Sunday, January 20, 2013

Dreams for My Brother

As salaam alaikum,

As I was walking drowsily home from work today--another uneventful night shift of one early admit and plenty of sleep--I started thinking of things that my brother and I would do if I were to become his guardian. I imagined me coming home from work and working out in the gym with a personal trainer, and my brother also having a trainer work with him on running and weight training. I imagined how healthy and handsome my brother would be if someone actually challenged him in the gym like that.

Though insha'Allah my parents will be able to take care of my brother for some time, the fact that I'll one day be my brother's guardian does cross my mind. Whether I imagine myself as a single, forty-something woman with her forty-something brother, a wife with kids and my brother being Uncle, a wife with kids helping my brother raise his own child or children, it's something I think about periodically when my mind is quiet and at peace.

It's not something stressful for me, but I must admit, I have lot of dreams for my brother. Dreams that are perhaps ambitious. Dreams that perhaps are unwarranted.

My mother claims she was the first one to say that the baseline in the first few bars of this classic Stevie song, "Another Star," sounded like my brother's head, but I remember it being me that said this reminded me of my brother's head.

It's hard to explain, but having known my brother for the past 25 years of his life, and especially as a child, the first few bars of this song is the closest to what I think it'd sound like to be in his head. What his head sounded like to my family. What my love for him felt like then and what it feels like sometimes now.

My brother has autism and epilepsy. He takes three medications three times a day to not have a seizure daily. The better his seizures are under control, the more I watch him continue to grow, even as an adult. The older he gets, the more hope I have for his healthy and happy future that is more expansive than the college-education paradigm.

My brother, like any individual, is like a bud on a tree, bursting with potential energy at all times. My brother is the son of two loving parents who are helping him plan his future and have fought for decades now to ensure his education and well-being. They are his biggest advocates, and for years I was integral in advocating, as the second closest person to him for many years, who understood his idiosyncrasies, his manner of speech, his desires more than my parents could at times. I was his interpreter for many years.

I could tell my parents that when he sang the lyrics "upside-down world" in a slight minor key, he was distressed and feeling like things weren't making sense. This was back in the days when he was scripting as his primary language, taking very appropriately phrases and refrains from cartoon dialogue and song to express how he was feeling. I watched a lot of the cartoons he did at the time and knew exactly where his phrases came from.

So I'd say, "Mommy, he got that from the cartoon..."

And he'd hold his hands out, as if embarrassed, "No no, wait, stop..."

My brother does not like watching family videos because he's embarrassed by his behavior as a child. I wish...

And this is where my dreams begin. I wish someone would find a delicate way to explain to my brother that he has autism. Which is where I part from my parents' party line. I agree with my mother that it may not be necessary, and why stress him when he already knows he's different, but part of me thinks that if there was a developmentally-appropriate way to explain it to him, maybe he would understand a little bit why its hard for him to communicate things and understand certain things, and maybe he would find new ways to adapt.

Just like it was him who came up with the idea to have a medicine alarm so he wouldn't miss a dose like he has so many times before. Since I helped him set up the alarm on his iPod touch, he hasn't missed a dose since. And he's been on antiepileptics for 15 years.

I wish I could find an sensitive way to explain to my brother his difference and set at ease some of the anxiety I know he feels at recognizing this, and help him move forward with this realization to become all that he may want to be.

I wish I could find opportunities to motivate my brother to do something that not only makes him happy, but helps him participate in his larger community as a productive and happy member of society.

I wish I could, yes, take my brother to the gym, get him a personal trainer that is willing and able to work with a young adult with autism and get him to a state of health he's never been.

I wish I could draw from several male role models for my brother as he continues to become the man he will be.

So many dreams for my brother. Cure is never a question for me. I just want his ability to communicate all that he feels and all that he is to be maximized. I've never known my brother any other way than through the filter of autism, and I see his personality, preserved in absolute innocence that few of us are able to maintain.

I have dreams for my brother and I've had dreams of my brother before, neurotypical, in a suit and tie, walking amongst his colleagues, important people in black and gray with neat suitcases, walking down the streets of Baltimore just outside of Hopkins, him looking up and recognizing his sister, nodding, and continuing with the conversation lingering from his meeting.

