Night Shift Revelations From the Hospitals of Naga

The Philippines has a rich medical history blending indigenous healing traditions with Western medicine introduced during the Spanish colonial period. Traditional Filipino healing, practiced by the albularyo (herbalist-healer) and hilot (massage healer/midwife), draws on extensive knowledge of the archipelago's medicinal plants and is still widely practiced, especially in rural areas. The Spanish colonial period established formal medical education, with the University of Santo Tomas Faculty of Medicine and Surgery, founded in 1871, being the oldest medical school in Asia. Filipino physician José Rizal, the national hero, was trained as an ophthalmologist and exemplified the deep connection between medicine and national identity.

Modern Philippine medicine has produced notable achievements despite resource constraints. The Philippine General Hospital (PGH), established in 1907 and affiliated with the University of the Philippines, remains the country's premier public medical center and training ground for physicians. Filipino doctors and nurses serve healthcare systems worldwide — the Philippines is the largest exporter of nurses globally, reflecting both the excellence of Filipino medical training and the economic pressures that drive emigration. The country has contributed to tropical medicine research, and Filipino physicians are recognized for expertise in managing diseases endemic to the tropics. Dr. Fe del Mundo, the first Asian woman admitted to Harvard Medical School (1936), revolutionized Philippine pediatric care and established the first pediatric hospital in the Philippines.

The Philippines possesses one of Southeast Asia's most vibrant and enduring supernatural traditions, reflecting centuries of layered cultural influence from indigenous animism, Spanish colonial Catholicism, and broader Southeast Asian folk beliefs. The aswang, the most feared creature in Filipino folklore, is a shape-shifting monster that can appear as a beautiful woman by day but transforms at night into a winged, viscera-eating predator that targets pregnant women and the sick. Belief in the aswang remains strong in rural Philippines, particularly in the Visayas region, where specific towns — such as Capiz province — are historically associated with aswang activity. The manananggal is a related entity: a woman who can sever her upper body from her torso and fly through the night with batlike wings, trailing her entrails as she searches for victims.

Filipino ghost lore includes a vast array of supernatural beings drawn from pre-colonial Austronesian mythology. The tikbalang is a creature with the head and hooves of a horse but the body of a man, which lurks in bamboo groves and leads travelers astray. The duwende (from Spanish duende) are dwarf-like earth spirits that can bestow fortune or cause illness depending on whether they're treated with respect. The white lady (multo) — a female ghost in a white dress — is among the most commonly reported ghostly apparitions in the Philippines, with sightings associated with specific locations throughout Metro Manila and the provinces. The tiyanak, the ghost of a dead infant or aborted fetus, takes the form of a crying baby in the forest to lure victims.

The Philippines' unique religious character — it is the only predominantly Catholic nation in Asia, with over 80% of the population identifying as Roman Catholic — creates a fascinating duality in supernatural belief. Filipino Catholics commonly integrate indigenous spiritual practices with Catholic devotion: attending Mass in the morning and consulting an albularyo (folk healer) in the afternoon, or wearing Catholic scapulars alongside anting-anting (protective amulets rooted in pre-colonial shamanism). This syncretic spirituality means that belief in ghosts, miracles, and supernatural healing coexists seamlessly with devout Catholic practice, creating one of the world's most spiritually layered cultures.

The Philippines, with its deep Catholic devotion, is one of the most prolific sources of miracle claims in Asia. The Santo Niño de Cebú (Holy Child of Cebu), an image of the infant Jesus given by Magellan to the Queen of Cebu in 1521, is venerated as a miraculous icon, with the Basilica Minore del Santo Niño maintaining extensive records of attributed healings. The annual feast of the Black Nazarene in Manila draws millions of barefoot devotees who believe that touching the centuries-old dark wooden statue of Jesus carrying the cross can heal illness and grant miracles. Marian apparition claims have occurred at multiple Philippine sites, including the 1948 apparitions at Lipa in Batangas, which generated claims of miraculous rose petal showers. Faith healers in the Philippines, particularly the psychic surgeons of the Cordillera region, attracted international attention in the mid-20th century with claims of performing surgery with bare hands — most notably Eleuterio Terte and Tony Agpaoa — though these practices have been widely criticized as fraudulent.

