Thursday, November 25, 2010

of Hanbali and Mazhab

For this semester. we're learning "Umdah al-Fiqh" which is one of the famous beginner's texts in Hanbali school ("mazhab")

The text was authored by al-Imam Muwaffaquddin Ibnu Qudamah al-Maqdisee who was one of the most prominent scholars of Hanbali mazhab.

He is also called "Shaikh al-Mazhab" (The scholar/leader of mazhab) and in Hanbali terminology, the word "as-Shaikhan" (the two Shaikhs) refer to the Ibn Qudamah and the Ibn Taymiyyah al-Jadd (the grandfather) [who is the grandfather of Shaikh alIslam Ibnu Taymiyyah and the compiler of Muntaqa al-Akhbaar, the basis of Imam as-Shaukanee's commentary (Nailul Autoor).This is as opposed to the as-Shaikhan in Hadeeth terminology which refers to Imam alBukharee and Imam Muslim.

Going back to the Hanbali mazhab, although it is the "youngest" of the four schools of jurisprudence, it is by far, the most "flexible" of all. It is actually a "myth" to think Hanbali mazhab as very rigid and strict.

What I meant by "flexibility" is that opinions from either Imam Ahmad himself ("riwayah"/narrations") or from scholars within the mazhab itself encompass other 3 mazhabs as well.

Another characteristic of the Mazhab is that it does not restrict the "acceptable opinions within the mazhab" (wujooh) to certain numbers of scholars. Therefore the "process of Ijtihaad" within the Mazhab is an ongoing process. Opinions of the Hanbalite scholars of modern days can be considered as part of the opinons within the mazhab.

However, this does not mean that Mazhab Hanbali does not have a "standard" or "official" stance. The "official" stance of Mazhab basically revolves around 3 Hanbali scholars: al-Mardawee, alHajjawee and alBuhutee.

As a finishing note, one should aspire to learn "fiqh of mazhab" based on mazhab texts as it paves the way for you to acquire your "malakat fiqhiyyah" (Fiqh Aptitute) although one should also strive to learn "fiqh adillat" (Fiqh of the Evidences (alQuran and asSunnah) as both should come hand in hand.

It is a dangerous mistake to assume fiqh of mazhab is born out of wild and haphazard imagination of fore scholars. Rather, it is a careful and precise steps based on clear principles derived from the Quran and Sunnah!

Friday, November 12, 2010


One of the greatest scholars of the past, Sheikh al-Islam Ibn Taymiyyah used to write very fast. He used to finish writing one whole(!) book in just one sitting, usually after Asr prayer until Maghrib

As a natural consequence of fast writing, his handwriting is generally not the best legible handwriting.

So illegible that after a few days, when he wanted to review his writing or notes, he could not even understand it!

So much he even needed to get his students who are used to his "style" of writing to decipher what exactly he wrote!

"A sample of Sh. alIslam Ibn Taymiyyah's handwriting"

It is said that one of the many contributing factors that his works initially were not well read and spread was due to handwriting!

Going back to my present reality as a doctor, it goes without saying how important communication is, because most of our work is centred around getting and giving the "right" information be it verbally or written in the "right" way

Many a time, we often get misled or turned off by people not giving or getting the right information. Once, we had a patient who we were told had left sideness weakness with preliminary diagnosis of TIA/stroke and eventually had CT Brain (which was normal) but if you take proper history, you would know that she actually had classic "sciatica"!

Similarly with handwriting, some handwriting can make your head spinning and some is so scrumptiously good, so good that it makes you read to the last letter.

Especially with handover, although I think myself as a very good handwriting reader, there were many instances where I was scracthing my head to understand poor handwriting,.

Sometimes with poor handwritten notes, people tend to overlook illegible parts which may or may not contain vital information, which in real life, can be the deciding point between life and death.

Fortunately, most of the time, the system usually provides layers of " protective walls" in place to prevent adverse events!

And some handwriting may give a different impression from what it is originally intended for..

"Probably colonising....."
I leave it your imagination.
(Apologies for my wife. I took it from her site)

Thursday, October 14, 2010

Emergency Medicine

In my final year of medicine, I was seriously considering Emergency Medicine as a career choice.

