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Authors: Vincent J. Cornell

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one does not want to end up with thousands or even tens of thousands of

Caring for the Ill in Islam
133

dollars in bills. If the primary organizing principle of hospitals is hierarchical, the organizing principle of health maintenance and other kinds of insurance organizations is bureaucratic, a structure that seems to lend itself to labyrinths of infl complex, and sometimes absurd procedures for obtaining the resources that are the right of the members.

A key characteristic of these organizations is that there is no way to develop a personal relationship with any individual. In hierarchical organizations like hospitals, it is relatively easy, once one understands and respects what each person can and cannot do, to make personal connections. However, in most health maintenance organizations and insurance companies, a series of barriers separate the member and those who have the power to reimburse claims. Most use automatic phone systems that are presumably designed to increase effi but that unnecessarily delay members whose problems can only be addressed by speaking with a live customer service representative. When a live representative is finally reached, he or she is instructed to identify himself or herself by their first names only, and it is more than likely that one will never speak to the same representative twice. When an initial, single error compounds itself into a series of errors that require multiple phone calls, each phone call will be answered by a new representative who will piece together what happened by means of their computer records, feeling no personal responsibility for the preceding errors and therefore no corresponding sense of urgency concerning the problem. While this system perhaps succeeds in its function of equitably distributing limited resources to members with the requisite stamina, this success comes at the cost of an outrage. The more you and your dependents have suffered through medical procedures, hospital stays, and doctors’ visits, and the more your time and resources have been stretched to the breaking point, the more you will be subjected to frustrating struggles with anonymous company representatives and systems. The point here is not to complain, as I am acutely aware of how fortunate I am to have good insurance and access to good medical care, but to point out the deficiencies of the providential god of the insurance society.

BARGAINING WITH GOD

Call upon [God] in fear and longing.

(Qur’an 7:56)

Of course, hospitals and insurance companies make for rather silly idols. Another trick of the religious imagination is more personal: the attempt to bargain with God. Uncharacteristically for me, I adopted this approach wholeheartedly in the period in which my daughter was having repeated
grand mal
seizures. No medicine seemed to work and the violent seizures

134
Voices of Life: Family, Home, and Society

increased, making it diffi to leave her alone for even a moment. It was diffi t to do anything but sit and wait for the next seizure, whether that would be in a few minutes or a few weeks. Little by little, I found myself unraveling. God did not appear to help me like the Superman I watched on TV and in movies as a child or in the news coverage of real-life Superman stories. When a child who has fallen down a well is saved, I am the first to start weeping. However, I am also the first to raise the moral question of the other children who are not saved but die horribly instead. Are there not enough Supermen to go around? But, regardless of my misgivings as to the integrity of the process, I began, in my distress, to do what I had assiduously avoided up to this point in my life: I began to pray to God, the merchant. What would it take to buy the end of my daughter’s seizures? I was willing to put everything I had on the table.

There is a degree of legitimacy to this approach; sometimes God sounds like a merchant in the Qur’an. The ultimate bargain, after all, is the afterlife. You work hard and try to behave yourself for a few decades and obtain happiness for eternity, which is a pretty good deal. But there is a problem. Justice of this sort, and the arguments of theodicy that assure you that every- thing will be fine in the end, work best when you are sitting on the fence at a distance, not sitting waiting for the next seizure.
9
The problem is in the moment, not later. Within the moment, there is no good reason for suffer- ing, especially the suffering of those without blame. A passage from Fyodor Dostoevsky’s novel
The Brothers Karamazov
is often quoted in discussions of theodicy.
10
This passage questions the notion that harmony in the afterlife can justify horrifi suffering, especially the suffering infl on others by human beings. When the character Ivan Karamazov visits his brother Alyosha, who is training to be a priest in a monastery, Ivan uses a number of horrible examples of tortured children and animals to argue that innocent suffering could never be part of a larger scheme of justice, or at least not one that he would want to be a part of.

