...It was 2013. Michael, age 43, had suffered from psychiatric problems since he was a teenager—epic procrastination, binge drinking, and depression. He’d seen psychiatrists for 20 years and tried almost every antidepressant. What had helped him, at least temporarily, was a prescription for stimulants in the wake of a diagnosis of adult attention deficit disorder in his early thirties...So one day in January 2016, Michael drove with his wife to meet Wolfson and Andries at the Pine Street Clinic in San Anselmo, where they rented space. There, water gurgled in a fountain, a bird twittered in a cage, and the smell of Chinese herbs filled the air. Wolfson, a big garrulous man with white, curly hair and a pronounced limp from several back surgeries, asked about Michael’s medical history. As a teen, Michael had had a noncancerous tumor removed from his abdomen. The tumor was acting like an extra adrenal gland, secreting hormones that prevented him from growing and caused him to sweat profusely, often until his clothes were drenched. The surgery was successful, but recovery had been long and difficult, he told Wolfson. He’d been intubated in the intensive care unit for nearly a week.
As Michael recalls, Wolfson told him, “You may be depressed, but I don’t think that’s the root of your problem. You have every glaring symptom of PTSD.” Michael wasn’t a veteran. He’d never been sexually abused. Wolfson’s diagnosis felt off. He also knew that, years ago, Wolfson had lost a son to leukemia; the detail was on his website. In that moment, Michael diagnosed his therapist. “He’s projecting,” he thought. Still, he felt comfortable enough with Wolfson to proceed.
...ABOUT SIX MONTHS after beginning with Wolfson and Andries, Michael had a breakthrough. As he was coming out of a ketamine session, his mind’s eye perceived a smooth, black object that reminded him of the monolith in the movie 2001: A Space Odyssey. He remembers chuckling to himself, and thinking “What the heck?” Then the monolith morphed into a single word: anesthesia. Michael saw himself as 14 and lying on an operating table. Surgeons in white coats and masks bent over him. One turned to him and said, cheerfully, “Don’t worry. You can’t feel this. You’re under anesthesia.” During a later session at home, with lozenges, the meaning of the vision became viscerally clear. Michael felt that man cut into his belly with a scalpel. He was overcome by a searing pain so unbearable that it seemed to expel him from his body. He felt like he was floating above himself.
What Michael seemed to have remembered was that he’d woken up during surgery decades earlier—that he was conscious when doctors removed that tumor. It’s impossible to know if the memory is real, although the phenomenon, called anesthesia awareness, is documented, and one of its consequences is PTSD. When I asked if Michael doubted the memory’s veracity, he said that what led him to believe the memory was true were the details he wouldn’t know to make up, like the oily plastic odor of the operating room and the cigarette smell on one nurse’s breath. Once that memory emerged, others surfaced as well. He recalled, for instance, that during his recovery in the ICU, the morphine often wore off, leaving him in agony over the 12-inch incision in his abdomen. Just when its analgesic effects waned, therapists would guide him through a series of coughing exercises to remove fluid in his lungs, which were excruciating because his abdominal muscles had been sliced open. “It was like being tortured several times a day,” he says. For Michael, these memories seemed to explain a lot. Here was the source of the PTSD that Wolfson had so confidently diagnosed that first day.
https://www.wired.com/story/ketamine-stirs-up-hope-controversy-as-a-depression-drug/