Behind Closed Doors: Physician Stories From Tibás
Second-victim syndrome—the emotional trauma physicians experience after an adverse patient event—remains one of the most underaddressed aspects of burnout in Tibás, San José. Research by Dr. Albert Wu, who coined the term, estimates that half of all healthcare providers will experience second-victim symptoms during their careers, including guilt, self-doubt, and intrusive thoughts. Yet institutional support for these providers remains inconsistent at best. Formal debriefing programs exist in some hospitals, but the culture of medicine still largely expects physicians to "move on" to the next patient. "Physicians' Untold Stories" offers a different mode of processing. Dr. Kolbaba's accounts of unexplained grace in medical settings validate the emotional intensity of clinical work and remind Tibás's physicians that not every outcome is theirs to control—and that forces beyond medicine sometimes play a hand.
Ghost Traditions and Supernatural Beliefs in Costa Rica
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.
Near-Death Experience Research in Costa Rica
Costa Rica's perspective on near-death experiences is shaped by its Catholic majority and the diverse spiritual traditions of its Indigenous and Afro-Caribbean communities. Bribri beliefs about the soul's journey after death — descending through various levels of the underworld before reaching its final destination — share structural similarities with NDE tunnel and journey narratives. The Afro-Caribbean community's beliefs about duppies and spirit survival after death, brought from Jamaica, provide alternative frameworks for understanding consciousness after clinical death. Costa Rica's well-developed healthcare system and high life expectancy mean that many deaths occur in clinical settings where NDE phenomena can be observed and documented. The country's medical community, while primarily trained in evidence-based medicine, operates within a culture that remains deeply Catholic and spiritually open, creating a context where healthcare professionals may be more willing to discuss and document end-of-life experiences than their counterparts in more rigidly secular medical cultures.
Medical Fact
Your body contains about 10 times more bacterial cells than human cells, though bacterial cells are much smaller.
Miraculous Accounts and Divine Intervention in Costa Rica
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.
Ghost Stories and the Supernatural Near Tibás, San José
Farm accident ghosts—a uniquely Midwestern category—haunt rural hospitals near Tibás, San José with a workmanlike persistence. These spirits of farmers killed by combines, PTOs, and grain augers appear in overalls and work boots, checking on fellow farmers who arrive in emergency departments with similar injuries. They don't try to communicate; they simply stand watch, one worker looking out for another.
The Midwest's tradition of barn medicine—veterinarians and farmers treating each other's injuries alongside livestock ailments near Tibás, San José—produced a pragmatic approach to healing that persists in rural hospitals. The ghost of the farmer who set his own broken leg with fence wire and baling twine is a Midwest archetype: a spirit that embodies self-reliance so deeply that even death doesn't diminish its competence.
Medical Fact
Surgeons often listen to music during operations — studies show it can improve performance and reduce stress.
What Families Near Tibás Should Know About Near-Death Experiences
The Midwest's medical examiners near Tibás, San José contribute to NDE research from an unexpected angle: autopsy findings in patients who reported NDEs before dying of unrelated causes years later. Preliminary observations suggest subtle structural differences in the brains of NDE experiencers—particularly in the temporal lobe and prefrontal cortex—that may predispose certain individuals to the experience or result from it.
Clinical psychologists near Tibás, San José who specialize in NDE aftereffects describe a condition they informally call 'NDE adjustment disorder'—the struggle to reintegrate into normal life after an experience that fundamentally altered the experiencer's values, relationships, and sense of purpose. These patients aren't mentally ill; they're profoundly changed, and the therapeutic challenge is to help them build a life that accommodates their new understanding of reality.
The History of Grief, Loss & Finding Peace in Medicine
High school sports injuries near Tibás, San José create a community investment in healing that extends far beyond the patient. When the starting quarterback tears an ACL, the whole town follows his recovery—from the orthopedic surgeon's office to the physical therapy clinic to the first practice back. This communal attention isn't pressure; it's support. The Midwest heals its athletes the way it raises its barns: together.
Spring in the Midwest near Tibás, San José carries a healing power that winter's survivors understand viscerally. The first warm day, the first green shoot, the first robin—these aren't metaphors for recovery. They're the recovery itself, experienced at a physiological level by people whose bodies have endured months of cold and darkness. The Midwest physician who says 'hang on until spring' is prescribing the most effective antidepressant the region produces.
