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Faith and Care of the Patient
An Islamic Perspective on Critical Illness
By F.A. Khan MD
Before discussing the Islamic perspectives with regard to the psychological issues that arise in those stricken with critical illness, it is important to lay some groundwork regarding Islam. This is necessary due to the widespread ignorance that exists concerning a basic understanding of just what defines Islam in terms of doctrine. Most of what will proceed about this topic will ring familiar to those who are acquainted with their own faith traditions - and this is by, dare I say, Divine design. This is true since Islam, in terms of fundamental beliefs and paradigms, does not claim to be a new or even separate 'religion.' Indeed, today's over zealous parochialization and rigid segmentation of things based on external appearance, including 'religion', runs counter to the Islamic scriptural admonition to never allow 'religion' to be a divisive issue. Thus far, the term 'religion' is surrounded by inverted commas, and that is because I wish to draw the readers' attention to defining the term 'religion.'
The term religion may safely be defined as that path that seeks a state of peace or submissiveness of the human self toward Divinity. This is what Islam exactly means in the Arabic language. One who practices this way is titled Muslim. Hence, we may conclude that the term Islam simply means religion.
The term Islam and its lexical derivatives are used throughout the Qur'an. "Qur'an" literally means recitation - and is the title of what Muslims consider a revelation from Divinity Itself in the Arabic language. This was a language spoken by the dwellers of the deserts of Arabia who were immeasurably attuned to the ways and realities of creation and the cosmos and developed an incredibly potent and rich language whose nuances and depth takes years to master for even the greatest savants of language. It should be mentioned that Qur'anic Arabic is not at all the same as colloquial Arabic spoken today. The very sounds, cadences and words of the Qur'an are considered the Literal Word of God as either revealed directly, or through angelic medium, to a highly purified and saintly figure named Muhammad who lived in the 7th century in the Arabian Peninsula. One may often witness Muslim patients reciting litanies or passages of the Qur'an in an effort to unlock alleged healing powers that emanate from its authentic recitation. One may anecdotally hear of positive results of such practices, and I am aware that studies have been done in an attempt to demonstrate their therapeutic value.
The Qur'an also defines itself as a scripture; in it we find the doctrine that Islam began with the Primordial Couple - Adam and Eve. The term Muslim is also employed in reference to Noah and Abraham. Islam is considered that perennial way of peace and submission to The Sacred as practiced by numerous saints and prophets mentioned in the Qur'an such as the above, as well as Lot, Isaac, Ishmael, Jacob, Joseph, David, Solomon, Job, Jonah, Moses, Aaron, John, The Virgin Mary, and Jesus, as well as others. This way was crystallized during the mission of Muhammad, and those who follow his precedent have adopted the title Islam as a proper name signifying their respective faith tradition that encompasses ritual, law and spiritual development. The sentiments of Zarahustra of the Parsi tradition, Buddha, as well as that, which underlies the Hindu doctrines - all echo the sentiment of Islam as defined above. Hence the Islamic tradition embraces that which is authentic in all faith traditions; as an extension, the Muslim who understands her or his religion will theoretically feel at home with any who believe in One God, accountability of ones actions before Divinity, and righteous conduct.
In fact, the Qur'an does not address itself to only those who follow the precepts of Muhammad, or Arabs, or the contemporaries of Muhammad; the call of the Qur'an is to any believer in God who wishes to deepen her or his relationship with The Creator. The Qur'an explicitly validates other faith traditions and recognizes that sincere practice in what is authentic in them provides legitimate vehicles to Divine Proximity. There is no such concept as monopolizing Divine Grace based on outward labels or form practiced by any particular group or tradition. At the same time, however, Muslims consider that tradition which was elucidated by Muhammad as the most authentic.
I've been asked to elaborate on Islam in the context of spiritual issues facing the critically ill because of the "unavoidable religious dimension" inherent in such a scenario. The whole approach to the topic reveals a curious aspect of today's contemporary academic climate. Post-modern secular humanistic thought - the paradigm that gives rise to and colors academic institutions - seeks to neatly and quite rigidly compartmentalize and even isolate various life issues. On some levels this is, I believe, appropriate. However, in others it may be a hindrance. In our scenario, this pattern may prevent both patient and caregivers from dealing with exigencies of the critically ill in a wholesome and fulfilling manner - despite poor medical prognosis.
