But the placebo can still be a significant part of the armamentarium with which we fight potent pain of all kinds. Psychiatry must take a step back from its neurological love affair and recall its roots, which were biopsychosocial in origin. It is a profession that, from the beginning, intended to treat the whole human, not just his neurons. So much has been lost in the craze to medicate, most especially the magic that happens whenever two people talk or touch.
Stung
Just outside the window of the study I used back before my divorce grows a large apple tree. It had never produced any fruit until two falls ago, when the tree was flush with its first apples. In the haze of its leaves, red globes bent the branches with their weight. When the wind blew, a handful of the apples would release their grip and smash on the ground, cracking open on impact, their interiors a satiny sheen of dense white. As the autumn passed, the fallen apples sweetly rotted, fermenting in the strong sunlight of the Indian summer days and perfuming the air with the smell of spiked cider. Bees and wasps, woozy with hunger, alighted on the gore of smashed fruit and suckled on the sweetness. Their heady humming filled the air. From my study window I could see as many as twenty wasps with their stingers pushed into the plushness, their bodies vibrating as they worked the nectar and juice.
One day, wanting a solid apple before the frosts came, I climbed a rickety ladder and thrust my hand up into the tree’s crisscrossed boughs. As my hand curved around a smooth globe, it was immediately attacked by unseen wasps—sting sting sting. I leapt off the ladder and hurled the apple into the air, pursued as I raced toward the house, hunched and batting at my hair, swatting every which way at the seemingly omnipresent wasps. Once I was inside, with the door slammed shut behind me, the wasps hung in the air on the other side of the glass as if suspended from string, then finally flew away.
My hand had been stung I don’t know how many times, so swollen it was more mitt than hand. The pain was pure fire. I thrust it under a flow of cold water but it continued to grow in a grotesque way. The already taut skin stretched over my hand tighter still, with numerous welts the color of vexed crimson. Oh how it hurt! I turned the water on full force and as cold as it would go but it was no match for the deep and persistent burn of the welts. And then, standing there by the sink, alone in my home with no one to help me, I thought I felt a funny tingle in my lips. The tingle danced its way down my tongue, which I was sure was swelling now too, and came to rest in my throat, which I touched with my other hand in an effort to assess if it too was going to swell, scared now because I’d heard stories of people who died when their throats closed up from anaphylactic shock. I’d never been bitten by a wasp before, not to mention an angry phalanx of them, so perhaps I was allergic and was finding out, as they say, the hard way. Should I go to the hospital? Should I call my husband at work? I was panicked, which made it hard to think, never mind move. I just stood by the sink with my hand still under the running water, trying to trace the tingle. It felt like my lips were growing into two huge scarlet crescents on my face. I pressed on their puffiness with my fingers, thinking, No air, no air, no air.
In the midst of all this the doorbell rang. A delivery man had arrived with a package. Through the plate glass doors, on which a wasp was climbing, I could see his truck rumbling in our driveway. I wobbled my way to the front door and opened it. The delivery man wore a FedEx uniform, which I found somehow comforting, the officialness of it. The package he was holding, an enormous cube wrapped in cardboard with a plastic sleeve, was labeled with my name. If I repeated my name to myself, I wondered, would that help pinion me in place?
The FedEx man held out his electronic signature pad but then, seeing my face, took it back and asked if I was okay.
I told him I’d just been stung by a horde of wasps. “I’m swelling up,” I said, but I couldn’t complete my sentence, not for lack of air but because tears now burned at the back of my throat.
“Let me see,” the FedEx man said softly, and he put down the package and his signature pad. I held out my hand, and he examined my pocked palm and knuckles. “I was an EMT for years,” he explained.
“Why’d you quit?” I asked.
“Ten dollars an hour,” he said.
“Do you ever miss it?”
“Yes,” he said, and then nothing more. With his index finger he traced my raised red welts.
“I think it’s in my throat too,” I said. “I’m afraid my throat is swelling up.”
He palpated my neck, then leaned in close and looked at my lips, all while he stood on one side of the threshold and I on the other. “You’re fine,” he announced.