Physician Burnout & Wellness
The specialty-specific patterns of burnout in Tibás, San José, reflect both the unique demands of each field and the universal pressures of modern medicine. Emergency physicians face the relentless pace of acute care and the moral distress of treating patients whose suffering is rooted in social determinants—poverty, addiction, violence—that medicine alone cannot fix. Surgeons contend with the physical toll of long operative cases and the psychological weight of outcomes that hinge on technical perfection. Primary care physicians drown in panel sizes that make meaningful relationships with patients nearly impossible.
Yet across these differences, a common thread emerges: the loss of connection to medicine's deeper purpose. "Physicians' Untold Stories" addresses this universal loss through narratives that transcend specialty. Whether a reader is an emergency physician, a surgeon, or a family doctor in Tibás, Dr. Kolbaba's accounts of the inexplicable in medicine touch the same nerve—the one that first activated when they decided to devote their lives to healing, and that burnout has been slowly deadening.
Telemedicine, accelerated by the COVID-19 pandemic, has introduced new dimensions to physician burnout in Tibás, San José. While telehealth offers flexibility and eliminates commuting time, it has also blurred the boundaries between work and home, increased screen fatigue, and reduced the physical presence that many physicians find essential to meaningful patient interaction. Research published in the Journal of General Internal Medicine suggests that telemedicine may reduce one aspect of burnout (time pressure) while exacerbating another (emotional disconnection), creating a net-zero or even negative effect on overall wellness.
"Physicians' Untold Stories" speaks to the disconnection that screen-mediated medicine can produce. Dr. Kolbaba's accounts are overwhelmingly stories of presence—a physician at a bedside, a patient's eyes meeting a doctor's in a moment of crisis, the laying on of hands that no video call can replicate. For physicians in Tibás who are navigating the trade-offs of telemedicine, these stories serve as anchors, reminding them of what is gained and what is at risk when the healing encounter moves from the exam room to the screen.
The financial toxicity of physician burnout extends beyond institutional costs to the broader healthcare economy in Tibás, San José. When physicians burn out and leave practice, patients lose access, communities lose healthcare capacity, and the economic multiplier effect of physician spending diminishes. A single primary care physician generates an estimated $2.4 million in annual economic activity through direct patient care, ancillary services, and downstream healthcare utilization. The loss of that physician to burnout represents not just a personal tragedy but a significant economic contraction for the local community.
Viewed through this economic lens, investments in physician wellness—including seemingly modest ones like providing physicians with books that restore their sense of calling—represent high-return propositions. "Physicians' Untold Stories" costs less than a single wellness seminar registration, yet its potential impact on physician retention and engagement is significant. For healthcare system leaders in Tibás calculating the ROI of wellness interventions, Dr. Kolbaba's book deserves consideration not as a luxury but as a cost-effective tool for protecting one of the community's most valuable economic and human assets.
Physician suicide represents the most catastrophic outcome of the burnout epidemic, and the data are sobering. An estimated 300 to 400 physicians die by suicide annually in the United States, a rate that is 1.41 times higher than the general population for male physicians and 2.27 times higher for female physicians, according to research published in the American Journal of Psychiatry. The absolute numbers, while tragic, likely undercount actual physician suicides due to underreporting, misclassification, and the reluctance of medical examiners to assign suicide as cause of death for colleagues. Importantly, physician suicide is not primarily a function of untreated mental illness—many physicians who die by suicide were functioning at high levels professionally, masking their distress behind clinical competence.
The Dr. Lorna Breen Health Care Provider Protection Act (Public Law No. 117-105), signed in March 2022, addresses some structural barriers. It funds training programs to improve mental health awareness, allocates grants for evidence-based wellness interventions, and includes provisions to reduce stigma associated with mental health treatment-seeking among healthcare workers. For physicians in Tibás, San José, this legislation represents a meaningful step, but legislative change without cultural transformation is insufficient. Dr. Kolbaba's "Physicians' Untold Stories" contributes to cultural transformation by validating the emotional dimensions of medical practice that the profession's stoic culture has suppressed—dimensions whose suppression contributes directly to the despair that drives suicide.
The Dr. Lorna Breen Heroes' Foundation, established by Dr. Breen's family following her death by suicide on April 26, 2020, has become the most visible advocacy organization addressing physician mental health in the United States. The foundation's efforts have been instrumental in several concrete policy achievements: the passage of the Dr. Lorna Breen Health Care Provider Protection Act, successful advocacy campaigns to remove or modify mental health disclosure questions on state medical licensing applications (with 27 states having made changes as of 2024), and the development of educational resources addressing stigma, help-seeking, and systemic burnout drivers.