In discussing compartmentalization, we should make mention of the current concept of the health care team - the Attending and resident MD, RN, Nurse's aid, case manager, social worker, at times the pharmacist, chaplain...etc. The nature of institutionalized care demand a certain parceling off of roles to different members. I chuckle in recalling a time during administrative rounds where all members of the team met to formulate plans of care. The tones of the discussion for my patient with pneumonia was that any one could write an order for antibiotics and treat pneumonia, but try to arrange for discharging the patient to a proper facility - that's the challenging part! So to a certain extent, expertise needs to be divided, but who is responsible for the "religious dimension" that arises with the critically ill? In terms of recognizing its presence and the need to pursue it if indicated - perhaps everyone.
Is it possible to restore a model of the healing profession that encompasses a sense of addressing spiritual/religious concerns - from not only a therapeutic perspective but beyond? The challenge these days lies in the great degree of plurality of the various traditions found in our culture. Naturally adherents to one particular faith tradition will feel most comfortable with their co-religionists in terms of having in common respective outward forms of practice. This is quite legitimate and should always be respected. At the same time, from the perspective of training caregivers to at least be conscious of a religious dimension, there is enough concordance (despite outward differences) among the faith traditions to allow competence in recognizing the need to open avenues of discussion and contemplation that seem beneficial to patients, or to initiate an enquiry which perhaps helps deal with unresolved issues or difficult questions that arise within a patient.
There is a saying: "faith speaks to faith". To this I've been witness. Just a few weeks ago, a chaplain from one particular tradition recounted to me how she dealt with a Muslim patient and I was certain her presence during the difficult moments that patient faced made a difference. There are scores more examples I know of where devout believers in one particular tradition are able to comfort adherents of a different faith tradition.
From the Islamic perspective, there is no essential demarcation between sacred and mundane, or the secular and spiritual. All of life's activities are infused with a spiritual dimension - echoing as it were, Divine remembrance - so as not to consider the material (including our earthly life) as an end unto itself. As testimony that this sentiment is characteristic of not only Islamic tradition, but also almost every traditional civilization, one often encounters the fact that healers have usually been well versed in the spiritual dynamics of their respective faith traditions - many were even masters in these fields. A little knows fact is that the Latin term psych means soul - which, unlike today's implicit view, was never considered fettered by a solely rational, inductive, deductive, or purely mental faculty - and certainly neuro-chemical manipulation would likely have been seen as a vulgar (but at times necessary) form of behavioral modification and transformation. The fields of Psychiatry and Psychology have done a great disservice to postmodern humankind by tacitly closing themselves to the realms of metaphysics and refusing to submit to thousands of years of accumulated wisdom from faith traditions, which in addressing the inner peace attainable by humans, have too much in common to disregard.
Certain themes arise in the context of serious illness that relate to the realm of religion and are specifically addressed in the Muslim world-view. I will elaborate on some: Namely - confrontation with mortality, coping with affliction, and the desire for companionship.
Facing the prospect of one's own death and the subject of human mortality is a tricky subject. This is true now, more than ever, as today's pop culture exhibits a tremendously condemning aversion and distaste for mortality, which to a certain degree is at odds with most religious doctrine. Most faith traditions, including Islam, implicitly, explicitly and categorically highlight the transience of our earthly sojourn; they promote the fact that a greater reality awaits. This theme is recurrently addressed in the Qur'an.
Many of the Prophet Muhammad's sayings (narratives and traditions known as Hadith - which are not considered Direct Revelation and hence are not part of The Qur'an) advise against deluding oneself into acting and feeling as if this life is one of permanence. One of these sayings, echoed in various forms by Saints and writers, dictates that we are indeed partially asleep or even dead here on earth and through our mortality we shall experience a "lifting of the veils" and experience reality in a far more qualitative and quantitative way. Another saying emphasizes upholding the attitude of a traveler who must traverse this life with care, always keeping the destination in view. These luminaries lived as such and they continually emphasized otherworldliness in their beings. An extension of that was to warn against succumbing to a pathologic attachment to the earthly phase of our existence. This attachment has many unfortunate manifestations - which would take us to another topic.
