Reflection at Coromandel

I woke up in the morning, seeing beautiful scenery presented before me, the air so fresh blowing, the weather so invigorating, providing perfect time and ambience to reflect beyond what is perceived.

I brought my daughter to see, to feel and to capture the moment, as it is not something permanent, something which is rapidly passing, but could only be experienced with alertness of senses so that passing of time can feel long, for the innate character of time which is relative.

It is very interesting to see, an innocent, not knowing, fresh white silk, baby presented with such a vast, perfect design of nature, what could potentially go into her mind? Birds, ocean, sky, mountains, plants, could all of these mean anything to her? The response I observed was a moment of staring at something new and unseen before, inquisitive in character and then her attention shifted to other things around, back to playing!

Such is the beginning of us all. We started from not knowing and things were thought to us by bimodal means, internal and external. Internal is the development of our neuronal networks in the different areas of the brains and sensory modalities as well as spiritual connection which is related to our heart while external is the world that is presented to us to induce and stimulate our internal faculties. The interesting bit is that the development of internal faculties is very dependent on stimulation from the external, the world. Similarly, the development and advancement in this world and the way we develop and maintain our lives would also be dependent and influenced by the extent to which our internal faculties develop.

In Denver's Development Milestone, we learn how a baby develops through the milestones. From crying, smelling and hearing to recognition of familiarity through senses, movement of gross motors, transferring objects passing the middle line, rolling over, crawling, kneeling, standing, walking and so on. All these are measured physical development as a manifestation of neuronal development. A busy process of new synapses formation and synaptic pruning occurred every seconds with several growth spurts throughout the course.

One of the capabilities which is very important and serve as the door to knowing, perceiving, and our dynamic worldview is observation and synthesis of our sensory perceptions. The other capability which is also crucial is an inquisitive mind. The sensory development allows the unknown to be seen, felt, heard, touched, tasted, smelled. The problem is that the sensations we perceive may be interpreted or non-interpreted in so many ways. Hence, there is a gap between sensory modalities, the information we get and what it really means. The development of internal faculties, stimulation from external environment leave within the human being a gap in perceiving what the design around really means.

Such has left human being rooms to interpret the world as they experience it, to test from observation and confirm from reproducible results from experiments. Regular patterns recognised and known as laws/principles and we understand, there are certain things which are principles and they are universal. There are certain things which are theories and hypotheses that may or may not produce the same results when tested again and again. The body of knowledge develops through this process and transferred from generation to generation.

Such interactions between the bimodal means created varieties and it is meant to be so by Allah SWT. It is very clearly mentioned in the Al-Quran that He created human being in different tribes so they can learn on each other. Different geographical context, different thought processes, deriving different knowledge, culture, arts ,etc.It comes back to the concept of unknown: something we have not seen ourselves but seen by others might mean to us differently compared with people who have the knowledge that has been tested across generations.

The design of internal faculties and external environment also leave human being with multiple beliefs and religions and this is also intended by Allah as He mentioned that if He so willed, He could make  all of human being believers.

From Islamic perspective, we understand while there are these varieties, there is a thing while it is left to human faculties and the Book of Nature for us to read, the two gifts will never be able to answer it and for which reason Messengers are sent from generation to generation. The very question of the purpose of life, who we are, is something that only the Creator, Allah SWT can lead us so that this journey of interactions between the two gifts will all fall into place. When this occurs, the other layer of knowledge is then opened, to see beyond what is seen, to read beyond what is readable, to understand beyond what is heard rooted in the right angle from which we project our journey of life.

I looked back at my daughter, knowing that she has already started her journey, with interaction between internal faculties and the Book of the World, with knowledge and education will she learn more and more of what she saw today, adding meaning to her life. What would be important is to teach her the Book of Signs( Al-Quran) so that interaction occurs between the Book of Signs and Book of the World so life is projected from the right angle.

It is verily true that Allah SWT teaches human being things they don't know, and the way to learn from this knowledge hidden in this Book of World is to start with His name to open another perspective, to see beyond what is seen, understand beyond what is presented, verily there must be a Creator who is beautiful and loves what is beautiful, for which reason this beauty is presented to us so that beauty is also implemented and applied in our life.

-Reflection from Coromandel, NZ-11.00 am, 2nd March 2015

Last day as a student-doctor

Alhamdulillah, thumma alhamdulillah.