“I am?” I said, and the relief was real, a weight wafting away.
“Put some cortisone cream on the welts,” he said. “But you’re not having an allergic reaction.”
I asked him how he knew.
He looked at his watch. “We’ve been standing here for four minutes,” he said. “Anaphylactic shock happens very quickly. You’re steady and stable.”
“Oh,” I said, and I thanked him.
“Not a problem,” he said.
“I really mean it,” I said. “Thank you so much. I thought I might be dying.”
“Not today,” he said, and laughed. He held out his electronic pad again. “Sign here,” he said, and I picked up the probe and swept my signature across the electrified surface, watching the magic of my name appearing solid and sure.
Then the FedEx man left. The package he’d brought was huge. It was a tuba, meant for my husband. But I was so relieved not to be dying, so comforted and elated to have been healed by the arrival of the delivery man, that I slit open the package right there on the kitchen floor and lifted the massive brass instrument into the light. The tuba was complexly shaped, flaring into something like a trumpet flower at the place where the music escaped its pipes and curves to rise into the air and meld with the music of other players in a symphony somewhere. I could almost hear it.
I slung the tuba over my shoulder, filled my lungs with all the air they could hold, and blew into the cold round mouthpiece, blew and blew until the instrument finally answered with a solid sound as low as a foghorn, no tremble, a sound that only someone healthy and whole would be able to make. I was that healthy person, standing in a kitchen one autumn day as evening approached. The air smelled like apples and the wasps were on the other side of the window and the sun was descending, casting its late-afternoon rays over the grass and turning it a deeper shade of green, backlighting the pine trees and fringing the clouds with fire. Mysteriously, I wasn’t hurting anymore. The stings were gone, each one like a bubble burst, and my hand and the veins at the rim of my wrist had returned to their normal color, the welts erased by the simple touch of a stranger.
6
Psilocybin (Magic Mushrooms)
God’s Flesh
A Strange Swelling
In February 2008, fifty-three-year-old Carol Vincent found a strange swelling on her body. Having just recovered from a bout of illness, she dismissed it as the last flutterings of the flu. Her fiancé persuaded her to consult her doctor, which she did, almost breezily, assuming he would tell hber that the enlarged knuckle-like node was of no real concern. Instead, as her doctor pressed and palpated, a shadow passed over his face and fear took hold in Vincent. The next thing she knew she was being x-rayed and biopsied. Later, dressed and seated in her physician’s well-appointed office, Vincent was informed that she had lymphoma, a kind of cancer for which there is no cure and no consistently effective treatment either. As days and weeks went by, the strange swelling migrated and multiplied, appearing in her armpit and the cradle of her collarbone.
Vincent, a writer and an entrepreneur who owned an advertising agency in Victoria, British Columbia, had a full life, a life she loved, a life that included a home, a fiancé, a grown son, and meaningful work. A born fighter, she wasn’t ready to give up on any of it. As she waited to find out whether the cancer would progress to the point where it would require radiation and c
hemotherapy, she decided to do everything in her power to conquer her disease. She gave up sugar, caffeine, and flour; she cleansed and juiced, drinking pureed wheatgrass so thick it coated the sides of the cup and left a mark above her mouth. She logged on to the Internet for hours each day, searching for studies, experiments, and medications. Information gleaned from Google informed Vincent that she had seven years to live, ten at the absolute outer limit. “Emotionally it was very stressful,” she said. “An anvil over my head. Every single decision was tricky. Should I drink super clean wheatgrass juice or just eat chocolate chip cookies because life is short? Do I pay off my mortgage or rack up my credit cards?” Before long, when the strange swellings abated, Vincent began to believe that her diet might be healing her. High on hope, she was shattered when the hard nodes returned, in new places on her body. A certain paranoia, or heightened awareness, overtook her. Was an excrescence emerging on her ankle? What was that bump behind her ear? Her body became a bomb, detonating slowly, over days, then weeks, then months, so that even though the end was some unknown number of years away, Vincent began to lose hope.
An Epidural for Death?