That was when I did my Emergency rotation at one of the foremost Emergency/Trauma Centre in Australia. It's the State Trauma Centre to begin with. There, even though I had not much opportunities to participate in trauma cases

Well, we were not allowed to be in the "cubicles" to begin with. We as in final year students and interns, 3rd years were off-limits. They even make lines outside the cubicles where we have to sit out of the lines. The constant presence of TV crews does not help our cause either. You know medico-legal stuff.
There, you see a lot of severe trauma, and you always have constant support of the high tech imaging, consultants, trauma surgical team who are always there 24/7, non stop.

Now, I'm finishing my Emergency rotation as part of my internship. Yes, it is indeed interesting but at the same time, it is taxing.

It is interesting when you see acute medical or surgical patient, work them up but the not so interesting part is that there is no continuity of care.

For example, I have once diagnosed a patient with bacterial menigitis who came with classic signs. We did all initial tests but then, I have no clue what happened to her eventually.

It is taxing because you feel that you're in perpetual "long cases" that never stop and sometimes, you can't stop wondering why certain patients came to.

For God's sake, don't ever come when you're constipated or drunk!

The other reality that when you work in rural area, you are not as privileged as your city counterparts in term of senior support, imaging and pathology. We don't have after-hour emergency consultants, imaging or pathology.

But hey, don't they say that which does not break you, makes you stronger. It may seem like a disadvantage but after a while, you will definitely learn a lot.

Now I can confidently say that I feel a lot more confident in making decision and synthesising my diagnosis.

I'm glad that I'll be to Frankston but I think I'd probably miss Warragul, most of all, the salary packaging bit! !

Wednesday, May 26, 2010


This is my first post since January.

Since then, I've gone through gen men rotation and now am finishing surgery.

Here in Australia, we work in shifts. So for surgery, we have day and afternoon shifts during weekdays. On weekends we have weekend shifts,

As day interns, we attached to units. Last time, I did colorectal for 4 weeks which is basically what every intern is entitled to. So day job involves doin ward round(s) ( note the (s) as certain units have more than one ward round depending invariably whether the unit consultant is overly enthusiastic( or unmarried)

So apart from ward rounds, there are referrals, investigations, discharges and etc. And not to forget, we have to be there on time to prepare the logistics for ward round( in another unglorified word, chasing bloods and getting all the medical histories together)

Now, on the other side of the day, there is evening interns. We usually start at 200 pm but as the day interns finish at 400 pm we have 2 hours of overlapping shifts supposedly for handover. But handovers are just a 2-minute affair.

Now by time evening interns start, 99% of important tasks are all done and our job's just basically filling in the cracks ( jelcos aka iv cannula, fluid order, drug charts etc) we sometimes are faced with some medical issues that need fixing e.g fever, hypertension, pain management, post op poor urine output) .

So most of our times are spent the best way possible as any keen interns would do. Reading voluminous medical journals, keeping ourselves up to date with current managemet guidelines, recapping materials learnt in med school.

Well, that is of course a lie.

In reality we ( ehem ehem more like I) enjoy ourselves in residents block, cruising internet, facebooking hoping no one would page us.

Who said being a doctor is hard? ;)

So much free time....

Which explains this post

Thursday, December 31, 2009

New Year

When I'm typing this entry, it's already 6 minutes past midnight.

Personally, I couldn't care less about new years. It's half a month of the first Islamic month anyway.

But still, apart from numerical change, the Earth gravitational pull doesn't feel stronger than usual, the time-space continuum looks innocuously four dimensional , no vortex or people from the past came knocking on the door.

To put in a simpler English term, it doesn't feel any different,

Yes, of course, except for the expanding waistline, however, it's not living in denial when you come to think of it as proper for the anticipated higher energy expenditure in the coming months.

And yes, by extension of that, I don't think a new year resolution would be relevant to me.

It just adds to my unwavering belief of such futile exercise that studies show that in 80% would just dump their new year resolution in February and the rest would follow suit.

And by the way, why do you have to wait for new year to make a resolution? Why can you just make it now? or every day ? or every month? Or every 43 minutes 25 seconds ??


