THE BIANNUAL
CONTROVERSIES IN PERIOPERATIVE MEDICINE
PRESENTED BY NORTH YORK GENERAL HOSPITAL
department OF ANESTHESIA
southern portugal
MAY 14 - 20, 2017

Controversies
Evora

sunday may 14
Arrivals in lisbon and on to evora

 

 

For those who like, we can organize hotel rooms, guides, restaurant suggestions, etc for pre-nights in Lisbon. 

For our rendezvous today, we will meet at the Hotel Intercontinental Lisbon at 1:30 pm.   It would be convenient for you to stay here if you are spending extra time in the city beforehand.

Hotel InterContinental Lisbon
Located in the perfect central Lisbon location, The InterContinental is a luxury 5-star hotel overlooking the famous Eduardo VII Park. It is just 500 metres from Marquês de Pombal Square and 700 metres from trendy Avenida da Liberdade's boutiques.  The hotel has chic, spacious guestrooms, many of them with panoramic views overlooking the park's green areas. All rooms have flat-screen TVs and free WiFi.

Lisbon
Lisbon is Portugal's capital, and a city that has been influenced by many disparate and distant cultures over the centuries.  It is the oldest city in Western Europe, inhabited by a series of conquerors – the Celts, Phoenicians, Hannibal and the Carthaginians, Julius Caesar and the Romans, Germanic Vandals and Visigoth tribes, Moors, the Spanish and the forces of Napoleon – before settling down in the 21st century to a contented and tolerant existence that welcomes virtually everyone within its borders. 



The city carries UNESCO World Heritage status and is filled with major monuments and museums - the Jerónimos Monastery, the Tower of Belém, National Azueljo Museum, The Gulbenkian, National Coach Museum, The Roman Theater, The Opera House, The Castle of São Jorge and many other major sites. 

But Lisbon’s real allure lies in its historic neighbourhoods, the lively areas filled with local bars, family restaurants and fado houses.  You can walk easily from spot to spot and an evening in the Bairro Alto will stay with you forever. 

From our pick-up point it will be a 1 ½ hour transfer to our 5-star hotel Convento do Espenheiro just outside the UNESCO classified town of Evora. 

Convento do Espinheiro, a Luxury Collection Hotel & Spa, Evora
Hotel Convento do Espinheiro is a gorgeous 15th-century golden-stoned convent recently renovated into a deluxe 5-star hotel. It is a member of Starwood’s top-tier Luxury Collection.  It is set within 23 acres of olive groves, vineyards and parkland with lots of outdoor space including a magnificent pool with views of the mountains in the distance.  There are also an exercise room, a large spa with multiple treatment rooms, indoor pool, steam and sauna, whirlpool, 2 bars and a restaurant that serve both indoors and outdoors around the cloister. 

Check-in and some time to unpack, play tennis, take a swim, visit the spa, enjoy a glass of wine by the pool. 

Evora
Evora is a UNESCO World Heritage Site and a member of The Most Ancient European Town Network.  It has been shaped by more than 20 centuries of history, going as far back as Celtic times. It fell under Roman domination and still retains, among other ruins, those of the Temple of Diana.

During the Visigoth period, the Christian city occupied the surface area surrounded by the Roman wall which was restructured. Under Moorish domination, which came to an end in 1165, further improvements were made to the original defensive system as shown by the fortified gate and the remains of the ancient Kasbah.

There are a number of buildings from the medieval period, the best known of which is the Cathedral that was completed in the 13th century. But it was in the 15th century, when the Portuguese kings began living in Évora on an increasingly regular basis, that Évora’s golden age began. At that time, convents and royal palaces sprung up everywhere - St Claire Convent, the royal church and convent of São Francisco, not far from the royal palace of the same name, and Os Lóios Convent with the São João Evangelista Church. These are remarkable monuments that are characterized by their Manueline Style that has survived in the major creations of the 16th century.



