VANISHING POINT
From my bed I could see a green hill to the south, almost untouched. After hours of darkness, the sun would slowly rise, bringing with it a measure of hope as it traced its arc across the window throughout the day.
It became my vanishing point. For a while, it distracted me from the hospital ward and from my fellow patients. The landscape, still free of development, was punctuated only by a handful of cranes standing on the hilltop. They heralded the arrival of the concrete apartment blocks that, just two months later, are already visible from the entrance to Fernando Fonseca Hospital and from the IC19 motorway. The same concrete that continues to spread throughout the surrounding area, one of the most densely populated regions in the country.
HOSPITALISED AND RESIGNED
This search for escape took place during my stay at Fernando Fonseca Hospital (FFH), better known as “Amadora–Sintra” Hospital.
I was admitted on two separate occasions, between late March and mid-April of this year. It was an experience that touched me deeply, left a lasting impression, and will remain with me forever.
Some moments are extraordinary not because they are brief, but because they unfold continuously over the passing hours, days, and nights. And how long the nights are!
As the hours passed, I became increasingly familiar with the people who, in one way or another, inhabited that place. There were those who, like me, lay confined to a hospital bed, anchored to the same spot, for whom each passing day made the world beyond the hospital walls seem increasingly distant.
Then there were those who never stopped caring for us. They came and went with every shift, moving constantly from room to room in an unending rhythm.
Both shared something in common: lives shaped by routine and permanence, occasionally interrupted by the unexpected.
When I mention those who worked tirelessly to ensure that we lacked nothing, I refer above all to the nursing assistants and nursing staff. I single them out because they were always there. They rotated through shifts whose organisation I never fully understood. Whether they worked eight or ten hours, as I was told, they somehow seemed to reappear almost immediately after the night had passed.
How can that be?
I often found myself asking, sometimes teasing those with whom I had become more at ease:
“Do you ever actually go home? Or do you sleep somewhere nearby so you can be back here so soon?”
Naturally, there are exceptions, but I speak of the overwhelming majority of those I had the privilege of knowing during those weeks.
For those of us who remained in hospital, more or less dependent on others, each day was defined by waiting—and by hope. Hope that, at some point the following day, discharge might finally come.
Among the patients who could still turn their heads despite the tubes and monitors that surrounded them, there was always the novelty of new faces. Stretchers came and went in an endless procession, carrying those arriving and those leaving. At times, I shared with them a fleeting physical closeness imposed simply by circumstance.
No one chooses their neighbours there. The curtains both protected and separated us. During the most intimate and vulnerable moments, they would be drawn, leaving only voices—and sometimes groans—to reach the others. Later they would be opened again, and everything returned to plain view.
Some remained fully conscious and could interact, even if only through gestures. Others could not. More or less withdrawn, they cried out in pain, lamented suffering that seemed almost unbearable, or simply gave voice to a loneliness that had nowhere else to go.
Adapting to this environment was not always easy. Suffering wounds us. The suffering of others does as well. At times, I wondered whether their pain surpassed my own. In truth, it hardly mattered. Especially during the silence and darkness of the night. It was a different kind of pain—but pain nonetheless.
FROM SILENCE TO ABUSE
Some of those around me drifted in and out of consciousness. In certain cases they received a visit, but afterwards remained alone for hours, motionless.
Silent. A silence that was unsettling, and which often became strangely loud.
Yet they were never abandoned. Far from that.
I remember one particular nurse speaking gently to a woman who was perhaps the least responsive patient in the ward. He spoke to her with remarkable warmth, trying, I imagine, to prevent a condition everyone feared might deteriorate further.
“So… you’re not talking to me today?” he asked.
“I’m tired…” she replied.
“I’m the one who’s been working all day and I’m the one who’s tired! Come on, let’s have a little chat, shall we?”
That persistence, that unwavering commitment, where giving up never even seemed to be considered, also knew how to respect silence. It was not performed for anyone’s benefit. It arose, unmistakably, from something deeply rooted within—a quiet, unconditional dedication.
And to think that, on any given day, she could die. How does one return the next day as though nothing had happened?
Watching this unfold moved me profoundly. Nor was it an isolated incident. I witnessed such acts of compassion repeatedly.
I also witnessed the opposite. I saw nursing assistants and nurses verbally abused by others. People passing through the ward called them every name imaginable.