Indeed, the very indices of real success and failure have little to do with what would be termed worldly and material indices of such, since material existence and progress are not ends unto themselves. Earthly life is to be enjoyed, but is important only so far as it impacts our spiritual development - either allowing it to soar to great heights or degrade into misery despite an appearance of earthly success. Hence factors such as wealth, talent, fame, status, reputation, fortune, ego, pain, affliction, loss, hardship, and misfortune can be seen as stimuli for spiritual evolution or devolution. The imagery of trials is often found in the Islamic tradition and ironically the saintly scholars are unanimous in stating that trial through misfortune is far easier to handle than trial through fortune - in terms of exhibiting the proper spiritual etiquette and growth before The Almighty.
In mentioning the term spiritual development we must examine the nature of human substance. The Qur'an alludes to the human being in several respects. There are references to our organic and embryologic composition, our physiologic and sensate faculties, our ability to speak, reason and contend and feel emotions. However, Islamic tradition goes further and adds to this, as The Qur'an clearly dictates that the quintessential defining characteristic of the human envelope is the soul (In Arabic: Nafs). This is a conscious, willful, transcendental component of being and the purpose of religion from an essential perspective is simply to guard, maintain and purify it. It must be emphasized here that there is no inherent conflict within Islamic doctrine between the physical, rational, emotional or spiritual components of the human being. Hence, there is no doctrine of harsh asceticism or turning away or shunning worldly aspects of ones identity, although there is recognition that the human condition is one of forgetfulness and distraction through worldly pursuits.
It is also abundantly clear that most of the great spiritual masters in the Islamic tradition, including the Prophet Muhammad himself, chose a most austere, simple, and non-lavish lifestyle - wholeheartedly content with a minimalist approach to material pursuits; moreover, during formal spiritual training under the guidance of sages and saints, there are times where restraint from worldly activities is called upon in an effort to re-harmonize the "components" of one's being.
For the Muslim and indeed any believer in most faith traditions, there is a sense of peace with regard to mortality. This thrust is often sensationalized, misused and misunderstood for a desire to seek death. Because of the maligning of Islam through contemporary geopolitical events and the tidal wave of woefully poor and infantile attempts at scholarship and journalism, I feel the need to explicitly state that on a concrete and doctrinal level, a Muslim does not seek death - but when it ultimately visits (as it always does), there is a sense of conciliation, rather than a horrid and even vulgar enmity.
The Qur'an mentions those who look forward to meeting with their Lord. A famous traditional narrative recounts the death of a child from an undefined illness. The saintly mother informed her husband by asking what he thought of the fact that something precious they had been entrusted with was returned to its Owner. The implication here is clear. For the Muslim, life and its contingencies (such as volition and will) are a trust (Arabic: amanat) that is ultimately returned. Indeed, one of the Attributes of Divinity is "al-Hayy," a Qur'anic term whose lexical field includes notions of "The Completely Alive" or "The Truly Existent" or "That which is Real Being" or "That which Fully Is." Our sense of being is but an infinitesimally pale reflection that subsists upon "al-Hayy." Language buckles here, so I need to say that these words are an attempt to describe an utter state of dependence.
An aversion to and discomfort with death may have multiple etiologies. From an Islamic standpoint some are valid. When the subject is a loved one, we encounter mourning a loss, closing a chapter of existence, and missing an earthly presence. All are very real and charged emotional states that are respected. With regard to self, this sadness at the approach of one's earthly conclusion and want of more time to cherish that which is here and now, or fulfill responsibilities - these sentiments are embraced. But when the aversion and discomfort toward self-mortality and the general topic of death stems from an over attachment to material life and a delusion that worldly and material life is the end all and be all - this is criticized by Islamic doctrine.
On a deeper level, the Qur'an mentions a certain type of aversion to death as analogous to a reflexive manifestation of a soul that fears a meeting with its Lord due to an intuitive understanding and witnessing of the negative qualities which have accrued on it via the willful damage it has consciously inflicted on itself (In Islamic doctrine, to sin is to wrong one's own soul - by extension, to harm others is also to harm ones self). In a way, it remembers just how sorely it has forgotten itself and neglected its mandate. To be on the lookout for a patient who wishes to open her or his door to remembrance is perhaps most critical - it is everyone's job. The Muslim is taught that in The Divine Exactitude, there is no sin too small, but through The Divine Mercy there is no sin too great. The Divine Mercy does exceed the Divine Wrath; in this the hope of the Muslims lie.
