How beautiful it is to stop somewhere every day!

How nice it is to flow without freezing and getting muddy!

What word that belongs to yesterday,

Is gone, my loved one, with yesterday,

Now is the time to say new things.

Open heart surgery is performed after putting the patient to sleep under a general anesthetic. The chest is then opened by the surgeon, and the heart is temporarily bypassed or deactivated for the duration of surgery (although in some new techniques like beating heart surgery or minimal invasion heart surgery, the operation is possible without deactivation of the heart) During this period the functions of the heart are performed by an artificial lung mechanism called the heart-lung machine (cardiopulmonary bypass machine). Performing surgery on a working heart cases where there is no facility for beating heart surgery would be like trying to repair the engine of a car while it is in motion. This is why it is necessary to temporarily prevent the functions of the heart during the operation, which requires great care and accuracy.

Stopping the heart

During this procedure the patient is connected to the machine, thin pipes called cannulae are inserted into the main veins which lead to the heart, and thus the blood which goes to the heart is directed into the heart-lung pump, fed with oxygen, and then redirected into the body. Preventing the function of the heart is not a very difficult process. When the heart-lung machine is activated and the blood is cooled and redirected into the blood vessels, the body temperature is reduced to below 30°C, and this lowers the heart rate and assists the heart to stop functioning. The actual stopping of the heart is performed by feeding a serum containing a concentrated solution of potassium ions into the coronary artery, which feeds the heart muscle. Potassium ions are normally found in the human body but in a fixed proportion; potassium is an electrolyte which, if increased, causes a defect in the heart’s rhythm and can lead to ceasing of the heart function. Feeding the coronary artery rapidly with a rich potassium solution causes the heart to stop within a few seconds and allows the surgeon to perform the operation on a non-functioning, motionless heart.

The heart should not be stopped from functioning for a long period, even if the heart-lung pump is performing the function of the heart successfully. Under normal conditions the pump cannot perform the whole duty of the actual heart and lungs. When the body temperature is reduced, there is a reduction of functioning in many organs of the body to such an extent that they almost stop working, especially the brain. This means that every organ freezes and if the patient’s pulse were taken within this period, they would be assessed as dead.

Restarting the heart

To restart the heart following the operation a reversal of the procedure performed at the beginning of surgery is necessary; the temperature of the body is increased to 36.5–37°C again with the help of the heart-lung pump, and at the same time the amount of potassium in the blood is reduced to a normal level. This is usually executed by ensuring the normal function of the kidneys which discard the potassium from the body. This is when the function of the heart is monitored closely because there is a reversal in the process of inducing low body temperature and the excess of potassium which caused the heart to stop. In other words, the barrier which stopped the flowing river is removed; therefore, according to the laws of physics, the trapped fluid should flow again at great speed, and although following surgery the majority of hearts do begin to function again when these procedures are performed, there is unfortunately no actual guarantee. There may be certain complications or even causes which we have not yet discovered, in which case an electric shock of 10–20 joules is delivered directly to the heart muscle to encourage it to function normally. If this is unsuccessful, medication such as adrenalin, which induces the functioning of the heart, is given to the patient. If, following these repeated procedures, there is no effect, and, regardless of all the effort, the heart does not function, then everything is performed again from the beginning, including the operation. But there is always the possibility that the desired result may not be achieved. Human beings always face the prospect of death in daily life, and although there is a very slim chance of death, with such a big operation there is always the possibility.

The result

We are normally totally unaware of the rhythmic incidents, a combination of great harmony, occurring within our bodies. Even breathing, a necessity for every living creature to stay alive, is not an action which we activate and continue of our own will. Sight, hearing, hunger and senses are acts of nature over which we have little direct will or power. Nevertheless, they are all events which we can only describe as divine miracles and what a great blessing it is that none of these complex functions of our bodies have been left to us humans.

The family is the smallest unit of society and it should be a source of happiness for the individual. This is why a sound dialogue between parents and their children is so important. When we bring up our children, we should regard them as being entrusted to us by the Almighty. Treating them affectionately and inspiring confidence in them plays an important role in terms of preparing them for their future life as physically and psychologically healthy individuals.

