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

Handwriting

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

Freetime

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