My last day as a student-doctor. A lot of memories, struggles and challenges faced throughout 6 years of journey. Thank you Allah SWT for  the help, assistance and guidance through teachers, family and friends.

Hoping for a constant and continous guidance to benefit humankind insyaAllah. It's a real privilege to be chosen to shoulder this job, hearing the sufferings and connecting with His blessings.

May Allah makes us all beneficial yesterday,today and tomorrow for the ummah and for human being insyaAllah.

1/11/12
15th Dzulhijjah 1433

How Islam Changed Medicine-Article from BMJ

How Islam changed medicine

Azeem Majeed, professor of primary care (a.majeed@imperial.ac.uk)

Author Affiliations

Department of Primary Care and Social Medicine, Imperial College Faculty of Medicine, London W6 8RP

Arab physicians and scholars laid the basis for medical practice in Europe

Islamic civilisation once extended from India in the east to the Atlantic Ocean in the west. Buildings in Andalusia such as the Alhambra in Granada, the Mezquita in Cordoba, and the Giralda in Seville are reminders of the architectural imprint this civilisation left on western Europe. Less well remembered, however, is the impact of Islamic civilisation on Western science, technology, and medicine between the years 800 and 1450.1 As was argued this month at the Royal Institution, today's Western world might look very different without the legacy of Muslim scholars in Baghdad, Cairo, Cordoba, and elsewhere.2

As Islam spread out of the Arabian Peninsula into Syria, Egypt, and Iran it met long established civilisations and centres of learning. Arab scholars translated philosophical and scientific works from Greek, Syriac (the language of eastern Christian scholars), Pahlavi (the scholarly language of pre-Islamic Iran), and Sanskrit into Arabic. The process of translation reached its peak with the establishment of the “House of Wisdom” (Bait-ul-Hikma) by the Abbasid Caliph Al-Mamun in Baghdad in 830. It made Arabic the most important scientific language of the world for many centuries and preserved knowledge that might otherwise have been lost forever.

As well as assimilating and disseminating the knowledge of other cultures, Arab scholars made numerous important scientific and technological advances in mathematics, astronomy, chemistry, metallurgy, architecture, textiles, and agriculture. Techniques they developed—such as distillation, crystallisation, and the use of alcohol as an antiseptic—are still used.

Arab physicians and scholars also laid the basis for medical practice in Europe. Before the Islamic era, medical care was largely provided by priests in sanatoriums and annexes to temples. The main Arabian hospitals were centres of medical education and introduced many of the concepts and structures that we see in modern hospitals, such as separate wards for men and women, personal and institutional hygiene, medical records, and pharmacies.

Ibn Al-Nafis, a 13th century Arab physician, described the pulmonary circulation more than 300 years before William Harvey.3 Surgeon Abu Al-Qasim Al-Zahrawi wrote the Tasrif which, translated into Latin, became the leading medical text in European universities during the later Middle Ages. Al-Zahrawi was also a noted pathologist, describing hydrocephalus and other congenital diseases as well as developing new surgical technologies such as catgut sutures.4 5 Some describe Al-Razi (Rhazes), born in 865, as the greatest physician of the Islamic world. He wrote Kitab Al-Mansuri (Liber Almartsoris in Latin), a 10 volume treatise on Greek medicine,6 and also published on smallpox and measles: his texts continued to be reprinted well into the 19th century. The medical texts of Ibn Rushd (Averroes) were also widely used in European universities.

Ibn Sina (Avicenna) was known in the West as “the prince of physicians.” His synthesis of Islamic medicine, al-Qanun fi'l tibb (The Canon of Medicine), was the final authority on medical matters in Europe for several centuries. Although Ibn Sina made advances in pharmacology and in clinical practice, his greatest contribution was probably in the philosophy of medicine. He created a system of medicine that today we would call holistic and in which physical and psychological factors, drugs, and diet were combined in treating patients.7

Eventually, the Islamic civilisation constructed by the Arabs went into decline. In the east, new powers rose: first the Mongols, who in 1258 devastated Baghdad, the greatest Arab city of its day, and later the Ottoman Turks, who brought large parts of the Arab world into their new empire from the 14th century onwards. Weakened by internal strife and civil conflict, most of the Islamic cities of Spain had been conquered by Christian armies by the 14th century. The last Islamic state in Spain, Granada, surrendered to the Spanish in 1492 and its ruler, Boabdil, was exiled to North Africa.8

