Night Shift Revelations From the Hospitals of Dubuque

Iowa's death customs are rooted in its strong Scandinavian, German, and Dutch immigrant traditions. In the state's numerous Lutheran communities, funerals are followed by church basement luncheons featuring hot dish (casserole), Jell-O salads, and bars—a communal practice so deeply embedded in Iowa culture that it defines the Midwestern funeral experience. The state's Dutch Reformed communities in Pella and Orange City maintain traditions of solemn funeral services emphasizing God's sovereignty and resurrection hope. Iowa's farming communities have a tradition of neighbors handling farm chores for the bereaved family for weeks after a death, a practical expression of solidarity that is as central to Iowa's death customs as any formal ritual.

Iowa's medical history is distinguished by the University of Iowa Hospitals and Clinics in Iowa City, the largest university-owned teaching hospital in the United States. Founded in 1898, it became a pioneer in numerous fields: Dr. Arthur Steindler developed innovations in orthopedic surgery in the early 20th century, and the hospital performed the first successful bone marrow transplant for a genetic disease (severe combined immunodeficiency) in 1968 under Dr. Robert Good. The university's College of Medicine, established in 1870, trained generations of rural physicians who served Iowa's farming communities.

The Iowa Methodist Medical Center (now UnityPoint Health) in Des Moines and Mercy Medical Center (now MercyOne) served as the capital city's major hospitals. Iowa's contributions to public health include Dr. Norman Borlaug, a University of Minnesota graduate raised on an Iowa farm, whose Green Revolution agricultural research saved an estimated billion lives from famine. The state's rural character drove innovations in telemedicine, with the University of Iowa pioneering remote consultation programs for farmers and small-town residents hundreds of miles from specialists. Iowa was also notable for its progressive mental health reforms, with the Mount Pleasant State Hospital (1861) among the earliest state-funded psychiatric facilities in the Midwest.

The United States has been at the forefront of medical innovation since the 18th century. Massachusetts General Hospital in Boston performed the first public surgery using ether anesthesia in 1846 — an event known as 'Ether Day' that changed surgery forever. The 'Ether Dome' where it occurred is still preserved.

Bellevue Hospital in New York City, established in 1736, is the oldest public hospital in the United States. The Mayo Clinic in Rochester, Minnesota — where Dr. Scott Kolbaba trained — was founded by the Mayo brothers in the 1880s and pioneered the concept of integrated, multi-specialty group practice that became the model for modern healthcare.

The first successful heart transplant in the U.S. was performed in 1968, and American institutions have led breakthroughs in everything from the polio vaccine (Jonas Salk, 1955) to the first artificial heart implant (1982). Today, the National Institutes of Health in Bethesda, Maryland, is the world's largest biomedical research agency.

The United States has one of the world's richest ghost story traditions, rooted in a blend of Native American spirit beliefs, European colonial folklore, and African American spiritual practices. From the headless horseman of Sleepy Hollow — immortalized by Washington Irving in 1820 — to the restless spirits of Civil War battlefields at Gettysburg, American ghost lore reflects the nation's turbulent history.

New Orleans stands as the undisputed spiritual capital of American ghost culture, where West African Vodou merged with French Catholic mysticism to create a tradition where the boundary between living and dead remains permanently thin. The city's above-ground cemeteries, known as 'Cities of the Dead,' are among the most visited supernatural sites in the world. Marie Laveau, the Voodoo Queen of New Orleans, is said to still grant wishes to those who mark three X's on her tomb.

Appalachian ghost traditions draw from Scots-Irish folklore, with tales of 'haints' — restless spirits trapped between worlds. In the Southwest, Native American traditions speak of skinwalkers and spirit animals, while Hawaiian culture reveres the Night Marchers — ghostly processions of ancient warriors whose torches can still be seen along sacred paths.

The United States has documented numerous cases of unexplained medical recoveries. In Dr. Kolbaba's own book, a physician describes a patient declared brain-dead who suddenly recovered after family prayer. The Lourdes Medical Bureau has certified one American miracle cure. Cases of spontaneous remission from terminal cancer have been documented at institutions including MD Anderson Cancer Center and Memorial Sloan Kettering. The National Library of Medicine contains over 1,000 published case reports of 'spontaneous remission' across various cancers and autoimmune diseases — recoveries that defy current medical explanation.

Cardiac rehabilitation programs near Dubuque, Iowa 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 Dubuque, Iowa—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 Dubuque, Iowa 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 Dubuque, Iowa 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 Dubuque, Iowa 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 Dubuque, Iowa 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.

Brendan O'Regan's philosophical framework for understanding spontaneous remission, articulated in his writings for the Institute of Noetic Sciences, emphasized the importance of distinguishing between "mechanism" and "meaning" in medical events. O'Regan argued that Western medicine's exclusive focus on mechanism — the biological pathways through which healing occurs — has blinded it to the equally important question of meaning — the psychological, social, and spiritual contexts that may influence whether and how those mechanisms are activated. He proposed that spontaneous remissions often occur at moments of profound meaning-making: spiritual conversions, psychological breakthroughs, life-changing decisions, or encounters with death that transform the patient's relationship to their own existence.

Dr. Kolbaba's "Physicians' Untold Stories" provides clinical evidence consistent with O'Regan's hypothesis. Many of the patients whose recoveries are documented in the book describe their healing as occurring in a context of profound personal transformation — a shift in meaning that coincided with a shift in biology. For researchers and clinicians in Dubuque, Iowa, this correlation between meaning and mechanism offers a potentially productive avenue for investigation. If meaning-making can influence biological healing — and the cases in Kolbaba's book suggest it can — then medicine may need to expand its toolkit to include interventions that address not just the body but the whole person.

The history of spontaneous remission research reveals a persistent tension between the desire to understand these phenomena and the methodological challenges of studying them. Unlike diseases, which can be induced in animal models and studied in controlled laboratory settings, spontaneous remissions occur unpredictably in individual patients, making them nearly impossible to study prospectively. Retrospective case analysis — the primary method used in spontaneous remission research — provides valuable descriptive data but cannot establish causation or identify mechanisms.

Dr. Kolbaba's "Physicians' Untold Stories" confronts this methodological challenge honestly, presenting its cases as carefully documented observations rather than as evidence for any specific mechanism. This epistemic humility is a strength of the book, particularly for researchers in Dubuque, Iowa who appreciate the difference between observation and explanation. The book's contribution is not to explain spontaneous remission but to establish that it occurs with sufficient frequency and consistency to justify the development of new research methodologies — prospective registries, biomarker tracking, immune profiling — designed specifically to capture and study these events as they happen.

The role of intercessory prayer in healing has been examined in over 17 randomized controlled trials, with mixed but intriguing results. The most frequently cited positive study, by Dr. Randolph Byrd at San Francisco General Hospital (1988, published in Southern Medical Journal), randomized 393 coronary care unit patients to intercessory prayer or no intervention and found that the prayer group had significantly fewer complications, required fewer antibiotics, and experienced fewer episodes of congestive heart failure. While subsequent studies have produced contradictory results — including the large STEP trial (2006, American Heart Journal) that found no benefit — the persistence of small but positive effects across multiple trials suggests that the question is not settled. For researchers and clinicians in Dubuque, the prayer literature serves as a reminder that healing may involve variables that our current research methodologies are not designed to capture.