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May 21, 2021 - This Past Weekend - Theo Von
01:50:32
E341 Ketamine Doctor Jason Pooler

Dr. Jason Pooler is the founder and medical director of the Chattanooga Ketamine Center. He and Theo discuss how ketamine therapy benefits people with addiction and trauma, the cultural stigmas and misconceptions of the substance and what Theo is hoping to achieve through his own recent ketamine therapy. Chattanooga Ketamine Center: https://www.infusionketamine.com Music “Shine” - Bishop Gunnhttp://bit.ly/Shine_BishopGunn​ Support our Sponsors Mack Weldon: https://mackweldon.com/TheoUpstart: https://upstart.com/TheoLiquid Death: https://liquiddeath.com New Merch: https://theovonstore.com​ New Tour Dates! https://theovon.com/tourPodcastville mugs and digital prints available now at https://theovon.pixels.com Submit your funny videos, TikToks, questions and topics you'd like to hear on the podcast to tpwproducer@gmail.com. Hit the Hotline 985-664-9503 Video Hotline for Theo Upload here: http://bit.ly/TPW_VideoHotline Find Theo: Website: https://theovon.com Instagram: https://instagram.com/theovon Facebook: https://facebook.com/theovon Facebook Group: https://facebook.com/groups/thispastweekend Twitter: https://twitter.com/theovon YouTube: https://youtube.com/theovon Clips Channel: https://www.youtube.com/channel/UCiEKV_MOhwZ7OEcgFyLKilw Producer: Nick Davis https://instagram.com/realnickdavis Producer: Sean Dugan https://www.instagram.com/SeanDugan/ See omnystudio.com/listener for privacy information. Learn more about your ad choices. Visit megaphone.fm/adchoices

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Recently, I've undergone ketamine therapy, and I wanted to speak with someone who is an expert in that field and to learn more about my experience and learn more about the therapy overall.
Today's guest is the founder and the medical director at the Chattanooga Ketamine Center.
It is Dr. Jason Pooler.
Shine that light on me I'll sit and tell you my stories Shine on me And I will find a song I've been singing just for me Shine on me
Dr. Jason Poohler, thanks for being in here today, man.
Thank you.
I appreciate it.
So you're a doctor of?
Well, I'm an MD, so I'm a physician.
Okay.
And I'm… A medical doctor.
Like you go to four years of medical school after college.
And that's sort of like Dr. Dre.
That's not a regular.
It's like in the United States, you know, the MD is sort of what people think of when they think of physician.
Those are, you know, that's the standard process.
You go to medical school.
Okay.
Then you usually do a residency to sort of subspecialize into a different area of training.
Okay.
And then you go to work.
And so these days you're working in a ketamine.
How did you get working in a ketamine therapy and like where are you at with it right now?
Like are you actually practicing it?
Are you running a practice that provides the therapy to people?
So both.
I was, it's kind of one of those long routes to get back to where you started.
And I originally trained as a general surgeon a long time ago.
And then I went into anesthesia and I did that for about a decade.
And ketamine therapy sort of became more studied as a result of its use in anesthesia.
And because it's an anesthesia medication, but it had some interesting side effects that they looked at over time that they couldn't explain.
And that research is what has brought us to ketamine therapy today in the use of treatment resistant depression and other mental health problems.
What exactly is it used to treat the therapy?
So you can use it to treat a lot of different things.
It depends on what you're doing with it.
The way it is used most often is to help people who have had a lot of problems with depression, who have failed a lot of other therapeutic approaches.
And so what ketamine offers is a new tool to help people who are still suffering tremendously kind of springboard back onto the road of life.
And it's really interesting that the way it works.
It doesn't work like normal antidepressant medicines.
has nothing in common with them.
The way...
So the easiest way to describe it is why they started studying it to begin with.
And that was back almost 20 years ago.
Oh, dang.
They realized that when they gave ketamine to patients getting operations, they required less narcotic pain medicine during the operation, in the hospital, and after the hospital stay than other patients.
And they said, well, why is this?
Why are they having less pain?
They had no explanation.
So they looked at it, and what they discovered was that what it does is it changes your perception of pain.
So you can see something that you've experienced as less painful.
Hence, you don't need as much medication to cover your pain.
I see.
So you're not feeling as much pain because you're not seeing it.
You're not seeing the seed of whatever it was as painful.
So therefore, like the growth of the pain isn't as severe?
At that time, the best way I describe it to people is, I have two daughters, and say we go get flu shots, and one daughter gets a flu shot, and she's like, ow.
And my other daughter, she gets a flu shot and she's like, oh, and her response is much more.
Okay.
We know that the shot is the same, but the response is different.
So one is perceiving something with more distress than the other.
And the way ketamine works is it helps your pain sort of shift from that more visceral response to a more hurt, but I'm okay response.
It's like changing the lens on how you see pain so that you can see things and you can kind of look at them from a distance and sort of go around things that have happened to you, and you can kind of connect to yourself from those places.
And it's not spiritual, but it's not far from it.
Right.
Do you feel like it gives you like a look at yourself?
Like you kind of see yourself.
Whereas a lot of us have a tough time seeing ourselves because we're in ourselves, you know?
Exactly.
Yes, 100%.
Because it's like if you're on the playing field, you can't really see what's going on.
And it sort of puts you up in the stands of your life.
That's interesting.
And you have a lot of places in your past, or a lot of patients that have come to me is, you know, you're living your life and life's hard and people get hurt.
And depending on where they are in their life, they sort of package that up and they put it away because they don't want to feel that anymore.
But it doesn't really go away.
And so those, let's call them firewalls, they're no-go places in your brain.
But they're still sort of resonating through your existence.
So they're shaping typically your relationships and your career.
Right.
And that's like that, what is that movie, Kung Fu Panda?
Oh, I was thinking of Master Ugwe and his We often find our destiny by trying to avoid it.
Oh, yeah.
Interesting.
Yeah, I was thinking of that movie where that boat gets stuck in Boston.
You know what I'm talking about?
Where they go fishing, you know what I'm talking about?
And there's all the storms.
Perfect storms.
Oh, yeah.
Oh, yeah.
Yeah.
That didn't have a good ending, though.
Yeah, it didn't.
But so I see what you're saying.
So yeah, it kind of gives you an experience to step outside of yourself.
So were you able to see that whenever you was working in anesthesia, were you able to see people having that experience?
Like, were you able to visually see that?
or were you not able to grasp kind of the concept of it of exactly that until I'm guessing later which we haven't discussed yet until you got into actually experiencing using ketamine when I was when I was practicing anesthesia I used Anesthesia guy is that hitman that rolls in there.
That's the guy.
A lot of people, some people don't even need, they'll be like, they just want the anesthesia.
Some people.
I have a buddy who's addicted to inoculations.
And he's breaking into Walgreens and doing all the damn whatever it is.
The COVID in the fucking?
I don't know if it was COVID.
It was before this.
So it was just doing flu shots, you know?
But that's, you know, people get into certain things, you know.
But anyway, I don't even know why I told you that exactly, but what I'm trying to tell you right now is just that.
Okay, so yeah, so were you able to see stuff whenever you were working as an anesthesiologist?
Were you able to see some of that?
Or was it more like that you got a stronger idea to work with ketamine and understand it later on?
What I noticed was that when we used it, and we didn't use it a lot.
I mean, you just give them it as part of anesthesia.
They did better.
So everything seemed to work better.
They just sort of seemed more functional.
They had what we saw was they just, they felt better.
They came out of it better.
They got up.
They got around.
And that was sort of how the ball got rolling on why is this happening?
And then they started figuring out that, hey, this is actually doing something in the brain for real, not just some accident.
And then they started experimenting, not experimenting, but they started using it in more of a clinical sense for people who are really struggling.
Because before ketamine, really the only thing that they had was ECT, putting electricity through your head.
And I have taken care of a lot of patients with that, and they did not like that.
And I can see why.
So did you ever have to do that to people?
I did, actually.
I'm not even familiar with that.
Yeah, I did it when I was an anesthesia resident about a decade ago.
They'd bring us a bunch of patients from the psychiatric hospital and they'd line them up and we'd put them to sleep and the psychiatrist would shock their heads.
And we were like wide-eyed and like, is this real?
And I guess it helped.
So you would put them to sleep first?
Yeah, just very briefly.
With like propofol or something.
So you would just make them unconscious just for a few minutes.
And I remember the psychiatrist, she had this head of hair that was huge and it was like gray and kind of like back to the future style.
And she would put these probes on these guys' heads.
And we're kids and we're just like, okay.
Wow, and zap them decently?
Oh, yeah.
Oh, yeah.
Yeah, because we had to paralyze them because when you shocked them, they'd be like...
And what was supposed to be happening?
My understanding is it actually helps a lot of people, but it is not readily accessible.
So we were doing this in a hospital in a recovery room with an anesthesia team in sort of the critical care area of the hospital.
So that's not something that is accessible to 99% of the population any given day.
And so that's sort of the problem.
So this electroconvulsive therapy, this in which small electric currents are passed through the brain, triggering a brief seizure, changes in the brain chemistry quickly reverse symptoms of certain mental health conditions.
So this was almost kind of like a ketamine.
This is ketamine's kind of like that?
No.
Okay.
No, this is what they were doing early on.
This was the only alternative.
Okay, so you go.
To provide what?
Relief from depression.
Okay, I see what you're saying.
Because they still have a therapy.
I have friends that go and get electrocuted a little bit every day.
Yeah.
Yeah.
So that is sort of like the oh yeah, there's a good one.