In spite of the cozy atmosphere of the home, we might come across some problems that are difficult to solve. Some problems are apparent to our friends and neighbors, while others are known only by family members and are kept secret. In such cases, we may not know how to deal with a problem, and therefore need to seek help from an expert. Wetting the bed is a typical example of such problems. When such a problem persistently occurs it is only compounded if we hurt the child and cause them to feel bad or inferior because of this problem; what many people do not realize is that this is a problem that is easily solved.

Families with children who wet the bed while between the ages of 5 and 15, sometimes even up to the age of 20 have a serious problem. Every morning, these families wake up to find another problem. The nasty smell, changing the sheets and cleaning the pajamas are not things that people enjoy first thing in the morning.

Along with the burden of dealing with dirty clothes and sheets, the family members become worried, as they do not know when the problem will end. But it is the child who worries most. The problem is only compounded as the child realizes that they cannot have friends to stay, nor stay at someone else’s house, as this may lead to others finding about the problem; such worries only cause further problems such as losing self-confidence, inferiority complexes, shyness and poor performance at school.

Some families do not try to search for solutions, saying illogical things like, “His uncle used to wet the bed too. That didn’t go on for too long. The same will happen with our child as well,” or “It’s nothing unusual. Most children do it. It will be alright,” or “It will just stop without treatment. They say that there is no treatment anyway.”

Bedwetting is actually a common problem. What then, are the underlying reasons? How common is it in reality? Is there an effective treatment for it? Does it just stop on its own? If so, when and how does it stop? Or is it possible for someone to remain a bed-wetter all of their lives? Does the treatment have any side effects? What is the success rate of the treatment? We will try to answer all these questions.

Occasional cases of bedwetting until the age of five are considered as nothing unusual. If bedwetting continues after the age of five, then this indicates an illness known as “enuresis.” Research carried out on primary school aged children found that between 20-30% of children wet the bed in general. It is usually more common among boys. The percentage increases with children from families of a lower socio-economic background, mostly due to malnutrition.

The main causes for bedwetting

Genetic factors are accepted as playing a role, based on the fact that 70% of the children who wet the bed have close relatives with the same problem, and that there is a high incidence rate among identical twins. It is thought to be caused mostly by a lack of an anti-diuretic hormone that reduces urine production at night. There are other reasons as well.

If a person with diabetes has too great an intake of fluids before bedtime they may wet the bed. Moreover, urinary tract infections, kidney stones, parasites, anemia, a lack of calcium, magnesium, zinc, or vitamins (A, B, D, E), problems with adenoids, and enlarged tonsils may all cause bedwetting.

Anemia and adenoids cause hypoxia (a deficiency of the amount of oxygen available in the blood) and hypercapnia (the presence of an abnormally high level of carbon dioxide in the blood). If these conditions are present, then the patient sleeps too soundly and the control of the central nervous system over the other systems is weakened. As a result, the patient wets the bed as they have lost some control over their muscles.

At least half of people who suffer from bedwetting are considered to do so because of psychological reasons. If a child begins to wet the bed in spite of having had no such problem before, this indicates that the child subconsciously wants to return to their infancy when they were the center of attention. By wetting the bed, the child might be wishing to receive more care from the parents.

Wetting the bed might be a reaction to family problems or the birth of a sibling. Various types of anxiety may cause the child to suffer from depression, which is another reason that causes very sound sleep.

Bedwetting is thought to result from psychological problems if it is accompanied by problems like suffering from a tic, stuttering, nail-biting, over-jealousy, or failure at school. A child with a urinary tract or bladder infection or kidney stones may not be able to control their need to urinate during the day either. If no physical illness can be detected, then there may be a serious psychological disorder.

Diagnosis and treatment

Starting from the principle “every disease has a cause,” we should first of all search for any possible causes. We can begin with simple ways, such as urine and blood tests. If these do not provide a satisfactory answer, then the other possible causes that were mentioned above should be investigated. The kidneys and the bladder should be checked with an ultrasound, while the adenoids and chronic bronchitis, as well as the tonsils, should be examined. If no viral or organic cause can be found, then psychological problems should be investigated. When the reason has been found, then it is time to start the treatment.

After a diagnosis has been made, the parents should be informed about the cause of the problem. It should also be noted that enuresis may result from incorrect forms of toilet training.

