The Courage to Speak: Doctors Near Sete Cidades Share Their Secrets

Portugal made significant early contributions to tropical medicine due to its vast maritime empire. Garcia de Orta, a 16th-century Portuguese physician stationed in Goa, India, published "Colóquios dos Simples e Drogas" (1563), one of the first European works on tropical pharmacology and the medicinal plants of Asia. The Hospital de Todos os Santos in Lisbon, founded in 1492 by King João II, was one of the largest hospitals in Renaissance Europe and a model for healthcare administration.

Portugal's Institute of Tropical Medicine (Instituto de Higiene e Medicina Tropical), established in 1902, became a world center for research on diseases affecting Portuguese colonial territories. Egas Moniz, a Portuguese neurologist at the University of Lisbon, won the Nobel Prize in Physiology or Medicine in 1949 for developing the prefrontal leucotomy (lobotomy) — a procedure now controversial but groundbreaking at the time. He also pioneered cerebral angiography in 1927. Modern Portugal's Serviço Nacional de Saúde, established in 1979, provides universal healthcare, and Portuguese medical centers have become leaders in areas including liver transplantation and regenerative medicine.

Portugal's ghost traditions are shaped by Celtic roots, Roman influence, medieval Catholicism, and the distinctive "saudade" — a uniquely Portuguese word describing a deep emotional longing for something absent, which extends to relationships with the dead. Portuguese folklore is populated by a rich array of supernatural beings: the "almas penadas" (suffering souls) who return from Purgatory seeking prayers, the "mouras encantadas" (enchanted Moorish women) who guard buried treasure in ancient ruins, and the "bruxas" (witches) who can take the form of animals and commune with the dead.

In northern Portugal, particularly in the Trás-os-Montes region, folk beliefs about the dead remain remarkably vibrant. The "estadão" or "procissão dos mortos" mirrors the Galician Santa Compaña — a ghostly procession of the dead witnessed at crossroads and near cemeteries on certain nights of the year. Portuguese maritime culture adds a distinctive dimension: centuries of seafaring produced legends of ghost ships, spectral sailors, and the ghosts of navigators lost in the Age of Discovery. The legend of the "Nau Catrineta," immortalized in a famous Portuguese folk ballad, tells of a phantom ship and its spectral crew.

The Portuguese tradition of "Encomendação das Almas" (Commendation of Souls) is a remarkable Lenten practice still observed in some rural villages. During the nights of Lent, a solitary figure — the "encomendador" — walks through the village streets calling out prayers for the dead in a haunting chant, reminding the living of their obligations to deceased souls. This tradition, documented since the medieval period, represents one of Europe's most atmospheric surviving rituals connecting the living and the dead.

Portugal's miracle tradition centers on the Sanctuary of Fátima, one of the world's most important Catholic pilgrimage sites. On October 13, 1917, an estimated 70,000 people — including skeptical journalists and secular observers — witnessed the "Miracle of the Sun," in which the sun appeared to dance, spin, and plunge toward the earth. This mass-witnessed event, reported in secular newspapers including "O Século" and "O Dia," remains one of the most challenging events for skeptics to explain. The shrine's medical bureau evaluates healing claims, though with less institutional formality than Lourdes. Portugal also venerates the Holy Queen Isabel (1271-1336), whose miracle of the roses — bread being transformed into roses when she was caught distributing alms against her husband's wishes — is central to Portuguese Catholic identity and hagiography.

Sleep researchers at Midwest universities near Sete Cidades, Azores 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 Sete Cidades, Azores—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 Sete Cidades, Azores 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 Sete Cidades, Azores 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 Sete Cidades, Azores 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 Sete Cidades, Azores—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 AWARE II study (AWAreness during REsuscitation), published by Dr. Sam Parnia and colleagues in 2023, expanded on the original AWARE study with a multi-center investigation involving 567 cardiac arrest patients at 25 hospitals in the US and UK. The study employed a groundbreaking methodology: placing concealed visual targets near the ceilings of resuscitation rooms, visible only from an above-body vantage point, to test whether patients reporting out-of-body experiences could identify these targets. Additionally, the study used real-time EEG monitoring to correlate reported experiences with brain activity. The results were complex and provocative. While no patient successfully identified a concealed target—a finding that critics used to argue against the veridicality of out-of-body experiences—the study documented several cases of verified awareness during cardiac arrest, including one patient who accurately described specific resuscitation procedures that occurred while they had no measurable brain activity. Moreover, the EEG data revealed unexpected spikes of brain activity—including gamma wave bursts and electrical signatures associated with conscious processing—occurring up to an hour after the heart stopped, challenging the assumption that brain function ceases within seconds of cardiac arrest. For physicians in Sete Cidades, Azores, the AWARE II findings have direct clinical implications. They suggest that patients undergoing cardiac arrest may retain awareness far longer than previously assumed, raising ethical questions about resuscitation discussions conducted at the bedside. "Physicians' Untold Stories" by Dr. Scott Kolbaba documents physician accounts consistent with these findings: patients who reported detailed awareness of events occurring during documented periods of cardiac arrest. Together, the controlled research and the clinical testimony paint a picture of consciousness as more resilient than neuroscience has assumed—capable of persisting, and perhaps even expanding, during the very conditions that should extinguish it.