See that guy right there?
On the left?
Oh yeah.
Oh yeah, he's going deep.
Yeah, that's what they did.
candle in his mouth.
Oh, my God.
Yeah, right.
You know, it's hard to get a lot of people to sign up for that because, I mean, you Google it and you see that and you're like, no, I'll pass.
Yeah, they're grilling that brother up, man, unfortunately.
That's pretty heavy, it seems like, to me.
So how did they evolve out of this?
So this isn't really practiced readily anymore.
It wasn't easy.
You said you had to have a lot of people on site to do it.
So ECT is still used in limited form today.
The problem with it is it's a pretty big deal to do.
And so you don't have doctors' offices doing ECT.
These are special circumstances, usually with patients who have profound problems, usually patients who are in inpatient psychiatric hospitals.
These are not people who are out walking, trying to hold jobs.
So this is a different level.
People who come and seek care for depression, they get talked to by their doctor or their provider and they get put on a medication or something and they go to a therapist and they try and work through that.
And usually at some point, some people sort of hit the wall with that.
Not everybody, but a lot of people are hitting the wall with it.
With ECT?
No, with just going to...
Yeah, that's, I mean, because that seems like, yeah, so you're saying that's more like in psych wards and stuff like that, like bottom of the barrel, really.
They're trying to jumpstart.
I mean, that looks like the damn Lord's jumper cable for it.
You know what I'm saying?
It literally is.
It's like you're trying to jump off the brain.
Wow.
Trying to get it hit to fire again.
Yeah.
And so that's like people who are like, you know, in hospitals mostly, people who are not holding down jobs, people who are not having relationships because they can't.
Okay.
Right.
So the rest of people who are struggling, you know, they go to their doctor, they get put on antidepressants, they go to a lot of therapy.
Right.
That's me.
That's been me.
I'm an example of that.
Yeah.
Yeah.
And so you're sort of chugging along and you're existing, but you're not really, you know, if you look at like the road of life, you want to be on the middle of it and you want to be comfortably cruising down it, you know?
And these are the people who they're like on the shoulder or they fall off into this, they go off on the side of their shoulder and they have a hard time pulling themselves back up.
And it's because the medicines, they help, but they don't necessarily get people to a place of well-being that they're seeking.
You know, there's existing and then there's like really living.
Right.
Yeah, I think I can definitely testament to that.
Yeah, I kind of feel like I don't understand.
One of the reasons I went to get the ketamine therapy is because I didn't know why I'm still on antidepressants.
It's like one of the weirdest medicines that, you know, I was having a tough time when I was like 20 and I went in, they put me on it, or I agreed to be on it.
You know, I mean, I took part in it.
And then now, 20 years later, I'm still on it.
So it's kind of like, like if you broke your leg, you wouldn't have a cast on forever, probably.
So some of that to me is like, what's going on here?
Like, is this something I need to be on forever?
So that's one of the reasons that I went in probably to check it out, you know.
And, you know, it's the work that is being done in this is amazing.
I mean, there are some very smart people who sort of helped shape this sort of treatment path.
And the way I look at it is I look at people who come to me and they have all these symptoms.
Either they're depressed, they're anxious, they can't sleep.
They have like attention problems.
They zone out because they can't zone in.
Then you have people who are like trying to kill themselves or they're addicted to things.
And what it really is, is somewhere within them, they have a lot of pain.
They have a lot of distress.
Something is primarily wrong.
And that is not going away with the antidepressants.
They're just more like a band-aid to it.
They're covering the symptom as opposed to addressing the symptom.
So the driver is usually a pain that is from somewhere in that person's past that they have not been able to truly grieve over and feel like sort of reconnected to themselves.
And as you probably experienced to some degree, when you went into the ketamine room, you could see your pain.
You could see around in yourself and you could kind of go places, those firewalls.
You could kind of look in places that you couldn't look in before because you had the capacity to.
You were sort of protected by the ketamine, so you could look around corners in your mind and see, oh yeah, that's there.
You know, I wish I'd have had a better, I was in there with a therapist, and I think they were just more of like there if I had an issue.
I sometimes wish that somebody would have been like prodding me more or telling me how to, it's almost like when you go snorkeling.
That's what it kind of felt like a little bit.
It was like I'm looking at a lot was going on.
You know, if I felt like I'm on a roller coaster, I felt like the world is kind of, I felt like I was on Space Mountain sometimes with my eyes closed, you know, just kind of like moving through like.
Did you have the round shapes or the square shapes?
I mean, I mean, I think there was a turf war going on because there was a lot of, there was some real, I think it was a lot of shapes out there.
You know, it was definitely like somebody was.
I mean, I remember one time literally yelling out that I was a cryptocurrency.
I thought I was like I went, it got pretty gnarly, you know, like it got pretty gnarly.
Like I remember one time thinking, there's no way I'm going to end up back in my chair in this therapist's office.
I don't know how I'm going to get there from where I am.
I've had some fun, you know.
So that kind of stuff was kind of exciting.
And I think sometimes I got too caught looking at the Experience and not using the experience.
Right.
So that's why I wish that there had been more before I went in to get it that I had had more of an understanding of how to navigate the universe a little bit and how to use the experience.
Yeah.
Because that I didn't have.
That's sort of a so we're learning as we go.
Right.
And so what, and this is relatively recent, ketamine-assisted psychotherapy.
So what is it?
And that's exactly what we're talking about is we know ketamine helps.
We know it works.
Do we know exactly how it works?
People are debating it because you have competing interests, you have competing ideologies.
But we know that people feel better.
Now, what we want to try and do is make that a more durable state.
Not you come in and get your ketamine, you feel good for a couple of days, and then you come back a month later and you get more ketamine because that's going to present a societal problem in time.
If you're always on ketamine, you know, we've kind of done the opiate thing.
So that's one thing that we don't want to do.
Because you have some places that are given you to go home with.
And that is sort of like you can do a lot more with ketamine-assisted psychotherapy.
You can use that place you're in to visit the pain that has brought you to this distress state.
Yeah, there was a moment.
I remember there was a moment where I got to see my dad, be around my dad, right?
And I'd never, my dad died when I was like 16, and he was really older, man.
He was 86 when he passed away, and I was 16. So he was older when I was born.
He was an adult, you know.
He was senior citizen.
But I got to have like this experience around him.
And it was like a real, like it felt like I was around him.
And I got to let him know, I got to, you know, I felt like my dad never knew how much I loved him.
I felt like I had just never gotten to an age where I could tell him that I loved him, you know?
And I didn't realize how much that was kind of haunting me, I think, somewhere inside of me, you know, like I just never knew like that that was such a big thing going on underneath me somewhere.
And I literally got to have a moment or a little bit, a couple moments with him in an emotional state, kind of.
It felt like anyway, to me, it felt very real to me that I was letting him know how much I loved him.
And that's priceless because there was no other way to do that.
I mean, there may have been, but I hadn't found that yet.
Yeah, that is core to what ketamines psychotherapy gives people access to.
It's like those little gaps, those little holes in our heart that happened to us when we're young shape a lot of our life.
And so to be able to reach back in time and find yourself then and there in sort of that grief, pain of separation that you didn't get to have with him, you could connect to yourself and sort of complete, almost in a way, like the grieving process.
So you could release that tension from yourself.
That distress that's in there and it's always in there.
And you don't know how to get it out.
And you're pushing through life and a couple of decades go by and you're like, it's still haunted by things.
And some people are not able to even see some of those things because I've taken care of people.
I mean, I've taken care of some pretty funny people, you know, like I have trees in my room where I do it and they're like sitting there and they're, you know, they're giggling.
And they're like, oh, that tree just got up and ran out of here.
And I'm like, okay.
And, but then some of them start singing for me.
And then some people start like trying to do yoga poses in their chair.
Really?
And I'm like, you can't quite do that right now.
And they, you know, no, I mean, this gets a little wild.
Well, I remember even being a child, I remember getting, something was wrong with my penis when I was young.
And they had to like, like, I had like a small urine hole or whatever.
I mean, I could pee probably 11 feet.
You know what I'm saying?
Like, I could really pee.
And it was, people were like, oh, he's magic and stuff.
People, you know, small town people think you're, you know, with a rival church or something, you know, all kinds of shit.
But so anyway, yeah, they said they had to cut the hole larger on my uretha, I think it's called urethra.
So I remember we went in, they put me on anesthesia, and when I came out, I asked where all the big black women are at.
And I remember the doctor telling my mom that, like, we thought it was just the craziest thing.
And my mom had said that before when I was even younger, I'd had a surgery and I had a law, a big black nurse, was the nurse.
So I wonder if maybe there was just some moment that was like stuck in my head, like through those little kind of deals.
But anyway, I don't know why I went off on this tangent, but I guess I just wanted to know, like, yeah, I guess, is there what's happening during the experience when somebody gets the ketamine, what's happening?
So the way I do it is I put a IV in them so I can like turn it up and turn it down so you can slow down if they start getting overwhelmed.
Okay.
Because sometimes people, and you can just see it, you know, they're like, because it's like lots coming at them.
And I'm sitting there and they tend to start having their blood pressure and their heart rate go up because they're getting like, they're seeing stuff.
And so you want to kind of try to minimize that.
You want to make it constructive yet sufficient to like have the experience.
It can't be so low that you're like, I didn't feel anything.
Right.
But you don't want to like, you know, ruin them.
I mean, not ruin them, but you don't want to make it so overwhelming it's no longer useful.
Right.
I see what you're saying.
Yeah.
So you want to kind of have a find a balance.
