Amyotrophic Lateral Sclerosis (ALS) is a terminal illness of the nervous system, resulting in the degeneration of neurons. When the motor neurons in the lateral spinal cord degenerate, the muscle cannot be stimulated and gradually atrophies. As the disease progresses, the brain cannot initiate and control muscle movement, so voluntary muscle actions, such as reaching for your phone or typing on a keyboard, are lost. Currently there are no treatments or cures to reverse the effects of ALS and the disease process is still widely unknown. Some noteworthy individuals diagnosed with this disease have included Lou Gehrig, Stephen Hawking, Jon Stone, George Yardley, Henry A. Wallace, and Steve Gleason. These are the facts, but I could have never realized what living with ALS was like until I listened to a retired senior, a teacher, and a musician tell me their stories.

The older couple told us of their past year as the husband wrote on an electronic note pad to fill in the gaps of his spouse’s version of their story. They had first noticed his symptoms when he began choking on his food, and they had to adapt as the disease progression got more and more severe. His wife comically said that she doesn’t know where to look when he’s trying to talk to her – “Should I look at his eyes, his mouth, this pad?” Every day, they had to face a new challenge and overcome it together, as a family.

Another patient was a mother, a teacher, now wheelchair bound and with a respirator to help her breathe. Because of her age, none of her physicians expected ALS and thought she was struggling from carpal tunnel syndrome or an ulnar nerve injury. She told us her husband was her biggest caregiver and supporter; her husband joked, “She makes the list and I carry it out.” He talked about his struggles, working full time as well as being a full-time caregiver for his wife and their 3-year-old daughter, as well as still finding time for self-care. Even with all this juggling, he felt guilty. This guilt was expressed by many of the caregivers: some because they didn’t even notice the symptoms and others because they felt like they couldn’t help their spouses. Guilt was felt by the patients too. The mother was upset because her daughter would only remember her in a wheelchair. Despite the difficulties, family was a major support system for each patient.

When asked about how she felt after getting her diagnosis, the musician said, “I felt like a deer in headlights… I never pictured I was going to go out that way… with a terminal illness… Last year I had no trouble walking, singing, cooking, gardening, and this year…” Despite all of this, she said she felt relieved. Her struggle to find a neurologist who respected her was heartbreaking. She had gone to a physician because she felt helpless; she was having trouble playing guitar, she was losing her identity as a musician. However, the physician assumed from her past medical history of anxiety that she was having mental issues with memory, anxiety, and depression. As she continued to receive hostile treatment, she found a second doctor who listened to her. Unfortunately, even though he took her seriously, he didn’t have the courage to diagnose her with ALS, telling her instead that she had a motor neuron disease and referring her to a specialist. When she finally received the diagnosis of ALS, she was relieved. She no longer felt crazy. She was able to be heard. She was able to communicate with someone who wanted to help her. ALS is already a hard disease to diagnose; not having someone on her side only made her situation more difficult. She says now, as each symptom appears, she isn’t afraid anymore, because she knows it’s ALS. This relief of having a concrete diagnosis, of having a diagnosable disease, even one that is untreatable, was reiterated by several of the other panelists.

Although a diagnosis was a relief for many of the patients, they all saw the importance of taking part in clinical trials. They recognized that ALS affects everyone at different times in different ways and hoped that one day they could explain why this illness is so hard to detect and track. Participating in various studies and trials made them feel like they were helping future patients and physicians to be able to better understand why this terminal disease can strike at any time, with no discernable warning signs, affecting each individual uniquely in initial symptoms and progression.

Getting a concrete diagnosis gave these patients the freedom to seize the day and live in the moment. For the musician, as her ability to play guitar diminished chord by chord, and she started slurring her words, preserving her voice and her identity became very important to her. She is using a message banking app to preserve her voice. The software requires her to read thousands of words and sentences. Although she had to accept the things she could no longer do, she realized that she did not have to give up her identity or love of music because of ALS. Overflowing with her love of music, she told us about how when choirs sings together, their hearts become synchronized; and how music lowers blood pressure and stimulates all areas of the brain. As she interwove details about her symptoms with her favorite song, Fire on the Mountain by the Grateful Dead, the two had become part of the same spiritual transformation. Smiling peacefully, she explained, “Maybe nobody else hears it the way I do. I see death as the final healing, finally being released from your body.” She viewed her diagnosis as graduating early and the symptoms that came attached with it as her disappearing slowly, rather than all at once. The unavoidable indignities were just something she had to accept. What mattered most to her was keeping her individual personality in the face of intense daily struggles.