The foundation's approach is notable for its emphasis on systemic rather than individual solutions. Rather than urging physicians to "seek help," the foundation advocates for removing barriers to help-seeking and restructuring the environments that create the need for help in the first place. For physicians in Tibás, San José, the foundation's work has tangible local relevance: changes in licensing board questions may directly affect local physicians' willingness to seek mental health treatment. "Physicians' Untold Stories" supports the foundation's mission by contributing to the cultural shift it advocates—a shift toward acknowledging that physicians are human, that their emotional responses to extraordinary clinical experiences are assets rather than liabilities, and that the work of healing exacts a toll that deserves recognition, not punishment.
Research & Evidence: Physician Burnout & Wellness
The international dimension of physician burnout illuminates both universal and culture-specific factors. Research comparing burnout rates across healthcare systems reveals that while burnout is a global phenomenon, its intensity and drivers vary significantly by national context. Studies in the European Journal of Public Health have documented burnout rates of 30 to 50 percent across European systems, with the highest rates in Eastern Europe (where resource constraints are most severe) and the lowest in Scandinavian countries (where physician autonomy and work-life balance are better protected). The United Kingdom's NHS, with its combination of resource scarcity and high ideological investment, produces a unique burnout profile characterized by moral injury as much as exhaustion.
For physicians in Tibás, San José, international comparisons offer both cautionary and aspirational lessons. The Scandinavian models demonstrate that physician burnout is not inevitable but is significantly influenced by system design—suggesting that U.S. healthcare reform could meaningfully reduce burnout if political will existed. "Physicians' Untold Stories" transcends these system-level differences by addressing the universal human experience of being a healer. Dr. Kolbaba's accounts of the extraordinary in medicine resonate across borders because the encounter between physician and patient—and the occasional appearance of the inexplicable—is a feature of medicine itself, not of any particular healthcare system.
The epidemiology of physician burnout has been most rigorously tracked by Dr. Tait Shanafelt's research team, first at the Mayo Clinic and subsequently at Stanford Medicine. Their landmark 2012 study published in the Archives of Internal Medicine established the baseline: 45.5 percent of U.S. physicians reported at least one symptom of burnout, a rate significantly higher than the general working population after controlling for age, sex, relationship status, and hours worked. Follow-up studies in 2015 and 2017, published in the Mayo Clinic Proceedings, documented fluctuations in this rate but confirmed its persistence above 40 percent. Critically, Shanafelt's work demonstrated a dose-response relationship between burnout and work hours, with a sharp inflection point around 60 hours per week—a threshold routinely exceeded by many physicians in Tibás, San José.
The Medscape National Physician Burnout & Suicide Report, conducted annually since 2013 with sample sizes exceeding 9,000 physicians, provides complementary specialty-specific data. The 2024 report identified emergency medicine (65%), critical care (60%), and obstetrics/gynecology (58%) as the highest-burnout specialties, while dermatology (37%) and ophthalmology (39%) reported the lowest rates. Notably, the Medscape data consistently identifies bureaucratic tasks—not patient acuity—as the primary driver of burnout, a finding that indicts the structure of modern medical practice rather than its inherent demands. For physicians in Tibás, these statistics are not abstract—they describe the lived reality of colleagues and of the local healthcare system that serves their community. Dr. Kolbaba's "Physicians' Untold Stories" responds to these data by offering what surveys cannot measure: a reason to keep practicing despite the numbers.
The measurement and quality improvement science behind physician wellness initiatives has matured significantly since the American Medical Association launched its STEPS Forward practice transformation series. The AMA's Practice Transformation Initiative includes modules on preventing physician burnout, creating workflow efficiencies, and implementing team-based care—each developed with implementation science rigor and evaluated for impact. The Mini-Z survey, developed by Dr. Mark Linzer at Hennepin Healthcare, provides a brief, validated instrument for assessing physician satisfaction, stress, and burnout at the practice level, enabling targeted interventions.
The Stanford Medicine WellMD & WellPhD Center, led by Dr. Mickey Trockel and Dr. Tait Shanafelt, has pioneered the Professional Fulfillment Index (PFI) as an alternative to the MBI, arguing that measuring fulfillment alongside burnout provides a more complete picture of physician well-being. The PFI assesses work exhaustion, interpersonal disengagement, and professional fulfillment as three distinct dimensions. For healthcare systems in Tibás, San José, adopting these measurement tools is an essential first step toward evidence-based wellness programming. "Physicians' Untold Stories" complements these measurement approaches by addressing the qualitative dimension of wellness that no survey can capture—the felt sense of meaning that sustains physicians through the quantifiable challenges their instruments measure.