And yeah, that's what the one I did, the place that I went, they did it and then they kind of just was a low dose until they kind of got to you to a level where they could, where it seemed like it was manageable and effective, I guess, to communicate with the therapist.
Yeah, because what I do is, you know, the way the research was done is you do six infusions and I like to have them come in and I don't usually have somebody start ketamine right away.
I usually want to talk to them because I want to know like their life narrative to some degree.
And then you kind of get an idea where the boundaries are.
Like, you can tell, like, I go through this thing where I'm like, okay, how was, you know, where'd you live?
Where'd you move?
How was that place?
How was this place?
How was first grade?
How was second grade?
And you keep going through it.
And things start popping up pretty fast.
And people don't realize what's in their head.
And then they're like, oh yeah, I forgot about that.
But you can kind of tell, and this is not in ketamine.
This is just sort of getting to know them because you got to know what are you going to do with the ketamine experience.
So I want to have like a roadmap.
And then as we do this, the first couple of sessions, you want to get their sort of like get everything chugging.
You just want to get them into a better state of well-being so that their capacity to examine some of these long-standing things is available to them.
You don't want them to not be able to sort of explore this.
You want them to be in good enough fighting shape that they're like, I can do this.
And we go through it.
And I've had people who couldn't remember entire years of their lives.
These are smart, very successful people who have been, it's like something's been wrong their whole life.
And you start going through it with them.
And it keeps going back further and further and further.
And it's sort of like the beginning of the flick of the wrist on that little thread of pain.
And a lot of times these little firewalls conceal it.
And then they have their ahas and they remember more and more and more.
And I'm not telling them what to remember.
I'm just listening.
And so what are examples of some things?
Right.
And you don't have to be specific to that person, obviously.
Right.
So I had a patient who had a series of moves that were sort of stressful on him as a child.
And after one of the moves, he was very seriously disciplined by his dad to such a degree that he didn't remember it until we sort of toggled the switches around it.
And we started sort of gently like, how is this location?
He was like, that was warm.
That was nice.
How was this location where you moved to?
I didn't like it.
How is this house you lived in this place?
I don't remember.
How is this house?
I remember not being happy.
So already we're pointing to narrowing it.
And he didn't remember in the ketamine session.
And then later that night, he did.
And so then we came back around the next time and we talked about it.
And we sort of work into the, and, you know, I approach this with, I guess the right word is like a great deal of reverence.
You know, these people are sharing with me their emotional pain.
And I'm helping or trying to help them connect to themselves so they can feel whole.
Because all this distress that people have, in a way, it's like incomplete grieving.
Yeah.
And people can't cry that much.
And so they sock it away.
And what the ketamine does is it allows you an opportunity to kind of go back in places that you can't do awake.
You just can't.
And I've seen that.
I've seen patients, I start talking, and you can tell they're like, they don't want to talk about it.
You know, I had a lady who I took care of who I was the first person she told in 40 years that she was raped in high school.
And she's, you know, she's in her 60s and her life has been tough.
And, you know, so her life has been shaped by fear.
Right.
Yeah.
I'm sure fear, probably feeling like she couldn't tell people things, shame.
And it shaped her relationships.
So she was in, you know, not the best relationships because she was put in this state by this experience that had shaped her ability to interact with life.
Right.
And here we are 40 years later, and she's a wonderful lady.
And that's why, I mean, it's like, I feel, I approach it with a great deal of, I think the right word is reverence because it's not sad, but it is like a very important, meaningful, and tender thing to do.
Yeah, 100%, man.
Yeah, I feel sometimes like I'm trying to make rope out of like the tattered, the very frayed pieces of like of my youth kind of as I get older, you know.
And not very frayed.
I'm not trying to have any self-pity or something, but I feel like that's what you try to, as you get older, you're just still trying to make this rope or make a knot out of this, make different knots out of rope that was kind of like ramshackly kind of tied to the beginning of the foundation at certain points.
Yeah, the underpinnings of wellness start early.
Yeah.
And usually attachment, feeling, you know, attachment injury is no joke.
So most children, when I mean most, say 99.999% of kids are loved by their parents.
But what happens is parents can show this much love.
And the child actually needs more love than they get.
And it's not that there's a malicious thing, it's just there's a mismatch.
Right.
And that mismatch creates this like this emptiness, the start of loss or grief or not being cared for.
And depending on how it gets nudged in life, it starts showing up as how they choose relationships, how they try to navigate life.
And if it's really bad, then they start having other things pop up and they get on medicine and it works or it doesn't.
medicines do work.
So let's not say they don't work, but they don't work great.
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Yeah, I notice, I start to notice that the behaviors that I feel like affected me when I was young are behaviors that I now exhibit, you know, and ones that I like imitate, you know, towards others that kind of keep me in a place that is comfortable, even though it's not the best place that I want to be in a lot of times, you know.
The devil, you know.
Yeah, it's interesting, man.
So when people go under the solution, under the ketamine therapy, right?
So I remember like, I mean, I remember like I would, yeah, I wish I'd have had, I think when I went and met with the therapist, we started the same day that I went.
So I do wish that I'd had a little bit more of a breadth of communication with them.
So I'd have probably had, just so that there was a better, so that we're like, okay, these are five points that we want to try and attack, you know, or meander around or things, you know?
Yeah.
Because sometimes I felt like, not that I was wasting my time, but that I was wasting the experience.
And I may not have been.
It could just be me being judgmental, but because I think it was helpful, but there were times where I felt like I was just kind of swimming through some of the same waters without really knowing what we were looking for or trying to do.
That's sort of the.
But that may be okay.
Maybe that's just what you do sometimes with it.
Well, and that's why, you know, this is an ongoing evolution in care because ketamine-assisted psychotherapy really hasn't existed very long.
Because you're right, people were like, okay, what are we doing with it?
And then as we started to, you know, explore what we could do with it, we realized that, hey, we can do a lot more than we thought.
When did it start?
Ketamine-assisted psychotherapy?
Yeah, or even just ketamine assist.
Like, when did ketamine start?
I mean, everybody always calls it a horse trank all the time, you know?
Well, ketamine was originally, I think it was invented in, what, the 50s or 60s?
And it is, it's an anesthesia medicine.
So horse tranquilizer, anesthesia, it's a dissociative anesthetic by definition.
Okay.
Okay.
So you use it to help put people to sleep for operations or procedures.
And is it found in nature or no?
It's not?
No.
No.
Not that we know of.
It could be out there.
Do you think it could be or no?
Probably not.
But yeah, there are other things that are sort of like synthesized in 62 by Professor who's tested on animals, which provided promising results.
It was used for testing on human prisoners in 64. There you go.
I didn't know that.
Proof to act faster and reduce toxic behavior, which made it the preferable anesthetic choice over PCP.
Damn.
It's interesting.
It's amazing how many drugs used to be just available.
Like, I remember I was working in Mississippi on a farm for a while, and the man said that they used to buy ecstasy at the bar.
They had it, like, in a jar on the bar, and you could go buy it.
You could buy a tab of ecstasy.
Like, before it was, I guess, illegalized, you know, like there was a brief time where it was a legal drug you could buy.
They, you know, prior to like, I think it was 1970, the LSD and all that psychedelic research was actually going really strong.
And what happened was I think the government finally said enough because it started beginning, it was recreating too much.
That was when you had sort of like the hippies and LSD and all that stuff.
And so when they shut it down, they shut down all the research too.
So it clobbered the ability to investigate all these kind of interesting substances for real clinical aid, you know, use.
Roll the ball forward, you know, 20, 30 years.
And now you actually have like the government is very interested in some of these therapies.
And the real reason is the state of veteran health.
You know, you have so many veterans that are struggling.
And, you know, they have these organizations that are trying to reach out to veterans.
But the suicide rate among veterans is just really horrible.
Wow, I didn't even know that.
Yeah, I saw a metric a while ago.
It was like more combat veterans from Afghanistan have killed themselves than have died in the line of fire.
Wow.
So you think about they're that distressed, and then they come back here and they just, you know, go back to work.
And it doesn't work that way.
And so the government's funding research on this stuff because they got to figure out how to help people.
Yeah, and it'll help save them money too if they can not to put it right there, but also, yes.
It is, but it's actually providing the gas for helping actual therapies that work as opposed to just throwing dollar bills at things.
Yeah.
So that's, you know, I'll take it, you know, if we can help get serious about it.
Yeah, for sure.
And so those are types of people.
So can people really use this therapy to get off of antidepressants and how does that work?
Short answer is don't know.
What I have seen, and like I said, this is sort of on the fly.
Like this whole body of knowledge has grown a lot is people who have profound distressors in their life that are underaddressed are going to have probably pressure to have symptoms.
So they're going to be in depressed states.
And if you can help people, through something like ketaminous assisted psychotherapy, resolve those long-standing pains of emotion in them, then it stands to reason that the odds of them finding a way forward are better.
That makes sense.
It's sort of a wishy-washy statement, but it's the same thing.
It's like, you know, at my place, we sort of break down why people are depressed.
And you sort of break them into these categories where you have your groups that's more like serotonin and then you have your dopamine people.
So I actually ask my patients, I'm like, what gets you high?
I'm like, what's booze do for you?
Or what's cocaine do for you?
Or shopping or gambling?
Because you're trying to stratify them.
Like, what's goosing them?
Right, right, right.
And so that helps you pick your therapy.
Because if you've got a guy who can't stand cocaine or stimulants like that, then it's probably, he probably needs more serotonin.
So you can sort of shape what you do for them to help him with that.