By the end of our discussion, I felt the weight of my white coat as I never had before and recognized that this would be the first of many times that I would have to carry this symbol of patient advocacy. As these patients spilled all their vulnerabilities to a group of 50 students, I realized the most important thing I will learn in medical school is opening my heart without getting crushed under negativity. I learned that, as doctors, we have the tendency to think the ultimate solution is life, when in truth, mortality is the reality. What matters is being present when there is a fire, realizing that “a pail of water” may not be enough to put it out, but continuing to carry that water for your patient.

Long distance runner, what you standin there for?
Get up, get out, get out of the door

There’s a dragon with matches that’s loose on the town
Takes a whole pail of water just to cool him down
-The Grateful Dead

After that question, I found myself at the doctors.

“If your heart is OK, then your body is OK,” she told me with worrying eyes.

“I’ve never had pain in my chest for this long,” I told her. “It feels as if somebody is sitting on my heart. But if I put my hand on my chest, that warmth helps to alleviate the pain.”

She was concerned. We stopped and she urged me to go to the ER immediately.

“I need to pray,” I told her. “It will take ten minutes and I will be at the hospital praying room. There are always a few people there, so don’t worry.”

She nodded. “I believe in the power of the prayer and meditation,” she added. And she ensured that I see a specialist for the chest pain.

I left that building and crossed the road to go to the other building. I was holding my heart, thinking the metaphors that we think of as a mundane saying. None of the metaphorical descriptions were solely poetry or were merely linguistic elaboration. Rather, they all meant what is untold and unseen and indescribable. At that moment I realized this heart was given to me. I was doing my best for a month to satisfy her needs and to ease her tension. But she was behaving as a separate and independent unit that has her own free will. I realized this for the first time in my life. Maybe the metaphor for this case would be extending a helping a hand to my heart, or to surround her with muscles. Maybe I forced too much on her, or did not appreciate the help my individual organs, my body as a whole, have given me.

That night, a friend of mine, not knowing what I had been thinking during the day, told me that we should talk to our bodies. “You should thank your feet that carried you all those years, my friend,” she said. “You should appreciate your eyes, which never gave up on you. You should thank your arms and hands since you would be speechless without them as a writer. You should thank your brain, for she listened to her Owner all these years and served you to be a better human every day.” “You know,” I added, “you are so right. After all, the one who cannot thank people and things cannot thank their Owner, the Beautiful, the Merciful, the Wise, the Choice Maker!”

I have been reading a lot lately. But there is something we learn from life and other people that no book can cover. Thus, I believe humankind is a unique book, its own kind of scripture. Humans read the universe with one eye, and the Scriptures with the other. Thus, we are given double eyes. And humans stand at the conjunction of these two books of meaning, being ourselves the third book which is uniquely because it is not just a book to read but also a reader. The more humans read these two books, the more we become a readable book.

So what is written in me? I suppose the basis of all lines is this sentence I heard from my doctor today: Save your heart, if the heart is good then your body and mind will be healthy. I wish I knew the language of the heart that would make my body healthy and would make my mind a reader and my self a book. The heart is at the center of human life, both in the physical and metaphysical senses. The heart is at the heart of the fact that humankind is a book to be read and discovered. The heart defines what we feel and motivates us in life. The heart defines which way the mind will travel. The heart is the teacher of the mind. Do you think we can unravel the language of the heart?

How is uterus to be placed in the frontier abdomen?

In order for a baby to survive, a suitable space in which it will be fed and protected is necessary. Therefore, the uterus is in the best location as it is, and its equivalent cannot be maintained in the belly. Let us consider that births would really happen through the belly. If the uterus, where a baby develops in 40 weeks, were placed in the belly, then a set of problems would appear. The opening of the uterus would be turned toward the abdomen wall, and thus there would be no strong bonds to tie it up with the surrounding area. In this case we cannot place the intestines, mesenteric blood vessels, aorta, and the net of nerves in connection to them in any way. If the uterus were in the belly, it would unavoidably pressurize the stomach, liver, spleen, and other internal organs, as the mass inside a pregnant woman grew. This could obviously pose a lethal threat for both the mother and the baby.

