Why I Started a Ketamine Clinic

In the fall of 2016, scrolling through Facebook, I came across a post in one of my physician mom groups that caught my eye. At that time, I didn’t know the women who had written the post, but she was congratulating herself for being able to repay her capital investment after starting a private clinic. I had just started my own small weight-loss clinic about a year and a half earlier. I read her post, wondering if I could pick up on any words of wisdom.

About six months prior, she’d started a clinic that administers intravenous (IV) ketamine for mental health and chronic pain.

WHAT!?!

I’d never heard of this, even though I am very familiar with the drug ketamine. It’s used in the emergency department, operating room, and (where I use it) the intensive care units frequently for pain control, general anesthesia, and sedation. However, it has some side effects that makes its use a bit interesting. Depending on the dose and how fast it’s given, patients can have hallucinations, feel separated from their bodies, even have a sense of movement — as if on a roller coaster. They often describe seeing moving colors, like a kaleidoscope, or detached from reality. The beauty of ketamine in clinical situations such as acute pain is the fact that it has no effect on a person’s respirations. Meaning a small child can be given enough ketamine to set a broken bone without having to worry about the child’s breathing slowing — or stopping altogether. Ketamine also has no associated drop in blood pressure like other pain medications and sedatives do. This means if a patient is already having low blood pressure, but needs an emergent procedure, ketamine can be given for sedation or pain control without further compromising the patient’s circulatory system and health.

Administering ketamine safely requires expertise in its effects on the heart, blood pressure, and other organ systems commonly affected. It requires understanding how to appropriately address the side effects mentioned above to keep a patient safe. In fact, when I was in medical school and in training, ketamine was a drug I was taught to never use. None of my attending physicians used it, so I was never exposed to it. It wasn’t until I was practicing on my own that the pendulum swung the opposite direction and ketamine fell into favor once again (thank goodness!).

Through my years working as an intensive care physician, I eventually became experienced at giving ketamine in various situations. However, what I read in that Facebook post stopped me in my tracks.

This Was All New

Ketamine for refractory depression? For PTSD? Ketamine for patients who weren’t responding to multiple antidepressants, or couldn’t take typical antidepressants due to intolerable side effects? Ketamine for veterans, and other victims of trauma, that resulted in such an improvement of symptoms that patients often claimed it saved their lives?

I took a screenshot of that Facebook post and immediately started my own research. I could not believe this was a “thing” — that ketamine was being used, and had been since about 2007, for mental health.

How had I not heard of this?

Fast forward 3 months. I reached out to the physician who had posted about her clinic. She was gracious enough to answer questions and help me navigate whether this was something I wanted to do. She and I are now good friends and I admire all the work she has done in this field. After researching for another few months, I finally decided the data (although limited) was good enough to offer the service to patients in my area.

I built the first ketamine clinic in the state of Iowa.

The end?…..Not quite.

My Why

The reason this became such an obsession for me is because, like many of my patients, I suffer from complex PTSD. Complex PTSD refers to symptoms that occur after trauma is experienced repeatedly over any length of time — as opposed to a single traumatic event. When I discovered how ketamine was helping people that had been in tremendous emotional pain for so many years, I immediately wanted to be part of that relief. I wanted to take the pain away, to help others NEVER feel the way I’d felt most of my life….the way I still felt at that time.

In reality, that’s all I’ve ever wanted to do — soften the agony others experience as a result of whatever has happened to them. I know my own demons: hopelessness, the darkness that never quite went away, the exhaustion of never being enough, the inconsistent progress through life as one day is completely functional but the next day is saturated with paralyzing self-doubt. I know how much effort it takes to do even the simplest of tasks because the internal dialog tells me I’m not good enough or I don’t deserve to be happy.

I felt I’d found a way to actually reach into another’s soul and potentially remove all that badness — to save them from the same emotions that made me feel I weighed a thousand pounds. There was no question. The service needed to be offered. I thought to myself, “I have to live with this, but I can help others.” And, that’s what I did. I started my clinic in March of 2017. By September of 2017, it was at capacity and I had a waiting list for consultations.

My Own Journey With(out) Ketamine

As the months passed, and I saw life-changing responses with this treatment, I grew resentful that I could not undergo the treatment myself. Still battling my own symptoms, I desperately wanted the relief I was seeing every day in my patients. They saw me weary and chalked it up to my work schedule and being tired. Of course, I told them no different. They saw me tear up during conversation, assuming it was out of empathy for whatever was being said. In reality, I was heartbroken that I had no access to their miracle.

More times than I can count, patients told me how ketamine had saved their life — unaware I was fighting for mine.

I looked into going elsewhere for the treatment, but it would have required two weeks of travel and I couldn’t manage that with a “day job” and two clinics to run. So, I continued to offer the best care I possibly could to those suffering from refractory depression and PTSD.

Six months after I started the clinic, I finally had the courage to revisit going to therapy and tackling my issues the old fashioned way. I knew I needed to address the things that had happened to me if I ever hoped to have the life I wanted — one where I can actually feel joy, one where I’m not plagued with social anxiety, and maybe even a life where nightmares don’t exist. I ended up finding a wonderful therapist who put me through a process called EMDR, which has been shown to be very effective for PTSD.

Going to therapy 1–2 times per week for nearly a year changed my life, although those were some extremely difficult sessions. Choosing to face hurts that have been buried for thirty-plus years, squaring up against them even though I felt my chest would explode, was not easy. But, I can now say without a doubt that it was 100% worth it

I never got to experience the miraculous transformation that ketamine offered so many of my patients, but I did reach my destination…just via a different route.

What’s Next?

Unfortunately, my “day job” (I put that in quotes because I actually work nights!) has changed and I am no longer able to run the clinic and it closed about a month ago. I can honestly say providing IV ketamine infusions was one of the best things I’ve ever done as a physician….and as a human.

My desire to mend the hurts of others will never go away. It’s an inherent part of who I am and always will be.

However, I now understand that to continue helping others — I had to save myself first. 💜