Monday, December 7, 2009

Medicine and Islam

Scholars in the like of al-Ghazzali (d. 505H) and an-Nawawi (d.676H) had discussed the importance of medicine in their works and they view it as a communal obligation (fardh kifaayah)

an-Nawawi said: " As for the knowledge of intellect, some of them are communal obligation such as medicine and mathematics..."

alGhazzali said: " You can not deny that medicine and mathematics are from the communal obligations. Because the knowledge such as farming in which people can not live without is a communal obligation, and medicine and mathematics are more important"

When the past Islamic scholars spoke about medicine, medicine is always spoken in the same breath as Islamic sciences.

We can see from the statement of our Imam, as-Shafiee where he said:

I have not known any knowledge after (the knowledge of ) Halal and Haraam that is more noble than medicine
It is no surprise to see that as-Shafiee himself had studied medicine in depth (this is besides of
the knowledge of Islam) to the extent, he baffled one of the doctors of his day with his medical knowledge.

One doctor said:

" When as-Shafiee came to Egypt and he discussed medicine with me to the extent that I thought he was not profiecient in anything else but medicine"

Another scholar worth mentioning is al-Imam Muwaffaq ad-Deen alBaghdaadee (d.557H) who has been described as "with his great knowledge in Shaariah and depth in Arabic, he was very learned in medicine" and "that students of Islam as well as doctors used to sit with him to study "

Now, one may wonder why such a prominence. Yes, we know that the knowledge of medicine is a communal obligation because of the survival of the nation depends on the health of its individuals but why after the knowledge of Shariaah? What is so special about it?

If we can agree that human is of two components: Spiritual and Physical. The health of human spirituality depends on the knowledge of the religion and its implementation, whilst the physical health is important to ensure the implementation of spiritual component of human.

Human spirituality and physicality interact with each other and affect one another. It is in this spirit that for example, we are to take food in precedence over prayer and we are not to hold onto the two al-akhbaathain (filths: urination and defecation) whilst in prayer.

It is this two aspects that we have to mindful of. It is sad when one fails to see the other aspect of the other because failure to see this two aspects will bring on the failure to treat and approach individuals as it is meant to be.

For example, it is sad to see where one ascribes Postnatal Depression to devil's whispering depriving the victims from the much-needed therapies while, in reality, it may or it may not be the case. I do not deny that it can be of the devils as much as I do not deny that it can be caused by organic dysfunction.

Ahkaam al-Jaraahah at-Tibbiyyah, Dr Muhammad ibn Muhammad alMukhtar AsShanqiti, Maktabah asSohabah, 1415H

Sunday, November 15, 2009

Tuwais "The Singer" (11-92H)

Interesting bits about one of the personalities in Islamic history as mentioned by Az-Zahabee in his Siyaar A'laam an-Nubaala' (4/364) and others.

Tuwais was the Maula (freed slave) of Arwa bint Kuraiz who was the mother of the Third Caliph, Uthman radhia Allah anhu. He was a "singer" (in the sense that he used to beat duffs and "sang" poetry). He was Abdul Mun'ieem Isaa ibn Abd Allah. Initially, he was called(laqab) "Thawus" (Arabic: peacock) but after he had "effeminated" (takhannatha) (?medical/?genetical/), he was then called "Tuwais" (Small peacock).

He was famous for three things which people made a standard out of him.

(1) Singing
He was one of the first to "sing" in Islam as he had learnt the arts from the prisoners of war from Rome and Persia and he excelled in it that people used him as a standard to compare others.

(2) Height
He was described to have extremely excessive height(mufrit fil tool)

(3) "Bad lucks"
Arabs used to say for someone who has a series of bad lucks, or when things always go wrong :" Ash'aam min Tuwaais" (More 'bad lucks' than Tuwais)

Why? Because:

The day he was born: Prophet sallahu 'alaihi wassalam died
The day he began to eat solid food: Abu Bakr died
The day he reached puberty: Umar died(1)
The day he got married: Uthman died
The day he had his firstborn chil: Ali died(2)

(1) Some say it was the day he had his circumcision
(2) Some say it was al-Hasan ibn Ali

Tuwaais used to say: "O People, As long as I'm still alive among you all, do expect the Daabbah (3) and Dajjal (the False Messiah) to appear, but if I die, you all will be safe!!"

(3) One of the Major Signs of the Qiyaamah.

Food for thoughts for medicos

Any differentials here for Tuwais.

He was described as having a squint, extremely tall, and have female characteristics? But appears to be able to reach puberty and have offsprings.