“God contracts and expands.” (2:245)

The heart is a fairly small muscle that beats 100,000 times a day and produces roughly 115,000 Joules of energy, enough to boil a cup of water for some tea. Like a flowing river, deoxygenated blood travels from the right side of our body to the right side of our heart via valves and chambers until passing through our lungs, where each breath we take facilitates the oxygenation of every individual blood cell with 4 molecules of oxygen. The now oxygenated blood, continues to progress, never stopping, now through the left side of the heart, again passing through valves and chambers, eventually being pushed out to the rest of our body with the help of the left ventricle. The left ventricle is the thickest, largest, strongest, and most muscular part of the heart because it has the responsibility of pumping oxygenated blood through the aortic valve and aorta to the rest of our body. If this continual circulation is ever interrupted, it can lead to catastrophic outcomes.

There are several ways this flow can be interrupted, many of which happen before birth and require immediate surgery after delivery. Congenital heart defects (CHD) are some of the most common types of birth defects, but as medical care and treatment have advanced many of the babies that suffer from them usually end up living long and healthy lives. Treatment isn’t required while babies are in their mother’s womb, because the circulation of the heart is different before the baby takes its first breaths, and there is normally a mixing of oxygenated and deoxygenated blood. CHD can be mild, like a hole in the heart between two chambers that allows the mixing of oxygenated and deoxygenated blood. Ventricular septal defects and atrial septal defects (holes in the heart) are some of the most common forms of CHD. Sometimes these defects can be resolved on their own or may not be realized until much later in life, or they may require a “patch” repair if they are larger. VSDs and ASDs are associated with Down’s Syndrome, and maternal risk factors including diabetes, obesity, and smoking. Patent foramen ovale (a hole in the heart that fails to close) is found in up to 30% of the general population. It usually requires no treatment and isn’t discovered unless complications like a stroke occur later in life by having a blood clot form, requiring the blood to then travel through the hole, and then be shot up through the aorta into the brain. All babies are born with patent (open) ductus arteriosus – the ductus arteriosus is a fetal blood vessel that allows flow from the right heart to the aorta, necessary when the baby is in their mother’s womb, but incompatible for life after the baby is born. Within the first few days of life, this blood vessel should close and eventually transform into a ligament that helps tether the pulmonary artery and aorta to each other. If closure fails and the ductus arteriosus remains patent, a continuous machine-like murmur can be heard with a stethoscope, and treatment with indomethacin is started. Untreated, a PDA would result in cyanosis (blue/gray skin) and Eisenmenger Syndrome due to decreased oxygen delivery [1].

The heart’s responsibility is not only to provide oxygenated blood to the rest of the body but to also somehow feed itself. The heart’s muscles exhaust 11.6% of the body’s total oxygen consumption in order to maintain its own contractile activity, coming in 3rd after the liver (20.4%) and the brain (18.4%). During contraction or systole, the heart pumps at 120 mm Hg to provide blood through the aorta and arteries. During relaxation, or diastole, the heart expands and allows for blood to fill into its chambers and also flow through the coronary arteries. These coronary arteries are the arteries that will feed the heart itself. Thus, in order to feed itself the heart must relax and therefore allow its coronary arteries to expand and provide blood to itself. When the heart is contracting and providing blood to the rest of the organs it is too constricted to provide blood to itself. Since these branches are located within grooves of the heart, when the heart is systole the arteries are too constricted for blood flow due to increased tension. This is especially true regarding the arteries supplying the left ventricle since it is larger and more muscular – remember this is where the aorta will branch off, providing oxygenated blood to the rest of our body.

This balance between contraction and expansion may remind some readers of the concepts of Qabd (contraction) and Bast (expansion) in Sufism or Tzimtzum in Jewish mysticism, and how one truly feeds the other thus allowing for growth through this cycle of contraction and relaxation. Tzimtzum is used to explain the process of creation, a contraction of infinity happening to give birth to a finite universe [2]. The Sufi tradition is a personal journey described as “contraction and openness are mysterious ‘bargains’ that have been made without the will or intention of the traveler. The first one blocks his or her way; the second one gives him or her wings to fly to new heights [3].” What is perhaps most interesting is that our physical heart performs this contraction and expansion perfectly so long as we take care of it, whereas our spiritual heart can have lapses in this critical exercise. Maybe, if we understand how to take care of our physical heart, we will also find the answer to keeping our spiritual heart healthy. Prophet Muhammad, peace be upon him, emphasizes this connection as follows: “Verily, in the body is a piece of flesh which, if sound, the entire body is sound, and if corrupt, the entire body is corrupt. Truly, it is the heart.”

Some ways to take care of our physical hearts include incorporating more physical activity into our daily lives, eating less and healthy, and controlling our stress. Perhaps our spiritual health would also benefit from these and similar activities, including regular acts of worship, fasting, controlling our temper, and being kind to others. When we don’t take care of our physical heart, it begins to fail since oxygen ceases to be delivered to our heart and the electrical currents can no longer travel effectively, thus resulting in a heart attack.

Coronary artery disease is the leading cause of death worldwide, and especially in developed countries. The deadliest heart attack occurs if there is a blockage of the left anterior descending coronary artery, which is why it is tragically termed the “widow maker.” Beginning from adolescence, arteries begin to accumulate fatty streaks and progress to an atherosclerotic plaque. This plaque can lead to several disastrous complications such as follows:

• a narrowing or complete obstruction of an artery, impairing blood flow and leaving the heart thirsty for oxygen
• a stroke due to a blood clot caused by decreased movement, breaking off and flowing to the brain
• a weakening of the vessel wall leading to an aneurysm, the vessel bursting

For some patients, a heart attack becomes a wakeup call in order to make the many necessary lifestyle changes that are necessary in order to live a long and healthy life. However, 20% of patients will experience a second heart attack. As the heart gets weaker and weaker it can eventually develop cardiorenal syndrome, a complication that results from the heart being unable to pump effectively resulting in it getting backed up in the heart and the right side of the body. This increase in volume in the body is further exacerbated by the kidneys, which continue to retain fluids and thus cause the body to become overloaded. This leads to edema, or swelling, in the legs that can eventually progress to the lungs and cause congestive heart failure. As the kidneys try to ameliorate the fact that the heart is not pumping effectively, they ultimately worsen the situation leading to end-stage renal disease and stage D heart failure.

Of course, as with almost all medical conditions, these fatal results can be prevented much earlier with lifestyle changes, even before introducing medical intervention with prescription drugs or other procedures. These lifestyle modifications include moderate aerobic exercise at least 3 times a week, a diet rich in vegetables and low in fats, sugars, and carbohydrates, smoking and alcohol cessation, and weight reduction (which would come as a result of these modifications). It is also important for patients that are already dealing with hypertension, diabetes, and hyperlipidemia should keep them well-managed and controlled.

Maybe similarly, some simple lifestyle changes, such as putting aside a few minutes every day to reflect, can be the secret to keeping our spiritual heart healthy. Our heart must remain healthy to keep the rest of our body healthy. Considering the close relationship between our physical and spiritual heart, our spiritual heart must be kept healthy to keep the rest of our spiritual body healthy. Spiritually healthy individuals will further reinforce the health of our community, for Prophet Muhammad, peace be upon him, says, “The believers in their mutual kindness, compassion and sympathy are just like one body. When one of the limbs suffers, the whole body responds to it with wakefulness and fever.”

“As the whole of existence is in His grasp and at His free disposal, it is He Who directs and disposes of all things, from the heavens to the human heart… When God wills, He contracts a heart so tightly for what only He can provide that only He can satisfy it. By contrast, He expands and exhilarates it to such an extent that it needs nothing. Contraction is caused by God’s Majesty; openness is caused by His Grace. (Fethullah Gülen, Emerald Hills of the Heart).”