And you can mix it.
So it's all becoming like this basket of ketamine sits alongside a lot of other tools.
And if you're using all of them together and you're helping this person who comes to you unpack what they're carrying and you give them better tools in their pack to go on, then the odds of them staying on the road are better.
Right.
And that's sort of like how integrative psychiatry works now.
It's like you don't just say, hey, here's your prescription, get out of my face.
You actually sit down and you talk to them and find out why they're suffering.
Not, oh, you have depression.
It's like, okay, what's wrong?
What hurts?
When did it get started?
How has it shaped you?
Can you talk about it?
In what level of detail can you talk about it?
And that's why, I mean, it's a very, like, almost a, it's a very intimate conversation.
Yeah, you know, that's a great, that's a great word, intimate.
It felt really intimate, you know?
I remember, I mean, right when I started going there, I just started, tears just like rolled out of my eyes, you know?
Like, I don't even know what was going on, really, you know?
I think it could have just been like, I mean, me, I'm always probably 30% sad, so who knows what it was, you know?
But, but I remember it just being pretty emotional right out of the gate.
And the first day I was dehydrated, literally, just from like crying, I think half of the whole session.
And some of it, I didn't even realize I was crying.
Like, I didn't even really feel it because I was kind of also, you get kind of, you're kind of anesthetized in a way.
So the main part of me that's still awake is kind of this, kind of that all-knowing place inside of your head where you have ideas and stuff, you know?
Yeah.
Like whenever you're thinking about something, you envision something like that place, you know.
I have had quite a few patients that, and I tell them this, I'm like, hey, you know, a lot of them tend to feel pretty quiet.
Like they have like all the mental movie is sort of taking a break when they're done for their session for the day.
And they kind of like, I'm like, yeah, just roll with that.
Don't do any homework.
Just sort of like try to, you know, I try to keep them on zero.
And I say, it is, you know, very possible that if you just start burst out into tears later tonight, that's normal.
Yeah.
That means like you're, you've connected to something and that's like an overdue release.
And so I remember I was talking to this young lady and she was, she was upset.
She was like, what am I crying?
I can't stop crying.
I was like, you're going to hate me for saying this, but this is very good.
Because she was just releasing all this things that she had packed up in her.
And the next day, she kind of like, you know, it's like after a good cry, you like, but she cried, you know, a big chunk of her life out in a night.
Yeah.
Yeah, that's a great way to say it.
I think it felt like that, like just a lot of stuff that was going on, you kind of got to like Take the pressure valve off a little bit in some ways.
But yeah, I would like to have another experience with it in the future and be able to know going in, have more of a game plan going in so that I can.
But then one of my issues sometimes is controlling things.
So it's interesting.
So I don't want to go in sometimes to that and try to manipulate, you know, control the situation, you know?
So, which might not even be possible under that.
It kind of depends on your mindset on it.
You know, I think what I try to do is I try to give people a lot of sort of neutralizing information so that they understand exactly what's, you know, the more you understand what's going on and why we're doing this, they sort of their guard starts to come down because really, if you don't want it to work, it's not going to work.
And so you want them to be like, okay, I understand why this is going to happen.
And so one of the best things I like to do actually is find out what they can do with it.
So I do this thing where I give my patients a, it's like a butcher paper.
It's, you know, it comes off a ream, but it's actually graph paper and I haven't put it up on the wall.
And we do these five columns and it's your age down the middle and then where you lived, what your relationships were, what your activities were, and what your substances were.
And you just sort of write it down from zero to today.
And if they can do that, then you can kind of get a, they can sort of look at their life.
And if they can't do that, that sort of shows me where we need to sort of use ketamine to examine some things that are like sort of like their no-go zones.
And I got a number of guys who, they can't finish it because it's sort of like you can't finish it.
And if you can't finish it, then, you know, I don't know how we're going to finish it in this context without it being emotionally brutal on you.
Right.
And that's what the ketamine allows is it takes the edge off looking at things that you can't look at.
Oh, wow.
Yeah, it was interesting.
Like, I wonder if there were things where maybe my being or whatever was just afraid to unwind them or just couldn't, you know, or couldn't find the way into them.
Sometimes it's such a small opening into getting into like an old feeling or an old way.
I see that pop up all the time.
Yeah, it's pretty fascinating.
We got a question that came in right here from a young gentleman right here that seemed like a decent guy right here.
What up?
I got a question for Dr. Pooler and for Theo.
So I wanted to start off, Dr. Pooler.
What is the negative connotations with the ketamine therapy and then what would be your argument against that?
Theo, what was your favorite thing about ketamine therapy versus regular therapy?
Gang Gang.
Gang.
That's a good question.
What you got, Doctor?
So the negative connotations, I think the societal thing is there's sort of a societal sort of frown against like psychedelics in general.
And it got started back probably with like the hippies and LSD.
And so you kind of get this blanket, oh, this is that psychedelic hippie-trippy stuff.
And so it can marginalize its actual utility as a real medical therapy.
And there's an organization called MAPS that is dedicated to doing high-quality research to counterbalance that notion that this is like, you know, step into my van type stuff and to make it legitimate and the proper studies and the proper funding from, you know, like the DOD and things like that because they want it to be as legitimate as possible.
Yeah, it's interesting.
Almost you really have to, like, there has to be a group kind of monitoring that branding and how that really, how it hits the public and stuff like that.
It's a little wild westy right now.
They've even said it in some of the publications because all the ketamine right now, it's technically off-label the way everybody's using it.
Now, a lot of medicines get used off-label all the time.
So is that a problem?
No, but it needs to be looked at down the road because it's like those Saturday Night Live skits in the 80s where you go to your doctor and you get a, hey, Doc, I got a, you know, my pinky hurts.
Oh, here's a prescription for some weed.
You know, remember those skits that were like that?
And it's like, you got to, you got to be careful you don't have the slippery slope because I get mailings from places they want to ship me like ketamine lozenges and stuff.
And that's not going to, that's not going to go well.
Yeah, I don't, I had six infusions like you're talking about.
Like you, like you mentioned, it's probably the probably protocol, not protocol, but it's the best.
No, it's the best.
That's the research.
That's the research.
That is what they ferreted out in the research was the most legitimate and best way to proceed is what you did.
And after four, I felt good after four.
The last two, I felt a little, it got a little griswold-y.
You know, I felt like I was on a, you know, it felt like I was just on a kind of a gnarly vacation.
You know, it was like, I don't really know if I needed the last two or maybe I did.
I don't know.
I just, I think at that point, I started to think, I wish I had a better game plan going into this so I could use it to the best of my ability.
I didn't know if I was using it to the best of my ability.
The therapist was saying, and it was a great place and everything, but he was saying that it'll work kind of no matter what.
Is there some truth to that, that it'll work no matter what?
Yes.
So we know it works.
Okay.
The question is, is how long does it work?
Right.
And what the sort of like the industry, the professional side of this industry is trying to do is make this a very serious, one-time attempt to get as much utility out of it so that the effect is very durable.
And that's why you got to do all the side work with it.
And that's why you want really, really Good assisted psychotherapy because you can sort of unwind things that are still sort of in the background if you're sort of poking around.
And the more things you can resolve, the more your heart can be at rest.
The odds of you needing more of it are less, and that's very desirable.
So, you know, like at my place, I've only had one patient ever need a booster.
And he's a veteran.
And there's some confounders with that.
But most people are, and I don't let them go either.
I don't like, when they come to me, I take them on and we get to know them on the front end, and we're following them on the back end, and I'm taking care of all their other sort of issues.
I don't like send them to places to, you know, you come to me and I work with you, and the idea is that we're here to get you into a better place of durable well-being.
We're not here to give you ketamine.
Right.
You're not like a sawmill.
You're doing actual boarding, kind of.
You're actually bringing them on.
What is the number one thing that a lot of veterans struggle with?
What is the some of that trauma you always hear about the PTSD?
There's two things actually, and it's actually interesting the way this is starting to pop up.
So PTSD and actually concussions.
So traumatic brain injuries.
If you take somebody who has been in combat and has had ordnance exploding around them and they've been taking those shockwaves to their head, even though they look fine, it has a pretty serious depressive effect.
And I talked to a guy out in Colorado last week about this.
They're trying to find ways to heal these guys because they tend to be very sensitive to emotional dysregulation.
Because you think about it, you take a fish bowl and you cook up like 30 bags of ramen.
And you put it in a fish bowl.
It's a bigger bowl.
Like a goldfish bowl.
So it's completely full of noodles, right?
Okay, say that's your brain.
And then you hit it with a bat.
The noodles are going to move.
So if you're taking concussions repeatedly, it's going to scramble your noodle.
And so those are nerve connections that are responsible for your daily function.
And as those get ripped apart and try to heal, they don't necessarily get it right all the time.
And so like people are hurt in a way that's hard to address.
Interesting.
Yeah, because it doesn't seem like we're meant to be batted around that much, you know?
No, not at all.
So those are some of the most common things you see as far as veterans is like stuff from concussions, stuff from… The other one is, frankly, the grossness of war.
I mean, you see two of your buddies incinerated in front of you, and that gets on a record that won't come out of your head.
And that's all they can see.
So then they get like super sensitized.
So they're stuck in this place in their mind where they're still driving down that road when that car bomb went off.
And so when they hear a door slam or something, that's a neural circuit that got burned in in the strongest of ways.
So they have this nerve pathway that's just seared into you.
And so it's on alert because it's still there.
And so your neighbor, boom, closes the door and you're like, or you hit the deck or you do those kind of things.