Divine Intervention in Medicine Near Tibás
Interfaith perspectives on divine healing reveal a remarkable convergence across religious traditions. In Christianity, healing miracles are documented throughout the New Testament. In Islam, the Quran describes healing as an attribute of Allah. In Judaism, the prayer for healing (Mi Sheberach) is a central liturgical practice. Hindu traditions recognize the healing powers of prayer and meditation, while Buddhist practices emphasize the connection between mental states and physical well-being. Physicians in Tibás, San José encounter patients from all these traditions and others, each bringing their own framework for understanding the intersection of faith and healing.
"Physicians' Untold Stories" by Dr. Scott Kolbaba is notable for its interfaith sensibility. The accounts in the book come from physicians and patients of diverse religious backgrounds, yet the experiences they describe share striking similarities: the sense of a benevolent presence, the conviction that the outcome was guided rather than random, and the lasting impact on the physician's understanding of their own practice. For the diverse faith communities of Tibás, this convergence suggests that divine intervention in healing may not be the province of any single tradition but a universal phenomenon experienced and interpreted through the lens of each culture's spiritual vocabulary.
The relationship between physician spirituality and patient care is a subject of growing research interest that has particular relevance for the medical community in Tibás, San José. A 2005 study published in the Journal of General Internal Medicine found that physicians who described themselves as spiritual were more likely to discuss spiritual issues with patients, to refer patients to chaplains, and to view the patient as a whole person rather than a collection of symptoms. These physicians also reported higher levels of professional satisfaction and lower rates of burnout.
"Physicians' Untold Stories" by Dr. Scott Kolbaba contributes to this research by documenting how witnessing divine intervention affects physicians' subsequent practice. Several accounts in the book describe physicians whose encounters with the unexplainable led them to become more attentive listeners, more holistic practitioners, and more humble in the face of uncertainty. For the medical community in Tibás, these accounts suggest that openness to the spiritual dimensions of healing may benefit not only patients but also the physicians who care for them—a finding that has implications for medical education, professional development, and the cultivation of resilient, compassionate practitioners.
Tibás, San José knows something about resilience. Through economic shifts, natural challenges, and the everyday trials that define community life, residents have drawn strength from faith traditions that teach the reality of divine care. "Physicians' Untold Stories" by Dr. Scott Kolbaba speaks to this resilience by documenting physicians who witnessed what they believe to be divine intervention in the very institutions—hospitals and clinics—where Tibás's residents seek care during their most vulnerable moments. The book offers local readers not merely inspiration but practical affirmation: the faith that sustains them through difficulty is recognized and validated by the medical professionals entrusted with their care.
How This Book Can Help You
The Midwest's tradition of practical wisdom near Tibás, San José shapes how readers receive this book. They don't approach it as philosophy or theology; they approach it as useful information. If physicians are reporting these experiences consistently, what does that mean for how I should prepare for my own death, or my spouse's, or my parents'? The Midwest reads for application, and this book delivers.
About the Author
Dr. Scott J. Kolbaba, MD is an internist at Northwestern Medicine. Mayo Clinic trained, he spent three years interviewing 200+ physicians about their most extraordinary experiences.
Medical Fact
Dopamine, the "feel-good" neurotransmitter, is also responsible for motor control — its loss causes Parkinson's disease.
Free Interactive Wellness Tools
Explore our physician-designed assessment tools — free, private, and educational.
Neighborhoods in Tibás
These physician stories resonate in every corner of Tibás. The themes of healing, hope, and the unexplained connect to communities throughout the area.
Explore Nearby Cities in San José
Physicians across San José carry extraordinary stories. Explore these nearby communities.
Popular Cities in Costa Rica
Explore Stories in Other Countries
These physician stories transcend borders. Discover accounts from medical communities around the world.
Related Reading
Do you think physicians hide their extraordinary experiences out of fear of professional judgment?
Dr. Kolbaba found that nearly every physician he interviewed had a story they'd never shared.
Your vote is anonymized and stored locally on your device.
Medical Fact
Frequently Asked Questions
Ready to Discover the Stories Medicine Never Says Out Loud?
Physicians' Untold Stories by Scott J. Kolbaba, MD — 4.3 stars from 1018 readers. Available on Amazon in paperback and Kindle.
Order on Amazon →Explore physician stories, medical history, and the unexplained in Tibás, Costa Rica.