How would the birth process begin?

If the uterus were anywhere else than its present position, it would contradict the physiology of birth. The fetus assumes three different positions along the developmental process: as it begins to be formed the head is up and the feet are down. At the sixth month, the baby assumes a horizontal position. When the birth draws near, feet and the hips are positioned on top and the head is turned downward, closer to the opening of the uterus. As the head gets closer to the opening, mechanical pressure increases. Thus, signals for the birth are sent to the brain so that the relevant hormone aid is sent in response. With the effect of the hormones, the uterus begins to contract in order to dispose of the being inside. As the opening of the uterus enlarges, the contractions increase. With its mechanical help, the sacro-coccigeal joint makes a 2-cm stretch to give way and with the support of the pubis bone in front, the birth is realized. If human birth was to occur through the belly, then how would the process—including the brain, pituitary gland, and adrenal glands—be triggered with mechanical pressure without the help of gravitation? If the uterus is placed inside the belly vertically, then a tube or similar opening is needed for a way out from between the legs. Even if there is mechanical pressure and the hormones to facilitate birth are secreted, then what way will the baby move? How can birth be realized through the soft-walled belly without any mechanical support at all? If human birth were possible through the belly without any support from the bones, the duration of birth would be much greater. In addition, as the size of the baby increased, a high positive pressure would be needed in order to balance the effect of gravity. However, the more a belly grows, the weaker its muscles become. If birth would ever be possible through the belly, then the mother would have to deliver her baby by lying prone in order to prevent the soft tissue to be torn. In addition certain flora (beneficial microorganisms) need to be placed to the birth channel in order to prevent relevant complications. Should the genital organ be transferred to the navel? For the best protection against complications, the baby’s head need to be in horizontal position as if it were swimming. The effect of gravitation applies different pressures on the baby’s head while the mother stands, sits, and lies in a supine position. In this case, by which force would the head be directed toward the opening in the frontal abdomen wall to start the birth process? The three different positions of a fetus along its development will never be possible in a uterus located in the belly. Then the fetus would dangle like a tree leaf under the effect of gravitation.

The easiness of normal physiological birth

A form of birth through the belly, a cesarean delivery is only realized in the face of certain anomalies. Although some women assume cesarean as a painless form of birth, findings adds to the cons of cesarean. Accordingly, rate of allergic asthma in cesarean-born children is found six times higher in comparison to others. It is thought that during normal birth, the baby receives some of the microorganisms on the mother’s genital organ and the immune system forms antidote against them, which provides protection against asthma.

Strapping up the uterus?

As the baby develops in a period which lasts more than nine months, the uterus gradually grows. In the mean time, it is necessary to fix the uterus with sound bonds so that it becomes resistible to shakes. Counting in both sides, 14 pieces of bonds fixes the uterus to the bones (ilium, ischium, pubis, sacrum) around the hips. Were the uterus to be in the belly, how could we find such sound structure to support the bonds?

To conclude, God Almighty could have created our body in a different form, and He would have shaped our anatomy accordingly, which would then provide the best means for an ideal birth. Thus, it is nonsensical to seek errors in our present biological makeup in order to dishearten the faithful in their belief. Leaving aside such speculations, one cannot help but admire the perfect arrangement in human anatomy when considered from the perspective of wisdom.

Arslan Mayda is a medical doctor at Sifa Hospital, Izmir, Turkey.

Through this religion, humanity welcomed the most profound and rewarding transformations spreading in ever-widening circles from the center and witnessed the most vital changes. It was Islam which indicated the paths leading to absolute peace and salvation; it offered decisive solutions to the problems of humanity that had amassed over centuries. And today, despite the age-long efforts of many aggressive and brutal people to defame its luminous face and prevent its advance, Islam still maintains its position as a unique source of hope and treats everyone who takes refuge in it with an elixir of immortality.

