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November 20, 2004

Reflections on Cardiovascular Pathology, Part I


Despite my perpetual whining about medical school, sometimes you learn some really cool stuff. Once in a while, though, you learn some really amazing things because it correlates to what our religion teaches us. For those of you who have followed my mindless ramblings since the blurty days, you know that I affectionately call these “Subhanallah Lessons”, i.e., lessons that are so incredible and beautiful that you cannot help but to remark in all amazement, Subhanallah (praise be to God).



Before getting into disease states, medicine is all about studying normal function, because only if you know what is normal, can you properly understand what is abnormal. In a normal heart, there is a dual circulation: the right side of the heart pumps poorly oxygenated blood to the lungs such that it can get oxygenated again, the left side of the heart then pumps that oxygenated blood to the rest of the body. This is what a “sound” heart does. There is a fascinating ayah of the Qur’an, wherein in Allah says, On that day when neither wealth nor children shall benefit – except for he who comes before God with a sound heart. In the healthy body, the sound heart is able to fulfill this dual role of oxygenating blood and sending it to the rest of the body. In the spiritual realm, this dual role is equivalent to drawing close to Allah through worship (and other acts) while at the same time serving the rest of creation. In other words, the pulmonary circulation (the one sent to the lungs) is one wherein the heart refreshes blood such that it can be used for the systemic circulation (the one sent to the rest of the body). For the believer, this is the highest manifestation of the putting the formulaic kalimah (testimony of faith) into action. The first part of the kalimah (There is no god but God) is reflected in a believer having that sound relationship with God through remembrance, prayer, mediation, etc.–acts of worship done on a personal level. The second part of the kalimah (Muhammad [salallahu `alayhi wa sallam] is His Messenger) is reflected in serving others and fulfilling one’s obligation to creation. The Prophet was certainly the highest ideal of this: his nights were spent in prayer and reflection, an act that was commanded to him in one of the earliest revelations: O ye who are wrapped in thy raiment! Rise to pray in the night, except a little: a half of it, more or less, or a little more; and recite the Qur’an in measured, rhythmic tones. In other words, this was the “pulmonary circulation”, the time wherein he was able to recharge himself by worshipping his Lord such that he would have the energy and courage (the oxygenated blood) to fulfill his tasks by day, the highest of these, of course, being to spread the Message of God to the people. It’s as if Allah taught him that fulfilling these duties by day and having to deal with people is going to sap you of all your spiritual energy and you have to replenish that at night. And if you dont replenish it, you will have nothing to give to others. (This is the problem with activism if it isnt combined with a strong spiritual foundation).  Similarly, the heart pumps blood into the body, only to have it return it back as deoxygenated blood as the body has used up all that oxygenated blood it has sent out. And it takes that deoxygenated blood, no matter how many times it comes back that way, and once again oxygenates it and sends it out to the rest of the body. In the real world, this translates to having people give one insults in exchange for the good one does to them. The Prophet and the people close to God certainly went through much of this–yet they continued to do good to others, knowing full well that people would continue to abuse them in return. Yet the expected results didn’t stop them from their tasks, and because of this, they were in a state of soundness. The heart does exactly this with its dual circulation, and because of this, it too is in a state of soundness. The lesson here is that our lives too must be ordered around this duality to have any level of soundness: a relationship with Allah that fuels us and gives us energy to fulfill our relationships to creation, and perhaps more important, gives us the perseverance to have–as Imam al-Ghazali said about those who truly know and love God–an infinite capacity to endure the wickedness of men.


 



