The Courage to Speak: Doctors Near Avellanas Share Their Secrets

Costa Rica has achieved remarkable health outcomes that place it among the healthiest nations in the Americas, often compared favorably with countries of far greater wealth. The Caja Costarricense de Seguro Social (CCSS), established in 1941, provides universal healthcare to all citizens and legal residents, and has been instrumental in achieving a life expectancy of approximately 80 years — comparable to the United States and higher than many European nations. Costa Rica abolished its military in 1948 and redirected military spending to education and healthcare, a decision that profoundly shaped the country's health outcomes.

The University of Costa Rica's Faculty of Medicine, founded in 1961, trains the majority of the country's physicians. Costa Rica's community-based healthcare model, featuring EBAIS (Equipos Básicos de Atención Integral en Salud) primary care teams deployed throughout the country, has been praised by the WHO and World Bank as a model for developing nations. The Hospital Nacional de Niños (National Children's Hospital) in San José has achieved internationally recognized outcomes in pediatric care. Costa Rica's Nicoya Peninsula is one of the world's five Blue Zones — regions where people live unusually long, healthy lives — making it a subject of intense longevity research.

Costa Rica's ghost traditions are rooted in a blend of Indigenous Bribri and Cabécar spiritual beliefs, Spanish colonial Catholicism, and Afro-Caribbean traditions from the Limón coast. The Bribri people of the Talamanca region believe in Sibö, the creator god, and maintain a complex cosmology where the dead travel to a place below the earth. Bribri shamans (awá) serve as spiritual intermediaries and healers, communicating with spirits through sacred cacao ceremonies — cacao being considered the sacred blood of the divine.

Costa Rican mestizo folklore includes several iconic supernatural figures. La Llorona, the weeping woman searching for her drowned children, is heard near rivers and streams throughout the Central Valley. La Segua (or Cegua), a beautiful woman who appears to unfaithful men on horseback and reveals a horse's skull face when approached, is one of Costa Rica's most distinctive ghost legends. El Cadejos, a large supernatural dog (appearing as either a white protective spirit or a black malevolent one), accompanies travelers at night. La Tulevieja, a woman cursed for abandoning her child and transformed into a hideous creature with a leaf-like face, haunts forests and waterways.

The Afro-Caribbean community of Limón province, descended from Jamaican workers who built the Atlantic railroad in the late 19th century, brought obeah spiritual practices and Caribbean ghost beliefs, including duppies (ghosts) and spirit communication traditions. These coastal traditions add a distinct layer to Costa Rica's supernatural folklore, creating a ghost culture that varies significantly between the Hispanic highlands and the Caribbean lowlands.

Costa Rica's miracle traditions center on its patron saint, the Virgen de los Ángeles (Our Lady of the Angels), whose small stone statue was reportedly found by a mestiza girl named Juana Pereira on August 2, 1635, on a rock in Cartago. According to tradition, the statue repeatedly returned to the rock after being moved, and a spring that emerged beneath the rock is believed to have healing properties. The Basílica de Nuestra Señora de los Ángeles in Cartago is Costa Rica's most important pilgrimage site, and every August 2, approximately two million Costa Ricans (nearly half the population) participate in the Romería — a pilgrimage walk to the basilica, many on their knees, seeking healing or giving thanks. The basilica's collection of milagros (small metal charms representing healed body parts) and ex-votos testifies to centuries of claimed miraculous healings. Bribri healing traditions, centered on the awá shamans who use medicinal plants and spiritual rituals, document healings attributed to spiritual intervention.

Sleep researchers at Midwest universities near Avellanas, Guanacaste have identified parallels between REM sleep phenomena and NDE features—particularly the out-of-body sensation, the tunnel experience, and the sense of encountering deceased persons. These parallels don't debunk NDEs; they suggest that the brain's dreaming hardware may be involved in generating or mediating the experience, regardless of its ultimate origin.

Agricultural near-death experiences near Avellanas, Guanacaste—farmers trapped under tractors, caught in grain bins, gored by bulls—produce NDE accounts with a distinctly Midwestern character. The landscape of the NDE mirrors the landscape of the farm: vast fields, open sky, a horizon that goes on forever. Whether this reflects cultural conditioning or some deeper correspondence between the earth and the afterlife remains an open research question.

Recovery from addiction in the Midwest near Avellanas, Guanacaste carries a particular stigma in small communities where anonymity is impossible. The farmer who attends AA at the church where everyone knows him is performing an act of extraordinary courage. Healing from addiction in the Midwest requires not just sobriety but the willingness to be imperfect in a community that has seen you at your worst and chooses to believe in your best.

The Midwest's land-grant university hospitals near Avellanas, Guanacaste were built on the democratic principle that advanced medical care should be accessible to farmers' children and factory workers' families, not just the wealthy. This egalitarian ethos persists in the region's medical culture, where the quality of care you receive is not determined by your zip code but by the dedication of physicians who chose to practice where they're needed.

The Midwest's farm crisis of the 1980s drove a generation of rural pastors near Avellanas, Guanacaste to become de facto mental health counselors, treating the depression, anxiety, and suicidal ideation that accompanied economic devastation. These pastors—untrained in clinical psychology but deeply trained in compassion—saved lives that the formal mental health system couldn't reach. Their faith-based crisis intervention remains a model for rural mental healthcare.

The Midwest's revivalist tradition near Avellanas, Guanacaste—camp meetings, tent revivals, Chautauqua circuits—created a culture where transformative spiritual experiences are not unusual. When a patient reports a hospital room vision, a near-death encounter with the divine, or a miraculous remission, the Midwest physician is less likely to reach for the psychiatric referral pad than their coastal counterpart. In the heartland, the extraordinary is part of the landscape.