And so that's one of the things that they're proposing that they use ketamine to work with patients on.
Why does trauma create such strong neural pathways or connection?
Does that make sense?
And does it?
It sounds like it must, right?
It does because it's post-traumatic stress.
What happens is when something happens to you, you form a temporary memory.
Like, what did you eat for dinner last night?
You could probably tell me what it is.
Salad.
But two years from now, two years ago, what did you eat for dinner?
I have no idea.
Yeah, I don't know.
So intense experiences make different signals.
Right, but I could tell you if I was in like a boat accident.
Correct.
Now, ramp that up to about 11. And we're Andrea Galen.
Yeah, then it gets pretty deep.
And then you can't forget about it because it's sort of your neurochemistry has decided that this needs to be a permanent reminder, probably from a more… Yeah, more of a fight, flight, or flee type thing.
And so given where we are in the world today.
So it's inflammation kind of then.
Yeah, so those are, yeah, because that's the craziest thing about it is the way the immune system works with your mind is phenomenal.
Like you can even measure it now.
Like, you know how when you get the flu, you feel crummy, you don't want to get off the couch, food doesn't taste good, sex isn't interesting, all that stuff goes away, right?
Imagine being like that, walking around, living life like that.
That happens because your immune system knocks out your dopamine system.
So you don't have access to your dopamine system because you're sick, because of your immune system, because you're supposed to be healing under a tree.
But if you're walking around and you have your immune system activated, you begin to look like somebody who doesn't have access to the feel-good.
Wait, explain that to me again.
Sorry, I got lost.
So your immune system, when you're sick, takes your dopamine system offline.
Oh, that's just what it does?
It does that on purpose so you can heal.
Oh, because they don't want you trying to feel good because you're not going to heal.
Correct.
Right, got it.
But if you're walking around, If you're walking around day in and day out, year in, year out, and your immune system is slightly activated and your dopamine system is always offline, then life is flat and feeling good is inaccessible to you.
And are you depressed or do you just not have access to your dopamine system?
Wow, that's interesting.
Yeah, that's a great question.
And you can check that with, it's actually pretty straightforward to check now.
Now you got to get a simple lab drawn to see if your immune system is activated.
And that helps point therapy.
So like what I do is when people come to me is I check some labs on them.
I get to know them a little bit in ways that I do my thing.
And so I kind of want to know where they're at so we can start shaping what comes next.
And that's before we take them in the room because I look at it as I want this to be as useful as possible.
And then so that when we get to the other side of it, we still are learning things.
But like I had a patient who he was done.
Okay.
But something else popped up in his mind because he was having this problem where on a regular basis, he would have panic attacks at a certain time of day.
Okay.
Like clockwork.
And I talked to him and I was like, what time of day did your dad get home when you were a kid?
And he just stopped.
Same time of day all his life.
Wow.
That's crazy.
But he was able to see it then because before he couldn't even see it.
But now we could talk about it and resolve it.
And so he was able to see it when he was under the therapy.
After, afterwards.
So we were done.
This popped up even later because he was saying, you know, I'm doing pretty good, but I still have this one thing that's popping up on me.
And I said, well, what is it?
We talked about it and I asked him and he's like, yeah.
Yeah.
Did you have a question that came up, Sean?
Sorry, let's get to that.
Oh, actually, this is a comedian friend of mine, Shane Moss, who he is a psychonaut.
So he's like a man who, he's a very funny man, and he also is a man who has experimented with different psychedelics and stuff over the years to have experiences, just like an astronaut would with like outer space.
He's kind of done them with like inner space.
So awesome to have this from him.
Theo, Shane Moss here, in case you can't recognize me.
I hear you're getting ketamine treatment.
I think that's fantastic.
Very, very worth exploring.
See if it suits you.
Psychedelics are not always the most linear thing in the world compared to other medications or drugs or what have you.
But mental health isn't a linear thing either.
And so I wish you the best of luck.
I hope it shows some improvements.
Thanks, man.
And my question for your guest is, I'm wondering if you could talk a little bit about experiential versus chemical change rather than taking, say, an antidepressant every day and altering your chemical imbalance or whatever.
A psychedelic journey is a lot more about using that temporary chemically induced change to have more kind of personal breakthroughs and insights.
And those insights are kind of what leads to the personal growth more than some permanent chemical change that you're doing or a long-term change that you're doing to your mind.
Oh, yeah.
Yeah.
Thanks, brother.
So this is like a two-headed animal here because you have like the neurochemistry of what happens, okay?
And then from there, you have what you experience as a result of the neurochemistry.
And he hit the nail on the head with that is therapy like this allows you to have.
So you're getting therapy or you're getting mood elevation from either therapists or from like a medication you're on regularly.
Well, you have this thing where it's called a rapid gain.
So you're cruising along, all of a sudden you have something that goes way up.
You're like, oh man, I figured that out.
And it goes like that.
But it doesn't work like that.
You actually have to go for a long time.
You don't have those very often with therapy.
So what ketamine does in psychedelics is it's like a lot of access to rapid insight for a prolonged period of time relative to, say, going to therapy for five years.
Right.
And it could be a couple hour, a couple minute actual portal.
Is that what you mean?
Kind of like that?
Well, and that's where you talk about what happens is we know that ketamine helps nerves grow.
So if you have nerves that are firing in a way that is causing you to have a depressed mood state or anxiety, and you basically soak those in ketamine for, say, a period of a couple weeks with six infusions, you can get some plasticity in how those nerves work.
So you can change how those nerves are connected.
They grow a little bit.
They actually like, they've seen it under microscopes.
These nerves actually grow little sprouts and they can change.
And so you're enhancing your ability to change at like a microscopic level.
And that translates into like a change in perspective on things.
Yeah.
Sort of metaphysically.
I mean, this is kind of like we're going into the realm between electron microscopy and spirituality.
You know what I mean?
But it is.
So if you look at it, how a person experiences it is that they can see what they've experienced.
They can find things that they've experienced and connect to themselves more fully.
And if they can be a more full person and have less pain carried in them because they were able to have an emotional release by connecting to a loss from the past, then they're probably going to walk away from it feeling better about life globally.
Yeah, you know, I think that's a good summation a little bit of just what I felt.
I felt like there were new ways to connect.
Yeah.
Kind of.
And I couldn't describe it exactly and I couldn't manage it.
But I felt Like it was helpful.
I felt like when I knew more tricks and how to almost use the controller better, I would go back and play the game again, if that makes any sense.
It does.
So, what's Shane is saying is that, so you're saying that, so academy is more of like an experiential type of thing.
It's both.
So, to the person who's experiencing it, they're gaining sort of a gaining like this alternate or this additional view of things.
They're gaining insight.
They're up here and they can look around themselves more like they're not in the game, sort of like they're looking at the game.
And from that, they can be like, you know, that really, that doesn't hurt as much as I thought.
And they can see like, oh, I never really got over that.
That's been sort of haunting me.
And like, okay, I'm okay.
And so that's what it can provide.
Now, the nice nudge is when you can have somebody like say, well, you remember you mentioned this and let's explore this a little bit and see how those decisions sort of were pushed by emotional distress or pain and rolled the ball through this event.
And then you kind of, so you try and sequence it through life so you don't want to miss things.
Right.
It's the gaps.
The gaps are the key.
Yeah, I could see that.
Yeah, I wish I, yeah, in hindsight, I would go with like a timeline, kind of a little bit of like more of a plan.
I like doing the school thing.
Like the grades, you see.
You know, the one question I like to ask people is, when was the last time you felt whole?
Jesus.
And then what was it that began to separate you from that feeling?
Yeah, I don't even know, man.
I probably was a damn zygote.
Yeah, and then you go back to, if they can't dial it back that far, you go back to like when they were like five, four, three.
When did they feel love?
Two, one blast off is when I probably felt it.
Maybe I don't even know.
Yeah, I don't know.
I mean, I know you're not asking me, but it's just, yeah, it's interesting for people to think that.
The place I was at, the therapist hadn't done the experience.
Does that matter if they've done it or not?
I don't know.
Maybe it doesn't.
It's kind of one of those things.
It depends on where the therapist is.
What made you care about this?
How'd you get into this whole universe?
You know, I did anesthesia for quite some time.
And you were a real doctor then?
Yeah.
Yeah, I have an MD.
And I saw ketamine work pretty well because I did anesthesia, right?
Was it fun being with anesthesia?
It was interesting.
It was fun and it was crazy.
But it was, you know, I mean.
Would you listen to music and stuff where you go in there?
Nothing like that.
Actually, we had a surgeon who would get noise complaints from the other ORs because he would listen to Death Metal all day, and he would turn it up all the way.
And so he sort of had like his own little crew because you kind of have to be like the right, be in the right mindscape to go in there and listen to Megadeth for 12 hours at 80 dB all day long.
Yeah, it's crazy.
You're cracking up in a rib cage and you're all hopped up at night.
The surgeons next door, in the rooms next door, we have one.
It's like being in a hotel.
They'd be like, dude, tell them to knock it off.
But it was crazy.
I mean, it was good, but it was like super busy, super high intensity.
Yeah.
And you have to stay the whole time or you just hit them with that dose and you roll out.
It depends.
But the way our model was, we had nurse anesthetists, and so we worked together with them and they would stay the whole time.
And I would come in and troubleshoot things and get the ball rolling.
And we were at a place where we took care of really sick people.
So it was, you know, it was, but you sort of acclimate to it.
And then you look around and you look at what you acclimated to.
But for me, what got me turned into the corner of this is sort of my understanding of suffering has evolved a lot.