The 16th century was a time of major urban planning and while Évora has many major noteworthy 16th-century aristocratic houses, the unique quality of the city comes from the coherence of the "less important" domestic architecture of the 16th-18th centuries. There are numerous low whitewashed houses, decorated with Dutch tiles and wrought-iron balconies and covered with tile roofs or terraces which line narrow streets of medieval quarters. It is a type of architecture that is perfectly adapted to the climate and the location.



Évora remained virtually undamaged by the great earthquake of 1755 that destroyed many towns in Portugal, including Lisbon. The city walls were classified in 1920 under national law and conservation measures were implemented in accordance with internationally recognized principles. As a result, despite the transformation of the city during the 20th century, most of its buildings have preserved their structural authenticity and the adaptation to modern times has not jeopardized the atmosphere of the urban setting. 

Those who would like to do so can have their bikes fitted, pedals mounted, special seats installed this afternoon. 

This evening we start with welcome cocktails and introductions in the garden and around the pool. 

Followed by a fun BBQ dinner and garden party enjoying some of the finest sparkling, white, rosé and red wines from the Alentejo region. 

Overnight: Convento do Espenheiro, Evora, Portugal.  

monday may 15
evora


 

 

Buffet breakfast in the restaurant from 7:00 am.

8:00-10:45 am. Medical meeting in the in the Sala São Jerônimo.

Today's Ride:

50 km return ride to the rug-making town of Arraiolos.  The morning’s ride will be totally on dedicated bike paths while the afternoon's will return on beautiful quiet roads.

Today's Hike:

10 km hike through small farms and vineyards along the 16th-century aqueduct built to bring water to the town of Evora.  Possible to transfer up to Arrailos following the hike to visit the rug-making center. 

Aqueduct of Evora
Evora contains one of the Iberian Peninsula's greatest 16th-century building projects, the Aqueduto da Água de Prata. The aqueduct provided clean drinking water to Evora by connecting the city to the nearest constant flowing river, 9km to the north. The channeled water flowed through a complex set of structures that included long tunnels, deep valleys and most impressively, over massive stone aqueducts. This clever design meant that the water from the river could flow unassisted into the Praça do Giraldo, the main square of Evora.  The northern sections of the aqueduct, close to the river Ribeira do Divor, pass through tunnels and channels, but closer to the city, aqueducts had to be built to span the wide valleys. These grand stone arches of the Aqueduto da Agua de Prata were major engineering achievements, and they highly impress most visitors to Evora. The highest of the Evora aqueduct arches is 26 meters high and spans one of the main roads into the city.


Both bikers and hikers will have a guided visit of the premier rug maker Tapetes Sempre Noiva in downtown Arraiolos.  There are a myriad of other small shops and producers nearby. 

Arraiolos
Arraiolos rugs are actually embroidered floor coverings using a cross-stitch technique that completely covers the linen cloth foundation. During the 17th and 18th centuries, the Portuguese aristocracy listed rugs in their catalogues of riches. Their rugs were treasures, with earthy, vibrant colors and intricate patterns.  There were four basic design elements - plants, including two dozen varieties of flowers, geometric patterns based on intricate linear designs of Moorish tiles, animals and birds, real and imaginary, and symbolic shapes such as hearts, crowns and amphorae which may have represented strength, nobility and wealth.



The origins of the techniques used to make the rugs are unclear but it is thought the craft was started in Portugal by the Moors who used carpets as wall coverings and prayer rugs.  When the Moors were ousted from Lisbon by order of King Manuel I in 1496, many of them traveled south to southern Spain and North Africa. But along their route of exile, some settled near the Portuguese trading town of Evora in this village of Arraiolos where fertile land for farming and grazing was available. Historians say the Moors taught their rug-making techniques to local women, and the town`s name thereafter became synonymous with this kind of embroidered rug and the stitch used to make it.

The rugs are still made by the same historically accurate and exacting, labor-intensive technique. In fact, rug-making is one of Portugal`s artisanal traditions and today most rugs are made via a cottage industry dominated by the women of Arraiolos estimated to number around 30,000.   

