and Archibald Garrod was a most brilliant clinician and scientist, and the man who succeeded Osler as Regius Professor of Medicine at Oxford. He or she does not aim to pass exams with the aim of entering the field to fulfil a desire for status, power or money. Indeed, this is one of the sad features of modern medical student thinking, as Neville Woolf, Vice-Dean and Faculty Tutor at the University College Medical School and professor of histopathology put it:

“It is a fact, albeit a regrettable one, that many students, perhaps the majority, are obsessively concerned with passing examinations, which become for them the raison-d’etre rather than a by-product of medical education. Even at this pragmatic level, it should be understood that the process of learning transcends the acquisition, partial retention and more or less accurate reproduction of a large body of factual knowledge. Real learning should be based on understanding and the ability to use knowledge in disparate contexts; it is one of the few of life’s pleasures which does not lose its savour with passing time, provided only that we do not lose our sense of wonder as the mysteries of nature are made clear, however slow and tantalisingly incomplete this process seems”.

Instead, they enter its world in order to fulfil the higher purposes of medicine - “to prevent disease, to relieve suffering and to heal the sick” (as the great Canadian William Osler put it, the ideal physician in my humble opinion), regardless of any consequences on power or money. He or she does not learn medicine without books (for that would be, as Osler, put it, like one who “sails an uncharted sea”). But he or she knows that “while books are good enough in their own way, they are a mighty bloodless substitute for life”, as Robert Louis Stevenson brilliantly put it, and using them alone, without seeing patients, is like one who “does not go to sea at all”[11]. He or she is dedicated to their message of advocating health and eliminating disease or its consequences.

I have just touched upon the sense of wonder, and I think it is vital to the progress of medicine and to the happiness of the practising medical professional and thus his or her patients. There is a notorious lack of wonder among members of the profession, perhaps because of external pressures, the way medicine has become much more mechanical, with an emphasis on protocols and guidelines, leading to its current state of mundane monotony. This feeling can only be eradicated with development of a refined sense of wonder. To paraphrase the great British geneticist John Durdon Haldane, the modern medical world I fear, “shall perish not perish for lack of wonders, but for lack of wonder”.

Everything in life is a wonder; nature is full of wonder. Not least medicine; it deals with one of the greatest works of God, the human body, and its diseases. Wonder is the default state in medicine, not the exception. I am not talking here about the wonders that seem to provoke media hype – the 62 year old Californian lady who recently “gave birth to her 12th child”, or the stroke patient who was given no chance of recovery, put on palliative care, yet recovered fully within a few weeks, or the young man whose story is recounted by James Barron in ‘The New York Times’ a few months ago:

“Alcides Moreno plunged 47 stories that morning last month, clinging to his 3-foot-wide window washer’s platform as it shot down the dark glass face of an Upper East Side apartment building. His brother Edgar, who had been working with him on the platform, was killed.

Somehow, Alcides Moreno survived

If you are a believer in miracles, this would be one,” said Dr. Philip S. Barie, the chief of the division of critical care at New York-Presbyterian Hospital/Weill Cornell Medical Center in Manhattan, where Mr. Moreno, 37, is being treated.”

I myself have seen many instances of similar ‘miraculous’ patient recoveries in my few years of practice, cases that struck the minds of even the most sceptical of my consultants, and it really is a stunning thing.

But it really shouldn’t, or at least it shouldn’t shake ones soul more than the observation of the more ordinary patients and their recovery. For wonder is everywhere, and as Francis Bacon put it, “God never wrought miracles to convince atheism, because his ordinary works convince it”. The miracle is the rule, not the exception. It is this sense of wonder, the sense of everything being a miracle that can seriously fill the medical professional, as it does the scientist, with the deepest awe. It’s a feeling that was so beautifully expressed by Albert Einstein, as follows:

“The most beautiful and most profound experience is the sensation of the mystical. It is the sower of all true science. He to whom this emotion is a stranger, who can no longer wonder and stand rapt in awe, is as good as dead. To know that what is impenetrable to us really exists, manifesting itself as the highest wisdom and the most radiant beauty which our dull faculties can comprehend only in their primitive forms - this knowledge, this feeling is at the center of true religiousness”.