Eventually, however, when she was nearing the point of surrendering hope entirely, it would return in the form of Roland Griffiths, a psychopharmacologist and professor of behavioral biology at Johns Hopkins University. Griffiths was in the midst of an experiment that involved giving psilocybin, the active ingredient in so-called magic mushrooms, to fifty-one end-stage cancer patients in an effort to alleviate their fear of death. Psilocybin, along with LSD, a similar hallucinogenic, is in a class of drugs known as psychedelics. As opposed to psychotropic drugs such as Thorazine, lithium, the tricyclics, the MAOIs, and the SSRIs, whose primary function is to alter the mood or function of the brain, the main action of psychedelics is to change actual perception or cognition, bringing the brain somewhere beyond ordinary consciousness.
Trained as a strict scientist and known for his meticulous research methodologies, Griffiths also continues to maintain a rigorous practice of meditation that he began about two decades ago. He is passionate about meditation, maintaining that it “opened up a spiritual window for me and made me very curious about the nature of mystical experience and spiritual transformation,” prompting “an existential question for me about the meaningfulness of my own research program in drug-abuse pharmacology.” His meditation eventually caused a swerve in his thinking, and this stern scientist began to meander and to muse. He started to wonder about wonder itself. And from that wondering grew his interest in psilocybin and its effects on the human psyche. Shifting his laboratory focus away from animals and drugs of abuse, Griffiths homed in on psychedelics. In 2006 he published his landmark study of the drug, straightforwardly titled “Psilocybin Can Occasion Mystical-Type Experiences Having Substantial and Sustained Personal Meaning and Spiritual Significance.”
The idea and the experiment were not new, of course. The novelist Aldous Huxley first tried psychedelics in the early 1950s and famously continued ingesting them to the very end. In 1963, expiring of laryngeal cancer and unable to speak, he made a written request of his wife to inject him with LSD on his deathbed so that he could leave this world in a psychedelic swirl of stars. What Huxley wanted, and what the work of Griffiths could realize, is for death to be less of a physiological process and more of a spiritual one.
Around the time of Huxley’s death, unrelated to the author’s personal experimentation, an anesthesiologist at the Chicago Medical School named Eric Kast, finding normal analgesics insufficient for managing the most intense pain of his dying patients, decided to explore whether LSD might be an effective alternative. In a study published in 1964, he compared the analgesic properties of Demerol and Dilaudid to those of LSD. The subjects of the study were fifty people suffering from various severe cancers, gangrene of the feet and legs, and a single case of shingles. Kast’s statistical analysis showed that LSD proved superior to the more common analgesics. On LSD, not only did the patients develop “a peculiar disregard” for their suffering and for the seriousness of their situations, but also they discussed their death more freely and with considerably less fear.
Building on the success of these findings, Kast went on to study 128 cancer patients to whom he gave 100 micrograms of LSD, this time looking not only at the drug’s potential to alleviate pain but also at its ability to alter attitudes toward illness and death. In this experiment, after the initial administration of the LSD, patients experienced dramatic pain relief in two to three hours, and their fear of death was reduced for ten days following the psychedelic session. Emboldened by these results, Kast did yet another LSD study, this time with eighty people whose malignant and terminal diseases gave them a life expectancy of just weeks or months. All eighty of Kast’s subjects knew about their diagnoses and were fully aware of the limits on their lives. In this group, 100 micrograms of LSD not only offered powerful relief from pain but also brought about “happy oceanic feelings,” along with enhanced communications between patients and an increase in morale and self-regard that made the physiological and spiritual aspects of dying easier to bear.
The Original Magic Mushrooms
Kast and Huxley were among the earliest psychedelic pioneers, but they were not the ones to bring into popular use the drug that would eventually help Carol Vincent and so many others. That honor belongs to R. Gordon Wasson, a public relations executive for J. P. Morgan & Co. and an amateur ethnomycologist—someone who studies the historical uses and sociological impact of mushrooms. As a businessman who wore a pressed suit to work every day, he was hardly a likely candidate for the job of mushroom messenger. In fact, up until his honeymoon Wasson had hated mushrooms, calling them toadstools or “excrescences.” His Russian-born wife, however, convinced him of their majesty and beauty.