The phenomenon of "Peak in Darien" NDEs — in which the experiencer encounters a deceased individual whose death they were unaware of — has been documented since the 19th century and represents some of the strongest evidence for the veridicality of NDE encounters. The term was popularized by researcher Erzilia Giovetti and refers to cases in which the experiencer meets someone during their NDE who they believed to be alive, only to discover upon resuscitation that the person had in fact died — sometimes only hours earlier. Dr. Bruce Greyson has documented several such cases, including one in which a young girl who had a cardiac arrest NDE described meeting a boy she did not know. She described his appearance in detail, and it was later discovered that a boy matching her description had died in a traffic accident the same day in a distant city, unknown to anyone in the girl's family or medical team. Peak-in-Darien cases are evidentially significant because they rule out the hypothesis that NDE encounters with deceased persons are hallucinated projections of known information. The experiencer cannot project information they do not have. For physicians in Avellanas who have heard patients describe meeting deceased individuals during cardiac arrest, the Peak-in-Darien phenomenon provides a framework for understanding these reports as potentially genuine perceptions rather than wish-fulfillment fantasies.

The phenomenon of 'shared death experiences' — reported by Dr. Raymond Moody and researched by William Peters at the Shared Crossing Project — challenges the neurological explanation of NDEs because the experiencer is healthy and not undergoing any physiological crisis. In Peters' study of 164 shared death experiences, experiencers reported elements identical to classical NDEs: leaving the body, traveling through light, and encountering a transcendent environment. The key difference is that the experiencer is at the bedside of a dying person rather than dying themselves. This eliminates oxygen deprivation, medication effects, and cerebral stress as explanatory factors. Dr. Kolbaba documented several cases of physicians who reported shared death experiences while attending to dying patients — experiences that profoundly shook their materialist worldview and permanently changed how they approach end-of-life care.

The International Association for Near-Death Studies (IANDS), founded in 1981, has played a crucial role in legitimizing NDE research and supporting NDE experiencers. IANDS maintains a peer-reviewed journal (the Journal of Near-Death Studies), organizes annual conferences, operates support groups for NDE experiencers, and serves as a clearinghouse for NDE information and research. The organization's existence reflects the maturation of the NDE field from a collection of anecdotal reports to a structured research discipline with institutional support, peer review, and community engagement. For physicians in Avellanas who encounter NDE reports in their practice, IANDS is a valuable resource — its publications provide the latest research findings, its support groups can be recommended to NDE experiencers who need to process their experience, and its conferences offer continuing education opportunities. The research community represented by IANDS provides the scientific infrastructure upon which Physicians' Untold Stories is built. Dr. Kolbaba's book exists within a well-established tradition of rigorous NDE research, and the accounts it presents benefit from the credibility that decades of systematic investigation have conferred upon the field.

The concept of "sacred space" in healthcare — the idea that certain environments within medical institutions are set apart for spiritual reflection and practice — has gained renewed attention as hospital designers and administrators recognize the healing potential of environments that engage the spirit. In Avellanas, Guanacaste, hospitals that have invested in chapel renovation, meditation gardens, and contemplative spaces report improvements in patient satisfaction and, in some cases, in patient outcomes.

Dr. Kolbaba's "Physicians' Untold Stories" supports the case for sacred space in healthcare by documenting moments where patients' spiritual experiences — many of which occurred in or near sacred spaces within hospitals — coincided with turning points in their medical care. For hospital administrators and designers in Avellanas, these accounts provide evidence that investment in sacred space is not a luxury but a component of healing-centered design — an acknowledgment that patients heal not only through medication and surgery but through encounters with beauty, silence, and the transcendent.

Dr. Kolbaba wrote: 'I learned that the majority of the physicians interviewed were spiritual beyond what I ever imagined and that they knew there was a power beyond our simple existence, a power who loves us unconditionally and who participates in our lives more than we realize, a power that many of my fellow physicians and I call God.' This revelation from a Mayo Clinic-trained internist carries weight that few other testimonies can match.

What makes Kolbaba's statement extraordinary is not its content — many people believe in God — but its source. A physician trained at one of the world's most prestigious medical institutions, practicing at Northwestern Medicine, with decades of clinical experience, is making a statement about the nature of reality based on empirical observation rather than religious doctrine. For physicians in Avellanas who share similar convictions but fear professional consequences for expressing them, Kolbaba's candor is a form of professional liberation.

Harold Koenig's research at Duke University's Center for Spirituality, Theology and Health represents the most extensive and systematic investigation of the relationship between religious practice and health outcomes ever conducted. Over more than three decades, Koenig and his colleagues have published over 500 peer-reviewed papers examining this relationship across dozens of health conditions, using a variety of research methodologies including cross-sectional surveys, longitudinal cohort studies, and randomized controlled trials. Their findings have been remarkably consistent: religious involvement — measured by frequency of worship attendance, importance of religion, frequency of prayer, and use of faith-based coping — is associated with lower rates of depression, anxiety, substance abuse, and suicide; lower blood pressure and cardiovascular mortality; stronger immune function; faster recovery from surgery and illness; and greater longevity.

These findings are not attributable to a single mechanism. Koenig's research identifies multiple pathways through which religion may affect health: social support from religious communities, health-promoting behaviors encouraged by religious teachings, stress-buffering effects of religious coping, and the psychological benefits of purpose, meaning, and hope. Dr. Kolbaba's "Physicians' Untold Stories" complements this epidemiological evidence by providing clinical narratives that illustrate these mechanisms in the lives of individual patients. For researchers and clinicians in Avellanas, Guanacaste, the combination of Koenig's systematic evidence and Kolbaba's case-based testimony creates a compelling, multidimensional picture of the faith-health connection that demands attention from the medical profession.