All the great scientists were of the wondering type. They never lost their childlike naïveté over the mysteries of nature, and through this faculty of not taking familiar things for granted, succeeded in causing the progress of science. Isaac Newton, the greatest scientist of all time put it this way:

“I do not know what I may appear to the world; but to myself I seem to have been only like a boy playing on the seashore, and diverting myself in now and then finding a smoother pebble or a prettier shell than ordinary, whilst the great ocean of truth lay all undiscovered before me”

The great Albert Einstein (regarded by some as second to Newton) wrote in a letter to a friend towards the end of his life, “We never cease to stand like curious children before the great mystery into which we were born”.

Simone Weil described science saying, “The true definition of science is this: the study of the beauty of the world”, and insisted, “A science which does not bring us nearer to God is worthless.” In a similar vein, I belief that one of the best definitions of medicine would be “the study of the beauty of the human body in health and disease, and the application of that knowledge to the sick”, and that if it were not to bring us nearer to God, the source of all beauty and wonder, it would be worthless.

In the medical world, unfortunately, we lack this sense of wonder, and why, compared with the natural sciences, particularly physics, medicine is still in its infancy. This is probably a harsh criticism of doctors, who are often engrossed in the practical care of patients, allowing little time to pause and reflect upon their practice. This contrasts with most physicists, who are daily engrossed with ‘understanding’ rather than practical problems. But there are practical physicists, involved in electrical and mechanical engineering aspects. Why can there not be a bunch of reflective physicians, who can spread the wonder of medicine around, while the more practical ones are occupied with their work? I feel it is necessary; only that will strip medicine from its current state of relative inexcitement, and strip us of our current overall state of arrogance and bewilderment, in a time when we think science, technology and power is everything, when the educated have lost the simplicity of belief in the One, the Master of All, and resorted to belief in complicated, dubious concepts such as evolution and quantum fluctuation. It will reconnect us with the attitude of our elders, who saw His hand in everything, leaving them stunned and humbled by the beauty of it all, they who knew that there is a greater power than us around, capable of achieving things we cannot achieve, and sang:

“I walk in beauty
Beauty is before me,
Beauty is above me,
Beauty is below me,
Beauty is around me,
I walk in beauty”



A physicist, Paul Heckert described his job as follows:

“Physicists are the perpetual three year olds of science. They always ask: Why? Physics is about observing nature, from elementary particles to the entire universe, and wondering why and how it works. While enjoying the beauty of natural phenomena such as rainbows or dark star filled skies, physicists continue trying to understand how they work. Achieving this understanding enhances nature's beauty. The best physicists keep their childlike wonder while unraveling nature's mysteries. As Whitman's Learned Astronomer, they show "the charts and the diagrams, to add, divide and measure them" while continuing to wander off "in the mystical moist night-air, and from time to time [look] up in perfect silence at the stars"”.

Since reading that I have wondered, how wonderful would it be if we had a bunch of three year olds of medicine!?

And the sense of wonder of physicists has, over the past hundred years, been connected with a sense of higher cosmic purpose. Virtually all the great physicists have been involved, in one way or another, with questions that would have been regarded before as a matter of metaphysics. This has especially been the case in post-Victorian times; prior to that physicists lived in ‘metaphysical security’, and didn’t deal with the deep questions of life the way the 20th and 21st century physicist does. With the sense of loss that has pervaded humanity over the past century, physicists have been trying to find solutions and answers from their studies.

The sense of cosmic purpose that many physicists have been advocating over the past 100 years should, I feel, be analogously utilised by medical professionals. As I have just illustrated, the medical world is an absolute mess at the moment. It is my firm belief that the idea of God and divine involvement within it can impart to it a great deal of order, and with that a great delight to the medical professional and his or her patients. This is what Jacob Needleman, a professor of philosophy at San Francisco State University says on the issue:

“The fate of medicine in the contemporary era is testimony to the teaching contained in the symbol of the caduceus. The meaning of the art of medicine, like the very meaning of being alive, cannot be found through one force alone. When the contemporary physician complains that the meaning of his craft is being taken away from him – by such mundane influences as government intervention, legal restrictions, hospital data banks, and insurance companies – we need to hear this complaint in a special way, because it is the same for all of us. More and more, we are all becoming aware that our lives are being lived for us by influences that, however numerous they appear, are in fact only so many reflections of one kind of movement in the life of man, a movement toward externals, toward needs and gratifications that, however justified in their own right, become destructive when they pretend to represent the whole meaning of human life….The meaning of being a physician can only be recovered through a rediscovery of the question of the meaning of human life itself, the meaning of being alive.”

