Sweet Ketamine O' Mine
"... suddenly the Earth Coincidence Control Office removed my penis and handed it to me.”
This photo is a personal favorite among my surfing shots. It’s such a beautiful wave, the form of it, the way the light hits it, the way it’s poised to break.
I was nothing much of a surfer. I still remember my longest ride, a two-, maybe three-foot wave off Kuhio Beach in Waikiki, even though it was almost 20 years ago. The wave was dying when another one caught it up, so I just kept going.
It took me all the way in to the beach; I stepped off the board as it slowed to a stop in perhaps 18 inches of water. I remember not thinking during the ride, just standing on this ludicrous whale of a board as it gently bumped along, heading into a nice breeze. Just … being, which became a cliché because it’s true.
This is a very crowded break, two of them, in fact, but nobody got in my way, I didn’t get run over by an outrigger, and I didn’t have to think about dodging anyone until just before I reached the beach. I don’t know how long it lasted, but it seemed like a long time—until it ended, when it seemed to have been over in an instant, and my arms were rubbery and I didn’t have the stamina to paddle back out. I was elated.
(Reading this issue of the newsletter will seem like a long time too. One hopes but cannot guarantee that you feel elated when it’s over.)
Famed researcher and psychonaut John Lilly was the unfortunate soul who suffered his penis removed, but he put it right back. That’s not happened to me. I don’t know why either way, but he was taking a fairly high dose of ketamine intravenously while my treatment is a smaller dose of esketamine—one of the two mirrored molecules comprising ketamine—and is administered via a nasal spray.
Both drugs have proved effective at relieving treatment-resistant depression, and particularly at short-circuiting depression with suicidal ideation. I didn’t suffer from the latter but one of the people I met at the clinic had for years, and said the treatment worked wonders immediately and has kept the dogs at a distance ever since.
Why esketamine rather than John Lilly-endorsed ketamine, if the drugs are so similar, you might ask. Because ketamine is dirt cheap, long out of patent, and nobody can make a fortune from it, while esketamine and the nasal spray are patented, FDA-approved, covered by insurance, and cost almost $1000/treatment at the maximum dosage, which is typically administered every two to three weeks after an introductory titration period lasting four weeks and involving eight, twice-weekly treatments.
Janssen Pharmaceuticals developed the drug and spray, and say that esketamine is more powerful than ketamine, so requiring a smaller dose. Hard to prove, one would think, but that’s what they say. I’ve not encountered the Earth Coincidence Control Office so how much stronger can it be?
I decided to try the drug last year during a prolonged bout of depression, of which I’ve a decades-long history, and which nothing has helped much. I had resorted to ECT, which had unpleasant side effects and involved multiple rounds of anaesthesia, the year before the plague. The presiding psychiatrist said it helped, and who’s to argue.
I opted into the esketamine treatment because dragging myself into the clinic daily for a month for transcranial magnetic stimulation (TMS), my first choice, which involves targeted magnetic pulses and is said to work well, seemed a burden too far. The initial twice-weekly esketamine visits sounded manageable.
I’m so glad the TMS was beyond my capacity.
The sessions are conducted in a cozy room with wonderful views of downtown Honolulu’s outskirts, and the not-too-distant mountains. The plush leather sofa with matching love seat and armchair can comfortably accommodate four patients, with an additional chair and rolling table for the attendant and her computer, through which the psychiatrist who owns the clinic watches the patients self-administering the drug-carrying nasal spray to see that it’s properly done.
I was the lone client on my first visit. I chose the love seat directly across from the windows with the view above, filled out the depression inventory, accepted the inert practice applicator from the attendant, and practiced well enough to earn my first live dose, which I snorted like a pro.
After adjusting my plague mask and shades, I settled back and started the music, beginning with the late Eddie Hazel’s poignant guitar on Funkadelic’s Maggot Brain.
The drug began to kick in after about five minutes. I began to feel as though I were falling into the music, and was cushioned and supported by it. My body relaxed and when the second tune, a live version of Pink Floyd’s Comfortably Numb, began to play, I felt fully enveloped by it—and that’s the point at which I stopped thinking until the drug began to wear off perhaps 15 minutes later.