And I had a brother, and he died last year.
He was injured as a child terribly.
And he never could get the help he needed.
And so he did a lot of drugs.
He tried to take his own life several times.
Oh, man.
Sorry to hear that.
He did all these things.
And I was sitting there and he knew he was dying.
He was in hospice.
But I was, you know, looking at what was coming down the pipeline, I was like, you know, if we can help people who've been traumatized, like, it's sort of like for me, it's like, if this would have been around 20 years ago, maybe I'd still have a brother.
Because he was sexually abused as a kid and didn't never tell anybody.
Nobody.
The only reason we found out about it is because our pastor was imprisoned after the fact by somebody else.
Dang.
And so I couldn't figure out what was wrong with him his whole life.
And I asked him one night and he goes, yep.
And I was like, fuck.
But the damage was just like.
Yeah, how much that shapes somebody that's young.
That's, man, that's heartbreaking.
I'm sorry.
Yeah.
So, and I'm sorry for him.
I'm sorry that, you know, it's heartbreaking to see, you know, I've been, you know, a lot of my family and being in recovery and struggling through those, you know, struggling through trauma and stuff like that, childhood trauma, not like that.
But different types of trauma and stuff has been pretty prevalent in my family.
And it's heartbreaking to see the effect that it has on people, you know?
It was, you know, the last six months of his life, I finally got him to say, because he was a crusty guy.
Was he?
Yeah, oh, yeah.
And the last.
Were you guys pretty close?
Yeah.
Oh, that's cool.
And he knew he was dying.
Was he drinking himself to death?
Yeah, he did.
And he had the operations, and he kind of stopped, actually.
But the problem was the damage was done.
But like, you know, one of the last times we spoke, I was sitting with him in the hospital.
He was on hospice.
And for the last six months of his life, I got him to tell me that I told him I loved him every day.
And he was like, I love you too.
And just for him to be able to express emotion was priceless.
And then, you know, one of the last moments we spoke, I said, I love you.
And he said, I love you too.
And then he goes, and he flips me the burden.
I was like, that's Mike.
And so it was like, you know, he knew at least he was loved.
Yeah.
And that was in.
It's important.
I think a lot of people's life, if they struggle with trauma, I think some of it is just, yeah, thinking that people don't care, people that think it unable to feel love.
It's weird how a traumatic event can block off other things, you know?
Yeah.
He didn't have the capacity.
And he never, so he was stuck and he could never get out of it.
And you kind of wonder or hope that if somebody else comes to me and who's a little younger and hasn't burned themselves physically, like damaged themselves enough, that you can help them turn the corner and get healing going in a way that they can get back on the road of life.
And that's sort of, that's, to me, is a very rewarding way to interacting with life.
You know, I can look over my shoulder and be like, I am okay with what I'm doing.
I'm helping people find peace.
Right.
Yeah, man, it's so fascinating how like if you can't, if you don't feel loved or if something makes you feel so unloved or so damaged that then you it's very hard to feel love after that.
Because I think there's just receptors in you that just do not trust it or just do not trust the world almost in a weird way.
And I don't even think you can access it sometimes.
Like that's the that's the such hard thing is to be able to access why or how to change it, to get the clay in your hands.
You know, it feels like you just can't find it.
You know?
So it's fascinating to hear that there's opportunities that this could be a way where people can.
You believe it.
I believe it.
I do.
I really do because I've seen it work.
I've seen it work on a lot of people.
And it's one of those things where it's like you get to see these people come to you and they're just broken.
And the first time you hear them laugh or smile, and you're just like, I'm in the right place.
Yeah.
That's fascinating, man.
Yeah, I noticed after a couple of treatments, I'd had an idea.
I was running one day, and I just had like a good idea.
And I used to have good ideas all the time.
I mean, I'm judging my own ideas, but I thought they were pretty good.
But I used to have ideas a lot.
And I just, for like a year, I just hadn't even gotten an idea.
Like, I've just been kind of living with the pieces of every day, you know?
And it's been fine.
Life has been fine.
I'm not complaining.
I'm not asking for any pity.
I'm just explaining where I'm at.
But I hadn't gotten anything new to come out of my brain, you know?
And so I noticed that.
I was running by some turkeys somewhere at this park.
And then, I don't know, I just got like an idea that was like fun.
And it made me laugh.
It made me smile.
I was like, oh, man, what a gift.
Like when something's able to just kind of travel through us and make us feel good, which is how we probably should be a lot of times, is to be a conduit for joy to at least pass through instead of being kind of a place where something is put up a fence or something is put up like a firewall or, you know, different elements like you're saying.
What are some of the side effects that we honestly do not know about?
Because just to be very honest and transparent with people who are considering this treatment.
So there are limitations, like there are actual limitations.
You can't really have problems with psychotic type problems or schizophrenic type problems.
I can see that.
It's like it doesn't work.
That wouldn't be cool, yeah.
No, and if you have problems with seizures, you really got to look into that because it used to be that ketamine was an automatic no if you have a seizure disorder.
And depending on what's going on with that, they're looking into it.
But the other things is like sometimes what you get is patients actually vomit.
And it happens, and I can almost see it coming now.
It's almost like the physical need to expel bad.
Oh, interesting.
So like I've taken a couple patients very recently and they were super overwhelmed, like way overwhelmed, crushingly.
And they just started vomiting.
And I knew it was going to happen and it wasn't a problem, but they didn't understand it.
I was like, yep.
It's like you needed to get it out.
Wow.
It was like a metaphysical expulsion of badness from them.
Oh, yeah.
And so that, it doesn't happen very often, though.
I could see that.
I could really see that.
Sometimes I think all types of things like that are a mole or something.
You see somebody with a mole and you say, that's a bad, that's somebody, you know, that's a bad idea or something you had, or that's something, you know, that's something bad that happened to you, you know, or sometimes you see like someone, like I'll feel sometimes like when I'm really going through therapy and it's going pretty good, I'll get pretty close to this feeling like there's something in my throat that I never was able to say or like to talk about when I was young.
Or I was afraid to talk.
And so I can almost feel the mass, whatever.
It's not, you know, it's all probably in my head, but it feels very real.
So those connections from your, you know, your core emotional centers are, they're, they're reaching out into everything.
And, you know, if you think about a nerve connection, think of like a thread of hair From an experience to somewhere else in your brain, it's still there.
It's just how often it lights up and it starts pushing on things.
And that's, you know, like post-traumatic stress is the hair is the size of my pinky.
Yeah.
And so it's got domain over your operating system, so to speak.
Yeah.
And, um...
What's the question that came in for...
Do you have another question that came in, Sean?
I do.
I know we have one from a young...
Hey, what is going on, my brother?
I just got a question for Dr. Ketamine as he's in the house.
This is Sam from Sydney here.
And, you know, down in Sydney, we're Team Ketamine down here.
You know, we got that special K on deck, I would say.
My question for the doc is, is this an addictive substance and will there be lasting effects from this kind of therapy?
Because I can tell you from secondhand right now, I got some friends that could argue there are some more long-term effects from this substance, and it could be quite addictive.
Some fellas getting banged out out there in Australia.
On and off, gang gang.
Gang brother, cheers, man.
Yeah, what are some of those?
What are some of the effects?
So it is addictive.
It is not that addictive, but I have talked to somebody who was completely addicted to ketamine.
Wow.
Now, the problem with ketamine is it's unclear, but this is what the best sort of notion on what's going to happen to people is.
If you're always taking a substance that causes neural growth and neural change, well, keep that ball rolling and see what happens to your mind.
So if you're always changing it and you're always growing it, your ability to be you is going to be called into question if you're always abusing it.
It's not like, you know, opiates, you can take opiates for 20 years and come out of it and still be your person.
Ketamine is putting your brain in a grow box and you're trying to grow all these new sprouts and all these new connections so that you can connect in a healthier way to traverse injuries from the past.
Now we know this is happening at the microscopic level physically.
So if you keep doing that all day long for years, what's going to end up?
Remember that bowl of ramen?
You keep putting more ramen in there.
I don't know what's going to happen, but I can probably reasonably predict that these people are not going to be the same and not in a good way.
That's why, again, the research was a set of infusions in order to traverse something that is essentially beleaguering you in a way that's preventing you from having access to wellness.
Long-term dosing of it, at a lower level, I'm not sure if that is going to – I You don't prescribe it?
No, I don't, because I have seen a lot of things, and I want it to be done in front of me.
Like that chap from earlier, you want the event to be very meaningful.
You want the sequence of events to be very enlightening and very meaningful and connecting to yourself emotionally.
You want those six sessions to be sort of like a time of introspection and healing that's been brought to an immensely higher level because you're seeing ketamine a lot.
I don't want that to be wasted, so I want to do it right from before beginning to afterwards.
But I don't want to be picking up that tool very regularly because I don't want to use that as the crutch because we've done that crutch with other substances in the past and it hasn't worked out so well.
Yeah, it gets bad.
And then people also have to make their own choices, but if there's some addictive nature to it, then yeah, it can be tricky.
And that's what I want to say.
Like, I'm not telling anybody to go get this therapy or saying that this is, you know, I wanted to have an experience with it because I'm going to try to get off of antidepressants.
So I'm working with my doctor now to try and slowly wean myself off, which is cool.
The place that I went, they have some follow-through there with trying to help me do that and manage that.
So I'm excited about that.
And I'm still working with my regular therapist.
But yeah, I definitely wanted to have the experience just so I knew kind of what it was like and what's possible.
You know, I love to kind of figure out how I'm thinking and feeling and why and stuff like that.