References

• https://www.heart.org/en/health-topics/congenital-heart-defects
• https://www.britannica.com/biography/Isaac-ben-Solomon-Luria#ref163236
• http://fgulen.com/en/fethullah-gulens-works/key-concepts-in-the-practice-of-sufism-1/qabd-and-bast-contraction-and-openness

We all focused on one topic throughout 2020: Covid-19. No single day passed without news on the pandemic as we counted numbers of positive cases and the death toll while anticipating for a vaccine. In the meantime, we got more familiar with some of the medical processes, like phases, clinical trials, mutations, etc. for all this had to deal with the most precious gift we are given: life.

In our last issue, we touched upon the history of pharmacology and how modern-day drugs are made in an article titled “Pharmacology: The Journey of a Chemical Compound into a Drug.” Now, we will explore the multiple, lengthy phases of clinical trials that drugs must undergo and why they are imperative in order for new medicines to get approved for the marketplace.

Clinical trials are a way to test new methods of diagnosing, treating, or preventing health conditions. The goal is to determine whether a substance is both safe and effective. A clinical trial is only done when there is strong reason to believe that a new test or treatment may improve the care of patients.

A variety of treatment methods such as medications, medication combinations, new uses for existing medications, and medical devices are evaluated through clinical trials. In the United States, all new treatments must go through these trials before being approved for public sale by the Food and Drug Administration (FDA).

At the discovery and development stages, thousands of compounds may be potential candidates for development into a “drug”. After early testing, however, only a small number of compounds look promising and call for further study. The entire process of developing a drug from its pre-clinical research stage to its final marketing phase can take approximately 12 to 18 years and often costs well over $1 billion [3, 4].

Clinical trials show us what works and what does not in the realm of healthcare and are designed to answer some important questions such as:

• Does the new treatment work in people? If it does, how effective is it?
• Is it better than currently used treatments?
• If it is not better, is it just as good and cause fewer side effects?
• Does it work in some people who do not benefit from current treatments?
• Is the new treatment relatively safe? There is virtually no treatment or procedure that is without risk, but do the benefits of the new treatment outweigh the risks?

Answering these questions, while giving as few people as possible an unknown treatment, often requires several clinical trials in different phases. Each phase is designed to answer certain questions while keeping trial participants as safe as possible.

Preclinical phase

Before clinical trials can begin in humans, tests and treatments are assessed in pre-clinical research, which can involve extensive laboratory research over several years of testing on animals and human cells. This research may aim to learn the chemical compound of a drug [1]. If the initial laboratory research is successful, researchers send the data to health authorities for approval in order to begin research and testing on humans.

Once pre-clinical research results are approved, human testing of experimental drugs can begin and is typically conducted in four phases that are denoted by Roman numerals (Phase I, II, III and IV). Each phase is considered a separate trial and, after completion of a phase over many years, researchers are required to submit their data to, and then wait for approval from their local health agency (the FDA in the US) before continuing onto the next phase. If the drug successfully passes through Phases I, II, and III then it will usually be approved by the national regulatory authority for use in the general population. Phase IV trials are “post-marketing” or “surveillance” studies that are conducted to monitor how safe the product is over several years [2].

Phase I

This is the first clinical phase that involves humans. Phase I trials most often include healthy volunteers, however there are some circumstances when clinical patients are used, such as patients who have terminal cancer or HIV. These treatments possess a much higher risk for healthy individuals and could cause to become ill and contract serious adverse side effects.

In a Phase I clinical trial, doctors collect information on:

• The dose or treatment
• When it should be taken, and how often
• Any side effects or complications
• How the treatment affects patients and their preexisting conditions

One of the primary goals of Phase I studies is to find the highest dose of a new treatment that can be given safely without causing severe side effects. Although the treatment has been tested in laboratory and most likely been used in animal studies, the side effects in people cannot be known for sure. During Phase I of a clinical trial, researchers spend several months to evaluate safety, side effects, optimal dosage amounts, and formulation method for the drug on about 20 to 80 people who have no underlying health conditions.

In addition to evaluating safety and ideal dosage, specialists also look at the best way to administer the drug such as orally, intravenously, or topically. These trials are often conducted in a clinical trial clinic where the subject can be observed by full-time staff. Safety always remains the foremost concern in Phase I. The research team keeps a close eye on the people and watches for any severe side effects.

Researchers start by giving very low doses of the drug to a few patients while higher doses are given to other patients until side effects become too severe or desired effects are seen. The drug may help patients, but Phase I trials are to test a drug’s safety. If a drug is found to be safe enough, it can be tested in a Phase II clinical trial. According to the FDA, approximately 70 percent of medications move on to Phase II.

Phase 2

Phase II of a clinical trial usually involves anywhere from 50 to several hundred who are living with the condition that the new medication is meant to treat. They are usually given the same dose that was found to be safe in the previous phase. Investigators monitor participants for several months, or years, to see how effective the medication is and to gather more information about any side effects it might cause.

Most phase II studies are randomized trials where one group of patients receives the experimental drug, while a second “control” group receives a standard treatment or placebo. These studies are mostly “blinded” which means that neither the patients nor the researchers know who has received the experimental drug in order to avoid from bias. Doctors use a computer program to randomly sort volunteers into these two separate groups. Each volunteer has an equal chance of ending up in any of the groups and are randomly put in any group.

This allows investigators to provide the pharmaceutical company and the health authority with comparative information about the relative safety and effectiveness of the new drug. When the development process for a new drug fails, this usually occurs during Phase II trials when the drug is discovered to not to work as planned or to have toxic effects. The FDA estimates that roughly one-third of experimental drugs successfully complete both Phase I and Phase II studies.

Phase II clinical programs historically have experienced the lowest success rate of the four development phases. In 2010, the percentage of Phase II trials that proceeded to Phase III was 18% [5] and only 31% of developmental candidates advanced from Phase II to Phase III in a large study of clinical trials conducted during the period of 2006 – 2015 [6].

Phase III

Phase III of a clinical trial usually involves up to 3,000 participants who have the condition that the new medication is meant to treat. These participants must include men, women, and people of different ages and ethnic groups in many places across the country (or even around the world) at the same time. This helps doctors learn how treatment works in different people with different genetic backgrounds, races, and ethnicity. These studies tend to last longer – up to several years – than Phase I and II studies.

One of the additional purposes of Phase III is to evaluate how the new medication works in comparison to existing medications for the same condition. To move forward with the trial, investigators need to demonstrate that the medication is at least as safe and effective as existing treatment options. Due to the larger number of participants and longer duration of Phase III, rare and long-term side effects are more likely to show up during this phase.

There can be more than two treatment groups in Phase III trials. The control group may receive the current standard-of-care treatment for their illness while other groups receive the new treatment on trial. Phase III trials are usually double blinded to eliminate bias when interpreting results.

Placebos may be used in some Phase III studies, but they are never used alone if there is a treatment available that works. Sometimes, a patient who is randomly assigned to the placebo for part of the study will at some point be offered the standard treatment as well. As with other trials, patients in Phase III clinical trials are watched closely for side effects, and treatment is stopped if they become too hard to manage.

Every patient in a Phase III study is watched closely, and the study will be stopped early if the side effects of the new drug are too severe or if one group has significantly better results. Phase III clinical trials are often needed before the FDA will approve the use of a new drug for the general public. If researchers demonstrate that the medication is at least as safe and effective as others already on the market, then the FDA will usually approve the medication.

In the United States, when Phase III clinical trials (or sometimes Phase II trials) show a new drug is more effective or safer than the current treatment, a new drug application (NDA) is submitted to the FDA for approval. The FDA reviews the results from the clinical trials and other relevant information.