I remember someone quietly drawing a curtain around a colleague—not to shield a patient this time, but to protect a fellow nurse from public humiliation. The very curtain intended to preserve patients’ dignity served instead to preserve hers. A few minutes later, the curtain was opened again. The nurse resumed her work, concealing what had happened as best she could. As though nothing had happened.
It’s beyond imagination!
These are people who work under extremely adverse conditions, constantly overcoming immense challenges, and whose commitment makes an immeasurable difference to those of us fortunate enough to receive their care.
CARING FOR A GROWING METROPOLIS
Fernando Fonseca Hospital is undersized for the population it serves. Everyone knows this.
As I suspected while looking through my south-facing window, apartment buildings continue to rise around it like mushrooms after the rain, covering what little undeveloped land remains.
Beyond the municipality of Amadora, the hospital also serves Sintra, one of Portugal’s fastest-growing municipalities during the 1990s, whose population has continued to expand ever since, albeit at a slower pace.
Primary healthcare services have struggled to keep pace with demand. Across this region, tens of thousands of residents remain without a family doctor. Unable to secure the appointments they need, many eventually turn to the Emergency Department—an alternative that could, and should, often be avoided.
Fernando Fonseca Hospital is therefore the principal referral hospital for approximately 550,000 residents of Amadora and Sintra. By comparison, the Porto metropolitan area, with around 1.7 million inhabitants, is served by several major public hospitals—including São João, Santo António, and Pedro Hispano—allowing patient demand to be distributed across multiple institutions.
Such comparisons are never entirely straightforward and may even be misleading. Yet, when considering the broader Lisbon and Porto metropolitan regions, where several hospitals share responsibility for the population despite also receiving referrals from more distant areas, demand tends to be more evenly distributed.
This is far less true at Fernando Fonseca Hospital, where the pressure is unrelenting.
Contrary to expectations, the opening just over a year ago of the new Sintra Hospital — where I have been receiving competent and dedicated care from the Department of Physical and Rehabilitation Medicine— is still far from helping to ease that pressure.
This is due not only to the fact that it was never intended to operate, like Fernando Fonseca Hospital, as a general emergency hospital. Rather, it was designed to provide scheduled care—particularly outpatient consultations, elective surgery, and diagnostic procedures—thereby allowing Amadora-Sintra Hospital to focus on more complex cases. In addition, it has faced a range of challenges, notably in recruiting healthcare professionals and in opening several of the services that were originally planned.
Furthermore, the Amadora and Sintra region is an area where hundreds of thousands of patients have no access to a GP. People are unable to book the appointments they need and, at times, going to the Accident and Emergency Department becomes the only alternative… one that could and should be avoided.
WHAT MATTERS TO ME
The media invariably focus on waiting times and overcrowding in this hospital’s Emergency Department. Public attention repeatedly—and often uncritically—highlights only what is failing.
I also witnessed — and personally experienced, more recently in that same department — care that I choose not to judge. Yet I do not dwell on what seems to me incidental when set against the experience that has shaped my view of that institution.
FFH. July 2026 © Jorge Murteira. All rights reserved.
What remains foremost in my memory is an extraordinary human community: people who devote themselves wholeheartedly to caring for others while constantly overcoming overwhelming demands.
They leave an environment defined by relentless pressure and stress, return home to care for their children, spend time with their spouses or partners, and then come back to immerse themselves once more in that same world—a place where every minute is lived under continuous tension and responsibility.
Yet none of this diminishes the pride, professionalism, or conviction with which they carry out their work.
A LESSON FOR LIFE
I left the hospital having learned a lesson that will remain with me forever. Much of what I saw and experienced moved me deeply. Without question, it changed me.
That is what I wished to acknowledge and place on record. Because these people have faces. They are real.
They give their time, their strength, and the very best of themselves. Too often, they are treated in ways that are simply indefensible. For that reason, it is important that we look upon them with the gratitude and dignity they so richly deserve.
And it is those very faces—those of everyone shown in these photographs, as well as those who, for one reason or another, are neither pictured nor named here — whom I wish to pay tribute to and express my deepest gratitude and appreciation:
Ana António, Ana Barata, Ana Fontainhas, António Rangel, Catarina Monteiro, Célia Godinho, Cadi Baio, Elisabete Figueiredo, Filipa Santos, Iraildes Soares, Jaqueline Rodrigues, Jéssica Silva, Klavdiya Kykot, Manuela Silva, Mariia Kostashchuk, Miguel Bravo, Renato Dias, Rita Garcia, Sandra Gomes.