So it's nice to kind of see what things I can get through and get away from.
Like anchors I can pull up kind of.
I find that in my practice, about half of my patients don't get ketamine.
Like we, you know, it's sort of like, why are you here?
And they're more like they don't know why they're there.
They're like, they want access to well-being.
They want relief from distress.
That's what they really want.
But they come in with like diagnoses.
I'm like, well, let's talk about what's really going on.
And then, you know, we talk and we've got to get, you know, it's like, we got to get to know each other.
It's not like I'm like, hey, yeah, here, get out.
And they may turn into ketamine patients once we find like hard stops, places that are, you know, like I shared earlier, I had the lady, she wasn't a ketamine patient.
Okay.
And as we got to know each other and I was sort of helping shape her therapy using other things, she felt comfortable sharing me with some pretty disturbing stuff.
And then she shared some even more disturbing, and then she couldn't.
She stopped.
I was like, yeah, it's sort of like, let's change gears because we're running into some very emotionally distressing things that she couldn't articulate at that point.
And in order to get through those, I wanted to protect her.
So that's when we slid over into the ketamine room.
And now she's in process and she's, you could just see the light in her eyes now.
She's, you know, it's like she, it's like, it's not just like, go get ketamine.
It's like, why are you here?
Right.
And that's why we talk about, well, what's going on?
And well, there was an experience.
I had an experience at one point where I felt like I ended up like in a corner of the world, kind of.
It was kind of like I felt like you ever been in like a video game and you get stuck somewhere on it and you can't even move, like your guy gets stuck and you're just, I felt like I got stuck at like the edge of the universe, like where the universe, like we, like I finally found like the two walls of the universe, like the ends of it, and I got stuck like in the corner.
And I don't know what was going on.
Were you leaving the chair or coming back to the chair?
I was on my way back to the chair.
Okay.
Yeah, it's interesting.
Like, you know, because like, did you feel like you were getting light in the chair and then like your fingers started to get all in the chat?
Yeah, you know, I didn't even notice that.
I just remember kind of talking in a conversation.
The next thing you know, I go on this ride.
Yeah.
And I'm not even talking that much anymore.
I'm just kind of on this journey.
People are...
But they come in different personalities.
Like you can kind of, there's, I'm starting to get a, there's different types that come in there.
Like I got my musicians and they start singing for me and, you know, they're belting it out or they're composing right there in front of me.
And I'm like, this is cool.
And then, you know, you got the guys who are my trees are running off the screen.
And my one kid who tried to hop up and run out, but he forgot he was on ketamine and he can't move.
He didn't even get out of the chair.
You could just see it.
He was like, oh, no, no, no.
And I was like, it's okay, man.
And that's crisped out, man.
He was probably all crisped out.
Yeah, he had some issues.
It gets, I mean, it's definitely gnarly.
I was, it didn't feel like, I guess in some ways it felt like a drug.
It felt like an experience to me.
Right.
You know, I felt like I was kind of grateful for the experience.
I was grateful to be back from the experience whenever I got back from the trip or whatever you kind of go on during it or whatever, like the visual, the experience, the out-of-body kind of experience.
I felt grateful whenever I got back to my chair because there was moments where I was like, I am never, you know, I don't care.
I'll never, they'll never find me.
Yeah, it's like I'm lost.
Like, where am I in the world, in the universe?
They will never find me.
I was at like, I was in Atlanta.
I was in Castlevania, that video game for when I was a kid.
I was in some, I was on the back of someone's neck.
There was a lot.
I was sliding down stuff, a lot of like moving along huge, I don't even know if it was like electronic land sides of walls.
I had a lady recently, she could hear, I got like these pictures of a forest in one of my rooms, and she could hear the forest.
Wow.
And then she was like, then she could hear a lawnmower.
And I was like, that's pretty cool.
She was not disturbed.
She was just like, oh yeah, I can hear the forest.
And I was like, that was a first.
The auditories are not as common.
That's strong.
Is there a reason?
Why do we all need therapy now?
What's going on?
Are we weak people?
Do you think?
Are we, you know, it's funny because I'll talk about therapy and stuff with my mother and she doesn't, she doesn't not believe in it, but she's just like, you just keep moving on, you know, you keep going.
She's more of like you tough it out type of vibe.
And I come from more of like a, well, why?
Well, what's going on?
Like that kind of type of vibe, you know?
I think...
You think it's an American problem?
Like, not problem, but do you think it's like a...
I think it's a...
Resiliency, okay?
People, people don't bounce back as well as they think they do.
And the other thing is, is like how old you are and how like, I'm sorry.
Young and having problems happen to you when you're young is very problematic.
And because if you look at like, say you're writing a program, okay, I got a coder here in Nashville, actually.
You're writing a program.
Okay, the earliest code you're writing sort of goes through everything.
Okay, so when you're a child, that's your earliest programming.
And so that tends to resonate through your life.
And if you're not being shaped with sort of like a good societal structure, good parenting structure, you know, they talk about keeping people out of the system.
Or once they're in the system, the system doesn't work.
Okay, well, how did they get in the system?
So where do we set the boundaries from the get-go?
You know, they used to have TV shows like Leave It to Beaver and things like that.
It was like sort of like showing you how people are supposed to behave.
And Andy Griffith's show.
They were very structured on this sort of false reality of how people are supposed to conduct themselves.
But it was very civilized.
It wasn't dysfunctional.
It was based on love, authority, respect, and things like that.
And then as you sort of, everybody does their own thing now.
Well, they sort of do their own thing in everything.
And so the underpinnings of youth have sort of gotten more flexible.
But that also means that their emotions are also more flexible in all directions.
Does that make sense?
At the end part, doesn't?
I don't know.
I mean, I know it probably should.
I just don't know.
If I was a different person, I would understand it, I bet.
Like, the way I grew up is like you do X, Y, Z, and you chug through.
Right.
And everything was supposed to be fine.
But as we've moved forward as a society, like my parents and a lot of people's parents, they had jobs where they had pensions and they had more stability.
Right.
And it's less stable now.
Now you have more flexibility, but with more flexibility comes more uncertainty.
Ah, yeah.
So people are like...
People Are feeling less secure in the world.
In reality, they're probably more secure, but they don't feel that way.
And like after 2020, you know, 2020 is like a rubber band.
You know, the suicide rate actually came down.
Okay.
Well, what's going to happen?
Right.
I don't know.
Because I have people showing up in my office now that are like they're beginning to cope with what happened to them in 2020.
And, you know, that's why we're here.
Yeah, it's interesting, man.
I mean, you know, I had like during the pandemic, I had like five friends that overdosed and died like that just because they couldn't get to recovery meetings, I think.
I think they didn't ever say that they're dead, but they, you know, I believe if they still had opportunity to get to meetings, which were closed, it would have just been helpful to some of them, you know, just to still have the ability to go.
Like once you lose that connection, you start to isolate more than so much stuff happens.
You get stuck in your own world.
And yeah, I think some of that too.
I think we also are at a time where there's just so much technology now and we get such quick reflections of us that are like just out in the world that aren't like rooted in ourselves.
I think that that can be very unnerving to people.
I share with patients, I'm like, you know, being connected, the feeling of being connected, it's not the icing on the cake.
It is the cake.
And you see that.
We're an incredibly disconnected society.
You go into any city and nobody knows anybody, even though they're living next to a million people.
And you can look at the history of Earth.
You go to these blue zones where people live unusually long, right?
You go to Okinawa, Costa Rica, I think Sardinia, Croatia.
These places, they're not terribly affluent, but people are really happy and they live a really long time.
And they're like, why?
And a big chunk of it is they have this thing with community.
They're all connected.
They're all part of, they're together.
And so when you, what's the opposite end of that is everybody's alone.
And when you're isolated, bad things happen.
Yeah, and I think that's one of the things that happens to our brain.
Our brain is literally a piece of machinery that has the ability to connect with other people.
You have to.
And it's like, so when we take our brain away from that and we're not doing it, of course our brain's going to get sick.
Yeah.
You know, it just makes sense.
It's like a plant, you know.
It's not like a plant, but it's like something.
Being connected is crucial.
And, you know, our family, my wife's grandparents are still with us.
So they're in their 90s and some of their brothers and sisters are still with us.
And so last year, it was like awful because these are people we would see every week.
And all the time, we would see them.
They'd show up to like events.
And then for like a year, they disappeared.
And like they'd stop and you'd wave at them because you were so afraid to, you know, because I worked, I'm doing my thing and I hadn't been vaccinated yet.
And so everybody's living in fear and everybody's isolating.
And you're just like, this is awful.
And then you see that, you know, you see that match.com commercial with the Satan dates 2020, you know, a match made in hell.
It's the funniest thing.
But it's a great sort of representation of how bad last year was.
Damn.
Yeah, I believe in Satan, though, but I would like to see the commercial, but I'll probably see it.
We can watch it later on.
Any other questions that came up?
Sean, there was one from a young lady that came up.
Do you want to play that real quick, and then we'll get you and then we can close it out.
We've gone almost two hours, huh?
Sean?
Got an hour and a half.
Hour and a half.
Okay, cool, cool.
Hi there.
My name is Courtney.
I actually have my first ketamine therapy appointment scheduled for next month.
And I've had some prep appointments, but I just wanted to get your point of view as to the potentials for how ketamine therapy can benefit people with complex post-traumatic stress syndrome.
I know there's a lot of information going around right now, and I am just really interested to hear your thoughts on it.
Thank you so much.
Gang Gang.
Thanks, Journey.