Cardiac rehabilitation programs near Naga, Luzon are discovering that NDE experiencers exhibit different recovery trajectories than non-experiencers. These patients often show higher motivation for lifestyle change, lower rates of depression, and—paradoxically—reduced fear of a second cardiac event. Understanding why NDEs produce these benefits could improve cardiac rehab outcomes for all patients, not just those who've had the experience.

The Midwest's volunteer EMS corps near Naga, Luzon—farmers, teachers, and retirees who respond to cardiac arrests in their communities—are among the most underutilized witnesses to NDE phenomena. These volunteers are present during the resuscitation, often know the patient personally, and can provide context that hospital-based researchers lack. Training volunteer EMS workers to recognize and document NDE reports would dramatically expand the research dataset.

The Midwest's public health nurses near Naga, Luzon cover territories measured in counties, not city blocks. These nurses drive hundreds of miles weekly to check on homebound patients, conduct well-baby visits in mobile homes, and administer flu shots in township halls. Their healing isn't dramatic—it's persistent, reliable, and so woven into the community that its absence would be catastrophic.

The Midwest's tornado recovery efforts near Naga, Luzon demonstrate a healing capacity that extends beyond individual patients to entire communities. When a tornado destroys a town, the rebuilding process—coordinated through churches, schools, and civic organizations—becomes a communal therapy that treats collective trauma through collective action. The community that rebuilds together heals together. The hammer is medicine.

Hutterite colonies near Naga, Luzon practice a communal lifestyle that produces remarkable health outcomes: lower rates of stress-related disease, higher life expectancy, and a mental health profile that confounds psychologists. Whether these outcomes reflect the colony's faith, its social structure, or its agricultural diet is unclear—but the data suggests that communal religious life, whatever its mechanism, is good medicine.

Sunday morning hospital rounds near Naga, Luzon have a different quality than weekday rounds. The pace is slower, the conversations longer, the white coats softer. Some Midwest physicians use Sunday rounds to ask the questions weekdays don't allow: 'How are you really doing? What are you afraid of? Is there someone you'd like me to call?' The Sabbath tradition of rest and reflection permeates the hospital, creating space for the kind of honest exchange that healing requires.

The emerging field of "spiritual epidemiology" — which applies epidemiological methods to study the health effects of religious and spiritual practices at the population level — has produced a substantial and growing body of evidence linking religious participation to better health outcomes. A 2016 meta-analysis published in JAMA Internal Medicine, examining data from over 75,000 women in the Nurses' Health Study, found that attending religious services more than once per week was associated with a 33% lower risk of all-cause mortality compared to never attending. This association remained significant after controlling for social integration, health behaviors, depression, and other confounders, suggesting that religious participation has health effects that are not fully explained by its social, behavioral, or psychological components.

Dr. Kolbaba's "Physicians' Untold Stories" provides case-level evidence consistent with these epidemiological findings — documenting individual patients whose active religious participation coincided with health outcomes that exceeded medical expectations. For epidemiologists and public health researchers in Naga, Luzon, the combination of population-level data and individual case documentation creates a compelling, multi-level portrait of the faith-health connection. The JAMA Internal Medicine findings establish that the association is real and robust; Kolbaba's cases illustrate what this association looks like in the lives of individual patients — patients whose stories put human faces on statistical abstractions.

Research published in the Journal of Clinical Oncology found that cancer patients who described themselves as spiritual reported significantly higher quality of life, lower rates of depression, and greater satisfaction with their care compared to patients who did not identify as spiritual. These findings held even after controlling for disease stage, treatment received, and social support. The study, which involved 230 patients with advanced cancer at Memorial Sloan Kettering Cancer Center, also found that spiritual patients were more likely to engage in advance care planning, more likely to use hospice services, and less likely to pursue aggressive end-of-life interventions — suggesting that spiritual coping promotes not only well-being but also alignment between patient values and treatment decisions. For oncologists in Naga, these findings underscore the clinical relevance of assessing and addressing patients' spiritual needs as a routine component of cancer care.

The concept of "theistic mediation" — the idea that prayer's effects on health are mediated not by psychological mechanisms alone but by the actual intervention of a divine agent — represents the most theologically significant and scientifically controversial claim in the faith-medicine literature. From a strictly scientific perspective, theistic mediation is untestable because it invokes a cause that lies outside the domain of empirical observation. Yet from a theological perspective, it is the most parsimonious explanation for cases where prayer appears to produce effects that no known psychological or biological mechanism can account for.

