Journey With Me Into the Keta-verse

Have you ever felt like you are a pair of lungs? Not that you have a pair of lungs but that you are lungs, floating in outer space, stretching and shrinking with each new breath of air?

No? That’s really too bad. It’s extremely fascinating, being a single human organ, but also impossible to describe.

This is one of the many examples of what makes my recent experience of getting IV ketamine for chronic pain so difficult to write about. When I set out to do eight infusions over the course of a month, I was sure I’d have a slam dunk essay by the end. But, as it turns out, using words to describe a ketamine trip is like Michelangelo using a Crayola marker on the Sistine Chapel ceiling. Writing is, somehow, not the best tool for this job.

Ketamine is a anesthetic drug that can be used for treating things like depression, PTSD, and (oddly) chronic pain. Though PTSD and chronic pain may not seem all that similar, the broad strokes are the same. In both situations, the brain is on high alert, worn down by either a sudden or sustained trauma, and ready to press the big, red PANIC button at the first sign of trouble. So though there is next to no research on using ketamine for treating migraines, if you squint hard enough, it seems like not the worst idea in the world. 

One worse idea, for example, is also one of the most widely accepted treatments for chronic migraine disorder: 31 Botox injections in the head, neck, and shoulders. Botox, as you may well know but likely don’t want to think about, is the same toxin that’s found in botulism. The amount of Botox used for treating migraine is 155 MUs, or “Mouse Units”—one Mouse Unit, by definition, is the amount of Botox it takes to kill a single mouse. 

I have, at this point, pumped enough poison into my face to exterminate two thousand mice.

What I came to expect of ketamine, after some extremely cursory research done by other people (I hate reading about migraines online, too depressing), was not for it to lessen my pain, necessarily. It does for some people, and I hoped it would for me, too, but when you’re in pain for years, pain is not your only problem. The emotional repercussions of pain can be just as debilitating as the pain itself. The fear of aggravating my migraines, for example, can keep me from going out with friends, sitting outside in the sun, or even just staying up late on a Friday night and watching a movie at home. So though I hoped the ketamine would help my pain, I was just as curious to see its other effects.

The dimly-lit ketamine room at the very singular medical clinic I went to for these treatments was small and windowless, and had the vibe of a hippie thrift store. A massage table took up most of the space, and on it was always a cushion, a pillow, and a freshly-saran-wrapped fleece blanket for me to use. Beside the table hung a flag of brightly-colored yin-yangs. A dreamcatcher—likely the luckiest dreamcatcher in the entire world, given that ketamine is known for causing hallucinations—watched over me from the opposite wall. A shelf in the corner displayed a statue of a Hindu elephant god and some Himalayan salt lamps. Other paintings, pennants, and knick-knacks were spread haphazardly around the room. A bluetooth speaker played the new-age soundscapes and guided meditations from atop a butterfly-patterned cabinet (though I soon learned I could bring my own music to listen to during the hour-long sessions).

This was what the ketamine room looked like when I wasn’t on ketamine. When I was on ketamine, it looked…different.

The main difference was it wasn’t a room at all. It was a large, glassy sphere orbiting around my body, black as night, covered with sparkling stars and majestic galaxies. And the table wasn’t a table but the top of a long, sweeping slide that spiraled down, down, down into the inky expanse.

“This doesn’t seem real. Should we freak out?” 

That’s my brain, shortly after ketamine starts dripping through my IV. I’m taken aback, as it’s not in the habit of asking my opinion. But I get the sense that my brain is waiting on me for once, ready for some marching orders in the face of this great unknown.

“Why don’t we have some fun with this?” I say to my brain.

“Fun?” Brain responds. “Ok, I’ll give it a go.”

This is when Brain tips me off the table and down the spiral. It feels like I’m actually moving, floating, flying. As I descend, all my edges go fuzzy, as if I’ve become a cloud, steam rising from a cup of warm tea. Then my body disappears. From head to toe, I am numb to the point of nonexistence. After four straight years of pain, I gulp the feeling of feelinglessness like a cold drink on a hot day.