Based upon the review, the FDA then decides whether to approve the treatment for use in patients with the illness the drug was tested on. If approved, the new treatment often becomes a standard of care and newer drugs may be tested against it before they can be approved. If the FDA feels that more evidence is needed to show that the new treatment’s benefits outweigh its risks, it may ask for more information or even require that more studies be done. Once Phase III is complete, a pharmaceutical company can request FDA approval to begin marketing the drug. Roughly 25 to 30 percent of medications move on to Phase IV.

Phase IV

Phase IV trials test new drugs that are approved by health authorities and often are called Post Marketing Surveillance Trials. The drugs are available for doctors to prescribe to patients, but Phase IV studies might still be needed to answer important questions. In previous clinical phases the drug may not have been tested for interactions with other drugs, or on certain population groups, such as pregnant women, who are unlikely to subject themselves to trials. This phase involves thousands of participants and can last for many years. Investigators use this phase to get more information about the medication’s long-term safety, effectiveness, and any other benefits.

This is often the safest type of clinical trial because the treatment has already been studied a lot and has likely been given to many people. Phase IV studies look at safety over time. These studies may also look at other aspects of the treatment, such as quality of life or cost effectiveness.

Phase IV studies can result in a drug or device being taken off the market or restricted depending on the findings in the study. Unless an adverse effect of the approved drug is shown or the drug is accepted as safe, it will stay on the market and also in Phase IV forever.

This clinical trial algorithm has come out after many scientific studies. Every point of the clinical trials, and possible problems, have been clarified by policies which may differ from country to country. At the end, clinical trials are a very safe and cautious method of finding out the safest and most effective treatment, or diagnostic method, for people. During clinical trials, scientists are very careful about ethical issues and try not to harm any living organisms, be them animals or humans. There is an ongoing public debate over pharmaceutical companies. While some think they play a major role in the emergence of many methods and scientific developments to benefit human health, others doubt their motivations and questions their contribution to the public good. This debate will surely continue for a long time, but under the current circumstances, pharmaceutical companies are found in the center of all these clinical trials described in this article. Regardless of the truth behind these doubts, it is important to be always aware of the priceless value of life, that it has been given to us and all living things as an inalienable right and a precious gift, and that it is a major responsibility take care of it well and seek healing when needed.

• https://www.nccn.org/patients/resources/clinical_trials/phases.aspx
• “The drug development process”. US Food and Drug Administration. 4 January 2018. Retrieved 17 August 2020
• Holland J (2013). “Fixing a broken drug development process”. Journal of Commercial Biotechnology. 19. doi:10.5912/jcb588.
• Adams CP, Brantner VV (2006). “Estimating the cost of new drug development: is it really 802 million dollars?”. Health Affairs. 25 (2): 420–8. doi:10.1377/hlthaff.25.2.420. PMID 16522582.
• “New drugs failing Phase II and III clinical trials”. MedCity News. 2011-06-02.
• “Clinical Development Success Rates 2006-2015” (PDF). bio.org. Retrieved 2018-02-11.

It has been over half a year since Covid-19 swept across the world and forced many countries into quarantine. Hopes of a quick resolution of the disease in many countries have since been, unfortunately, proven to be wrong, and it is evident that the virus is here to stay for a while [1]. The virus is so difficult to deal with considering it can be transferred from person to person even if the carrier does not outwardly display symptoms. Even animals, ranging from mice to tigers, can contract and transmit it to humans [2, 3], and we cannot quarantine or force them to wear facemasks. The virus will eventually hit each person; it is just a matter of time. The virus may additionally arrive in multiple waves, as it is possible to be reinfected [4]. COVID-19 will most likely have a lifespan of a few years, much like other major virus outbreaks of the past such as the swine flu in Hong Kong or Spanish flu. It will probably come and go like a common flu in never ending waves. So, each of us need to be ready until a successful vaccine is developed, and the wisest action for each person to be ready would be to boost our immune systems and practice effective social distancing and sanitation measures, while we deal with this virus for however long it may last.

Vaccines are critical for stunting the development and spread of viruses; however, they can be costly, time-intensive to develop, and not always perfect. It is worth exploring alternative methods to help protect our bodies from these pathological invaders while vaccines are being researched. As it so happens, the best method of prevention to date for HIV infections is not a vaccine, but is instead a tradition that is as old as thousands of years: male circumcision [5]. To give a comparison, the current widely popular and heavily promoted influenza vaccine is considered “50% effective against influenza B/Victoria viruses and 37% effective against influenza A(H1N1)” [6]. On the other hand, according to an article published in the prestigious medical journal, The Lancet, circumcision is up to 88% effective in preventing heterosexual transmission of HIV [7]. Male circumcision does not have any medicinal side effects, and the only risks that are involved are those related to any minor surgery – bleeding and infection.

In the 1980s, when I first heard of HIV, I remember reading articles which claimed, quite arrogantly, that vaccines and cures for the condition would be found within two or three years [8]. Forty years later, and after spending many billions of dollars on research, we are still nowhere near an HIV vaccine. At best, we found treatments which helped keep the HIV virus at bay [9]. To date, only two people have been fully cured with a method far too expensive to be applied to the general public [10]. In the meantime, at least 30 million people have died with more than half a million in the year 2019 alone [11]. While vaccines are critical for helping to eradicate viruses, putting all of our eggs into that basket alone can be a risky public health strategy due to how difficult and time consuming they are to discover, verify, and distribute. It is impossible to know for sure how long it will take to develop a vaccine for the coronavirus. In the meantime, communities should heavily consider following the instructions of their local health officials which often include social distancing, limited size gatherings, and frequent hand washing as these methods are already proven to help reduce the spread of the virus.

Development, and even the rushed development of a vaccine, is always a very tedious and dangerous process. The science behind them is exceptionally complex, and imperfect results can have disastrous consequences upon thousands of people. This is further complicated by the fact that phase 2 and phase 3 trials can have quite diverging results [12]. In the USA, AstraZeneca’s COVID-19 vaccine trials were stopped after trial participants fell ill [13]. Third phase trials, which encompass thousands of people [14], still can give little indication of the long-term side effects to any vaccine. Besides, even though there is human life at risk, the vaccine has already become an instrument for many political and economic disputes and conspiracy theories. Some governments claim they have already developed a vaccine, while others find them unreliable, or try to lure a foreign company to work for themselves [15]. In August of this year Russia rushed registration of an unproven Coronavirus vaccine and named it, in Cold-War-like fashion, the “Sputnik V” [16]. The announcement was made by none other than Vladimir Putin himself. It was offered to the USA, but was rejected due to safety concerns stemming from a belief that the drug was not adequately researched and developed [17]. In the meantime, Russia announced the development of a second vaccine [18]. Surely enough, it was dismissed and downplayed by the West as unproven and unreliable. On the other hand, a vaccine developed by a Chinese company Sinovac proved to be the most successful in its phase 3 trials in Brazil [19]. Sao Paulo Governor João Doria purchased 47 million shots of the vaccine. However, the transaction was stopped, arguably for political reasons, by the Brazilian President Jair Bolsonaro [20]. Bolsonaro’s comments when rejecting the purchase of the Sinovac vaccine on the basis that “the Brazilian people will not be anyone’s guinea pig” are not totally without merit. Recalls of “proven and tested” vaccines have happened in the past [21].

It is important for all people to continue exploring methods to develop their immune systems and prevent the spread of the virus while we wait for a vaccine. In an article I had previously published, I discussed the benefits of fasting, vitamin C, and Wim Hof breathing methods to help protect the body from disease [22]. All of these methods are well known and quite benign with respect to side effects, however they are unable to cure Covid-19 or prevent its spread. Additionally, the Center for Disease Control (CDC) has heavily stressed practices included social distancing and the wearing of non-ventilated face masks. Our hope is that going above and beyond to protect ourselves and our neighbors will give scientists the time that they need.