Dr. Kolbaba's "Physicians' Untold Stories" navigates this tension with remarkable skill. The book presents cases that are consistent with theistic mediation without explicitly advocating for it, leaving readers in Naga, Luzon to draw their own conclusions. Kolbaba's physicians describe what they observed — the prayers, the recoveries, the temporal correlations — without claiming to know the mechanism. This epistemological humility is itself a contribution to the faith-medicine debate, modeling an approach that takes both scientific rigor and spiritual experience seriously without reducing either to the other. For philosophers of medicine and theologians in Naga, the book provides rich material for reflection on the relationship between empirical evidence and transcendent causation.

The field of thanatology—the academic study of death, dying, and bereavement—has generated a rich body of knowledge that informs how communities in Naga, Luzon, support their members through loss. From Elisabeth Kübler-Ross's pioneering work on the five stages of grief (now understood as non-linear responses rather than sequential stages) to William Worden's task model (which identifies four tasks of mourning: accepting the reality of loss, processing grief pain, adjusting to a world without the deceased, and finding an enduring connection while embarking on a new life), thanatological theory provides frameworks for understanding the grief journey.

"Physicians' Untold Stories" engages with each of these theoretical frameworks. For readers working through Worden's tasks, Dr. Kolbaba's accounts can assist with the most challenging task—finding an enduring connection to the deceased—by suggesting that such connections may have a basis in reality. For readers whose experience fits the Kübler-Ross model, the book's accounts of peace and transcendence can gently address the depression and bargaining stages by introducing the possibility that the loss, while real, may not be absolute. For thanatology professionals in Naga, the book provides valuable case material that illustrates phenomena at the boundary of their field's knowledge.

The palliative care movement's approach to total pain—Dame Cicely Saunders' concept that suffering encompasses physical, emotional, social, and spiritual dimensions—has profoundly influenced end-of-life care in Naga, Luzon. Modern palliative care addresses all four dimensions, recognizing that adequate physical comfort is necessary but not sufficient for a good death. Spiritual pain—the existential suffering that arises from questions about meaning, purpose, and what follows death—is often the most resistant to intervention, requiring not medication but presence, listening, and the kind of deep engagement with ultimate questions that healthcare systems are poorly designed to provide.

"Physicians' Untold Stories" addresses spiritual pain through narrative. Dr. Kolbaba's extraordinary accounts engage the reader's ultimate questions not by answering them but by presenting evidence that invites contemplation. For patients, families, and caregivers in Naga grappling with the spiritual dimension of suffering, these stories offer what Saunders called "watching with"—the compassionate presence of a narrator who has been at the bedside and is willing to share what he witnessed, without interpretation or agenda. This narrative watching-with is itself a form of palliative care for the soul.

The theoretical framework of Terror Management Theory (TMT), developed by Greenberg, Pyszczynski, and Solomon based on the cultural anthropology of Ernest Becker, provides a provocative context for understanding the psychological impact of "Physicians' Untold Stories." TMT posits that awareness of mortality is the fundamental anxiety of human existence, and that culture, self-esteem, and meaning systems function as psychological buffers against death anxiety. When these buffers are disrupted—as they are in bereavement—death anxiety surfaces, producing defensive reactions that can impair psychological functioning and interpersonal relationships.

Research testing TMT predictions has been published in hundreds of studies across journals including Psychological Review, the Journal of Personality and Social Psychology, and Psychological Science. The data consistently show that reminders of mortality (mortality salience) increase adherence to cultural worldviews, boost self-esteem striving, and intensify in-group favoritism—defensive reactions that can be either adaptive or maladaptive. "Physicians' Untold Stories" offers an alternative response to mortality salience. Rather than triggering defensive reactions, Dr. Kolbaba's accounts of the extraordinary at the boundary of death may reduce death anxiety directly by suggesting that death is not absolute annihilation but a transition accompanied by meaningful experiences. For bereaved readers in Naga, Luzon, whose mortality salience is elevated by their loss, these accounts may function as a form of anxiety reduction that operates not through denial but through the expansion of what the reader considers possible.