I’m still rolling, still sliding, when my brain picks up the conversation: “Why are you sad so often, Natalie?”

“Because I–no, you–no, we–have an incurable disease. And that’s sad.”

“Yes, I suppose it is,” says my brain, “but that’s not all we have.”

Suddenly I’ve reached the end of the slide and Brain throws me into a giant ball pit, like they had at McDonald’s before germs existed. (I’m also still in the starry spherical expanse, so this is, in fact, a giant ball pit floating in outer space.) As I pick up each of the brightly-colored balls I see a person I love, something in the future I’m excited about, or a time when I laughed. The pit is overflowing, the balls are bouncing onto the floor (is there a floor?), and I am suddenly very small and safe, like a child wrapped in a warm blanket.

“Wow,” I say to my brain, “I have a pretty great life. But I also know I won’t believe this in an hour.”

“You’re right, you won’t. So let’s make the most of it.”

This is when I become a pair of lungs, or rushing river, or a gemstone, clear and cut like a diamond. The specifics change each time. When I’m a gemstone, a light shines from inside me, filling each of my facets with warm, shimmering color. Sometimes the light is green, sometimes red or blue or yellow. And I’m rolling over lush green hills, tumbling and turning in the sunshine. (Did this particular hallucination come from the fact that my mom was addicted to Bejeweled when I was a kid? I still remember the sound of the gems clicking into place on the screen, and the pop, pop, whiz of the bonuses.)

Many of my ketamine sessions went sort of like this, and at the same time, nothing like this at all. This is when I would invite you to use your imagination, if I thought any human imagination could even scratch the service of my experience in the ketaverse.

But this story is, unfortunately, not entirely unicorns and rainbows. There was one time where I fell into a “k-hole,” as they say. This happened directly after I ate a Chipotle chicken adobo burrito bowl for lunch. I was a bit anxious that particular morning, though I don’t remember why, and, because of my meager amount of online research, I didn’t realize that the dissociative effects of ketamine can actually worsen anxiety. I figured the treatment would calm me down. 

“This doesn’t seem real AND I’m pretty sure that burrito bowl was poisoned. Should we freak out?” 

“It’s not real, Brain. But why don’t we have fun with it, like the last time?” I suggest. “Besides, the burrito bowl seemed fine to me.”

“RED ALERT! We are being deceived AND poisoned by evil adobo chicken! Abandon ship! I repeat, abandon ship!!”

The plastic balls bursted all around me. Everyone I cared about was dead, and everything I was looking forward to was worthless and terrifying. Laughter didn’t exist, never had existed. The ball pit was empty, hollow, dark, and no longer in outer space. I sat alone on the hard, cold floor. To make matters worse, sinister-looking burritos floated around my head, mocking me with sneering teeth and furrowed eyebrows. Though they weren’t exactly sinister burritos, just the essences of sinister burritos. Sinister burrito spirits? All I can say for sure is they had deep, imposing voices, and they seemed burrito-ish.

I dissociated a few times in the days after tumbling down the k-hole. (Dissociation is when the brain disconnects from the body in order to cope with stress.) But not long after, I caught myself dancing alone in the car to “I Wish You Would.” This is remarkable not only because I was dancing, but also because I don’t usually like Taylor Swift.

Now, my bad experiences with ketamine are as difficult to recall as nightmare in the morning. 

I finished the ketamine treatments in August. Their most immediate effect? Waking up each day with a different Christmas song stuck in my head. The morning after my last infusion was “Santa Baby,” one of my absolute least favorites, followed by “It’s the Most Wonderful Time of the Year.” 

I have also been in less pain. How long the improvement will last is anyone’s guess, but for now, it’s nice to put my next Botox treatment on hold and to make my face a safe snack for mice. I’ve also gone out to a movie, stayed up late, and tried some new restaurants despite being on a really strict diet. Some of these experiments have gone well, others less so, but all of them are things I wouldn’t have even attempted a few months ago.

I also haven’t forgotten, and I hope to never forget, about the big ball pit. In outer space.