So mortality is not necessarily an enemy. As a physician, I am very careful not to confuse mortality with morbidity, which is indeed the enemy. Morbidity and suffering are things to stamp out and alleviate and indeed can be thought of as separate from mortality. Many fear mortality because they confuse it with morbidity and suffering. Conceptually they are indeed separate and uncoupling the two for discussion is mandatory in our context. There are many who experientially and quite firmly realize this crucial difference between mortality and morbidity - those in health care, those who are critically ill, those whose loved ones suffer through critical illness - these all understand that mortality can be an end to suffering. This again is a loaded topic, but the dichotomy between the two needs to be stated.
The next issue to address in dealing with this topic is the idea of coping - coping with critical illness more specifically. It is safe to assign critical illness under the rubric of trial, and affliction in terms of formulating an understanding of a reaction to such states from an Islamic perspective. The first crucial premise to realize regarding our dealing with and reacting to conditions in terms of behavior, formulating sentiments or action is that for the Muslim, the primary audience is Divinity. From a certain angle, the Qur'an is simply a recurrent medley encouraging an experiential realization of this notion. The Muslim is encouraged to always be in some form of Dhikr - "remembrance" of the vertical dimension to reality, even more, remembrance of Divinity.
As stated earlier, there is no essential division between the secular or sacred. Hence the litanies, inspirational utterances and religious sayings for everyday things such as eating, using the bathroom, entering a home, beginning a task, making love to one's spouse, embarking on a journey.... etc. One of the reasons for this is to surround oneself with Dhikr. Directly extending from this is a care to maintain oneself in a state of proper Adaab, a term that includes meanings such as etiquette, posture, courtesy, approach, standing - all before the Primary Audience of Divinity.
To summarize the Islamic perspective on coping, one can say that the Muslim is encouraged to struggle to alleviate affliction and hardship based on a sincere understanding of a given situation. The caveat is to maintain a sense of peace in ones' inner self no matter what the outcome of the endeavor - success or failure. The very act of intention and effort, or in our case want for regaining health and coping with affliction, pain and therapeutics - these very thing are indeed an end unto themselves, the results may go either way. This notion, among other things, is an acknowledgment of The Divine Will - which the Muslim knows is never capricious.
Now what is it to maintain a "state of peace in ones' inner no matter what the result?" Well, in the context of a successful outcome, it is to don an attitude or display the adaab of Shukr - which essentially means gratitude. In the context of perceived failure of a struggle, it is to don an attitude or display the adaab of Sabr- a highly charged term that includes meanings such as patience, perseverance, fortitude, keeping ones chin up, and there is a hint of resignation in the term as well.
There is a narrative tradition which states that the believers' heart on whatever level is perpetually in the adaab of either Shukr or Sabr, and another narrative which states that a lifetime can be viewed as a couple of days — one a good day (to express shukr) and the other a bad day (for sabr).
We need to explore the term Sabr (patience, perseverance, fortitude) a bit further since the struggle with critical illness obviously calls for it. It is indeed the hallmark for a Muslim when confronted with hardship. Implicit in the context of adverse conditions is a struggle to ameliorate ones circumstances; hence, it should not be confused with passivity or fatalism. The term Sabr is used over one hundred times in the Qur'an. Recall that for a Muslim, the Qur'an is the Literal Word of God, and as a common saying goes, "God does not waste words." There are verses that proclaim that "God is with those in Sabr", and "God loves those who practice Sabr." Practicing Sabr is seen as a most potent vehicle to Divine Proximity, for spiritual development and purification. There is an expression found in the Middle East: "May your hardship (or loss/trial/affliction) be for you a source of nearness to God. " From a converse angle, Divine Proximity is what the Muslim seeks; Sabr delivers such and necessitates the presence of hardship and affliction for actualization. Again, this is not to be taken to mean that a Muslim seeks hardship or affliction, but when the circumstances come around, there ensues a quest for Sabr.
The Qur'anic verses promising struggles throughout ones life are seen from this regard rather than a design by some whimsical and sadistic deity. Again we approach the impenetrable questions, as to the ultimate whys. The Muslim understands that to approach The Plan of God with the faculties of mental gymnastics is to approach taking in a landscape while blind, or to solve a multi-linear Boolean equation with simple arithmetic. However, there is a far more powerful faculty of realization and understanding for the Muslim, which when awoken renders protests of the mental and rational faculties into the annoying and irrelevant whining of a spoiled brat. The Qur'an refers to this as knowledge or witnessing of the heart, and it is this arena we are told the "why" is put to rest. This awakening comes only through Divine Proximity, and practicing Sabr is a potential route. So for the sincere believer, it is possible to come to terms with hardship and struggle, not so much through empirical deduction, reason, or discursive cognition, but through spiritual realization - at least this is what we are taught by the Prophets and saints. For the secularist cynic, this is nothing but a self-serving fantasy and delusion.