In the treatment of psychologically-caused cases of bedwetting, taking the child to a doctor, carrying out blood and urinary tests, and the family’s efforts to treat the child (i.e. paying for the treatment, waiting at the doctor’s, etc) are all considered to be part of the treatment. The child sees that importance has been given to them, that efforts are being made and that money is being spent on them alone. Having seen that the parents and the doctor have played their part, it is the child’s turn to do what is expected of them. Prescribing the correct medicine, or if there is no physical problem, merely saying, “nothing is wrong” is the start of the treatment.

If the bladder turns out to be smaller than normal, the child is advised to hold their urine longer than normal in order to expand the bladder. The period of waiting is lengthened gradually. The child is asked to keep a record of “wet” and “dry” days and they are rewarded for the “dry” days. Drinking less in the evening may facilitate treatment.

Medication and treatment

The medication changes according to the diagnosis. For instance, if there is a urinary tract or bladder infection, then antibiotics are used. If there are psychological reasons, special pediatric anti-depressants will be prescribed. Anti-depressants cause the patient to sleep lighter. When the child does not sleep so soundly, they are able to control their urination, and wake up and go to the toilet.

There are drugs that help to expand the bladder capacity of people whose bladders are smaller than normal; these drugs can be very useful indeed. Some problems with the urinary tract or bladder can also be eliminated by surgery.

If the patient has trouble breathing due to adenoids or enlarged tonsils, these should be removed by surgery as well. For anemia, the patient is given substances such as vitamins, iron and zinc along with a prescribed diet. In cases of calcium deficiency, a calcium-rich diet and calcium tablets are recommended.

If a child shows more than one of the symptoms, then a combined treatment is followed. Laser acupuncture treatment can also be useful. Bedwetting can be prevented by using anti-diuretic hormone tablets or sprays as well. With the correct diagnosis and treatment, the success rate of such treatments is between 95-98%.

The most common occurrence is that children will stop wetting the bed after puberty without any need for treatment. However, it is not a good idea to wait for this to happen, because treatment that will help bedwetting stop occurring is available. Only 2-5% of patients continue to wet the bed after the age of twenty. Most often, such patients wet the bed due to some organic problem.

The medicines prescribed against bedwetting have been in use for about 30-35 years; they have been proven to be safe and to have no side effects.

A related study

In a study carried out in Bursa, Turkey, the records of 164 patients who suffered from bedwetting were examined. According to this study, the following data was obtained: 52 patients (32%) were girls and 112 patients (68%) were boys. 36 of the boys were aged 6-8, 48 of them were aged 9-12 and the remaining 28 were 13 years of age or older. 20 girls were aged 6-8, 16 girls were aged 9-12 and 16 girls were 13 or older.

When the causes were investigated, it turned out that 18 of the 112 boys (16%) had urinary tract or bladder infections and kidney stones, while 18 boys were suffering from cystitis, which can be diagnosed with an ultrasound, 12 boys (11%) had problems with their adenoids, chronic bronchitis, and tonsils, which made breathing difficult for them. No organic causes were found in 64 patients (57%); in these cases it was found that the cause was purely psychological. 24 out of 52 girls (46%) had urinary tract or bladder infections, while the other 54% had psychological reasons for wetting the bed.

Half of the patients stopped wetting the bed at the end of the first month, and almost all the patients were treated successfully by the end of the second month. The success rate was 98%.

After having examined this data, it is clear that the problem of bedwetting is not difficult to solve without blaming and hurting our children. When we confront such problems in life, we should not despair or panic. We should keep in mind that God Almighty has created a cure for every problem, and that finding the cure requires patience and determination.

Said Nursi, also known as “Bediuzzaman” or “the wonder of the age” by his contemporaries, was born in eastern Anatolia (modern Turkey) in a turbulent era towards the end of the nineteenth century.¹ The Ottoman state was struggling to keep up with advances in science, technology, industry, and economy. After centuries of super-power status, Ottomans were deep in decline. The Muslim world was under continuous attack by the European powers on many fronts: economic, cultural, and military. People were questioning their beliefs and values in search of an explanation for their predicament. Most people were pessimistic and skeptical of their cultural inheritance. Under these circumstances, Bediuz¬zaman was a lighthouse of faith, hope and activism. Bediuzzaman was very far-sighted in his assessment of the conditions surrounding him, and in identifying solutions to the problems he encountered. His noteworthy stands include his championing of democratization, republicanism, the marriage of natural sciences and theology, and his advocacy for dialog with people of other faiths.