And what a beautiful dream it was to get a glimpse of what my brother might have been if it weren't for autism. And to know that I loved my real brother no less or was no less proud of him despite this brief image was a relief. In a realm outside of my brother's body, he exists like this.

And one day, insha'Allah, we'll get to know each other in that way, outside of the filter of autism. I rarely think about that, but now somehow I know.

This is my brother, and I love him and if I need to I will go to the end of the earth for him. That bass line is his head, the sound of my love for him as I understand him. That bass line reminds me of everything I want for him, everything I dream for him.

To start, I want my parents to get set up an email account for him so I can start writing to him to help him with his writing.

And buy him a cell phone so I can make his Head Music his ringtone.

Wednesday, January 16, 2013


As salaam alaikum,

I do not take a break from the wonders and perils of being a woman (hahaha, get it?), but I feel like this is an issue that is sex- and genderless.

This song is how I feel inside of my body right now, from the urgency of that early 90s feel, to the lyrics...I urgently need relief:

I can't listen to it again, because it made me feel agitated. My calm shall be prayer. I had a rough day at the hospital today, and in all the helping voices among my seniors, family and friends, I know there's something that is missing. The trust in myself, which is an extension of my trust in God.

Of course not saying I am God or part God. Not even sure I'm saying God is in me. I'm just saying...for every time I thought I was a failure and a waste of a human being, I'm not trusting The One who not only put me here but gave me abundant blessings.

And for the first time, I'm not beating myself up about that. I beat myself up so much about any twinge of that in the past that I barely acknowledged it as fact. That I don't entirely trust God.

And for the most spiritual among us, it sounds like sacrilege! Even in my least adherent times, I didn't want to make the pronouncement. I was going through a phase, figuring things out, just taking with me my faith in God and having to reform my religion around it.

But my faith and trust have never been complete. And I think to expect that they would was once again my attempt to approximate the near impossible near perfection that I never nearly achieved.

I do not completely trust God. There are things that I trust God more for than others. I personally fear making any pronouncement about which things those are, nor do I want to make the pronouncement of why I am afraid to make that pronouncement, less God makes that fear come to fruition.

And then I'll be left thinking, "What did that mean?"

The things I take for granted daily, I do not pray about. The things I trust God to guarantee to most likely preserve especially if I pray about them, I pray the most about.

I can talk more comfortably about the things I don't have "proper" trust in God for.

I, over time, have had little trust in God in the relationship/marriage department. And by trust in God, it's not that I don't believe He's not here with me and able to help me in decisions. No, I know He's always here. My trust is mainly my trust in prayer, our main conduit of communication, if you will.

I have little faith that my prayers for relationships/marriage will be answered, just because so many weren't, at least within space and time parameters I understood when I prayed. I trust so little that I rarely pray about it anymore. Embarking on a relationship and not being able to bring myself to God about it, the One who I more fully place my trust in for so many other important aspects of my more momentous than the relationship itself has been. And though that is not entirely attributable to my entire unhinging this afternoon...and never has been, but I think is a more comfortable place for me to feel like things are's still huge!

The only thing that has brought me relief in this hectic day is admitting the above to myself. All of the above. That one thing, that so important to me thing that I've never really had a lot of trust in God for, before and after the advent of my adherence to Islam. Admitting it makes me realize it for what it really is. And it helps me parse out that other area of my life, other than my growth as a physician, that feels off for me right now.

I feel like, as a result, every step I take is against God, when it doesn't have to be. I will take it to prayer, even though I feel right now that the result of the prayer is that I will be painfully alone for many more years, if not forever. I think I must have hit rock bottom with this as some point because for the first time in a while, I feel like I have a mustard seed of faith...and some small part of me feels like God will actually help me in my current situation and not shun me to a lifetime of loneliness, which was my status quo prior to this.

I'm going to take that mustard seed and run with it! As painful as it feels right now to try to hold fast to that mustard seed of trust! It hurts to trust when you fear getting burned!