Of course the ultimate inspiration for the practice of Sabr are the Prophets and Saints. Historically speaking, they suffered like no other. We take the example of Muhammad. He was maligned and slandered. He was assaulted many times, and beaten. He was the target of multiple assassination attempts, had a bounty hunter quick on his heels and was poisoned. He had his tooth knocked out, had entrails and feces flung on him, and was literally stoned and run out of a town. Historical accounts relate that when he fell ill, his suffering would account for the suffering of two. When he spiked a fever, it would be double that of others. There is more, but the picture is fairly vivid. For Muslims, the Prophets (including Moses, Mary and Jesus) and the Saints are pillars of Sabr and are forever an inspiration to those undergoing hardships — and the Muslim remains steadfast in the belief in a Quranic doctrine which states that the soul of a servant is never stressed beyond its capacity.
From the Islamic perspective, suffering from illness itself also contains within it a purifying and redemptive nature. There are traditions that allude to the pangs of illness being able to shed sins and spiritual pollutants as leaves are shed from a tree. This expationary Grace is operative with even minimal discomfort, such as injury that comes from the prick of a thorn. It is also functional with suffering from chronic afflictions - epilepsy and blindness are mentioned, amongst others. The underlying premise to this pattern of thought is that it is far better to atone, purify, and rid oneself of spiritual pollutants here in this world as opposed to dragging them to the hereafter.
One absolutely crucial point to understand is that purification, spiritual development, atonement and expiation which comes in these scenarios and with Sabr is strictly conditional upon whether the subject allows Divinity into her or his consciousness. From the Islamic perspective, God does not impose upon the human consciousness; it is for the human will to accept or reject, and hence a respective acceptance or rejection of The Divine Grace follows.
The following tradition illustrates this superbly: The Prophet Muhammad visited an elderly Bedouin who had fallen ill and offered him words of comfort and prayed that his hardship serve as a source of blessings. The Bedouin didn't see it that way and scolded that his illness is nothing else than an entity whose pain crushes his very bones and whose fever boils his blood and hastens him toward a miserable death. Muhammad gently replied, "Then it is so."
From the Qur'anic standpoint, will and consciousness are not playthings in the least - the Qur'an makes mention of the fact that the heavens and the earth cowered from the proposition of being granted will and consciousness. Hence, from a certain angle, ones' consciousness carves out ones' reality. Interestingly, the brilliant physicist and mathematician Von Neumann employed the phrase consciousness created reality, in acknowledgement of the way quantum theory and the new physics has overturned any attempt at explaining reality from an objective or truly empirical point of view. Yet how stubbornly and dogmatically many cling to their ideas of "the way things work" when it comes to ultimate realities and life's deepest issues.
Another element to keep in mind before we leave the subject of coping with illness is best summed up by the colloquialism, which states that sometimes things are "a blessing in disguise." This hardly needs any exposition, as almost all have been witnesses to this in their own lives - a time where hardship and difficult circumstances turned out in hindsight to be not such a malicious occurrence after all. The Qur'an narrates how this very important facet of life was impressed upon Moses in his travels with a mystical and saintly figure named Khidr. Moses witnesses devastating tragedies and paradoxical situations that are engineered by Khidr. With the evolution of time and practicing some Sabr, Moses discovers the wisdom inherent in such circumstances. Hence, Moses is convinced that indeed, even the direst situations may be blessings in disguise.
Since Sabr does not imply passive resignation, it does not preclude an intention and effort to ameliorate one's condition. Hence, it is little wonder that therapeutics are embraced. The civilizations that in the Middle Ages were spawned by Muhammad's influence (which in turn engendered many facets of this one) were noted for their advancement in the sciences and health care. Surgery, Medicine, and Pharmacology were established fields and industries. An Islamic tradition states, "For every ailment, there is a remedy - except old age". Hence, strides in the fields of research and teaching were welcome. Cities like Baghdad, Cordoba, Damascus and Fez in the 12th century had scores of hospitals dedicated to teaching, research, with wings for social work and medical students! More importantly, the lifestyle exemplified by the Muhammadan precedent (which was and is most often neglected by Muslims) pointed to simplicity and moderation, emphasizing care in the diet (very pertinent these days considering the toxins that exist in industry foods) and meticulous hygiene, including oral. Muhammad was quite explicit in warning of the dangers of filling the stomach, as he stated that at fullest, the stomach should be a third food, a third water, and a third empty. So from the Islamic perspective, preventative medical policies and evolving new therapies to combat illness are fully consistent with tradition.