The flow of technology and ideas from the Islamic world to the West slowed and, in the past 600 years, has reversed. Academics and politicians still debate the reasons for and consequences of this decline in Islamic science and technology. The legacy of Islamic civilisation, though, remains with us in making possible Europe's own scientific and cultural renaissance.9

Footnotes

• Competing interests None declared.
• BMJ 2005; 331 doi: 10.1136/bmj.331.7531.1486 (Published 22 December 2005)
• Cite this as: BMJ 2005;331:1486

References

1. ↵ . Islam and the West: speech at Oxford Centre for Islamic Studies, 1993. http://www.princeofwales.gov.uk/speeches/religion_27101993.html (acccessed 3 Dec 2005).
2. ↵ . Science and learning in Islam—a shared legacy. Royal Institution of Great Britian, London, 1 December 2005.
3. ↵ . The discovery of the pulmonary circulation revisited. http://www.kfshrc.edu.sa/annals/152/mh9422ar.html (acccessed 3 Dec 2005).
4. ↵ . The scientific history of hydrocephalus and its treatment Neurosurg Rev 1999; 22: 6793.
   Medline
5. ↵ . Thousand years of missing history. Manchester: Foundation for Science, Technology and Civilisation, 2004.
6. ↵ . Oriental medicine: an illustrated guide to the Asian arts of healing. London: Serindia, 2003.
7. ↵ . Doctors and ethics: the historical setting of professional ethics. Rodopi: Amsterdam, 1993.
8. ↵ . Moorish Spain. London: Phoenix, 2001.
9. ↵ . The case for Islamo-Christian civilization. Irvington, NY: Columbia University Press, 2004.

Pearls of ICU – At the verge of life and death

Pearls of ICU – At the verge of life and death

In the name of Allah, Most Gracious Most Merciful

      It has been a spectacular, interesting and rich four weeks of ICU rotation so far. Each case has been an eye opener, more and more so when time is spent next to patients and their family after heavily informative ward round. Very interesting, in normal medical or surgical wards, we do encounter cases that touch our hearts, but patients are normally stable and do not need intensive care and monitoring. In ICU, the environment is really different. As trainee intern, you are surprisingly valued by all, from consultants to highly trained nurses. Intensive care also means intensive learning, close monitoring of system physiology and understanding how they interact with each other. It is also an understanding of pathophysiology and how drugs intervene in the physiological process to keep patients basic homeostasis at satisfactory level. Having what defines human being at the back of the mind, the focus will initially be about sustaining life before starting to link life to complicated human demands. It is also unique from medical perspective since it ties three big fields of medicine nicely, namely medicine, surgery and anaesthesia.

      What is the core to medicine? Some may argue it is medical sciences. Some may say it is doctors. Others may say patients. We have seen in the history of medical practice, medicine shifts from paternalistic model of doctors telling patients what to do to a more patient-centred medical model now. Tell us what you think is wrong with your body and we can share the idea and goals of how to get you better. I came across a medical article discussing about this issue and apparently, medicine revolves around suffering so to speak. It is quite an interesting perspective and I suppose it holds some truth in it especially when doing ICU currently. Suffering teaches us a lot. Learning from suffering and from seeing others suffer give us a push on how we can better the situation next time. No wonder people involve in research, to find answers to questions that may shine lights to others in their lives. Hence, at the very least, learning and researching to ease the sufferings would be the energy that drives the expansion of medical dimensions including sciences, ethics, cultures, principles and values as human being. 

     “Ask me any question you feel like asking, but please don't ask the question why this happens to your family”, said one of the ICU consultants in a family meeting. Truly it is probably one of the biggest challenges by doctors and medical professionals dealing with hugely emotional situations and predicaments faced by the family. It is easy enough to explain how secondary brain injury can be reduced and controlled. It is probably easy enough to inform what can be done to treat what is possible but to face patients or family members with possible answers of why this has to happen to them will be something that no man will have an answer. The answer will very much depend on reconciliation between our own heart and our own faith. While people will suffer due to physical debility, and all following consequences that shall affect activities of daily life and quality of life, the main suffering shall come from failure to reconcile oneself with one's perception about why this has to happen to he/she.