The heart itself benefits from pumping blood out to the rest of the body via the systemic circulation. In fact, it needs this oxygenated blood, and that’s why the heart itself is perfused with arteries that supply it with oxygen/nutrients to keep it going. It’s interesting to note here that the main arteries wherein atherosclerosis (the build up of fatty deposits in blood vessels) occurs are the coronary arteries (ie, the ones that supply the heart itself). This blood supply to the heart itself is so crucial that without it, the heart fails. In other words, when we serve others, we’re actually benefitting ourselves–the pinnacle of selflessness is actually poetic selfishness, meaning one should be selfish for one’s afterlife such that one is in a state of absolute selflessness in this world. In Kitab al-Zuhd of `Abdullah b. Mubarak, he writes that the great Companion `Abdullah b. `Umar, when he would be asked to accompany some people on a journey (and they would ask him such that they could benefit from his company), he would not agree to go with them unless they agreed to let him be their servant for the duration of the journey. In other words, the ultimate worship of God is to serve creation, because this in reality is to serve yourself and thus be raised in the sight of Allah. We too need to look at our service of creation as so vital to our own well-being that we not only fulfill that obligation, but are desirous to fulfill those duties. Maybe it’s fitting that one of the major diseases of our time is coronary artery disease: it’s perhaps a sign that people are not fulfilling our obligations to humanity and creation, and therefore they’re suffering from this. The physical world merely mirrors the spiritual world.


In a normal person, the heart automatically adjusts to meet the body’s needs for increased oxygen/nutrients when the situation arises. For example, it beats faster when we are exercising, slower when we are sleeping. What’s amazing is that we don’t have to “think” about the heart doing this, it automatically does it. The heart makes second-to-second adjustments in its behavior to deal with any given situation. The lesson here is that we too have to be able to make constant adjustments (i.e., improvements) in ourselves to deal with the situations that we face with everyday.


Alright, I need to get back to studying. I’ll put up a part II tomorrow Inshallah. I wasted some time watching this movie cause it was on TV. Even though I’ve seen it before, I had to watch it again, cause it has to be one of the greatest movies of all time. I’m not afraid to admit that I teared up during the movie….

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10 Comments
  1. Anonymous permalink

    yeah today was a teary eyed day for me too.
    teared up during I am Sam, then teared up watching the Rookie
    THen i watched a porn movie and I was back to normal!

  2. Anonymous permalink

    Asalamwalakum    The point you made about the fight is actually pretty good. I really didn’t see that vantage point but thats a real possibility about that helping NBA advertisement. Nice observation, very nice.Asalamwalakum

  3. Anonymous permalink

    Cry Baby…a lil advice from the people who try to read ur xanga. Re-take English 101 (or whatever it’s called). You really need to work on your use of paragraphs (or lack thereof). I was gonna read the whole thing but after reaching Line 15 of paragraph 1, i gave up.
    You cry watchin Movies? Maybe you’re the type of girl that Hisham says u can pick in Round 7 of the Wife Draft?

  4. Brother Kamran, don’t let these haters bring you down. It’s okay to cry at some movies. Just as long as it makes sense like for a sad flick like “I Am Sam” or “Mystic River.” If you start crying about some cartoon like “The Incredibles,” I’m going to have to inform your future wife.

  5. Anonymous permalink

    kamran is a nigga…and im happy to welcome him into the Nigga Fo Life (NFL)…

    nigger-ul-haq

  6. Anonymous permalink

    lol Asad cries while watching movies too..
    you guys are sissies

  7. here’s your eid present

  8. hey salaam. WALLAHI *thrusting a quran into the air* i was not saying something mean about you at all. we all just know that you have an ego and even YOU have to acknowledge it. granted, masha’allah, you have a teeny tiny right to be happy with your accomplishments… but it’s not like i have to remind you that anyone with an atom’s worth of pride will not enter jinnah… oh wait, i just did lol.  cheer up little man. -khadijah

  9. out of curiosity… how do you reason that im happy with my accomplishments and thus have an ego? explain.
    put aside your qur’an and wallahis. i dont care what people say about me behind my back, it was just a little surprising to see that you had said it on a third person’s website. i dont usually bother reading comments on other people’s xangas, and when i saw saud’s two line post get comments, i clicked on them and was quite surprised to see your comment. i’m not mad… it’s just sad that in general, im getting bashed on random people’s xangas. i dont mind at all, but people oughta find better things to do with their time than waste it on coming up ways to put me down. im not worth those few seconds.

  10. it’s not being said behind your back. HELLO?! i know that you check people’s xangas. if i thought something bad about you, i wouldn’t even say it, i have that bit of decency in me, contrary to popular belief. rather than take things as jokes (drop down one line on the comment i left and you’ll see the phrase “JUST KIDDING!!”) did you even get that far, or were you perhaps trying to find something to get upset about? drop it. misunderstanding.

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