A sturdy jute backing is used, and an elongated cross-stitch, reinforced by a double thickness of all-wool yarn covers the canvas. There are two grades of stitching - petit point and gros point (or little and big). The smaller stitch takes more time but it is more durable and expensive. It also allows for more intricate designs. The original vegetable dyes, which produced vibrant reds and blues, have been replaced by a varied palette of chemical colors.  Arraiolos rugs are not made on a loom so they can be produced in any size, shape, pattern and color.  They are exported to North America but generally cost about 5X what they do in the town itself.  Easily folded into a suitcase-sized bundle, they can be transported home with no problem.  Tempting?

Lunch at leisure for both bikers and hikers.  Most likely in the town of Arraiolos. 

Biking and hiking continues through the early afternoon but both groups arrive back to the hotel in plenty of time to enjoy the pool and spa.

This evening we transfer to the award winning winery of Quinta do Carmo for a visit, tasting and then wine tasting dinner with Hugo Carvalho.

The Quinta do Carmo is part of the wine group owned by billionaire Joe Berardo and the Bacalhôa Group.  The gardens, the vineyards the beautiful cask ageing cellars from the 15th century will be ours exclusively tonight.

Alentejo Wine
Alentejo is a well-known, highly respected wine region covering about 1/3 of Portugal. This hot, dry area is best known for its red wines, the best of which are sold under the Alentejo DOC (Denominacao de Origem Controlada) title. These wines are typically made from Aragonez (Tempranillo), Castelao and Trincadeira grapes or a rich, ripe, jammy blend of the three. Although famously diverse in its portfolio of native wine grapes, Alentejo has not been sluggish to adopt such globally popular varieties as Syrah andCabernet Sauvignon. Yet one of the most remarkable things about modern Alentejo winemaking is its ability to create auniquely Alentejano wine style from quintessentially French grape varieties.  The Antão Vaz is the star white wine grape of the region, with good acidity and tropical fruit flavors. It also responds well to barrel-fermentation. 

Overnight: Convento do Espenheiro, Evora, Portugal. 

tuesday may 16
evora


 

 

Buffet breakfast in the restaurant from 7:00 am.

8:00-10:45 am.Medical meeting in the Sala São Jerônimo.

Today's Ride:

57 km through gorgeous rolling countryside south to the towns of Viana do Alentejo and Alvito. 

Today's Hike:

9 km from the east near Machede along the Degebe River into the outskirts of Evora. 

Lunch at leisure for both bikers and hikers.

Biking and hiking continue through the early afternoon but both groups arrive back to the hotel in plenty of time to enjoy the pool and spa.

This evening we split into two groups. 

One group will take a short transfer through immense cork forests to The Almendres Megalithic Enclosure for a presentation at the monument as the sun begins to set. 

Almendres Megalithic Enclosure
The Alentejo region contains numerous Neolithic stone formations but the finest is the Almendres Cromlech (Cromeleque dos Almendres).  The 95 standing stones of the Almendres Cromlech form two large stone circles and were once part of a ceremonial site dedicated to a celestial religion. The entire monument was constructed over a very long period, with the first stones laid in 6,000 BC, and was in continual use until 3,000 BC. Many of the stones have ancient patterns and diagrams of unknown meanings, which add to the mystery of the site.  Thankfully, the local government has not fenced off the stones so it seems very uncommercial.  It is also not easy to access the site so there are relatively few visitors compared to similar sites elsewhere. 

Cork
Growing to a height of 70 feet and more, cork oak is a unique and valuable tree species. Unlike many other oak trees, cork oak is an evergreen and does not drop its leaves. The thick and bumpy dark grey bark is the actual part known as “cork.”  During the harvesting of cork, the tree remains alive and standing while large sections of its outer bark - the cork itself - are cut and peeled from the tree. Cork oak is unique in its ability to regenerate its outer bark. After a tree reaches 25 years of age, it can be stripped of its cork once every 9 to 12 years without causing damage to the tree. A single cork oak, which lives up to 200 years, can be harvested over 15 times.

Cork oak is found throughout southwestern Europe and into northwestern Africa as well as in Portugal, Spain, France, Italy, Algeria, Morocco and Tunisia. Portugal, which is home to the largest collection of cork oak trees, is also the world leader in cork production. Here, cork oaks are found in mixed forests alongside other tree species, including a variety of other oaks, stone and maritime pines, and even wild olive trees.