I wish to share and reflect over a few of the cases that I involved directly as a clinical student.

A case of traumatic brain injury and multiple injuries

      Miss A is a 28 years old lady who involved in a severe motor vehicle accident when her car was hit by a carrier van drove at a speed of 100 km/hour. She was the right back passenger wrapped by the car steel as the crash happened. She sustained serious multiple injuries including fronto-temporal hematoma, bilateral pneumothoraces, L forearm fracture, unstable pelvic fractures, bilateral comminuted subtrochanteric femoral fracture, left tibio-femoral butterfly fracture, right distal phalangeal fracture also with R 4^th toe laceration.

     Her GCS has been very poor on presentation with pupil size 2 mm L and R with sluggish pupillary response to light, E1 V-intubated M1. She was sedated with propofol and fentanyl infusion, intubated and attached to mechanical ventilation. Blood transfusion commenced as well as crystalloid transfusion to keep the SBP>90 and MABP between 50-70. ICP and CPP monitoring were in place and ICP target outline by neurosurgical team to be < 20 mm Hg. Hb target set at 110. Over 24-48 hours, she has been left deeply sedated to ease metabolic demands as well as pain and patient response which can shoot up the ICP. It was initially a difficult ICU management trying to juggle between replenishing fluid secondary to blood loss from pelvic and other bony fractures and maintaining reasonable but not high MABP to limit ICP level.

    Days afterwards when she was weaned off sedative agents, she didn't show much response to pain stimuli or commands. It went to an extent where we thought could this be a locked-in syndrome which would then mean a big disaster for this patient and her family. MRI could not be done due to ex-fix of pelvis and nobody would want to be absolute that those metal/steel/carbon would run alright through MRI machine. A few complications developed throughout ICU stay but she was managed well. From neurosurgical perspective, the chance for this lady was quite bleak. Given her young age, there is a possibility of recovery but to what extent shall be a continuous mystery. Severe traumatic brain injury as reported by journals give 25% a statistical figure of patients who are able to live independently again. That would mean one in four, but who knows the fate for this lady. Nobody can tell given hugely heterogenous outcome from severe traumatic brain injury. This patient remained in vegetative state up till now, able to breath but mechanically supported, heart is till beating but loss interaction with the world and surroundings. This relates again to the quest for the meaning of consciousness and being alive.

    This patient, looking from the bedside seemingly loss her autonomy, and things which normally define human being. She is alive but bodily dead or perhaps very minimal response. I still remember one day when her sister came and visit, looking her from the side, trying to console the heart, to ease the beloved sister on ICU bed, rubbing mostuiriser, grooming her to give this sense of human being, tears collected in this sibling's eye. Father was on the way since this family was not from NZ. No medical insurance, no travel insurance, this will be a second huge burden that awaits the family.

    SubhanAllah, life is so fragile, what initially planned as part of working holiday plan turned out to be permanent severe disability which shall be endured for the rest of the life for the patient and the family. 28, what a young age. This also poses a big ethical question from Islamic perspective as well as from general ethical perspective. Should we wean the support very early on, but we don't know what shall be the possible future, should we support and be aggressive like what was done? Again, it is going to be a constant battle in medical world in trying to tie between medical care, resuscitation and what it shall mean for patients and family as well as what shall be the best decision.

    This is one of many cases encountered in ICU, insyaAllah, hoping to write more when time permits. But for now, it leaves a big thing to ponder about the reality of life and death, to assume resuscitation or to leave the present to take its course. As a muslim, it reminds a lot about ahsanu a'mala, people with the best deeds. The creation of death and life is to see who among humankind are best in deeds. May Allah gives us strength to learn this sign and to constantly better ourselves, inculcating humanity in the heart, responding to His call and serving people in difficulties. Oh My God, Grant us guidance, piety and richness in our heart, as well as the love towards the poor.( du'a of prophet Muhammad saw after the event and encounter with Abdullah Umi Makhtum).