Mark my words, dear readers. I'm including this and my stresses at work in prayer, knowing that the more I can trust God, the more that I can trust that I am beloved creation with poise and purpose and if I'm not able to appreciate the value of that realization in and of itself, hopefully I can appreciate that it will make me a more effective practitioner...

I'm praying tomorrow is better, that God guides me in my current relationship, and addition to those things that I steadily have more trust in God for.

Tuesday, January 8, 2013

The Wonders and Perils of being a Woman

As salaam alaikum,

I performed my first circumcision yesterday, after seeing one performed for the first time since third year medical school. The baby boy was pretty much done with me when I injected the lidocaine into his penis and screamed the rest of the time until his father found an effective way to dispense sugar water. That was at least reassuring that I had sufficiently numbed the area as he stopped crying as I made the actual incision.

My mother, of course, upon telling her the news (I get excited when I get to do procedures!) was ambivalent. Although a practicing Muslim, she wonders how necessary circumcisions actually are. I reassured her that physicians are actually using anesthetic now based on a study 20 years ago. When my brother and I were kids, they were just performing the procedure and not giving any anesthesia because it was assumed that the baby boys weren't really feeling pain.

Only one way in which the medical establishment has been less than genius.

According to my preceptor, an observational study performed a little while back demonstrated that adult men who are circumcised as adults reported feeling less sensation than they did while uncircumcised. My mind immediately drifted to FGM, and it did make me feel bad about circumcision.

That is, until one of my guy friends said, whatever, I enjoy sex anyway.

He then celebrated "winning" the conversation by making the most inappropriate comment. It was my fault...clearly walked into it.

To which I responded...whatever, man, y'all can have it...I'm just glad I'm female.

I've said it before, and then I immediately think, not that being female is at all simpler. Not at all. And I'm not talking from a social, gender perspective...I'm speaking strictly biological for a second.

When we are born, because of our mother's hormones, sometimes we bleed from our vaginas and our breasts express milk. Once our mom's hormones calm down, we go into our presumed asexual infant existence. Except, we're never entirely asexual, because infants do engage in self-stimulation postures at pretty young ages. Not anything any young parent likes to think about...the foreshadowing of your baby's sexuality.

Anyway, at base, we as females, because of our anatomy, are more prone to urinary tract infections. Baby boys with foreskin are more at risk for urinary tract infections than circumcised baby boys, but not as much as baby girls. Urinary tract infections and any potential causes of sepsis in infants is serious and requires hospitalization.

As we grow up and are little girls, we're still more prone to urinary tract infections, something that will continue until we're adult women. At least as adult women our UTIs are considered "uncomplicated" and can be treated even empirically without visiting clinic if we have them often enough. But of course, the wonders of biological womanhood do not end with infections, though it begins there.

And in many ways, it continues. Because of our anatomy, we are also more prone to sexually transmitted diseases. With the exception of men who engage in receptive anal sex, we are more likely to contract HIV, for example, than our male partner(s). While human papilloma virus, HPV, infects both men and women, women bear the brunt because of those virulent strains that can lead to cervical cancer.*

Of course, the greatest vulnerability, biologically and anatomically, are the consequences of our reproductive system. We are one of the few mammals that menstruates instead of undergoing an estrous cycle, where the lining is reabsorbed. The monthly shedding of unfertilized uterine lining, which begins when we are very young, is not painless for all of us. Some of us, myself included, have overactive prostaglandins that lead to a fair amount of inflammatory pain in our uteri and surrounding organs, making the monthly cycle painful without fair amounts of pain medication or birth control.

(I often think that women who just bleed for their period without pain complain to much about bleeding. If I could ever just bleed for menstruation, I'd probably blissfully forget I was bleeding.)

Of note, one of the wonders of not having the estrous cycle is that our sexuality as females is not restricted to those moments in the cycle when we are fertile as it is with mammals on estrous.

We also blessedly don't get to count on being assaulted by our male counterparts when we are "in heat."