When forests are managed properly, cork oak can provide a sustainable and renewable timber product. Cork is primarily used as a stopper for wine bottles, but also functions as a closure for olive oil and other products. In addition, it’s used to create flooring, furniture and even footwear. Though it is lightweight and elastic, cork remains impermeable to gases and liquids -- the reason it has remained a popular liquid stopper since the times of Ancient Greece.

Cork oak also provides its ecosystem with several benefits. The trees help prevent soil erosion from wind and water, and increase the absorption rate of rainfall. The cork oak forests of the Mediterranean act as a barrier to the advancing process of desertification from North Africa. Furthermore, a harvested cork oak tree stores up to five times more carbon than an unharvested tree, since the tree utilizes additional carbon in the regeneration of its bark. Each year, cork oak forests account for 10 million tons of CO2 absorption.

The cork oak faces many threats such as fire, deforestation, agricultural expansion, disease and climate change. Another threat, counterintuitively, is increased demand for alternative wine stoppers. As we embrace the screw top, plastic, and even glass stoppers, the market for cork decreases and fewer cork oak landscapes will be conserved. 

Ending with a fun and lively dinner at Restaurant Fialho.

The other group will transfer into the UNESCO World Heritage Center of the town of Evora classified as a site of Outstanding Universal Value.  A guided visit of the Cathedral, the three Churches of Loios, St Francis and Graça, The Royal Palace, The Roman Temple and finally ending in Giraldo Square. 

The Renaissance Fountain of Portas de Moura was built in 1556 and carries an original design that includes the globe surrounded by water.

The Holy Spirit College of the Order of Christ, today the nucleus of the University of Évora, was constructed by Cardinal-King Henrique in 1559, and includes 16th-century Mannerist elements, in addition to academic buildings and cloister constructed between the 17th-18th century.

The Royal Palace of Évora was built by King Manuel I in Gothic-Renaissance style and according to some chroniclers, it was in this palace, in 1497, that Vasco da Gama was given the command of the squadron he would lead on his maritime journey to India.

The Palace of the Counts of Basto is a primitive Moorish castle and later residence of the Afonsine dynastic kings. Its outer architecture displays features of Gothic, Manueline, Mudéjar and Renaissance styles.

The Palace of the Dukes of Cadaval is a 17th-century palace built from the remains of an old castle burnt down in 1384.  It later served as The Governor and Royal residences. The palace includes Manueline-Moorish architectural elements, including the Tower of the Five Shields, and its first floor houses a collection of manuscripts, family portraits and religious art from the 16th century.


Dinner will be at leisure with suggestions from tapas all the way to refined gourmet dining.

Overnight: Convento do Espenheiro, Evora, Portugal.  

Wednesday may 17
evora


 

 

Buffet breakfast in the restaurant from 7:00 am.

8:00-10:45 am. Medical meeting in the Sala São Jerônimo.

Today’s Ride

40 or 60 km west past the very impressive Great Zambujeiro Dolmen and through a beautiful system of tiny lakes and rivers surrounding the Serra de Monfurado. 

Today’s Hike:

10 km along tiny vineyard lanes from the village of Valverde, past the astonishing Great Zambujeiro Dolmen to the tiny settlement of Nossa Senhora de Guadalupe.  

Great Zambujeiro Dolmen
The Great Dolmen of Zambujeiro dates from c.4000-3500 BC, is the largest dolmen in Europe, and a treasured protected National Monument of the country. The dolmen is located in an isolated setting, unfenced among olive and cork trees and has been covered by a simple structure only recently to protect against the elements. The main chamber - measuring 8 meters high and 6 meters in diameter - is formed by eight standing stones leaning inward. Leading to the chamber is a 12-meter-long approach corridor made of smaller standing stones.  The capstone has been removed by archaeologists and the artifacts found here (pieces of pottery, flint tools, beads and other items) are on display at the Museum of Evora.  Dolmens are collective funereal monuments that correspond, generally, to the second phase of regional megalithism.  They were built, for the most part, at the end of the Neolithic Period, about 6,000 years ago.