Abu Asr

7/2/2012

Sanity, a gift that reminds, part 1

Sanity, a gift that reminds

In the name of Allah, Most Gracious Most Merciful

Alhamdulillah, I praise Allah for all His blessings upon us that many times we forget and many times we appear, seemingly but not really remember. The essence of gratitude is so deep and so does the essence of realising all these bountiful blessings which requires deep thoughts, meditation and sincere heart. That is perhaps the very meaning of solah, to thank and to invoke, to submit and to remember, to love and to learn to love, to discipline and to focus.

Sanity, a word which describes safe and sound mind. A word that describes normality of mind. A word that differs societal perception and tiering human social and psychological levels. The opposite, insanity is also a word which counters sanity, describing a loss in a great bless that also defines human being and human innate ability. Depending on how we perceive perception, sanity gives us at least two important perceptual definitions, being sane in our thought process and being sane in our thought contents. In our walks of life, we often encounter people that say “You are just insane” or” This is insane.” The context when it refers to thought content often refers to ideas that make out of sense when perceived by others in their comfort of normality. What is sane according to one can be perceived as insane by others. What is sane in others may sound insane by us. Now, there is a spectrum to normality in contents above which things really make no sense. In saying that, there is one important issue needing realisation here, ignorance is a jail of mind and being ignorant jumps one to perceive others as being “insane” so easily. An example of which can be taken when the last Prime Minister of Malaysia, Tun Mahathir introduced the idea of producing local cars in 1980s. To some, it was insane because the idea went out of calculated possibility by some given limited knowledge and creativity. The second issue which limits sanity is absence in component of trust, faith,confidence and socio-cultural influence. People can easily perceive something insane when the content clashes with pre-conceived beliefs, ideas and mental knowledge structure. To an atheist, an existence of a Creator of this universe is just insane given physically imperceivable Power that can be captured by mental and special sense organ faculties.

Sanity can also be defined in the light of thought process. Have we ever come across people who talk next to the road, seemingly so serious and so real, but it just does not make sense. We thought we don't understand, but in reality it can't be understood. The thought process is so bizarre that it went out of spectrum of linearity into circumstantial and tangential thought processes. We know the basic logic as introduced by Socrates, if A=B, and B=C, therefore A=C. Although this is basic and does not hold true in every situation, this flow of logic is absent in people with disrupted thought process. Understanding these two perspectives, we came with an idea that aberrant thought process or content or both throw people into a group we call “crazy” be it literal or with connotation, be it content or process.

Alhamdulillah, life is a lesson and everything that happens is a Sign from Allah Almighty for us to think and ponder over. Hence why the prophet Muhammad saw cried when Surah Ali-Imran, verse 191 was revealed – Verily, in the Creation of heaven and earth, and in the alteration of days and nights, there are Signs for people who would like to contemplate. Contemplation to read His signs in order to believe and to have faith in Him. To contemplate to understand that He SWT is very close and guiding closely with His signs. In the book, In the Footsteps of the Prophet Muhammad saw, Prof Ramadan outlined this very nicely how Khadijah was a remarkable sign of God Almighty's help and support to Muhammad saw, and how Hajar and Ismail were signs of His help and consolation for Ibrahim as. ( Refer Chapt 4). I was blessed with the opportunity to meet one patient who gradually lose normality of his thought content. Here is his story.

He is a gentleman who at his teenage age, developed this bizarre thought that the world is rubbish. He claimed people don't understand him and gradually developed this thought that people are talking and planning something against him. He looked at a drawing and thought that it is alive. His behaviour also changed to be inappropriate and disorganised. Some things he does are purposeful, other things can be inappropriate. His thought process is linear at times but can be tangential at other times. He loses insight that he seems to be out of what he normally is.

It reflects about psychological disorder we call psychosis or craziness. It is bizarre and has been a mysterious subject until the last 50 years when research enlighten us a bit about this still mysterious subject. This patient out of sudden developed aberrant belief secondary to his frontal lobe determination and perception that people are against him. This is further strengthened by auditory hallucination from activation of temporal lobe that people are talking about him. Without going in depth about different types, we learn to understand automaticity of brain function without external stimuli from the surrounding can induce a “perceived world” in which these kind of people interact and form their judgment, reaction, logic and etc. It is made worse when these people lose their insight losing perceptual attachment from what perceives by others making them not understanding us and us not uderstanding them. In short, the physical present is there but these people are in fact in a “different world” from us. This is in-line with what mentioned in Harun Yahya quoting verses from Quran about the fact and the reality of this world. The world is but a perception that we perceived from our sense organs and brain interpretation. From time, the essence of physical being and many things around are what we perceived from senses we are given with. At the end of our life time, these senses will definitely shut down and we will move from this “perceived world” into another dimension of eternal life, as perceived by us, Muslims as Hereafter.