I don’t want harmony, for love of mankind I don’t want it. I want to remain with unrequited suffering. I’d rather remain with my unrequited suffering and my unquenched indignation,
even if I am wrong.
Besides, they have put too high a price on harmony; we can’t afford to pay so much for admission. And therefore, I hasten to return my ticket. And it is my duty, if only as an honest man, to return it as far ahead of time as possible. Which is what I’m doing. It’s not that I don’t accept God, Alyosha. I just most respectfully return him the ticket.
11

I have always sided with Ivan. In the moment or string of moments of horror and terror, do we have to tolerate the intolerable? Is
this
what has to be put on the bargaining table? A point comes where the language of prayer moves from the mercantile to the
crie du coeur
(cry of the heart), from the rational bargaining of resources, goods, rights, and entitlements to cries into the unseen. What kind of prayer is appropriate when you are alone with your

Caring for the Ill in Islam
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child in a hospital room in the middle of the night and an excruciatingly painful and invasive medical procedure must be done, especially when you are not totally convinced that it is necessary? I do not have an answer to this other than to relate something I heard from a 13-year-old girl. Some years ago, I was with a group of young Muslim girls who were talking about whether it is acceptable to pray to get good grades at school. Several of them were shocked at the very idea of asking God for something so petty, thinking prayer should be saved for more serious matters and for the benefit of others. This girl, however, vehemently denied this line of thinking; she kept repeating, ‘‘There are no boundaries! There are no boundaries!’’ The desire to obtain good grades or a soul mate, and the pleading to stop the suffering of oneself or another is, in the end, all the same. Prayer, at the point where the bargaining stops and honesty begins, is a dive off a cliff into the unknown.

In the beginning, when I was a novice in love,

My neighbor could not sleep at night from my whimpers.

But now, as my pain has increased, my whimpering has decreased.

When fire takes over something completely, smoke dwindles.

(Ahmad Ghazzali d.1126
CE
)
12

THE TRIAL

The human being was created weak.

(Qur’an 4:28)

The human being was made of haste.

(Qur’an 21:37)

The human being was created with anxiety.

(Qur’an 70:19) Say: Even if you were to possess the hidden treasures of the mercy of my Lord,

you would cling to them, afraid of expending them. The human being is ever niggardly.

(Qur’an 17:100)

The love of worldly desires has been made attractive to human beings: the desire for women, sons, piles of gold and silver, fine horses, livestock, and fertile land.

(Qur’an 3:14)

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Voices of Life: Family, Home, and Society

Souls are prone to selfish greed.

(Qur’an 4:128)

You love possessions with an ardent love.

(Qur’an 89:20)

The human being wearies not of praying for good; but if something bad touches him, he is despairing and hopeless.

(Qur’an 41:49)

Alongside the terrifying moments of acute medical crises, there is the grind of chronic conditions, and it is in this daily grind that one has the time to experience the breadth and depth of one’s faults and weaknesses. The quotes from the Qur’an above suggest that the very substance of the human being is comprised of weakness, impatience, agitation, selfi self-pity, greed, and the narcissistic need for material things and other people. The angels themselves were aghast when power was entrusted to this strange and fright- ening creature with its all-consuming desires and lack of self-control:

When your Lord said to the angels, ‘‘I am putting a deputy on the earth,’’ they said, ‘‘Why put on it one who will cause corruption on it and shed blood while we glorify You with praise and proclaim your holiness?’’

He said, ‘‘I know what you do not know.’’

(Qur’an 2:30)

Although the angels could not understand what God understood, they were prescient in their assessment. They knew that the weaknesses with which Adam and Eve were created would lead to the actions that caused their fall from the Garden and their subsequent actions on earth. The seal on the fate of human beings was ‘‘Go down, each of you an enemy to the other’’ (Qur’an 2:36, 7:24). This is a curse suggesting that, down here on earth, enmity fl more naturally between human beings than does altruism, mutual aid, or care for one another. The ferocity with which humans deal with one another is met in equal part with the burdens experienced by the vulnerability of the body on earth, with its burdens of illness, hunger, thirst, and need for shelter. To be human is to experience corporeal and emotional vulnerabilities: bodily pain and discomfort, fatigue, anguish, grief, and fear. As the Qur’an says, ‘‘We created mankind in trouble’’ (Qur’an 90:4).
13