One way of giving that time to scientists is fasting. Fasting, like circumcision, is a tradition that is thousands of years old. In recent studies, a three-day water fast has been shown to reset the immune system of elderly people to the level of a twenty-year old’s [23]. At this current level of emergency in the world it would be very easy to find thousands of willing volunteers to trial monthly three-day water fasts and/or to take extra doses of vitamin C, not as a cure, but as a shield against COVID-19. This kind of study would not pose much risk and would definitely be very cost-effective. We could dive straight into the third phase of trials, for any side effects of fasting are already well known. And finally, if proven effective, its uptake by the population at large would be basically cost free and readily available across the whole world.

Our world has been enduring a difficult and challenging period for the better half of a year now. Time has given us the ability to learn more about the virus, how it disrupts our bodies, and how it spreads. This knowledge has, in turn, allowed us to research it and develop effective social guidelines for limiting its spread. Still, there is much work to be done. Hysteria and haste are not conducive to producing a vaccine that is thorough, effective, and efficient. It should be the responsibility of every able-bodied citizen to do what they can to learn more about how they can protect themselves from the virus and thus prevent it from spreading even more while we wait for a vaccine.

1. https://www.wuky.org/post/beshear-next-few-weeks-will-be-critical#stream/0
2. https://www.washingtonpost.com/science/2020/09/03/coronavirus-deer-mice-spread/
3. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/animals.html
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326402/
5. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(99)03421-2/fulltext?_eventId=login
6. https://www.aafp.org/news/health-of-the-public/20200226interimfluve.html
7. Halperin, D. T., & Bailey, R. C. (1999). Male circumcision and HIV infection: 10 years and counting. The Lancet, 354(9192), 1813-5. doi:http://dx.doi.org/10.1016/S0140-6736(99)03421-2
8. https://www.immunology.org/publications/bsi-reports/60-years-immunology-past-present-and-future/the-hunt-for-hiv-vaccine
9. https://www.cdc.gov/hiv/basics/livingwithhiv/treatment.html
10. https://www.medicalnewstoday.com/articles/2nd-person-cured-of-hiv-thanks-to-stem-cell-transplant
11. https://www.unaids.org/en/resources/fact-sheet
12. https://www.fda.gov/media/102332/download
13. https://www.usatoday.com/story/news/health/2020/09/09/covid-vaccine-astrazeneca-trial-hold-what-does-mean/5757590002/
14. cancer.org/treatment/treatments-and-side-effects/clinical-trials/what-you-need-to-know/phases-of-clinical-trials.html
15. 15 https://www.nytimes.com/2020/03/15/world/europe/cornonavirus-vaccine-us-germany.html
16. https://www.theverge.com/2020/8/11/21363135/russia-coronavirus-vaccine-unproven-registration
17. https://www.techtimes.com/articles/251792/20200814/covid-19-us-says-no-to-russias-vaccine-sputnik-v-saying-theyll-never-use-it-on-monkeys-let-alone-people-vietnam-and-philippines-say-otherwise.htm
18. https://abcnews.go.com/Health/wireStory/russia-approves-2nd-virus-vaccine-early-trials-73614460
19. https://fortune.com/2020/10/20/covid-vaccine-china-brazil-testing-ground-safest-most-promising-sinovac/
20. https://apnews.com/article/virus-outbreak-brazil-state-governments-health-sao-paulo-b7b5b620ba54f402dbf803e26fe6b842
21. https://www.cdc.gov/vaccinesafety/concerns/recalls.html
22. https://medium.com/@arasweb/surviving-the-pandemic-370b47120d8d
23. https://news.usc.edu/63669/fasting-triggers-stem-cell-regeneration-of-damaged-old-immune-system/

We woke at the thud, panicked.

My wife and I had been dozing in bed, squeezing the last seconds of sleep out of our pillows before the inevitable onslaught of little people. It’s something of a delicious defeat when you hear the door creak open and steps on the carpet. You know you’re trading something so precious to you (sleep) for someone so precious, who you just wish would be precious elsewhere. But then they’re all warm and soft and tousle-headed and snuggly and saying things like “daddy, can we have special cereal?” and poking their knees into your side and sitting on your face with a full diaper and sticking cold toes into your armpits.

This morning they didn’t get to do all those precious, horrible things to us because we woke up to the sound of something thwacking against our window. After shaking off the confusion (no, it’s not a child on the roof; they can’t reach the window), I recalled why I knew the sound. It was a bird. And from the sound, a pretty sizable one.

I said as much to my wife, as I tried to open my eyes but managed only a half-squint. She half-muttered sympathy, as if she cared deeply inside but couldn’t get past the early morning fog. I added that since it was a big bird, it probably got away a little dazed, no harm done. I tried to find her to give her a reassuring pat, but I was too drowsy and missed completely. I also couldn’t pry my eyelids open still; they ached a little, as if I hadn’t used them for a week instead of approximately six hours.

I’ve read that birds, reptiles, and some mammals have something called a nictitating membrane, a third eyelid that acts as a translucent shield when they are diving or flying. They can draw it horizontally across each eye to moisten and protect it. For instance, many birds use it when they are regurgitating food for their kids so they don’t get their eyes poked out by little beaks.

I think of things like this when I’m abruptly disturbed from sleep. Things like this, and demonic children’s songs that will not be exorcised for hours.

We turned over and buried ourselves in the blankets for three more minutes before the precious, horrible people came and got us.

Nadia was playing hopscotch out on the sidewalk later in the morning when she found the bird. Robins are always the first birds my children encounter and remember. It was easy for her to name the body she stumbled upon, one story below our window, and quite dead. We had a little flurry of don’t-touch-that’s and daddy-is-it-going-to-be-okay’s, and I managed to deposit it into a small terrarium for them to look at. Animals can die of diseases communicable to humans, but this one died upon impact, and it was still warm. So the kids and I examined it carefully.

It was larger than any bird I’d seen this close. The wings were tucked in beside its impossibly light body. Many of its bones were hollow, for ease of flight. The neck was at a weird angle, a wrong angle. The death in front of me was at a wrong angle. It always has been, but it just felt much more wrong suddenly, because it was also in front of my children. Blood speckled its beak, a dark decoration above the warm red tinges on its chest.

I realized that it was a young one, probably a teenager in robin years. Its feathers were perfect, straight and sleek, pinions just slightly larger and smaller on each side, forming beautiful strong wings. And the roses on the sides under the wings were just barely forming up into a speckled breast. It was about the size of an adult but without the experience, which is why it probably hit our window.

One eye was slightly open and looking like black jelly, like it would spill out of the socket as liquid if you tipped the bird over slightly. The other eye was closed. This teenage robin had eyelashes on the under-lid. It had whiskers. Its feet were curled and delicate.

It was too beautiful. It was too sad.

Nadia was watching me. She told me she was sorry that it died because she could see the sadness in my eyes; but I wasn’t really mourning after the bird. We touched its wings, feeling its perfect form beneath our fingers: the surreal softness, the preciousness of a young fleeting life snuffed out. Not a sparrow falls but that He sees it. God saw this.

Woodpeckers will close their nictitating membrane, then tighten it a millisecond before they hit the tree so that their eyeballs don’t fall out on impact. Perhaps we need similar shields.

Only a few days earlier we had discovered a young robin hopping around the pine tree down in the yard. We took pictures. The kids enjoyed watching it hop around. There was a hawk above, circling around, and I like to think we saved that little robin’s life. There was a little one then, alive and bouncing, and then a bigger one, dead and stiff.

God saw this.