In medicine, there are several conditions that mimic formation of “perceived world.” In children , we have a condition we call Autistic Spectrum Disorder, in psychiatry we have psychotic disorders and in different cultures and beliefs, we have meta-physical influence. All these will be discussed in my next writing – Sanity, a gift that reminds part 2. Stay reading and may knowledge leads us to be grateful and thankful, God Willing.

Abu Asr

11/1/12

Medical Questions : 

1) Why can anti-psychotic cause development of galactorrhoea and parkinsonism?

2) What is the cardiovascular condition that can be trigerred by anti-psychotic s and how do we manage patient that develops this?

3) What are the two groups of anti-psychotics and which trigger more anti-cholinergic effect but less extra-pyramidal side effects?

Understanding Consciousness

Understanding Consciousness
Understanding Consciousness 2

Human Consciousness and Conscience

Human Consciousness and Conscience

In the name of Allah, Most Gracious Most Merciful

     Two of the many great blessings which many would have but would not realise are having consciousness as well as conscience in mind and self. Interesting, the whole issue of consciousness and conscience has aroused many intellectual talks, experiments, debates and research in multiple fields such as philosophy, neuroscience and psychology to try to explain these two inter-twined things human being have. These two values, abilities or whatever we want to call them dictate the significance of self and significance of life for us as human being.

     This writing is not intended to explain exhaustively about what each two really means but more of trying to invite readers to think about the essence of these two, how they are inter-connected, how we view from philosophical, medical and neuro-scientifical perspectives and eventually bringing the issue into the context of how Islam views the issue. Consciousness generally speaking means the state of wakefulness, alertness and awareness. While it can be defined as those, consciousness indeed exists in a continuum rather than discreet. Somebody can be awake but not necessarily sharp in awareness or alertness. Somebody can also shut down to the extent he loses his wakefulness, alertness and awareness. From medical perspective, often we talk about alteration of consciousness that can occur with complex seizures where patient does not necessarily lose his full consciousness but alteration that he loses the understanding, memory of what is going on. In anaesthesia, we also talk about degrees and levels of human consciousness and how deep should we induce the level of unconsciousness in our patients. Many Research enlighten us with the discovery of level of consciousness.

                                                Alert and Oriented

                                                       Fatigue

                                                       Stupor

                                             Locked-In Syndrome

                                            Minimal Conscious State

                                                       Coma

                                             Persistent Vegetative State

                                                    Chronic coma

                                                   Brainstem Death

Decreasing level of consciousness moving down the diagram( with exceptions in some respects)

      The state in each level is very interesting. Locked-in syndrome for instance is a state where a patient is fully awake but lose motor control of the body making it possible to be physically perceived as unconscious. Patient is locked in the body in not being able to walk,talk, move and others but the primary vegetative function such as heart beating and respiratory function. Here is where we can throw in or out a debate to consider whether it is a state of conscious or unconscious. Again, that is why from medical perspective at least, consciousness exists in a spectrum. Glasgow Coma Scale which was initially invented to gauge the extent of traumatic brain injury which was then modified and used as a means to measure conscious level of patients, explains well the existence of consciousness in a spectrum.

    Let us bring this to another step. We know neuro-scientifically, reticular formation via reticular activating system is what controls variety of functions including cardiorespiratory control, pain modulation, sleep and wakeful cycle, somatic motor control and habituation. Reticular formation interacts with various aspects of cerebral cortex to alter our perception of things around and our consciousness as well as interaction with optical circuit to provide body with circadian rhythm. SubhanAllah, cerebral cortex also sends signals down to reticular formation to allow good control of tone, balance, coordinated movements through central pattern generators, etc. These two brain parts interact with the body via spinal cord. This designates beautifully how mind and body actually works and how mind will be affected if body is affected and vice versa.