Pregnancy, of course, is the greatest consequence of our reproductive system. Our anatomy is the receptive anatomy, and our gamete, the ovum, is the receptive gamete that receives the other for fertilization. Our gamete, unlike the male gamete, is with us from our own gestation. As fetuses, we have already made most all of the ova we will have.** By the time we are born, they're already declining. By the time we menstruate, we have thousands less ova than when we were born. And even as we menstruate, we lose more ova than are not fertilized each month. But they're with us all of our lives, in these bodies that we carry through triumph and tribulation, and we really don't understand the impact our decisions and our ingestions make on our gametes.

The ovum, unlike the sperm, has more cytoplasm and contains mitochondria, powerhouses necessary for aerobic energy generation in our cell. It also contains its own unique genetic material, different from what is found in the nucleus of our cells. In that way, the genetic material from mitochondria we only inherit from our mothers.

And once fertilized and implanted, because not all fertilized eggs are implanted, the female body begins a ingeniously orchestrated balance of hormone and cytokine expression that begins the symbiotic relationship between fetus and maternal body. Our scientists and physicians still do not understand how the female body does not reject in the womb what in any part of the body would be regarded as foreign material and attacked by our immune system before it could divide into a morula.

And the female body is taken through so many changes in the course of a pregnancy. So many stresses, and not just the expansion of the uterus, pushing intestines and bladder and lungs aside in favor of the growing fetus, affecting digestion, urination and breathing. So many other physiologic changes happen, importantly including the increase in fluid volume, the relaxation of the connective tissue in the body, not only in the hips, but everywhere, which is the reason why some women's nose looks different during pregnancy. The connective tissue in the feet also relax, which is why some women notice a change in shoe size after pregnancy. But the hips expand to make room for the presenting part of the fetus with impending delivery. The hormone balances that we do not entirely understand can cause morning sickness, hyperemesis gravidarum, and yes, alterations in mood.

But much more than this takes place in the body of a pregnant female. There are also risks. Pregnancy is a hypercoagulable state in which deep venous thrombosis and pulmonary embolism, the latter which could lead to death, is more common. Because of the increased fluid, women with cardiovascular disease have their systems stressed during pregnancy. All of a sudden, its not just about the anatomy and physiology of our reproductive systems. When pregnant, the entire female body comes into play in an important way to keep both female and fetus alive.

Then there are the various dangers within the reproductive unit, from the cervix to the sac to the placenta, all important for maintaining the pregnancy to term, all of which, for reasons that we don't entirely understand, can fail early and lead to preterm delivery. Diseases of placentation can lead to death of both fetus and female from bleeding.

But somehow, alhamdulillah, most pregnancies are relatively uncomplicated and carried to term.

But the perils of pregnancy are not over for the pregnant female at term. There is still labor.

Labor is something I've only experienced as an observer and practitioner. I've had the easy part of delivering babies from women who have carried them near or all 40 weeks, and then some for some women and whose bodies have undergone all of the changes, who lay before me experiencing the pain of their lives. The first pain is of the gradual decent of the fetal presenting part, which can also cause severe back pain. The next pain is that of contractions. When the presenting part gets very low, then its perineal pain. All the while still feeling the pain of contractions and back pain as baby makes its way low in the pelvis. The final primary pain I've heard women in the second stage of labor (the pushing stage!) describe is the "burning ring of fire." Especially women who opt for natural child birth feel the burning when the head is coming to crown, and then, as one woman aptly described, feel as if your "[buttocks] is being ripped apart" as the baby crowns and is born.

A baby is born, the entire reason for the female reproductive system has realized itself.

And still, the perils of pregnancy are not yet at an end!

The body takes some time to reverse from its pregnant state. Never does it revert to its pre-pregnant state. From head to toe, the female body has undergone some permanent changes. Even the hair reacts, as many women experience telogen effluvium, the loss of hair in masses which can happen after, but is not limited to, pregnancy. Right after delivery, the female body is still hypervolemic, still in that hypercoagulable state, still at risk in those ways. But the oxytocin that once drove the contractions to push baby is now the oxytocin of contracting the uterus back to size and milk let down.

The breasts have now transformed into what was for centuries the infant's only means of survival, and is still the infants best means of thriving.