What is it about seeing that is comforting? Wouldn’t catching the sparrow be more comforting? Wouldn’t solving the problem, ending the great horror – death – wouldn’t this be a more lasting comfort? You see me, God. You see my children. But if you were to let them fall…

Sharks close their third eyelid when they attack. This way they can see their victims without getting blood in their eyes.

Kai got out of the house when he was only one year old. We noticed when it was too quiet. He had slipped out the screen door moments after I arrived home from work, and neither Linnea nor I had seen him. I locked the door. It was five minutes before we noticed he was gone, and in those five minutes he was down the outer stairs of the apartment building and toddling along the street.

The terror in my heart: I was running down the sidewalk in my dress slacks, socks, and undershirt, desperately looking for my son, expecting to see him lying in the street, expecting to be one of those parents we pray for, expecting to live with the knowledge that we didn’t see him, we didn’t see him, and then it was too late to see him…

He liked stairs, so he had kept to the house side of the sidewalk, and a kind and observant couple had pulled over and were with him four houses down when I ran up. The man was on the phone with the police, and I heard him say, “Oh never mind, it’s okay. The father’s here.” I thanked them, breathless, and held my son, and held him walking back, and held him up the stairs, and held him for another hour until he didn’t want to be held anymore, promising him I would see him, always, I would see him.

God saw this. How can I say it differently, to ease the pain? God sees… me?

If we mourn this way, how must God mourn at all He sees, at all the flickering lights snuffed out, the bruised reeds broken, the sheep silent before the shearer? Death is nothing new to Him, and in fact, He knows it as an old friend, an old foe, better than us all.

Today, this day, my children are alive and real, perfect in form and surreally soft. They are the preciousness of young life, fleeting, and my God sees them. Lest you think me morbid, think on why this is precious, why as a parent, as a child, as a human I am determined to cherish this thing we call life, why I must defend it for those I love, why death is such an aberration and a destiny and a defeated foe. The thought of death is morbid, maybe, but so is the thought of life without the thought of death. For now, we need both. And God sees us, in both.

God sees us.

Peregrine falcons see too, because as they dive at over 200 miles per hour, they blink their nictitating membranes repeatedly to clear away the debris and clean each eye.

In the midst of holding onto my family’s break-neck life, I find that I am unable to bring myself to accept such a thing as death, and yet… I know that it’s what I must do, for we will all encounter it, sooner or later. This dark thing I wish to dismiss by forgetting, or fighting, or examining on the operating table of a small terrarium: Death will come for us all.  I know, in my spirit, it is good – a gift given so that our difficult, fallen lives will not last forever, but it will never lose its dread, even when it has lost its sting. And perhaps I will embrace it as a friend when more years have passed beneath my feet, or perhaps I will embrace my Savior, and He will carry me through it into the place where it cannot enter.

And my heart holds its breath for all the times I must try to prepare my children for that moment – the one I feel certain I will never be fully prepared for, the one that God sees. I know I am actually only trying to prepare myself. I know it is not up to me, and I wish I could take more comfort in that. Perhaps someday I will. Every day is another reminder that I am not in control, and death is the great Out-of-My-Control.

But I know this. Each day that I walk in the sight of God, He will train my eyes, and my sight can be strengthened by seeing life and knowing it itself is but a shadow of the life to come.

Nadia, my little avian maven, knows that birds need nests. So she settles herself in a patch of fragrant clover and picks flowers as a pillow for the bird. She is kneeling in her pink flowered dress, a lily ringed with gingham, examining the ground and plucking appropriate stems carefully, precisely, preparing for burial. Perhaps, preparing for flight.

And I blink back a tear.

The human cerebrum is divided into two hemispheres, the right and left. These sides are not identical to one another in structure or function. The right hemisphere is in charge of coordinating functions related to the left side of the body, and the left part of the brain controls the right side of the body. To date, science hasn’t been able to explain the reason for this split.

There are other differences between the hemispheres, including functions like speech and motor skills. For example, in 90% of people, speech and hand skills are centered in the left hemisphere. However, skills such as drawing, architecture, or sense of perspective – skills that are spatial and dimensional – are dominated by the right hemisphere. While the two hemispheres are employed for various tasks, they communicate with each other. For this to happen, a structure called the corpus callosum, which contains only axons as nerve extensions, is placed between the two hemispheres and enables the transfer of information. For instance, if a needle sticks your left hand, this is perceived by the right hemisphere. In patients where the corpus callosum is missing or disconnected, when an image of a red apple is shown with the left eye closed and again with the right eye shut, the patient will report having seen no apple.

The lack of a corpus callosum is rarely encountered as a birth defect (corpus callosum agenesis). In this instance, there is rarely a deficiency when it comes to movements and sensory receptions. Activities such as speaking, standing, balancing, walking and running are almost similar to normal levels.

In the case of epilepsy, an abnormal electric current is observed in the cerebrum. The corpus callosum can be cut by surgery, disconnecting the two hemispheres in order to prevent the dispersal and transfer of abnormal electricity to the other hemisphere of the brain.

These days, this surgery is not implemented unless necessary. Obviously, performing this surgery means communication between the two hemispheres is interrupted; the tasks that are assigned to the right brain remain only in the right and the ones assigned to the left brain stay in the left. This can complicate basic motor skills. For instance, if a person wants to write or throw a ball with two hands, this task is first planned in the left hemisphere, then it is transferred to the motor-skill regions found in both hemispheres via the corpus callosum. These skills are developed via both sides of the brain and our hands, and usually one hand is better in these skills than the other. Because the left brain is usually dominant, most people are right handed.

Schizophrenia is a permanent psychiatric disease that affects a person’s emotions, thoughts, and behaviors. It means being split-minded, or the separation of the mind (in Greek, schizo means split, or divided, and phrenos means mind). In schizophrenia, the coordination between the hemispheres is disrupted and the two hemispheres intervene simultaneously to solve the same problem. Briefly, it may not cause a problem if a specific task requires only one hemisphere to be in charge; however, complications arise when both hemispheres try to solve the same job. In schizophrenic patients, it has been reported that a problem exists in the corpus callosum; therefore, communications are hindered between them. This results in a disruption.

At this point, some questions may arise. Why is our body controlled by two brain regions that have different jobs? Why do these two hemispheres communicate? What would happen if our brain was not built in two parts?

It’s hard to give answers to these questions. Sometimes, we end up with nothing to say but, “if God creates in this way, then it must be in the most beautiful form.” There is nothing useless, extra and unnecessary in the human body. But the following can be hypothesized regarding the two sided functioning of the brain: cerebral hemorrhages always occur in only one side of the brain. Speech is lost if the left side is injured, and spatial and geometrical skills are lost when the right side is injured. Therefore, maybe while a function is lost on one side, the functions of the other side are conserved.

Though the different hemispheres of the brain are in charge of different functions, they successfully fulfill their duty to activate our bodily functions through constant communication. Despite continuing clinical studies, the full extent of the brain’s power remains mysterious. Its incredible design, which allows the body to function so perfectly, is a sign of humanity’s remarkable architecture.

On holy days, we reflect on the joyous past and the beautiful future yet to come.
When the sun rises over our land,
only then will it be our holy day…
Alvarli Efe

Holy days are days of joy and pleasure, especially for those who perceive their true meaning. On holy days, people seem to be more serene and peaceful. They are aware that they have gained the forgiveness of their Sublime Creator, attained redemption, and once more, have experienced the feelings of both the past and the future.

Every holy day is reflected in people’s hearts, and in the whole land, as a source of delight and rejoicing. These feelings peak when they remind us of the sweet memories of the past. From these memories of previous holy days, joy flows in our souls and sometimes inspires us to reach glorious delights and pleasures that may outshine previous ones.