                                                 Human brain

     We understand biologically the basic about how human gets his consciousness. This is only a foundation to consciousness in the context of human psychology and socio-culture. Consciousness when discussed in other areas means more than just this. Consciousness brings the meaning of being aware of your very self, who you are and many other questions we encounter in philosophy. I believe that consciousness is the essence of philosophy and it is the essence that dictates how we define ourselves, the others, and how we function in our lives. To make it more interesting, when we understand this, we know that we can be biologically conscious but spiritually unconscious. We can be biologically conscious but culturally and socially unconscious. We can indeed be an unconscious being that walks in this world and we can also be consciously unconscious in our dealings everyday.

     In Islam, we have this saying that those who do not know themselves shall never know their God. In the holy book Quran, Allah mentioned about people who live in this world but in real fact dead in their inner-selves, nauzubillah. Everything in this life has its trigger. Nothing happens without reasons, and nothing is co-incident in nature. Charles Darwin and the evolutionists might not agree when they adopted the evolution theory basing creation and universe existence as co-incident. This is the basis that differentiates divine religions with agnosticism and atheism. Divine religions exist on the basis that creation and universe were created and nothing occurred as co-incidence. Science over time repeatedly shows that there are process to things. Water is only made when Hydrogen atoms bind with Oxygen molecule. Such a ruling will certainly sound absurd without specific design and rules determination. Co-incidence does not create beauty, haphazard work does not create a beautiful design to this universe. The same goes to consciousness, it is not co-incidental. It has its trigger. It maybe difficulties in life, it maybe after going through decades of wasted life or anything that makes people gain the sense of consciousness in any respect of their lives. This includes the very first question everybody needs to ask themselves, why am I in this world, what is my purpose of life? We also need to remember that to not answer this means to actually have answered it ourselves.

     From Islamic perspective, Allah the Almighty innumerably mentioned in the holy book about people who ponder over, people who think, people who contemplate, people who remember. Islam emphasizes the need for this as the key to everything else. Having the verse that asked the prophet Muhammad saw and the muslims to read links very well with the urge to contemplate. It is by reading and by contemplating that human being in general get the message, the realisation and receive the consciousness. Islam also talks about roles and responsibilities having had the consciousness to deliver the message of Islam and to establish justice and peace between human being.

     Let us talk a bit about conscience. What is conscience? It is also a term discussed from many angles and perspectives, from religion to atheistic, secular and science. In general, it is the realisation and the feeling of what is right and what is wrong. It is what generates guilt when doing “bad”. It is also what generates the feeling of good and integrity when doing “good”. Biologically, I personally think that we don't have a specific lobe or area generating this. I do think that it is an integration of multiple lobes which function to generate this higher level function yet being part of the essence of human quality. This is because the conscience which informs our moral judgment can be influenced by upbringings, religions, cultures, social dynamics and values which all require brain perception, memory, judgment, etcetera to eventually formulate the feeling. People won't feel guilty if they perceive what they are doing as right!

                                                       cartoon picture

     Understanding what conscience is, let me the share how Islam perceives conscience. It is interesting to first analyse the fact that consciousness and conscience are very close and inter-related. With conscience, people feel when they are doing bad or good. Consciousness makes people use their conscience when doing things. Also true is when people have conscience, it inculcates consciousness when they are doing things. In Islam, the centre of change is the heart( qalb). It is the centre that perceives good and bad based on common human values and commandments of Allah the Almighty. Islam values conscience very much and it is the action  having this conscience and inspiration of right and wrong that dictates whether the heart is purified or dirtied. When a believer follows his conscience based on what is commanded, then he is indeed answering to the call of God and bringing himself into God's peace and vice versa. Islam also recognises the two whispers that are all prevailing in human being, one calling for evil and the other calling for good. This is what creates tension in human being, and jihaad as often being misquoted is the very value that help to self-control and defeat the evil and violence in oneself. Conscience in Islam is also related to the concept of asking forgiveness and salvation. Conscience is a value, feeling or attitude, but many times human being go against their conscience out of failure to control and master themselves. Islam opens the door to salvation and forgiveness widely, provided believers realise, asks for forgiveness and have the intention of leaving the mistakes. The salvation in Islam is also about not losing hope in God, and it is for believers to do their best, and leaving what is beyond their control to Allah, the God Al-Mighty.

Let us value our consciousness and conscience, insyaAllah( God Willing)

Abu Asr

27/12/11