The phenomenon of "peak in Darien" experiences—deathbed visions in which dying patients see deceased individuals whose deaths they had no way of knowing about—represents some of the strongest evidence for the objective reality of deathbed visions. The term was coined by Frances Power Cobbe in 1882 and refers to John Keats's poem describing the Spanish explorer Balboa's first sight of the Pacific Ocean—a vision of something vast and unexpected. In Peak in Darien cases, dying patients describe seeing recently deceased individuals—often relatives or friends—whose deaths had not been communicated to them and, in some cases, had not even been discovered by the living. Erlendur Haraldsson documented multiple such cases in his research, including instances in which a dying patient described seeing a person who had died in a different city within the previous hours, before any family member knew of the death. These cases are extremely difficult to explain through hallucination theories because the content of the hallucination (the deceased person) was unknown to the experiencer and subsequently verified as accurate. For physicians in Sete Cidades, Azores, Peak in Darien cases represent the intersection of two categories of unexplained phenomena: deathbed visions and anomalous information transfer. "Physicians' Untold Stories" by Dr. Scott Kolbaba includes accounts consistent with this pattern—dying patients who described seeing individuals whose deaths they could not have known about through normal channels. These cases, if confirmed, constitute evidence that consciousness at the point of death can access information that is not available to the dying person through any known sensory or cognitive pathway—a finding that, if replicated under controlled conditions, would have transformative implications for neuroscience, philosophy of mind, and the understanding of death.

The AWARE II study (AWAreness during REsuscitation), published by Dr. Sam Parnia and colleagues in 2023, expanded on the original AWARE study with a multi-center investigation involving 567 cardiac arrest patients at 25 hospitals in the US and UK. The study employed a groundbreaking methodology: placing concealed visual targets near the ceilings of resuscitation rooms, visible only from an above-body vantage point, to test whether patients reporting out-of-body experiences could identify these targets. Additionally, the study used real-time EEG monitoring to correlate reported experiences with brain activity. The results were complex and provocative. While no patient successfully identified a concealed target—a finding that critics used to argue against the veridicality of out-of-body experiences—the study documented several cases of verified awareness during cardiac arrest, including one patient who accurately described specific resuscitation procedures that occurred while they had no measurable brain activity. Moreover, the EEG data revealed unexpected spikes of brain activity—including gamma wave bursts and electrical signatures associated with conscious processing—occurring up to an hour after the heart stopped, challenging the assumption that brain function ceases within seconds of cardiac arrest. For physicians in Sete Cidades, Azores, the AWARE II findings have direct clinical implications. They suggest that patients undergoing cardiac arrest may retain awareness far longer than previously assumed, raising ethical questions about resuscitation discussions conducted at the bedside. "Physicians' Untold Stories" by Dr. Scott Kolbaba documents physician accounts consistent with these findings: patients who reported detailed awareness of events occurring during documented periods of cardiac arrest. Together, the controlled research and the clinical testimony paint a picture of consciousness as more resilient than neuroscience has assumed—capable of persisting, and perhaps even expanding, during the very conditions that should extinguish it.

The ethics of acting on clinical premonitions present a dilemma that medical ethics has not addressed—and that Physicians' Untold Stories raises implicitly for readers in Sete Cidades, Azores. A physician who orders an additional test because of a "feeling" is, strictly speaking, practicing outside the evidence-based framework. But if the test reveals a life-threatening condition that would otherwise have been missed, the physician's decision is retrospectively justified—not by the evidence-based framework but by the outcome. This creates an ethical tension between process (following evidence-based protocols) and result (saving the patient's life).

Dr. Kolbaba's collection includes accounts where physicians navigated this tension in real time, making clinical decisions based on premonitions and then constructing post-hoc rational justifications for their choices. For readers in Sete Cidades, these accounts raise important questions: Should clinical intuition be incorporated into medical decision-making? If so, how? And who bears the responsibility when a premonition-based decision leads to a negative outcome? These are questions that the medical profession will eventually need to address, and Physicians' Untold Stories provides the clinical case material for that conversation.

Every account of a medical premonition in Physicians' Untold Stories involves a physician making a choice: to act on the premonition or to ignore it. In Sete Cidades, Azores, readers are discovering that this choice—and the courage it requires—is one of the book's most compelling themes. A physician who acts on a premonition is acting without data, without protocol, and without professional cover. If the premonition proves correct, the physician may never tell anyone how they really knew. If it proves incorrect, the physician has ordered unnecessary tests, delayed other care, or deviated from standard practice without justification.

Dr. Kolbaba's collection documents physician after physician making this choice—and the emotional texture of their accounts reveals that the decision to act on a premonition is rarely easy. The physicians describe anxiety, self-doubt, and the fear of appearing irrational, alongside the urgency and conviction that the premonition generates. This internal drama—the conflict between training and experience, between professional norms and personal knowing—is what gives the book's premonition accounts their particular emotional power and what readers in Sete Cidades find most relatable.

Historical accounts of physician premonitions extend back centuries. Hippocrates described physicians who received diagnostic insights in dreams, and Galen reported cases in which patients' dreams accurately predicted the course of their illness. In the 19th century, the Society for Psychical Research documented multiple cases of physician precognition, including a celebrated case in which a physician dreamed of a patient's hemorrhage hours before it occurred and arrived at the hospital in time to save the patient's life. These historical accounts are remarkably consistent with the modern physician premonitions documented by Dr. Kolbaba, suggesting that the phenomenon is not a product of modern medical culture but a persistent feature of medical practice across historical periods.