Freedom from thought is my holy grail, and there it was.
The experience is often described as dissociative, similar to an out-of-body sensation. That’s not been my experience—I feel very much of a piece—but I had decided in advance of the treatments to construct a ketamine playlist (K-Hole on my phone) to anchor me during the high and to help, I hoped, recreate the clinical experience at home to whatever extent would be possible by listening to the same music. (I don’t know anyone else who has done this, but someone must have.)
(I couldn’t imagine doing without the music until I left my earbuds at home two months ago and in fact did without the music; not an edifying experience, oh no, oh no. Sitting there, aggrieved, waiting to come down and get home and listen to my music. Not to be repeated. God damn.)
So the anchor wasn’t necessary, as things developed, but it was an excellent decision, and it has provided me the sensation of surfing (if one could surf with the muscle tension of a human puddle) an ocean of music, of riding the musical waves with nothing else intruding, no thoughts, no sounds but the music, no interaction with other people or computers or phones, just a pure, extended moment of relief.
Perhaps two months after the first treatment, I began to feel somewhat odd, mentally, riding the elevator down to street level, and was troubled until it struck me: I felt good.
Just good, no black river running under the surface, and no troubling over-exuberance. When was the last time that happened? Memory fails. The feeling only lasted a day or two, but “only” in this context is relative; the possibility of repeating it exists, and I’m so much more functional now even with the depression still in the background.
My first experience with the highest permitted dosage had me thinking—as the drug kicked in before the thoughts kicked out—”I am too fucking high.” But it went away in a few minutes and all has been well since then, other than the one music-less day.
So: surfing. This was all good, the stuff works, I’m better and satisfied with it and then, about two weeks ago, I experienced an astonishing bout of clarity, like the lifting of a veil, trite as it seems, and I sat down to write, and wrote, for the first time in years feeling capable of developing an idea and converting it into prose, and have been writing since.
(I don’t still feel that degree of clarity, it was crystalline and blinding, but close enough for jazz.)
How was this ever a party drug? The very last desire it would evoke in me is interacting with other people.
The K-Hole playlist is below the “Contributors to this post” list.
(Contributors to this post include Sampa the Great’s The Return; Jay Som’s Anak Ko; Thom Yorke’s Anima; and The Breeders’ Mountain Battles. Music recommendations are welcome.)
K-Hole in order:
Funkadelics’ Maggot Brain, from the eponymous album;
Pink Floyd’s Comfortably Numb, from the live album Pulse;
Bill Frisell’s My Buffalo Girl, from his Good Dog, Happy Man album;
Funkadelics’ Can You Get to That, also from the Maggot Brain album;
Frisell’s cover of the surf tune Pipeline, from the album Guitar in the Space Age;
David Byrne’s and Brian Eno’s Everything That Happens, from their album Everything That Happens Will Happen Today;
Simon and the Bar Sinisters’ Surf the Wild Gowanus, from their Look At Me I’m Cool! LP;
Stevie Ray Vaughn’s amazing instrumental Lenny, from a SRV compilation;
Bill Frisell once again, covering Link Wray’s Rumble, also from the Guitar in the Space Age album;
and Mountain Jam from the Allman Brothers’ Live At Fillmore East album.
It’s about 90 minutes (Mountain Jam alone is more than 30 minutes) but I usually resurface no later than Lenny.)
Off you go now.
Prose Master thee be.
I'm so glad it's worked out well for you. If there's a cooperative compounding pharmacy nearby one might do as some of my clients have done and had some inexpensive nasal ketamine crafted for them.
I'm hopeful about psilocybin/mushrooms as well, but we'll see. John Lilly is used as an exemplar for ketamine addicts; I suppose that of all the psychoactive substances in the world, there's someone out there who would become addicted to it. (When I was testing teens in treatment programs, I did meet a few who were abusing relatively exotic botanicals, for example.)
Thank you for the playlist, and for your well-expressed experience with ketamine and its impact on you.
You've probably heard this, but...
https://youtu.be/1l6z4BUUR1Y