The hips (and feet) remain in their relaxed state, the cervix, which expanded to 10 centimeters to allow the more-than-10-centimeter head of the baby through, will never be the same. The changes in the body make it easier for any subsequent births, as the body has motor memory and has already made its greatest expansion to accommodate the fetus.

The female body settles down from pregnancy but is never the same.

And whether the female is pregnant or delivers or not, for many the cycle continues until menopause, when the hormones that made us bleed and express milk as infants have run their course in our bodies. The hormones that protected the female body against heart disease and orchestrated the production of one or a few ova each month relent, and the reproductive system takes the rest of the female body with it into the final phase of change. The female body now is exposed to increased risk of cardiac disease, potential for osteoporosis, among other things about women's health that we are just coming to understand.

And thus, if only relegated by our anatomy, though I remain "glad" (understatement) that I'm a female, I acknowledge that it is a state of being that is not, nor has never been, simple.

And this is just speaking strictly anatomically, physiologically and pathophysiologically. This ignored most if not all social dimensions of being female, thus gender. There, it becomes even less simple.

Though explained in a dire way, what with all of the risks of disease and death, what makes us biologically female and the consequences that this small part of our bodies has on our entire bodies and, indeed, our entire beings, is perilous yes but more wondrous yet. We are powerful human beings with the capacity to carry living beings within our bodies, like our other mammalian counterparts. While both male and female components are necessary for the propagation of our species, the 40 week commitment of the female body and initial participation of the ovum, much more sparse than the male gamete in quantity and production, is absolutely integral.

And yet, like our male counterparts, we are so much more than our reproductive biology.

And so it continues...

* Once again, in men who engage in receptive anal sex, HPV can lead to anal cancer.
** Some studies are indicating that women have the capacity for gamatogenesis after birth and retain the capacity throughout their reproductive lives, which calls into question but does not definitively reverse the previous notion that women are born with all the ova they'll ever have.

Sunday, January 6, 2013

Happiness III

As salaam alaikum,

Being mindful that one is imperfect does not mean that one embraces their imperfections anymore than being mindful of one's sorrow means that you are embracing it.

Being mindful of sorrow, for example, after one suffers a loss means that one says to herself, "You know, I'm sad because this person just died. It makes sense that I'm sad, and it's okay."

I didn't use to do this. I would analyze my sorrow, which does also not equate to mindfulness. If I didn't cry, if I were able to rationalize the death medically or spiritually (the life to come is better than this!), then I was strong, spiritually and emotionally. If I cried, I was weak and really only mourning myself, not actually the person.

Or, whenever I was sad, I tried to get as sad as I could, as if I expended all the sad early, it would dissipate faster, and my happy would be even better by comparison.

No. I'm sad because this person just died. There are many reasons why I am sad, but they all make sense, and it's okay to feel this way. It will not be always, but this is where I am right now.

It really helps to not drift into despondency, downward spiraling it to various levels of self-destruction.

Similarly, being mindful of imperfections does not mean that I'm glorifying then, especially when my imperfections may be bad habits or certain strains of detestable behavior.

No. I am imperfect because I am human. This is where I am right now. I have some room for improvement, but it's okay that I am where I am right now.

Mindfulness in the moment. One could feel this way after being rude to someone, using crude language in a way that made someone uncomfortable. Mindfulness is not an oh-well moment. It's knowing where you are in that moment. Moments, just like days, really, are fleeting, and recognizing where one is in the moment does not define the next moment, the next day, whenever.

And that is the power of mindfulness. It breaks up time into a more manageable schema and helps us make meaning of our life while not locking us in any single state for any given period of time.

I'm mindful of my choices and their consequences. I've deliberately made this choice, and while I would have rather done things another way, I am satisfied with my choice for now. I pray as always for God's mercy as I travel through this life, and I pray that my choice elicits only the best of consequences.

Mindfulness, while a very secular exercise, is not mutually exclusive with my own spirituality.

Living life more mindful has made me infinitely more happy at baseline, not just with the shift in the way of thought, but because of the life decisions I've made because of it.