Backbiting the Dog

Backbiting, or talking negatively behind a person’s back, is considered one of the major sins in Islam. In an incident involving his students and a dog, Bediuzzaman used this term to discourage his students from talking negatively about a dog. The incident happened as follows:

One day a dog found a piece of meat that was hidden in a container to keep it cool. The dog ate the meat and when it could not get its head out of the container, it broke the container. Upon discovering this, some of Bediuzzaman’s students made a plan to trick the dog to bring it back and punish it. When he learned about the incident and the plan, Bediuzzaman questioned the student who attempted to punish the dog: “Tell me honestly, if you were extremely hungry and you find a piece of food in the open, wouldn’t you eat it?”

His student replied: “Indeed I would.”

Bediuzzaman: “And you are an intelligent being. Now realize that this is a dog. It does not have the intelligence that you have. It cannot realize that the food belongs to somebody. Can it be blamed for eating it?”

Student: “No.”

Bediuzzaman: “Then stop trying to punish this creature and do not backbite it (i.e. do not speak negatively behind its back).” It is noteworthy that he used the term “backbiting” to prohibit talking negatively about a dog, while this term is normally reserved for humans.

Killing of a Lizard

One day, after a long lesson, Bediuzzaman let his students go out and refresh themselves for a while. The students went out to the nearby plains to walk and relax. Upon their return, Bediuzzaman asked them what they had done. One of the students said that he had killed a lizard. Upon hearing this Bediuzzaman was visibly sad and told his student in a mournful tone: “You have demolished your house.”

Student: “The people of my hometown believe that killing seven lizards earns you as much reward as visiting the Ka’ba.”

Bediuzzaman: “All right then, sit here and let’s talk about this. We will try to find out who is right. First, let me ask you this: Did this animal attack you?”

Student: “No.”

Bediuzzaman: “Did it steal something from you?

Student: “No”

Bediuzzaman: “Do you provide sustenance for this animal?”

Student: “No.”

Bediuzzaman: “Was it passing through your land?”

Student: “No.”

Bediuzzaman: “Did you create it?”

Student: “No.”

Bediuzzaman: “Do you know the wisdom behind the creation of these animals? Do you know their functions in nature?”

Student: … (Silence)

Bediuzzaman: “Did the Great Lord create this animal for you to kill? Who told you to kill it? There are numerous functions these animals fulfill. You have indeed committed a great mistake by killing it.”

The House of Ants

Bediuzzaman was teaching his students near the city of Van. In summer, they used to climb Mount Erek near the city and do their studying there in order to avoid the excessive heat around the city. After a summer spent on the high plains, the fall was beginning and the weather was getting colder. They thought of building a place to take refuge before it got very cold and it snowed. Upon the suggestion of Bediuzzaman they decided to dig something like a cave or room into a hill and make a hole to serve as a window. The students started digging.

After a while they saw ants coming out of the place where they were digging. Bediuzzaman immediately told them to stop. One of the students responded:

Student: “Why should we stop? We have dug quite a bit. We will be done shortly.”

Bediuzzaman: “No. We cannot demolish a home in order make a home. Search for another spot.”

They changed their digging place three times before settling on a place where there were no ants, and they built their sanctuary.

Mr Ox

Bediuzzaman was being sent into exile based on charges that he was involved in an uprising in an eastern province. It was known by people around him that he had, instead, tried to stop the rebelling leaders from taking arms against the government. But this did not stop the government from sending him to exile. He was transported by a difficult path to the port city of Trabzon from his home city of Van in eastern Turkey. It was winter and everything was covered with snow and ice. It was the month of Ramadan. Bediuzzaman was one of the few people in the group who was able to continue his fasting under difficult conditions.

On the snowy road over the mountains, they were riding a wagon pulled by oxen. At one point, a leg of one of the oxen got hurt by rocks on the road and began bleeding. Bediuzzaman quickly noticed it and told his companions:

Bediuzzaman: “My friends! Let’s get off and walk. The leg of Mr Ox is bleeding.”

