What A Long, Strange Trip It’s Been

By

Leonard Zwelling

https://www.nytimes.com/section/magazine?action=click&pgtype=Homepage&region=TopBar&module=HPMiniNav&contentCollection=Magazine&WT.nav=page

https://www.nytimes.com/interactive/2018/05/16/magazine/health-issue-what-we-lose-with-data-driven-medicine.html?rref=collection%2Fsectioncollection%2Fmagazine&action=click&contentCollection=magazine&region=rank&module=package&version=highlights&contentPlacement=4&pgtype=sectionfront

On Sunday, May 20, The NY Times Magazine published its Health Issue. These two articles couldn’t be in more stark contrast.

The first is excerpted from Michael Pollan’s new book called How To Change Your Mind: What The New Science Of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression and Transcendence. Apparently, LSD is making a comeback or at least hallucinogens are. Real doctors and some underground “guides” utilize psilocybin and other control substances to help people with severe mental problems like depression, overcome their disease. And, it works. It is actually being studied in both phase 2 and phase 3 trials under the auspices of the FDA.

However, if you are like Pollan and not afflicted with any serious mental diagnoses, access to tripping is a bit more limited and one must troll the underground, which, it turns out, is both extensive and safer than one might imagine as there are practitioners who can guide one through the experience of using the magic mushrooms toward mind expansion. To help you, “turn off your mind, relax, and float downstream.”

In the article, Pollan describes the trip he finally got to take under the guidance of Mary. Reading this I reflected back on my own psychedelic experience in 1969 with what was probably LSD or mescaline. (I was told the former, but it could have been the latter.) My trip was under far less control than Pollan’s and I don’t encourage anyone, including my kids, to follow in my footsteps. The description Pollan gives is remarkably close to what I can remember from almost fifty years ago. There’s the synesthesia, cross wiring of the senses. I could feel the music and see it as well. In my case it was Crosby, Stills and Nash. In Pollan’s, electronica. I think my choice was better than his as he seemed to crawl into a computer and all I can remember is the colored lights of “Guinevere.” My memory is a little hazy after that part of things. I did finish a medical school lab assignment as I was coming down from the trip and was amazed the next day by all the scratches on my hands from the rats I was handling, but had not felt the tear on my skin the night before.

My trip, like Pollan’s, was transcendent. I never took drugs again. I was afraid because I liked it so much I thought I would become hooked (we know more now and hallucinogens are not physically addictive). I never did understand what happened to me that day, but there is clearly another perception of reality available to us, should we choose to access it and I suspect that it will be integrated into conventional psychotherapy soon enough as it will probably work, be safe and make a difference in people’s lives. You know, do what doctors are supposed to do with useful medications.

And on that subject comes the second article, by fabulous writer and doctor Abraham Verghese. It is about the effect of the electronic medical record on the manner in which we deliver medical care and on what that does to us as people. It’s not a glowing report. As a reluctant, yet frequent consumer of medical care, I can assure anyone who wishes to know that I hate those damned EHR things. They get between patients and doctors and patients and nurses. When you are in the hospital, all you see of the staff is their frames behind COWs, computers on wheels. Verghese agrees with my perception that the EHR may decrease medical errors, especially medication errors, but does little else of use because it tends to compound erroneous medical histories through its cut and paste function and detract from any meaningful communication between a caregiver and a patient. It sucks to be a patient when your doctor has to use the EHR. It sucks more to be a doctor and spend more time as a clerk than as a healer.

The future of psychotherapy may be getting brighter if psychedelics can be mainstreamed to practice and assist many with intractable problems of the brain and mind. The more closely the understanding of the brain and that of the mind come together, the more likely it is that mental illness can be combatted with these old new age agents.

As for the EHR, I have no solutions. As long as they assist in billing, they will be employed. If they could also assist in patient care, that might be useful. But if the EHR is adding to physicians’ disaffection with the practice that had been a calling when they went to medical school, then the EHR is both dangerous and potentially useless.

Leonard Zwelling