In every holy day, we bring together and embrace both the past and the future side by side in our imaginations, kiss both the hands of our magnificent ancestors and the foreheads of our bright-eyed, future grandchildren and taste eternal bliss. Although pessimistic and daunted souls cannot comprehend much from the past, with all its glory and dazzling colors, or the future, with all its ebullience and enthusiasm, every holy day becomes just like a rainbow over our heads, and bestows upon us such bright and festive ceremonies.

Certainly, there is no other felicity that can be equal to the happiness we experience when we watch the panorama of our past and the most striking scenes of the future side by side!

In feelings, thoughts, and heart, the human soul is connected with the past and the future just as much as with the present, and can be deeply moved by the delights and pleasures of all times. From such a broad viewpoint, it can surely perceive holy days, with their many different dimensions.

A holy day that is perceived with this meaning is very different from the one that is described by the day laborers who are stuck in the moment. Their dull and colorless holy days, which are completely detached from the past and the future, can only be described as the few days that are allocated for handing out some candies to children, but can never be considered a holy day in the true sense of the word.

To me, every holy day comes with its festive nights full of dazzling colors, shining sweet and impressive images of our history into my heart. In the coming and going of holy days, I watch in my imagination the future’s happy generations, who are both mentally and spiritually enlightened, attaining a pure and delicate heart, and embracing each other as they become one with their souls. These scenes enrapture me. At such moments, individuals at full rest in their hearts, whose minds are full with science and technical knowledge, and whose conscience are full of deep faith in their Exalted Creator and love of their Lord and all beings, appear before my eyes. My heart becomes overwhelmed with the spiritual pleasures that they carry, and I experience unique minutes of blissfulness. In that atmosphere – when I imagine the elderly as individuals who are highly esteemed and humanely honored, the youth as chaste and forbearing of their extreme sensations and refraining from wrongdoings, the children as bright and cheerful as sunflowers in the shower of light from above, and the women as the main constructors of this magical scene – I feel delighted to the bone.

At such times, the whole administration is temperately, moderately, and prudently carried out by the most sensitive, responsive, and professional people, while peace, law, and order appear before my eyes like the finest patterns of a canvas or embroidery. In this scenario of the future, ordinary people are side by side with the highest administrators and intellectuals, all acting in a great harmony. Justice vigorously reaches every little corner of the land, while the enfeebled and daunted evil sulks in its dark pit. In that new world, neither the heedless yells of the atrocious are heard, nor the moaning of the oppressed…

On holy days, I visualize schools, each of which operates like a laboratory that tries to solve and reveal all the mysteries of the universe. And in those schools, I see uplifted teachers who elevate their pupils to mysteries that extend beyond the heavens, outstanding teachers whose faces are shining, whose actions are all conducted with deep sincerity, and who are straightforward in their thinking…

On such days, I sometimes feel as if I am hearing the drums of victory from the borders of our civilization! The clatter of victorious armies comes to my ears; armies of those who forsook all their personal pleasures and desires to confront dangers of all kinds so that they could ensure a balance of power among states, and stability in the world…

Every holy day emerges in my soul with such dazzling colors, prayers, and hymns. With all its inspirations and reminders, they mesmerize my heart. I feel purified and cleansed, completely refreshed and renewed. With all these feelings, I cannot help saying to myself, “I wish everyday would be a holy day!”

For some people, all these feelings are just a fantasy, but for others, they are a sublime ideal where thousands of examples are witnessed in the past, and an explanation of the eternal signs of reality which appear on our horizon…

No matter how fast or how far a person runs, the horizon will always be beyond them. This being the case, the real distance and depth of the horizon is inside a person, it is in their mind and perception…

A race I will always remember

Not too long ago, when I was still a little boy, I found myself running from my father’s village to my mother’s, and from my mother’s to another and to another, in the hope of catching up with something that was neither a ball, some other toy, nor a bird, but rather the point, the line where the sky seemed to touch the earth. We call it the “horizon.” That line, that “place,” first presented itself to me hiding right behind the trees to the left of my father’s house. I started out that day walking rather leisurely because the distance between me and the horizon seemed so short. When I observed that the sky had moved, or rather seemed to have moved further away, I hastened my steps. Then I noticed that the sky moved further and further away. Well, being determined to reach the place where the sky certainly touched the ground, I kept walking faster and faster until I found myself running.

I ran for quite a while until I realized that “there”, where the sky and the earth met, was still further away, that it would take me more time and effort than I had thought. I went back—I had to go back—to my father’s village, back to my usual village life because I saw that perhaps much more was involved, that maybe much more effort was called for in order to achieve what I desired, namely, to get to the point where I could touch the sky, where I could climb the sky. I went back to the ordinary, the normal life and experience of the village and of my people. But I did not tell anyone, I did not discuss the experience with anyone, even though I did not stop and could not stop thinking about it. I thought to myself that perhaps a week, a month, maybe a year would suffice for me to reach the place where the sky and the earth embraced. I was absolutely certain that right there in front of me, over there, not too far away, the sky touched the ground. And I thought that perhaps all I needed to do was keep walking, keep running, and keep racing forward, without stopping, without interruptions, without distractions in order to get to where the sky kissed the ground.

Today, thirty-five years later, I have realized that I was not wrong. I was right. The sky did touch the ground. It touches the ground all the time. You may ask “but where and how?” The sky touches the ground in our perception. Look across from your window into the distance. What do you see? Or, go outside and look in the distance. What do you see? The sky is right there, over there, touching the ground, the road, the houses, the trees, the mountains, the sea, and remaining there. But keep in mind that this is all happening in our perception. In perception, things are the way they appear, the way they seem. No rigorous, critical thinking is involved. And this happens so many times, and in fact is happening now; it happens every time that we are not thinking deeply, with attention and effort. It happens every time we fail to allow other perspectives, other possibilities and other possible interpretations to emerge.

The sky touches the earth, embraces and kisses the ground, right there in a fixed position, as long as you do not move. Once you move, it moves. And when you run after it, it too runs, not towards you though, but rather away from you. If you stand still, it stands still. If you stay where you are, it remains where it is. If you move even an inch, it will move. It will never allow you to catch up with it, to touch it; it will never allow you to possess it, to tame it; it will never allow you to take possession of it. And yet, it is always there, “putting everything into perspective.” By that I mean the horizon enables us to see, for without horizon one cannot see much of anything. Think about it! Everything presents itself in horizon. Everything dwells in the horizon, everything is within the confines of the horizon, and depends more or less on this phenomenon. And if I may borrow an expression from Saint Paul’s speech at the Areopagus (Acts 17:28) and be at liberty to use it as I see fit in this context (just as some scholars say he himself was at liberty to do with the same expression from the writing of Epimenides of Knossos (6th Century B.C.)), one can say that “that in which we live and move and have our being” is the horizon.

Standing still, remaining in one fixed position is not in the nature of the horizon. Its every stop (or what appears to be its end, its boundary) is temporary and transitory, like a pilgrim’s stop on a journey whose destination is still far away. It keeps moving, and it invites us to keep moving too, keep working, keep meeting people, keep exploring, keep digging, keep sowing, keep cultivating, keep harvesting, keep looking, keep reading, keep writing, keep thinking, keep talking, keep wondering.

We hear, not infrequently, the expression, “on the horizon/in the horizon.” What does it mean? It means in view, in the possible future, in sight. That which is in or on the horizon appears close, and seems to be approaching; it is as if it’s right there among the things that one hopes to do soon, as something squarely within one’s reach, among the things that one’s abilities can handle. What is in the horizon, then, is something that appears “present” and seems quite achievable.

What is a horizon? And what does it do?