His companions looked at Bediuzzaman’s face with astonishment: “But we have paid the owners of these oxen!”

Bediuzzaman was unshaken in his stance. He jumped off the wagon himself first and said: “They are not owners of these oxen, only users or managers. Only God is the true owner. Have pity for the animals and get off the wagon.”

They all jumped off to the relief of the oxen.

Encounter with the Wolf

During their stay on Mount Erek near the city of Van, he asked his student named Molla Hamid to go down in a valley and get water from a creek. The creek was a place frequented by wild animals. Molla Hamid was visibly reluctant. He said: “Sir, I am reluctant to go… I am afraid.”

Bediuzzaman: “What are you afraid of?”

Molla Hamid: “Sir, there are all kinds of wild animals that roam around the creek. I am afraid one of them might attack me.”

Bediuzzaman: “Go. Do not be afraid. Nothing will happen.”

Molla Hamid reluctantly accepted and went to the creek. He came back with a bucket of water. Bediuzzaman asked: “What did you see?”

Molla Hamid: “Nothing sir.”

Bediuzzaman: “One should have some courage. Let me tell you a recent experience of mine. A few days ago I woke up in the middle of the night and I was putting on my clothes. An animal entered through the door. At first I thought it was a dog. It began to approach me. Then I realized that it was a wolf. Then I began to think what its intention might be. Then the wolf came right over to me and started to look at me. And I looked at it in return. We looked at each other like this for roughly half an hour. Then it simply turned and left. I interpreted his look in this way: It was as if it were trying to tell me ‘I stood with you for so long and you did not offer me anything to eat. I will not rely on your generosity. I will seek my sustenance from my Lord.’”

Then Bediuzzaman continued: “As you see we do not have any weapons. If these animals were not under the control of God, they could have easily attacked and ravaged us. But they did not. So, do not be afraid. Every single thing moves under the command of our Lord.”

These are a few incidents from the life of a prominent scholar of Islam and a contemporary student of a timeless teacher, Prophet Muhammad, peace and blessings be upon him. Love of animals was manifest in a number of stories narrated to us by the Companions of God’s Messenger and related through books of Prophetic Tradition. Let us have a look at some examples:

The Crying Camel

A Companion of the Prophet, Abdullah ibn Ja’far relates the following incident:

“The Messenger of God went to a garden in Madina with a few Companions. A very scrawny camel was in a corner. Seeing the Messenger of God, it began to cry. He went near the camel, and after staying beside it for a while, he severely warned the owner to feed it properly.”²

Earning Paradise through Kindness to a Dog

It is related in the prophetic tradition that the Prophet said: “A prostitute was guided to truth by God and ultimately went to Paradise because she gave water to a dog dying of thirst. Another woman was sent to Hell because she left a cat to die of hunger.”³

The Screaming Mother Bird

While returning from a military campaign, a few companions removed some young birds from their nest to stroke them. The mother bird came back, and not finding its babies, began to fly around screeching. When told of this, the Messenger became angry and ordered the birds to be put back in the nest.⁴

These stories illustrate the overflowing love and appreciation of creation that is a manifestation of the divine love our Creator and Sustainer for us.

Footnotes

1. Weld, M., Bediuzzaman Said Nursi, Sozler Publications, 1992.
2. Gulen, M. F., Prophet Muhammad: Aspects of His Life, Fountain Publications, VA, 2000.
3. Bukhari 4. 538; 3.553
4. Hadith Encyclopedia, Harf Information Technology, Cairo, 1996.

by which they fly to the clime where angels fly.

With hearts at rest, with spirits having reached their aspirations,

They hear God’s compliments distinctly, word by word.

The faces of the believers are bright with flashes of joy.

They overflow with emotions while walking illumined roads.

The merriment of union is heard from a few steps ahead.

Voices rise in the company of the melodies of houris.

Flowers shimmer all around like narcissi,

and hearts beat with a different sound.

Eyes shining brightly pour forth smiles.

If it were possible, a heart would stop for happiness.

Souls go to their ease in the highest realm of Paradise,

where colours, patterns and harmonies charm the eyes.

Sometimes beauties excelling those of Paradise are sensed,

and angels visit that festival on their mounts…