Among those who do not consider themselves practitioners of a religion, there is a common perception of religion as a kind of security blanket for believers, offering some degree of defense for its holder against fear and

Caring for the Ill in Islam
137

despair. Although this may be true for some believers, there are also many examples of religious fi res who express the pain of life without trying to minimize it, even as they turn toward God. The classic literary expression for this spiritual attitude is the lament or complaint. In the Qur’an, Mary is described as having to face the pain of giving birth to Jesus alone, her sense of isolation intensifi by a community that is quick to condemn her. As she is overwhelmed by the agonies of childbirth, she cries out, ‘‘Would that I had died before this and been a thing forgotten!’’ (Qur’an 19:23). The Prophet Jacob has to bear not only the lies and deception of his sons but also his grief for the son that has been taken away from him:

And he turned away from them, saying, ‘‘Oh my sorrow for Joseph!’’ His eyes were full with of grief but he suppressed his anger. They said, ‘‘By God, will you never stop remembering Joseph until you are overcome by disease and then death?’’ He said, ‘‘I complain of my sorrow and grief to God alone, and I know from God what you do not know.’’

(Qur’an 12:84–86)

The Sufi master ‘Abdullah Ansari (d.1039
CE
) cries out in his rhymed

Munajat
(whispered conversations with God):

Oh God, this is not living but torture.

This is not life, but a structure reared on water. Without Your grace, we are undone.
14

Another Sufi, Abu al-Qasim Muhammad al-Junayd (d. 910
CE
), has a much dryer style. This is especially useful for dispelling the mental trick that seeks escape from the realities of pain and suffering by imagining that the particular events of one’s own life are unusual, thereby granting one the illusion that one is somehow special in one’s pain. Instead, life’s indignities and cruelties are only too normal for countless numbers of people. Junayd said, ‘‘I don’t perceive what I endure from the world as something loathsome. For I accept it as a basic fact that the here and now is a house of grief and sorrow, of tor- ment and affliction, and that the world is utterly bad. Thus, it is normal if it confronts me with everything I fi repulsive. If it confronts me with what I like, that is something above the normal. But the original, normal situation is the first case.’’
15

The famous Sufi and poet Jalal al-Din al-Rumi (d. 1273
CE
) was amazed that we remain attached to a world that causes so much pain:

Look not at time’s events, which come from the spheres and make life so disagreeable.

Look not at this dearth of daily bread and means of livelihood! Look not at this fear and trembling.

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Voices of Life: Family, Home, and Society

Look instead at this: In spite of all the world’s bitterness, you are passionately and shamelessly attached to it.
16

The trial or affl of being human, then, is the experiencing of our vulnerability both from without and from within, from those who would hurt us, from the affl of the body and poverty, and from the endless refilling of our desires and fears.

According to the Qur’an, humanity brings additional pain and suffering upon itself in three primary ways.
17
I have already mentioned the absurd intensity and diligence with which one can look for help in all the wrong pla- ces. This is the cognitive error that the Qur’an refers to as idolatry (
shirk
).
18
Another cause of pain for human beings is the disconnection between stated belief and actions, a phenomenon that the Qur’an refers to as hypocrisy (
nifaq
). The problem most often referred to, however, is called
kufr,
a word that is usually translated as ‘‘unbelief’’ or ‘‘infidelity.’’ ‘‘Unbelief’’ is a prob- lematic translation because the English word ‘‘belief’’ suggests a cognitive function that is implied only secondarily in the Arabic. ‘‘Infidelity’’ is better, but it still fails to capture the full sense of the Arabic word, which connotes the refusal to acknowledge the favor or benefit that has been conferred upon one; its antonym is thankfulness (
shukr
).
19
The Qur’an says, ‘‘Verily, We have displayed for humanity all of our signs in this Qur’an, but most people refuse to acknowledge them, except by rejecting them (
illa kufuran
)’’ (Qur’an 17:89, 25:50). The primary meaning of
kufr,
then, is relational. In English one can say, ‘‘I believe in you,’’ which implies wholehearted support for another person. The word
kufr
refers to the rejection of this kind of belief. To be an ‘‘unbeliever’’ (
kafir
) is to think badly of God.

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