The last element to discuss in the context of critical illness is the desire for companionship. A sense of isolation is commonly felt by the afflicted, and visiting the stricken is a staple of Islamic social mores - and is indeed common to most traditions. One narrative relates that Muhammad had a neighbor that used to purposefully empty trash on Muhammad's doorstep and walkway. Once when Muhammad noted not having to wade his way through garbage - he was seen soon after at the neighbors' door enquiring about their health and asking if he may be of service. Such is the premium of helping those who are ill.
At one level, visitation provides comfort through sincere well wishing, sympathy, empathy, sharing, love and service. Most often, family is best able to actualize this and this truly is one of the blessings of familial love - so selfless and pure. Those who notice what happens to the elderly and chronically ill removed from family in extended care facilities experientially realize the importance of familial love and support and know there is simply no substitute for familial care. But visitation and companionship has a different level of meaning more geared for health care professionals and those in the ministerial fields. This has to do with what in the Islamic context is called "Sohba" - a term denoting companionship and presence. When referring to presence, I speak not of the word in its' secularized context i.e. Being in the same place in space and time with someone. Rather presence as it is used in the phrase, "such and such has got a real presence about them." This attribute can indeed transcend space and time; for instance, it is the Muslim who does her or his best to achieve presence with Muhammad and of course tries to feel The Presence of Divinity. So it should be the goal of those who seek to minister and provide companionship for the critically ill to develop an authentic presence in order to make fruitful their sohba with the patients. Authentic presence in the scenario of visiting the sick translates to an uplifting comfort, inspiration, love, encouragement, strength, exhortation to fortitude and even healing. Those who interacted with the Prophets and Saints reported feeling this very often - these luminaries exuded such qualities and it was part of their charisma.
According to the spiritual masters, emptying ones' self of ego and becoming a receptacle that reflects certain hallmarks of Divinity actualizes this presence. These hallmarks include Peace, Compassion, Love, Strength, Constancy, Support, Patience, and others. In other words, the task of those who minister is to become a locus of Divine Manifestation. I must emphasize here that this cannot be learned through textual studies and a secular curriculum. To some extent it is a reality inherent in the human condition and many can shine simply by being real and true to themselves and those around them. But due to the pollutants of many forces hostile and cynical to fulfilling ones' true human being, there is much work that needs to be done in allowing authentic presence to shine through - so we are told by the Prophets and saints in the Islamic tradition.
From the converse angle, we note that in the Islamic tradition serving and visiting the sick is a vehicle for Divine Proximity for the visitor. There are numerous narratives that explain this. In one account, during Judgment, God will ask some folks why when He was hungry they did not offer food, or when He was thirsty, why they did not provide drink, or when He was ill why they did not visit. The response of course will be one of confusion as those spoken to will respond, "Glory be to You, Lord of Reality - You are above such needs and suffering!?!" The reply will be, "Yes, but you were aware that my servant here was hungry, and my servant there was thirsty, and my servant over there was ill, and through serving them you would have found ME."
Another narrative advises to look for Divinity amongst the meek, poor, disenfranchised, and sick. We can conclude that for those who visit with and minister to the ill with as much sincerity and presence as they can muster, there is a reciprocal dynamic and exchange of Divine Grace and Mercy through which both parties are hopefully transformed. It is never a one-way street with caregivers, be they an MD, RN, Nurse's aid, chaplain, or social worker. Now matter how much they stumble, they tread the path of saints and prophets. However, if not possessed by proper attitudes, the situation may become downright disastrous, openly or otherwise. Despite appearances, it is an enormous task - hence the anguish, frustration, and burnout that exists side by side with epiphanies of joy and accomplishment.
All of the above discussion was an elaboration of Islamic doctrine as it relates to the subject of care giving to the critically ill. As mentioned earlier, these ideas resonate with other faith traditions. Understanding these values and sympathizing with patients who are attempting to actualize them can lead to a more fulfilling and meaningful encounter for both caregiver and patient.
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