I love that I've found happiness. Mindfulness hasn't changed the parts of life that are difficult, but it has reduced the anxiety. It hasn't changed the fact that I will faced challenges in life, but it makes them less daunting because I now have a much more manageable way of coping. It hasn't changed the fact that I am almost 28 and unmarried but it has taken away most all of the former anxiety that I used to have about that. I look on without jealousy as more friends get engaged, get married and become pregnant because I no longer see those things as impossible for me because I only digest life one moment at a time now and it's no longer near impossible because I have accepted not being nor ever being near perfect.

Right now, I'm not even the best that I can be, and that's okay. I just pray that I am good.

And in this starting over, remaking and rebuilding, that's what I strive to be. Good. I pray that I am a good person, a good physician, a good daughter and sister.

The great thing about being good is that you can be better without reaching your ceiling, ever, in little ways, in little moments, and I pray that I am.

I pray that I can fill my surroundings with peace and charity.


Saturday, January 5, 2013

Happiness II

As salaam alaikum,

I'm starting over. I'm letting go of a lot of how I've constructed myself over the past 9 years that I moved out of my parents house and embraced the practice of Islam because somewhere along the way I lost Islam. I lost peace, I lost a way of life compatible with my values, I lost my spiritual solution.

I no longer have a fear of my inherent Western individualism. It makes no sense to live my religion in any other way than what works for me. If it doesn't work for me, then what of it? Do I thrash myself for being imperfect, to I begin to suspect, as I did before I was practicing, that my life is written and I was intended for the hellfire, anyway, so why bother? How did I even get close to being back there?

I still don't believe that the purpose of life is simply happiness but I also don't believe that this should be excluded from one's life pursuit.

Our lives aren't always surrounded by all things beauty, but we do have those moments when it is. Moments when our minds are at ease about our dying relatives and the general injustices of the world. And it's okay to be happy in those moments just as it is okay to be sad or angry in those times when our minds are not at ease about all of the unlovely things in our lives and the lives of those around us. It doesn't make the struggle any less real. And we're all living the struggle, whether we believe in it or not.

I'm starting over and discovering that it's okay to be happy. It's okay to be mentally sound.

Instead of practicing Islam to bring me spiritual balance, I twisted Islam, as many others have, into an insufferable life form that amplified and justified my anxieties. It bred despondency that was already there, thriving on its own. And it's only predictable that that would have happened to me, following a path that many other men and women before me followed and recorded with their own vantage point, colored by their own anxieties.

If I'm happy, it's not because I'm doing something wrong. Not that I ever consciously believed that, but sometimes, that's just the way it would end up.

Happiness, for me, could only be achieved in perfection of faith. Since I also believed that such perfection was impossible (though near perfection was the goal), happiness was always something that would happen later. The standards I set for that near perfect faith were near impossible, of course.

I colored my Islam through the eyes of my own perfectionism. After all, what better realm of life to be a perfectionist than in the realm that determines your eternal fate?

There's so much that, in the last year, I've blamed on Islam as it was constructed before me. I blamed it on my ill-fated quest for spiritual balance that somehow ended terribly wrong. I blamed too much on it, almost everything, from my dysfunction in finding a life mate to my inexperience in hosting a large number of guests at my apartment for dinner.

I finally stepped back and realized that none of this was the fault of my spiritual quest. There were other, less expansive explanations. I've never hosted a large number of people at my apartment for dinner because I've lived with roommates or in dorms for the past 9 years of my life and have therefore never entertained on my own. I had roommates or lived in dorms because I was a student for the past 9 years of my life.

And so many of the other idiosyncrasies in my life have really simple, intuitive answers like this one.

Nothing is quite so grave anymore. The nickname I use in the hospital no longer feels like I've suffered dissociative fugue. Love is not impossible for me anymore because it doesn't have to be near perfect.

Wow. I really like that. Excuse me, I have to repeat it for myself.

Love is not impossible for me anymore because it doesn't have to be near perfect.

Because it's nowhere close to perfect, just like I'm not. And mindfulness helped me accept that. That was something that was incompatible with my version of life before this. Imperfection, being satisfied with imperfection. I should always strive to be better...