A picnic lunch of petiscos (Portuguese tapas) for both hikers and bikers enjoyed near the great Dolmen. 

Biking and hiking continues through the early afternoon.

This evening we again split into two groups and flip the activities from Tuesday evening.

One group will take a short transfer through immense cork forests to The Almendres Megalithic Enclosure for a presentation at the monument as the sun begins to set.  Dinner at Restaurant Fialho.

The other group will transfer into the UNESCO World Heritage Center of the town of Evora classified as a site of Outstanding Universal Value.  A guided visit of the Cathedral, the three Churches of Loios, St Francis and Graça, The Royal Palace, The Roman Temple and finally ending in Giraldo Square. Dinner at leisure with plenty of suggestions. 

Overnight: Convento do Espenheiro, Evora, Portugal.  

thursday may 18
evora


 

 

Buffet breakfast in the restaurant from 7:00 am.

8:00-10:45 am. Medical meeting in the Sala São Jerônimo.

Today's Ride:

55 km to the ceramic center of Redondo where we will have a chance to visit numerous small artisanal producers

Today's Hike:

12 km from near Terena into the ceramic center of Redondo where we will have a chance to visit numerous small artisanal producers. 

Redondo Ceramics
Hand-painted Redondo Pottery is perhaps the country’s most interesting ceramic production.  It is quite rustic, even rough and simple, with the main decoration of flowers, leaves, the sun, roosters, small cottages, cork trees and shepherds.

Lunch at leisure for bikers, hikers.  Most probably in the town of Redondo. 

Biking and hiking continue through the early afternoon but both groups arrive back to the hotel in plenty of time to enjoy the pool and spa.

This evening is at leisure for everyone. Shuttles will run from hotel to the center of Evora and return every 1/2 hour from 6 - 11 pm.  There is the chance to visit other cultural sites in town, enjoy dinner at a restaurant that tempts you, or simply relax around the pool and have a simple dinner outside in the olive grove or something more elaborate at the award winning restaurant of our hotel.  

Overnight: Convento do Espenheiro, Evora, Portugal.  

friday may 19
evora


 

 

Buffet breakfast in the restaurant from 7:00 am.

8:00-10:45 am. Medical meeting in the Sala São Jerônimo.

Today's Ride:

A choice of 35 km to a wine tasting at Adega Ervideira in Vendinha or carrying on further through Reguengos de Monsaraz to Mourão and a total ride of 65 km. 

Today's Hike:

9 km leaving the Castle of Mourão and following the Guadiana River and the edge of Lake Alqueva.  Possible to wine taste at Adega Ervideira on our return journey. 

Adega Ervideira
The estates of Monte da Ribeira and Herdadinha both belong to the Leal da Costa family, which can be traced back to the Count of Ervideira, a successful farmer who lived between 19th and 20th centuries. The Count, who received his noble title from King Carlos I in recognition for his social work in the region, began producing wine in 1880.  With 370 acres of vineyards, divided between the Vidigueira and Reguengos estates, Ervideira’s administration is held by the family matriarch D. Maria Isabel and her six children.

Lunch at leisure for both bikers and hikers.

Biking and hiking continue through the early afternoon but both groups arrive back to the hotel in plenty of time to enjoy the pool and spa or perhaps pack in anticipation of tomorrow’s departure. 

This evening we enjoy a gala final dinner in the cloister of our hotel’s gourmet Restaurant Divinus. 

Overnight: Convento do Espenheiro, Evora, Portugal.  

saturday may 20
departures for lisbon


 

 

Buffet breakfast in the restaurant from 7:00 am.

Two group transfers will take place this morning.

1.  Transfer to the Lisbon Portela Airport (LIS) arriving there at 8:00 am in case anyone is trying to connect home today on an early flight. 

2. Transfer to the Hotel Intercontinenatl Lisbon in central Lisbon arriving at 10:30 am for those who are staying on in Lisbon for a few days after the trip ends.   If desired, this transfer can carry on and drop you off at the Oriente Train Station in central Lisbon.