Only by knowing our purpose in life, that we were created to worship and glorify God, will medicine find its meaning, and the medical professional will find his lost soul. The atheist or agnostic has no higher purpose in life – for he or she do not believe anything exists outside that perceived by our five senses. This point can only be realised by incorporating the idea of God with discussions of medical problems.

And linking this sense of higher purpose with the sense of wonder, one reviewer reviewing Needleman’s fantastic book, ‘The Way of the Physician’, writes:

“The physician has become the dispirited pawn of a "medical arms race" in which financial considerations are taking precedence over the welfare of patients. Cut off from great ideas and awakening experiences, doctors are either complacent or riddled with tension. Addressing them directly, the author mourns: "You are dying in your tracks, and you know it." Medicine for the practitioner and the patient alike, this book says that we need to train doctors to be wise healers working on the heart, not mechanics who fix bodies. Carrying resonances of Robert M. Persig's ground-breaking Zen and the Art of Motorcycle Maintenance, it points to the physician's quest, now, as our own: to rediscover the moral wonder that will enable us "to do the right thing and do it well".

The best physician is one who addresses the body and mind of all his or her patients, and addresses the ideas that impact those two things within his community. He need not do this with drugs; in fact, he should go to drugs only as a last resort for illness of all types, physical and psychological. He knows that, “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (the WHO definition, “a definition which was ratified during the first World Health Assembly, and has not been modified since 1948”), and that this will not be achieved in the presence of so many astonishingly bad philosophies and ideas. Thus, in this work I may go off on a tangent here and there, discussing a philosophy or ideology which is connected directly or indirectly, in a very subtle or blatant fashion, so as to help achieve this purpose. (The same case applies of course for the female physician)

With that in mind, let us begin our journey into the medical world, and explore it by way of wonder. There is no more powerful tool for the recall of knowledge than associating it with an element of wonder and the happiness that comes with it. A recently published medical textbook states that, “Facts are most efficiently memorized as visual images, chunks, acronyms, rhymes, webs etc, and as we update our knowledge, we must first recall our pre-existing schema of the topic, and then peg the new data onto this internal structure” (Bentley, 2007). How about if this internal structure was that of happiness and wonder? Socrates remarked that “wisdom begins in wonder”. It is not a surprise that the Arabic words for wise man and physician are the same, (‘hakeem’), both of which also overlap with the word ‘Failasuf’ (philosopher) – from the Greek for ‘the love of wisdom’.

The methodology is this - I begin most discussions of diseases with a brief look at how they have impacted humanity, mainly by glances at their impact on history or historical figures and how the latter particularly coped with their illness. There is much to learn from the historical outlook, and it would enrich the present day medical student in more than one way. Most importantly, it makes the learning of medicine much more pleasurable and enthralling, and less dry than commonly seen in present day textbooks (is it just me or did the medical writers of the past really write more joyfully than their present counterparts?!). I then proceed with discussion of the various presentations of illness, highlighting the features I have discussed in the aforementioned section.

As is natural for a book like this, many of my personal opinions are expressed, and personal heroes have crept in and extensively quoted. I hope the reader will find no offence in this. Finally, if this book were to instill in the kind reader that sensational moment of wonder and delight, the beautiful perception of the mystical, as Albert Einstein would have put it, its aims would have been achieved. I hope that God will accept this work as an act of gratefulness to Him, the source of all beauty and wonder.

Dr. Fahed Al-Daour
2nd of September 2008


[1] Newton, and this may come as a surprise to most readers, spent a far greater proportion of his 85 years in the study of religion and the Bible than on his scientific theories.