A horizon is inseparable from a living, perceiving human being who is in the open or in the frontier of the open. There are no horizons in closed spaces, closed places. The distance between a living human being and the line where the sky and the earth meet is very wide. It is infinite. It is far, far away. You can only measure it with your eyes, your mind and your soul. You can figure out how long it is only to the extent that your eyes, your mind and your soul can go. An application of any other measuring device will only frustrate you because the moment you start going after it to measure it, it will recede. But the truth is that what you are actually seeing of the horizon is only a small part of it. The bigger part is on the other side of the horizon. Every horizon has at least two parts: a front and a back. The front of the horizon consists of the part you are seeing, and its back consists of the part hidden from you because of the hills and mountains, the earth, the road, the trees, the sea. In fact, the line where the sky seems to touch the earth is really only a perceived curve or a perceived point of contact, but the horizon really goes far and farther away, without end: it stretches into infinity.

All the things we are seeing are in fact standing in the way of the horizon. Similarly, all the things we are thinking right now, all our thoughts and ideas, everything that is presently on our minds can be an obstacle to a deeper and fuller understanding and appreciation of the horizon. We have to let go of all of these things in order to begin to have an idea of the depth and richness of the horizon.

For now, let us focus on the part of the horizon that is visible to us. It is a world, the world that we live in or would like to live in. Normally, it consists of people, people of different religions and/or of no religion at all, people of different languages and cultures, different experiences, different states and walks of life, different situations and aspirations, people driven by different desires, values and visions, people of very deep opinions, inspirations, beliefs and deep convictions other than our own, people heading in a thousand and one directions. This world, this visible side of the horizon also includes animals of many different types and habitats, which eat different kinds of food and have different spans of life. It also includes many different trees, bushes and flowers, and different types of grasses, etc. Mountains and hills and valleys too, rivers and big oceans, streams and creeks, are all part of this side of the horizon. Small and big houses, low and high buildings, shelters and palaces, mud houses and ghettoes are all part of this side of the horizon that we are seeing. But we do not actually see everything that we know is out there, that is all around us, that is over there in front of us…

How do we even know that there is anything out there, that other people are out there? A long walk, travels, meeting people, doing business with people, education, etc. confirm that there are other people out there, other lifestyles, other ways of thinking, other ways of doing things, other attractions, other things that people consider as very precious and worth dying for. We read about these things, have actually met and seen them with our own eyes, have lived with people of different orientations and values, have had some great opportunities to exchange ideas with them. But neither our reading and studying nor our investigative and explorative eyes can exhaust the visible side of the horizon because even the visible side has its own invisible aspects and invisible faces. Let us take for example persons, situations and objects.

From time to time, a person whom I have known for many years, not only surprises me, but also seems to be a surprise to herself/himself whenever s/he says something or does something I could never have thought or imagined her or him doing. And people of this nature are not uncommon.

How about situations? They are similar. Even the most familiar situations often have aspects that are new and different, which we can see if and when we look with more attention and care. And the moment we become used to these, even newer different aspects of the same situation emerge. The same goes for things such as books, clocks, chairs, doors, and so on. A book often presents us with information that we did not see the first time we read it. And if you read it again, you will again see something you missed the second time you read it. If you wish, you can read it again and again, and you will see something new every time. The book will never fail to make you see something new and/or think something new.

Can a chair or a door do something similar? That is, can a chair or a door make you see something new or think something new every time you encounter them? Let us see. A chair, unlike a book, seems to have no generative power. It seems mute and sterile. But can a chair speak and make us think? The answer is yes, it can speak and make us think. No one would disagree that the chair of Pontius Pilate, the chair of a Court Judge, the chair of Saint Peter, and so forth do have a powerful message. Although these chairs I have cited are special, every chair can say something to us and really make us think. For example, chairs for children and for adults make us think different thoughts, which by the way, make us give children appropriate chairs and to adults what is suitable for them. If we did not think differently of these chairs, chances are we would give adults the chairs meant for children and vice-versa, or give the same kind of chairs to everybody, children and adults alike, seriously compromising comfort. And some chairs would even fall apart (that is, if children’s chairs are given to heavy people like me to sit on).

Doors too make us think. For example, the Door of No Return in Goree Island in Dakar, Senegal, and the Door of Hope in Johannesburg, South Africa, makes every visitor think. But again, although these specific references are special, every door, including those that may seem unimposing and insignificant, can really make us think. Every door has a message.

The bottom line is that even the most visible side of the horizon can have aspects that may not be totally obvious and immediately accessible. Therefore, the visible, that which seems completely clear can still make us think because it often has layers, folds, dimensions, messages that lie beneath its surface. There are always other meanings, other messages behind the obvious. And the moment we finish harvesting one message, the moment we finish reading one meaning, the horizon presents us another one, and yet another, and so on and so forth. Inexhaustible indeed, this horizon can constantly give new meaning, hope, color, shape, style, texture, depth, taste and strength to our lives for endless joy and delight, even under very difficult circumstances. Why? Because the horizon has power to liberate us from the present, the immediate, the obvious. As it draws back, so to speak, that is, when we attempt to respond to its invitation into the open, when we dare to go after it, go with it into the deep, when we allow ourselves to move with it and flow with it, then it can open new doors, generate new ideas, launch new beginnings, reveal inroads, illuminate new bridges, disclose exits, uncover new faces, make terrains of other possibilities visible, make cooperation and collaboration possible, make teamwork possible, bring along other solutions, other fertile soils. With the horizon, there are no closed doors, no human being is a finished project, no done deal, no finished once-and-for-all discussions, no insurmountable barriers. The horizon’s open field stretches into infinity.

All of this is but an invitation to read between the lines, i.e., “to resist simplistic interpretations that dogmatically ascribe fixed significations to [things]” (G. Weiss, Refiguring the Ordinary, Indiana University, Bloomington, 2008, p.58).

It is about the need to go on researching other possible meanings and interpretations of a text, to go on searching for other possible answers to certain problems, to appreciate the expanding limits, and to devote more time and energy to the lifelong project of exploration of self and of the world (and of God) (see P. Okogie’s “Horizon: the birthing world” in the Journal of Horizons of Horizons, Vol. 1, no. 1, Duquesne University, Pittsburgh, 2012, p.10).

Rev. Dr. Okogie is Assistant Professor of Philosophy and Bioethics, University of Saint Anselm, Rome, Italy.

Why is this surface area so large? What could the wisdom behind it be? Tiny endoplasmic canals play a role in inner cell transportation and distribution of matter. ER is the organized industry district in the cell. Most of the factories of molecules produced by chemical reactions are found here. ER is the production spot in the cells of proteins and hormones. Consequently, a broad surface area is very necessary and important.

Different degrees (pH) of acid are necessary for each reaction. However, because the acid necessary for one reaction can negatively affect the other reactions, thousands of opposite, intricate and different reactions take place. For this reason, membrane surface areas need to be wide. Sometimes hundreds of protein molecules are produced in just a second in a cell. The rapid and flawless lining up side-by-side of tens, hundreds or thousands of amino acids can only be achieved with a knowledge and power that surpasses these very small structures.

Wrapping the inside of the cell like a web and forming a buffer against mechanical effects, ER is responsible for establishing the flexibility and soundness of the cell. In muscle cells, ER takes the name Sarcoplasmic Reticulum (SR), which has a very important duty in the contraction of muscles. The size of the surface area of SR in the muscles of the structural frame is proportionate to the speed of muscle contraction. Consequently, there is more SR in muscle cells where there is rapid contraction. SR also serves as a calcium depot in muscle cells. Normally calcium is a deadly poison for the cell, and for this reason it is kept out of the cell. The concentration of calcium outside the cell is 10,000 times more than it is inside the cell. However, SR stores calcium in the cell in its own body. Thus, it both prevents the cell from being harmed and it provides the necessary calcium for contraction.