I still believe in striving to be better. I just no longer believe that dissatisfaction with one's current state is a prerequisite to that striving.

To be continued...

Friday, January 4, 2013


As salaam alaikum,

There were no retrospectives, no reflections, no words for the end of 2012. I meant to, I really did, but I didn't finish the entry, and it's no use now. So much happened in 2012, so many great life shifts, from matching in family medicine to graduating from medical school with my dual degree, from moving to Seattle to making moves in the relationship department. There were a lot of big transitions in my life in the last year of the Gregorian calendar, but many more subtle, though no less great, transitions. I graduated from medical school, becoming a doctor, and now I'm in residency, becoming a doctor.

The transition itself is not so subtle, but I guess I mean that there's no succinct way of describing it.

A big transition for me that I have not at all discussed is still in progress. It's a huge, spiritual revolution of sorts. I'm changing the way that I think about life and my pursuits in this life. I let go of so many anxieties and became a healthier person. And it all started with one afternoon in the park.

One of our faculty members is our resident integrative medicine specialist. She completed a fellowship and brought her expertise to our program. Not only does she have exercises for our patients, but she does a lot for us residents in terms of self-care. So, just a couple of weeks into our program, while we were still in our glorious orientation month, we sat in a circle in a little park just a block up from the residency office and talked about holistic self-care techniques and mindsets. She taught us about mindfulness.

I've mentioned mindfulness before. In fact, it wasn't the first time I'd heard of it. I'd had a counselor in the past that introduced it to me, but part of me was still back with the, "Oh, she doesn't understand. I'm a Muslimah. I can't live this way..." or "She's minimizing something that is a real struggle for me that does not have any easy, religiously-sound solutions."

But it was something about sitting in a circle in a park on a beautiful, sunny Seattle day and where I was in life and everything that happened and all that I had done that allowed the message of mindfulness resonate with me.

And everyday after that, with only a few exceptions, I've been living my life one day at a time, sometimes, one moment at a time. It was a fast but slow transition. I shifted my mode of thought immediately but it took a while for old habits to dissipate. I would live my life one day at a time but still have moments of internal panic at some of the decisions I made as a result. I still occasionally wondered if this was the best thing for me to do spiritually. I made the transition to living one moment at a time but it took me some time to accept my occasional cognitive dissonance with the idea.

I worked hard to learn a theology, a way of life that taught me to keep my eyes on the prize, the Afterlife, and constantly strive to be better. I worked hard to learn a way of life that taught me that the purpose of life is not happiness, it is service. Service to Allah (swt), which for me is often too esoteric for me to understand serving God who doesn't have a need for my service, pleasing God who does is not sustained by my appeasement, so I simplified it to all of the elements of service that make sense to bettering the world in which we were placed. Service was the purpose of life. Happiness was not, especially if it interfered with your service or following one's nafs over God's will for us.

I never aimed for happiness. After all, the next life is better than this. If I suffer in this life in pursuit of service, striving at all times to submit better, be better...then yes, I shall have happiness. In the next life.

It's funny how even though my understanding of Afterlife is organic and yet I never thought of what impact a self-imposed life of tumult would have on the state of my soul after this space-and-time-bound existence expires.

Restated, I believe that when we pass from this existence, we bring with us the balance or the summation of all that we were in this life. If we strove to be good people and fill our surroundings with peace and charity, that good essence will define ourselves and surroundings once no longer on this earth. So somehow, I believed this organic version of Afterlife but did not believe in pursuing happiness at all.

It was more like, service should make me happy, and alhamdulillah, it does, but if I were not to have happiness, oh well, such is life and so God wills.

I've read Purification of the Soul, I used to ascribe to the belief that depression and anxiety were in fact spiritual deficits with spiritual solutions, all the while suffering from both, and I delved into Islam with the hope that this was the spiritual solution to that anxiety and depression, not realizing that popular ways of thinking that I embraced in becoming more practicing actually exacerbated my problem.

I just took it as my personal jihad, that this was something I would tussle with, and insha'Allah He would help me find the solution as I grew in faith.

I never thought for a moment that I'd have to start over...

To be continued, insha'Allah...