[2] For without the idea of God enshrined in one’s daily thoughts, as it is in atheism, putting it on the shelves, as secularists do, to be consulted only when one feels he or she wants to, would be the easiest thing.
[3] I cannot help but quote how the late Martin Seymour-Smith described Dawkins’ writing style in his brilliant ‘The 100 Most Influential Books of All Time’, “He gained a facility for a style of writing which like that of the tabloid press, conceals its confusions beneath a mask of almost bewildering facility. “The argument of this book is that we, and all other animals, are machines created by our genes. Like successful Chicago gangsters, our genes have survived, in some cases for millions of years, in a highly competitive world. This entitles us to expect certain qualities in our genes. I shall argue that a predominant quality to be expected in a successful gene is ruthless selfishness... This gene selfishness will usually give rise to selfishness in individual behavior. However, as we shall see, there are special circumstances in which a gene can achieve its own selfish goals best by fostering a limited form of altruism at the level of individual animals. 'Special' and 'limited' are important words in the last sentence. Much as we might wish to believe otherwise, universal love and the welfare of the species as a whole are concepts that simply do not make evolutionary sense. This brings me to the first point I want to make about what this book is not. I am not advocating a morality based on evolution. I am saying how things have evolved. I am not saying how we humans morally ought to behave. I stress this, because I know I am in danger of being misunderstood by those people, all toll numerous, who cannot distinguish a statement of belief in what is the case from an advocacy of what ought to be the case. My own feeling is that a human society based simply on the gene's law of universal ruthless selfishness would be a very nasty society in which to live. But unfortunately, however much we may deplore something, it does not stop it being true. This book is mainly intended to be interesting, but if you would extract a moral from it, read it as a warning. Be warned that if you wish, as I do, to build a society in which individuals cooperate generously and unselfishly towards a common good, you can expect little help from biological nature. Let us try to teach generosity and altruism, because we are born selfish”. This astonishingly confused rubbish, in which the complex and essentially interactive gene is individualized, simplified, and personalized and then taken quite illogically to resemble a whole human being, had and still has some popularity among certain sorts of reader. ..there is certainly no room here for the archdunce Dawkins”. Seymour was a professor of English Literature, and, as the poet and critic Robert Nye put it, was "one of the finest British poets after 1945”. So he knows what he is talking about. And he was an atheist, so his attack on Dawkins cannot be attributed to a difference of opinion with regards to the idea of God.
[4] ‘Peace’ (Al-Salam) is one of the names of God, as is apparent from the following verse, “He is Allah–there is no god but Him. He is the King, the Most Pure, the Perfect Peace, the Trustworthy, the Safeguarder, the Almighty, the Compeller, the Supremely Great. Glory be to Allah above all they associate with him”(59:23). In addition, “In Arabic, Islām derives from the three-letter root س-ل-م, which means "to be in peaceful submission; to surrender; to obey; peace". Islām is a verbal abstract to this root, and literally means "submission/obedience," referring to submission to Allah”. Islam is about being at peace with oneself, and with others, through a continuous awareness of God.
[5] I am yet to see a suicide attempt that was triggered by something more serious than that.
[6] Bertrand Russell put it best, “Drunkenness is temporary suicide: the happiness that it brings is merely negative, a momentary cessation of unhappiness”.

[7] The Quran put it beautifully, “Already have We urged unto hell many of the jinn and humankind, having hearts wherewith they understand not, and having eyes wherewith they see not, and having ears wherewith they hear not. These are as the cattle - nay, but they are worse! These are the neglectful” (7:179).

[8] We read the following verses of the Bible – Colossians (1:16) which says, "All things were created by him and for him." and Isaiah (43:21), “The people which I formed for Myself, that they might tell of My praise”. In the Quran, two similar verses embody that belief, “I have created not the jinn and men except that they should worship Me” (51:56-58) and, “So glorify the praises of your Lord and be of those who prostrate themselves (to Him). And worship your Lord until there comes unto you the Hour that is certain (i.e. death)” (15:98-99)).

[9] The same idea, of our purpose in life being to glorify God is expressed in the wonderful deistic traditions of the American Fathers and French Enlightenment, whose chief American exponent, the great Thomas Paine, writing in his classic ‘The Age of Reason’ (1794), said, “The true Deist has but one Deity, and his religion consists in contemplating the power, wisdom, and benignity of the Deity in his works, and in endeavoring to imitate him in everything moral, scientific, and mechanical…(his religion) honors reason as the choicest gift of God to man, and the faculty by which he is enabled to contemplate the power, wisdom and goodness of the Creator displayed in the creation; and reposing itself on His protection, both here and hereafter …While man keeps to the belief of one God, his reason unites with his creed. He is not shocked with contradictions and horrid stories. His bible is the heavens and the earth. He beholds his Creator in all His works, and everything he beholds inspires him with reverence and gratitude. From the goodness of God to all, he learns his duty to his fellow-man, and stands self-reproved when he transgresses it. Such a man is no persecutor”.
[10] Indeed, Harun Yahya wrote an article on the issue, ‘The Weaknesses of Man’, which reads like a medical description of the human body. Highly recommended reading (see appendix).
[11] It is the genius of Osler that he does not say ‘the sea’ here; for both the unqualified ‘sea’ is heard the same as see, and the meaning is equally powerful.