Wasson, converted by his wife into a “mycophile,” had heard stories of magic mushroom ceremonies in Mexico that supposedly occurred only under the cover of darkness and were led by a sacred shaman. Research revealed to Wasson and his wife that when Cortés overtook Mexico, he discovered that the Aztecs were using different kinds of mushrooms in their religious rites, calling them teonanacatl, “God’s flesh.” That may be because some of the Indians believed the mushrooms grew only where droplets of Christ’s blood or saliva had graced the ground. The Mexican mushrooms fascinated Wasson and his wife. Were they real? What made them so special? Were they purely a plant of the past or did they still exist? With these questions uppermost in his mind, on June 29, 1955, Wasson and his friend Allan Richardson traveled to a remote Mexican village in Oaxaca, in the Mixtec region, in search of teonanacatl. It was a trip about which Wasson would write a Life magazine story two years later.
The village was small and dusty and sunstruck, its streets eerily empty. At an altitude of 5,500 feet, it was so remote, and the past so well preserved, that even the unique language—Mixtec—was intact. In the town hall Wasson found a young Indian man, a síndico, the official in charge, sitting in a large empty room. Wasson leaned down and asked the síndico if he could help him “learn the secrets of the divine mushroom.” Nothing could be easier, the síndico replied, instructing Wasson and Richardson to come to his house at siesta time. The two men did so and encountered there, in a ravine, hundreds of moist mushrooms. Wasson and Richardson knelt in the grove and gathered their goods, hearing the wet snap of the stems as they picked, piling their finds into a box, and then trudging uphill, high above the síndico’s house, to meet María Sabina and her daughter, the two curanderas, or healers, about whom the síndico had told them. “We showed our mushrooms,” wrote Wasson, and “they cried out in rapture over the firmness, the fresh beauty and abundance of our young specimens. Through an interpreter we asked if they would serve us that night. They said yes.”
Thus Wasson and Richardson found themselves, that evening, as the first known white men ever to partake in an ancient Indian mushroom ceremony. The ceremony took place in the lower chamber of the síndico�
��s house after eight o’clock. At about ten thirty, the curanderas began to prepare the fungi, washing each individual mushroom and praying over the entire lot. The room was filled with Indians sitting on mats, waiting to be served. Children were also present, although they did not partake, and as the evening progressed, they slipped quietly into sleep. Before midnight the mother and daughter shamans passed out the mushrooms, giving each adult a portion and keeping most for themselves. María Sabina snapped a flower from the bouquet on a table to snuff out the candles’ flames and all light was lost. Richardson had promised his wife he would not ingest any mushrooms, the price of her agreeing to his undertaking the expedition in the first place, but he found himself swept into the ceremony, as was Wasson, for whom this was the culminating moment in a long pursuit. Both men bit into the fresh fungi and chewed them slowly.
After ingesting the mushrooms, they lay on their mats in dense darkness, in a world, in a culture radically removed from anything they knew. After half an hour had passed, spectacular visions began appearing to Wasson—a steady stream of gorgeous geometrics, then palaces of pearl, arcades, gardens, chariots pulled by mythological beasts. Each image was perfectly etched, clearer than clear, so that Wasson felt that for the first time he was really seeing reality. Then he suddenly broke away from the body on the mat and floated free. The walls of the home dissolved, and his spirit whirled in space, looking down on caravans of camels passing through ancient archways, a balmy blue lake, and tier upon tier of mountains rising all the way to the horizon.
Throughout the ceremony the shamans sang, chanted, and occasionally danced. Sabina, hands clasped together in prayer, cried out: “Am I not good? I am a creator woman, a star woman, a moon woman, a cross woman, a woman of heaven. I am a cloud person, a dew-on-the-grass person.” Sometimes her voice changed, and this was because God was speaking through her, giving her the answer to whatever question had prompted the mushroom ritual in the first place.
Blue Dreams Page 25