And we may have answered that, really, didn't we?
Or did we not?
I can answer it in a way.
So ketamine therapy is, I think a more genuine or credible way to look at what ketamine therapy does is it allows you access to healing, to reconnecting with yourself, from seeing pain that you have in a different way, like at a more like ethereal way.
So a diagnosis is not really a description that is what we're trying to do.
Why the diagnosis is a better way to look at what we're trying to approach.
And like I have people who come to me who've had very bad things happen to them.
And so I want them to be able to reconnect to that part of them that's stuck in there.
And if that part of their emotional baggage that's sort of pinned to that moment, if they can connect to it and grieve and get that release, that emotional release of connection, then they can begin to feel better.
And it's not like we're checking off like, oh, anxiety, check, PTSD, check.
It's more like, what's, you know, why are you hurting so much?
And how does that show up in your life?
Because you can take somebody who's struggling with something and somebody will have insomnia.
And you can take somebody who's struggling with something and they'll have depression.
And so it's like, what really is the distress?
What really is the root of their pain as opposed to like a diagnosis?
And it's more fundamental.
It gets back to what's wrong.
Yeah, you know, as I'm hearing you say that, I felt like sometimes when I'm in therapy, it's hard.
Sometimes it's like if my mood isn't that great that day, I won't even want to talk to my therapist.
I won't want to share with them.
Sometimes I want to be like, you know, I want to be kind of, I don't know, sometimes I won't really be in the mood.
Sometimes I'll keep information from them because I'm scared to share it or because I don't feel comfortable.
You know, but this kind of, I felt like this kind of takes away some of that, for me anyway, took away some of that, my own thoughts, my own bullshit, whatever I'm attaching to whatever's bothering me in my life and let me kind of just see what was bothering me.
Yeah.
A little protection.
Yeah.
It just kind of like, it didn't even, it just, it felt like I was just there to get some help.
It was like, it was almost like going in for like a deep, deep, deeper deal.
Yeah, you're, you're, all your normal defense mechanisms are sort of taking a break.
Yeah.
And you can be more genuine with your emotional state.
And, and in that state, you can be like, what really hurts versus what have I convinced myself is my problem versus what is really bouncing around in the back that I don't want to look at.
And it's just, it's a, yeah, it's a much more like rich sort of conversation with yourself.
Yeah.
Yeah, man.
It was, it was definitely, it was, it was really interesting.
You know, I would like to get some more tools so then I go when I go back.
What are some tools you think that I could use when I go back to, or what are tools that someone can use when they go into their ketamine therapy after they've met with their therapists and stuff like that?
What are things that you feel like they can do to best get the most effectiveness out of their experience?
Well, so a couple of things are is kind of getting some information on where you are.
So what I like is I want patients to get a couple of labs because I want some pointers.
I want some data to show me where they are.
So I have them get a vitamin D. I have them get a high sensitivity CRP test.
CRP is like a test for inflammation.
I do some brief questionnaires.
So we have this little online thing.
And they get these health questionnaires, but it's like it generates a number.
It's like, how distressed are you?
Okay.
And then we start sending that to them every week or so.
So we want to see what we're doing.
We want to see the baselines.
Where are we starting?
Because what are we doing?
And so we get some data on the front end, and I get to know them on the front end.
And then as you go into the ketamine, you sort of organize your – I think I mentioned that.
I got this big thing of paper, and I want them to, like, look at their life because that's how you sort of want to – like, what are we doing?
Where do we propose that your distress is sort of seated?
You know, what happened?
Right.
And so then you kind of know where to toggle it.
And what can they do?
If they are, if, if the patient is sort of.
Like, how can they best help you and the medicine?
Or the therapist and the medicine?
Usually it's just I got to get to know them a little bit.
So it's like I got to know what brought them to me.
Right.
Like what really brought them to me as opposed to a diagnosis.
I see.
Is there a state that they can be in?
Is there an attitude that they can have?
Yeah, absolutely.
So we know now that a predictor of failure is resistance or the inability to accept it.
So basically, if you're not willing to let go into it, it's not going to work that well.
So we know this.
It's actually a study popped up.
I saw it a month ago.
I can't remember what it was, but they actually have some predictors now.
And the resistance to the process is going to keep it from working for you.
So if you're like, I don't want to do this, I'm not ready to let go.
I would get yourself into a better headspace first.
And that's why we want to get them into a better headspace going into it.
I got to get them sleeping first.
If you're not sleeping, you can't do anything.
So first thing I do is get people sleeping because then you've got to be able to sleep to do anything.
And so I try to get my patients sleeping first.
Oh, you do?
I mean, like, when they come in.
So like I usually see my patients for a couple of weeks at least before they come in.
So I want to get them sleeping on a regular schedule.
Oh, sleeping on a regular schedule.
I thought you meant put them to sleep when they get there.
No, no, no, no.
No, I'm sorry.
Like, so prep work is I want to get their sort of their life sort of moderated to some degree so that the process is far more useful.
Right.
Unless they're in like really bad shape and then you just do it because it's harm reduction.
That's a different category.
Yeah, my calm, dude.
I had to go to a comedy show one night after it, and that was pretty good.
Jesus comes.
It was okay, man.
I mean, it was pretty good, honestly, but it wasn't top-notch.
You know, I just felt a little glitchy.
I felt like I was about two centimeters off of my regular skin.
I'm in this fellowship of people out of the Integrative Psychiatry Institute out of Boulder.
And we had a little get-together, like a Zoom session.
And there was one of the psychiatrists.
She had just gotten back from surgery on ketamine.
And she was like talking to all of us.
And we were like, and it was fascinating.
She was like fresh and she had gotten something done to her.
And we're just sitting there watching this.
And I was like, wow.
And she was having insights about her relationship with her mother that went back like decades.
And, you know, it's fascinating.
I mean, you stick around, you just hang out in the areas where people are doing this.
And you can really, you kind of get an idea of what this is doing to people.
It's just the insights and the perceptions and the healing that are sort of swimming around in this whole thing.
It's not covered by a lot of insurances, right?
Not yet.
Not yet.
So it depends on where you are.
You know, where I am, not so much.
But my understanding is if you kind of like the further west you go, the insurers are more friendly to it.
However, interestingly, because of 2020, mental health is actually getting much more important historically in sort of all the industries.
And so that is good because, A, it's long overdue.
And B, it means that people can really get access to kind of healing as opposed to limping.
And it's sort of like it's the hope of everybody who's in this is that when you have somebody who's been harmed in a way that they are not able to interact with the world in a way that is peaceful, you want to do everything you can in a way that is safe and sort of research-based to get them on the road again.
Why not?
Well, I'm sure that 30 years ago or whenever there was a conversation between two people about like antidepressants that was just like this, possibly.
You know, it's like you never know, like something new is always coming along.
New things are always coming along and we're always evolving and stuff in different spaces.
And yeah, I'm certainly curious.
I love the idea of actually trying to find some healing as opposed to getting a crutch every day.
Because that starts to be ridiculous.
When I think of that, every day I have to take a pill when I get up, just that my mind has to even think about that.
Instead of being able to be in this free space where it can just wake up, it's kind of crazy to me.
It almost wonders how much of a hitch in my vibe is that overall.
Just that my brain knows right when it gets up that it has to remind me to go take a pill.
It's like, it's kind of weird.
It kind of feels very unhuman.
What actually happens to your brain, to the parts in your brain during the ketamine therapy?
So what happens, there's a bunch of, there's actually two things that happen.
The receptors get tagged that are responsible for your anxiousness and depressive symptoms.
But the other cool little thing is there's a triggering cascade from a, it's called BDNF.
And what it is, is it helps your neurons like sort of change, like grow little sprouts and the synapses, the little ends can sort of become plastic and make changes to your nerves and they grow a little bit.
And you can actually see it.
They've imaged this.
You can Google it and find pictures of dendritic sprouting or dendritic spines that have been exposed to ketamine.
And so that's like actual growth.
So if you think like if you're growing things in your head, you know, you can do something with it.
That's like that cyborg stuff.
You could have a new garden.
Well, and you slide an electrode in there, and all of a sudden you can grow connections into different things.
And you're going to have high def out the rear in no time on the back of your head.
You didn't have a backup camera.
I mean, you think about it.
I mean, we didn't have cell phones 20 years.
We didn't have an iPhone 20 years ago.
So we're going to go to the moon every day in 10. I would bet we're going to be pretty augmented.
Kids don't have any problem wearing electronic gear on their heads now.
So I don't know.
I'll have neurons growing onto a chip out of my ears pretty soon.
It'll be pretty freaky.
Look.
Let me know how it goes.
Okay.
I'll call you.
I'll call you.
As long as you're the guinea pig first, man.
I think that'll work out.
Dr. Jason Puller, thank you so much for being here with us today, man.
You bet.
Thank you.
We really appreciate it, man.
Now, I'm just footing on the breeze, and I feel I'm falling like these leaves.
I must be cornerstone.
Oh, but when I reach that ground, I'll share this peace of mind.
I found I can feel it in my bones.
But it's gonna take a little time for me to sleep and pocket breath and let myself.
on me I'll sit and tell you my stories Shine on me And I will find a song I will sing it just for you And I
I've been moving way too fast on a runaway train with a heavy load of past.
And these wheels that I've been riding on, they're warm so thin that they're damn near gone.
I guess now they just work.
Ladies and gentlemen, I'm Jonathan Kite, and welcome to Kite Club, a podcast where I'll be sharing thoughts on things like current events, stand-up stories, and seven ways to pleasure your partner.
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