Although there have been some who chose to darken their fate by breaking away from Islam during a gloomy period or by opposing it for the sake of obstinacy in a false cause, Islam’s ever fresh and fulfilling message has always been like a lighthouse for those on the voyage and a safe haven for those in peril. For all some people may say, the entire world will one day appreciate this great truth thanks to the real representatives of this religion and will run to its climate of soothing breezes. Who knows? This religion may embrace us all, just like in the first ages of revival, and blow a new soul into this moribund world! May the followers of this religion not disappoint those who pin their hopes on them by dallying and wavering; may they not shake the trust in them that has started to grow in public opinion.

In a single breath, this religion once saved the masses that had sunk up to their throats in heedlessness, ignorance, and aberration, and it elevated them to lofty horizons beyond imagining; likewise, it will certainly be a source of inspiration for today’s dispersed and aimless masses and speak to them of the privilege of being human.

One day, with its well-preserved heavenly nature, this religion will wake the riotous masses of this age to being truly human and will reveal the divine in Islam’s essence to everyone; for this religion is not an empty system that consists of nothing but abstract measures, principles, and theories. Islam is a combination of systems that is perfectly compatible with human nature and rich enough to meet all the material and spiritual needs of humanity. It is the voice originating from the realms beyond the heavens that promises a bright future for every individual and society. And now, with its unique rhetoric and enchanting effect engrossing everyone, it offers to humanity a mysterious key to unlock the gates of this world and the afterlife by way of carrying them to the heavenliness once attained in the past.

Although our religion is not being fully expressed due to some of its disloyal followers and destructive enemies-as is no doubt the case today-its voice will be heard in the skies and beyond at a providential period of time, by means of the efforts of its auspicious students who have managed to wed their heart with their mind; this will be the true shab-i arus (wedding night) for the people of their time.

If such splendors were achieved in the darkest days of history, why should they not be realized once again? As long as they are aware of their own wonder and spiritual merit, human beings are the same human beings that they were in the past, happiness in this world and in the hereafter is the main goal as it was in the past, the disciplines need to reach the goal are the same disciplines as they were before …. All that remains is for the representatives who are spiritually alert with faith, hope, and tenacity to roll up their sleeves ready for work. Hearts are under God’s control; so all this can come true one day. “When God manifests Himself with His favor, He makes everything easy / He creates the means for attainment, and grants it instantly” (Ibrahim Haqqi). We cannot say representatives of the necessary caliber do not exist at all today. It is true that there is some slackening of enthusiasm and we are acting slowly, but it is also true that many exceptional projects have been realized so far.

So many of our precious values have been revived all over the world that to ignore that fact would be ungrateful, just as it would be unfortunate to remain in despair while they stand before our eyes. How many other developments can we refer to that have been achieved as fast as that in our day? How many other revivals were there that have been as immediate as that of our day? And how many philosophies and worldviews have we seen that have been embraced by the masses in a time as short as this revival we see in our day? The world is the same planet, humanity is the same humanity, the goal is the same goal; then, why should past achievements not be realized again? Once the long-awaited truthful representatives can make their voices heard, albeit at low volume, but in a tone appropriate for all humans of diverse natures, and if those with sensible minds and spirits are made aware of their own true values, then fair-thinking souls who have always sought a glimpse of light throughout the ages will be saved from the confinements of this world and will rush forward to the expansive lands of these enlightened representatives, discovering a very different life.

Opposing revivalist movements, hedonistic circles try to sabotage every positive development; resistance comes especially from a powerful minority whose minds are completely fixed on gaining this world at the expense of the afterlife. These circles go all out to damn and smear the most positive and innocent activities that do not fit into their worldview, if it can be called a view. While they engender a new conflict every day by attacking every thing that is carried out on behalf of religion, sometimes with words like “backwardness” and at other times with delirious slanders like “fundamentalism” and “fundamentalist,” the pure souls who have awakened to true human values have always smiled back and entreated God the Ever-Patient, hoping that even those hostile circles-who are also favored with the wonder of being human-may one day feel regret for what they have done and ask pardon.

What falls to our share today is to put our faith in God, to walk with added determination on the path we know as straight, to embrace everyone as compassionately as we can, and to pronounce even to hostile groups our overflowing love for humanity. What remains beyond this is to be content with God’s will, to assume active patience against the exasperations of the time, and to move forward with consideration.