ER has the duty of eliminating the poison in the liver cells from the body by means of gall. For example, jaundice-causing bilirubin is a deadly poison for the brain especially in newborn babies. If jaundice is not treated, motor loss (paralysis) and intelligence loss can result from brain damage. Bilirubin and glucuronic acid combine by means of some enzymes on the surface of ER in the liver and are thrown into the gall bladder. In this way ER plays an important role in making foreign matter harmless and in reducing the side affects of medications to a minimum. Babies’ sensitivity to some medications during the first three months of life is due to ER’s not yet being developed enough to eliminate their harmful effects.

If it is taken into consideration that all of these mechanisms exist in human, animal and plant cells, it can be clearly seen that a broad and complex structure in such a small volume and its many functions can only have been placed there by the All-Powerful whose knowledge, wisdom, artistry, will and power permeate every moment and every spot.

Celaloglu is a freelance writer from Turkey with a degree in biology.

We remember Africa today with recent famines and drought, especially in Somalia, Ethiopia, and Kenya, worst in the last sixty years. If one is not watching only wild life documentaries, Africa is one large portion of the old world, home for diverse cultures, a continent rich with natural resources, and this last one has been the major reason why it has become a large battlefield for many centuries.

Nigeria is the most populous country of Africa (seventh in the world), with over 250 ethnicities, over 500 different languages spoken (one of the countries with highest linguistic diversity). Nevertheless, Nigeria has also been the stage for tribal warfare and strife, and bitter incidents of some recent bloodshed still linger in our memories. In this respect, the theme of the conference fits perfectly well in this country, where there are seventeen schools, a university, and a recently established dialogue foundation inspired by Fethullah Gülen.

What other forms of engagement can we offer other than education and dialogue for peaceful engagement? What can be a more lucrative investment for a peaceful future than the one made in education and dialogue? With awareness of this need and commitment to serving all humanity, regardless of race, color, religion, or nationality, growing numbers of volunteers of education and dialogue are establishing schools, hospitals, dialogue centers, and relief organizations all over the world. Humble but selfless efforts of these volunteers who are inspired from thinkers like Fethullah Gülen are now yielding fruits of dialogue in more than 130 countries where children of warring nations are educated side by side, members of different religions enjoy the same meal, and pray for a peaceful future.

The current issue of The Fountain offers essays reflecting this culture of coexistence. The lead article expounds on the unique qualities of being human, reminding us the “know thyself” principle of Socrates, for “the one who has perceived the secrets of his or her own self has also known God.”

“Different Approaches to Interpersonal Conflict” stresses on how vital it is to be familiar with “conflict-related behavioral tendencies” for it “might help in the development of strategies for interpersonal, intercultural conflict resolution or prevention.”

Also in this issue Dr. Kurucan explains Islam’s stance for issues like freedom of practicing and teaching one’s religion, and in what conditions Islam allows war, if it does, in cases of violation of this right.

As the only Muslim woman in the room, outside their prayer circle, I was there to observe their prayer session by the invitation of my friend C. As they sighed and tried to find words to console and inspire one another, I could feel their despair about creating a more peaceful and understanding world. They were truly concerned about America’s position in maintaining peace in the world, but after the events of the last decade, they ran out of hope.

When they don’t have hope, what could they pray for?

Pitched into this darkness, I heard myself say, ‘Well, actually, I am feeling hope.’ There was an uneasy creak of folding chairs and tired faces. Their looks said, ‘Please, not another voice of denial…’ but they were kind enough to listen to what I had to say. ‘I think America has the greatest potential for peace,’ I continued. Glimmers of candlelight played across the eyes in the room. Having heard a Muslim woman say this was new for them.

‘Well, I think so because…’ I paused for a moment to search for the right words, and continued, ‘… because it all began with French fries.’ Once I saw their puzzled faces and the half smiles playing on their lips, I knew I had caught their attention to tell them my story. When I saw, for the first time, people calmly dipping individual fries into cups of ketchup with bare fingers, I had just arrived in America to go to the graduate school. I couldn’t believe that they used no forks, no toothpicks—just eating greasy fries with their bare hands. How crude, I thought. But then another foreign student from Morocco shared with me that in her country, people ate with their hands, too, and that eating with one’s hands enhances the flavor of the food. I saw her, also for the first time in my life, enjoy chicken biryani with her fingers. It was my first glimpse of just how wide the world was. It was the fragrance of my own budding tolerance.

After I saw how eager they were to hear about it, I continued my story. I told them I had come to the United States ten years before, on a college scholarship from Turkey. I’ll be honest. Before coming to America, I had never spoken to a person who was not Muslim, much less shared a meal with them. But here, in America, where I met fellow graduate students from India, China, Africa and Europe, I experienced first-hand that we could all live and eat in our own unique ways, learning side by side, and live in peace. My tolerance grew.

Then I walked in to the Islamic Center of the city I lived in. I saw different Muslims, from around the world, in different clothing, of different races, speaking different languages, bowing down in reverent prayer side by side. All those differences seemed like jewels and beads on an elegant dress, enriching and beautifying the fabric in harmony. It was a vision, and witnessing it, I felt such a profound peace. I thought, though they, my fellow Muslim brothers and sisters, dress or talk and eat differently, we all bow down in front of God the same way. We are all the same in the important stuff, and only different in the minor issues. What significance does it have if one eats with their hands, with a fork, or with a couple of chopsticks?

In later years, I was blown away when I witnessed how Christians worshipped at my friend B’s church. They sing, listen to the sermon, read passages from the Bible, which is considered a holy book in Islam and to be respected, and they get connected with the God. And when I noticed how the stories, values, and traditions we claim as ours were also shared by them, my first image of Americans collapsed completely. Before I came to this country, the only Americans I knew were from the movies and soap operas. Naturally, I thought all American women were blond, tall, and beautiful, and all the American men were tall, rich, and handsome. They didn’t have any financial problems, health problems, or any real-life problems; they had only relationship problems and cared about no one but themselves. This was the image in my head about Americans. How wrong I was! I was surprised and fascinated when I observed my friend B’s church worship, when I came together with other families from my son’s school for play dates, or when our neighbors invited us to their Thanksgiving dinner, and also when they came to ours for a Ramadan iftar. It came to me in a flash: Americans have similar family values, religious values, holiday traditions, and love and compassion for their neighbors, just as we do. They are not actors in a soap opera!

What is more, they welcome thousands of foreign students, scholars, refugees, and immigrants from many different countries around the globe each year. Every year Americans are exposed to many cultures, languages, and faith traditions, and hardly anyone is jumping down anybody’s throat for being different. Of course, there are occasional negative comments toward what is different, but even then, most people come together to neutralize that negativity with support and compassion. Different is viewed as richness, as variety, and as interesting. My own tolerance and appreciation of other cultures blossomed because of these experiences.

The United States can have a great ability to bring about peace, as I shared with the ladies that night, because American culture is already open, tolerant of religious freedom, and welcoming to people around the globe. These are the perfect ingredients for peace. America has the power to wage peace in other countries, not with war or fear, but with goodness, faith, acceptance, and aid, to build hospitals and schools, and create jobs and programs that acknowledge human rights and generate good will.

America has long been a mixed salad. Its unique blend of people from around the world, stirred together with mingling flavors, develops a taste for tolerance, for freedom, for the savory experience of diverse cultures living together. May our prayer in this post-9/11 world be this: that we move beyond the ineffectual and destructive politics of warfare and fear, and hold fast to the goodness and power of this nation’s moral tolerance, constitutional freedoms, and potential for peace. God has created us with this potential. More powerful than any military force, I hope my experiences of tolerance and good will in the United States offered a recipe for hope for my friends that night.